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Another important decision making item is "saturation". In areas with large senior Advantage plan users, provider networks can be a bit more extensive. If your in Waitingforgodville Florida, Advantage Plan network providers are more likely to be found. But, in Wheretheheckbei Montana, there may be a few doctors in the plan spread hundreds of miles apart. The larger the saturation of users, the greater the level of accepting providers. However, with traditional Medicare and supplement/medigap, all that is need is them accepting Medicare.
I assumed Advantage plans (with extra benefits) were income based.
I won't let go of my Medicare. My supplemental is fine. If private insurance companies go bust, can you get your regular Medicare back? I don't think so, but not 100% sure.
I assumed Advantage plans (with extra benefits) were income based.
I won't let go of my Medicare. My supplemental is fine. If private insurance companies go bust, can you get your regular Medicare back? I don't think so, but not 100% sure.
Advantage plans are not income-based.
If a particular Advantage plan will no longer be offered, then the current enrollees in that plan will have a 63-day window to enroll in another plan, and can choose original Medicare with Guaranteed Issue Rights for a Supplement within that window.
I assumed Advantage plans (with extra benefits) were income based.
I won't let go of my Medicare. My supplemental is fine. If private insurance companies go bust, can you get your regular Medicare back? I don't think so, but not 100% sure.
That is probably worth thinking about, as I was just reading this article, and wonder how it will impact the Medicare Advantage Plans, but I suspect they will continue, but with reduced benefits over time, as that is pretty much the way other types of insurance are operating these days.
It amounts to cuts being made and how it may reduce benefits under the MA plans.
Medicaid is income based, but if one qualifies for Medicare, Medicare is considered the primary insurer, and Medicaid is the secondary insurer. Extra benefits usually, as far as I have seen, amounts to covering prescription costs. I have an adult son with Down syndrome, so this is what I gathered from his benefits. Interestingly, when my husband retired, they switched my son's primary insurer to Medicare, which I frankly do not understand the reasoning.
The article I linked talks about Medicare fraud which in the billions, so that really needs to be what they address if they need to save money!
That is probably worth thinking about, as I was just reading this article, and wonder how it will impact the Medicare Advantage Plans, but I suspect they will continue, but with reduced benefits over time, as that is pretty much the way other types of insurance are operating these days.
It amounts to cuts being made and how it may reduce benefits under the MA plans.
Medicaid is income based, but if one qualifies for Medicare, Medicare is considered the primary insurer, and Medicaid is the secondary insurer. Extra benefits usually, as far as I have seen, amounts to covering prescription costs. I have an adult son with Down syndrome, so this is what I gathered from his benefits. Interestingly, when my husband retired, they switched my son's primary insurer to Medicare, which I frankly do not understand the reasoning.
The article I linked talks about Medicare fraud which in the billions, so that really needs to be what they address if they need to save money!
Thank you and Ged. I was thinking about the free groceries, dental, eye, hearing, the card where the money rolls over if you don't spend it all.
I had a client with Medicaid and boy did she take advantage of all of the freebies, definitely committing Medicaid fraud.
My husband and I switched from traditional Medicare (plus we paid out-of-pocket for a supplement plan plus a drug plan) to a Medicare Advantage Plan with Blue Cross Blue Shield over a year ago.
We're very happy with our Advantage plan.
It includes some dental and vision coverage, $90 quarterly for OTC medicines/vitamins and some health supplies like toothbrushes, floss, paste, band-aids, etc. from membership drugstores (Walgreens, CVS, Walmart) and covers, for zero cost, the generic drugs we take for high blood pressure. The drug plan we used to have still cost us $ for these drugs...
This works well for us and saves us quite a bit of $. We're generally healthy except for the HBP. The doctors we see are fine.
We live in North Carolina so not sure if all BCBS Advantage plans offer the same coverage in other states.
My husband and I switched from traditional Medicare (plus we paid out-of-pocket for a supplement plan plus a drug plan) to a Medicare Advantage Plan with Blue Cross Blue Shield over a year ago.
We're very happy with our Advantage plan.
It includes some dental and vision coverage, $90 quarterly for OTC medicines/vitamins and some health supplies like toothbrushes, floss, paste, band-aids, etc. from membership drugstores (Walgreens, CVS, Walmart) and covers, for zero cost, the generic drugs we take for high blood pressure. The drug plan we used to have still cost us $ for these drugs...
This works well for us and saves us quite a bit of $. We're generally healthy except for the HBP. The doctors we see are fine.
We live in North Carolina so not sure if all BCBS Advantage plans offer the same coverage in other states.
Hope this helps.
Being healthy is the big reason for that. They offer you pennies so that they can save dollars. The Advantage plans are problematic for people who get sick with large deductibles, co-pays, out of pocket maxes and limited networks.
Being healthy is the big reason for that. They offer you pennies so that they can save dollars. The Advantage plans are problematic for people who get sick with large deductibles, co-pays, out of pocket maxes and limited networks.
Most Advantage plans are zero deductible, and many of the copays are fixed dollar amounts that aren't very much if you are talking routine care. But for major services, those copays can be significant, and annual max out of pockets can often be in the $5000-$8000 range, understanding it will take a year with major services to hit that amount. You're saving on premiums, but have a higher copay cost exposure than original Medicare paired with a Supplement. So for those who would have conditions that require costly recurring treatment, Advantage plans probably aren't going to be the most cost effective option.
As for limited networks, that's going to be location-specific. Generally, the larger urban areas will have a lot of contracted providers, but smaller towns and rural areas, not so much. Of course, less populated areas usually have few choices of providers, to begin with.
Very good discussion happening here and thanks to those experiencing it and participating with their views! Each and every post is providing nuggets and gems to consider.
If any out there have links to high level comparisons of the various options and their pitfalls, in a more laymen language, it would be very helpful. We can go to the Medicare site and do individual plan comparisons but that is not only very low level but also can be a daunting thing to do when there are so many potentially available. Also they are very opinion/anecdotal neutral and I am sure there are various higher level options that should be avoided.
Gosh darn it I hate getting old! The creaky bones and other ailments sure are looking good compared to having to figure out all this Medicare nonsense!
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