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For what you pay for an Advantage plan, you could have a top tier Supplemental. We pay half that for Aetna Plan N, after a few years of a disappointing, even embarrassing Advantage Plan.
The problem is the lack of specialists here. If you have a "top tier Supplemental" or even if you are paying cash, it can be difficult to find comprehensive care in the outer islands.
Kaiser has the most complete medical system in Hawaii, and they operate the ONLY hospital on Maui.
If you live on Oahu, the same plan is much less expensive ($29-139 per month) since they won't be paying for travel. Unusual treatment that is only available on the mainland is included as well.
Last edited by Futuremauian; 05-19-2024 at 03:42 PM..
As a former enrollee in a Humana Advantage Plan, I never realized that there were so many ways to pencil-whip a member to avoid paying legitimate claims. I spent hours on hold with them, only to have my calls disconnected, repeatedly.
Finally, I gave up and reluctantly switched to the Kaiser Medicare Senior Advantage Plan. I love it!
After treatment for cancer and follow up care, I sometimes feel guilty about how much they have spent on me. In Maui, there is a doctor shortage, and if I need to see a specialist not available on this island, Kaiser's travel department arranges and pays for me to go to Oahu for care, (including a companion). I've done this at least a half-dozen times.
The Kaiser Moanalua Hospital on Oahu is rated as one of the top two in Hawaii. They also provide shuttles and taxi vouchers. My only expense is for parking my car at the Maui airport while I am away.
I pay a monthly fee of $220 for my plan, which includes an optional $40 in upgraded dental and eyeglass coverage. No co-pays for treatments, doctor visits or prescriptions.
Not all Advantage plans are evil. Kaiser is awesome!
Quote:
Originally Posted by Futuremauian
The problem is the lack of specialists here. If you have a "top tier Supplemental" or even if you are paying cash, it can be difficult to find comprehensive care in the outer islands.
Kaiser has the most complete medical system in Hawaii, and they operate the ONLY hospital on Maui.
If you live on Oahu, the same plan is much less expensive ($29-139 per month) since they won't be paying for travel. Unusual treatment that is only available on the mainland is included as well.
I've read many of your earlier posts on Kaiser in HI, truly exceptional coverage, and well worth the money.
No supplement will provide what your plan does.
The travel WITH A COMPANION is an outstanding benefit and Kaiser's extremely patient-friendly, proactive response to the logistics often faced by those off the mainland.
I am not a fan of Advantage generally, but you literally have the gold standard in health care, here. Don't change a thing.
As a former enrollee in a Humana Advantage Plan, I never realized that there were so many ways to pencil-whip a member to avoid paying legitimate claims. I spent hours on hold with them, only to have my calls disconnected, repeatedly.
Finally, I gave up and reluctantly switched to the Kaiser Medicare Senior Advantage Plan. I love it!
After treatment for cancer and follow up care, I sometimes feel guilty about how much they have spent on me. In Maui, there is a doctor shortage, and if I need to see a specialist not available on this island, Kaiser's travel department arranges and pays for me to go to Oahu for care, (including a companion). I've done this at least a half-dozen times.
The Kaiser Moanalua Hospital on Oahu is rated as one of the top two in Hawaii. They also provide shuttles and taxi vouchers. My only expense is for parking my car at the Maui airport while I am away.
I pay a monthly fee of $220 for my plan, which includes an optional $40 in upgraded dental and eyeglass coverage. No co-pays for treatments, doctor visits or prescriptions.
Not all Advantage plans are evil. Kaiser is awesome!
Kaiser Hawaii Advantage was my first medicare plan. Cost me a fortune in copays--$50 to see a specialist, $1200 for a CT. Flying to Oahu for every specialty gets old real fast, spending an entire day to get a CT scan which could have been done on my island. Now I'm on the mainland, it's half an hour, including travel time.
Hint: make sure you link each flight to your frequent flyer plan. That gave me enough miles to pay for travel to Moanalua to see a competent oncologist, instead of the third rate doc they sent to the BI. Also, it's a corporate account, so Hawaiian will reschedule your flight for free if you get done early.
My medigap program costs less than I was paying Kaiser, and covers all my costs; no copays. I joined it in Hawaii, but it followed me to other states with no hassles or gap in coverage.
There is a reason I just signed up for Medicare, and NOT Advantage.
The best advice I have heard was from Clark Howard "the ONLY reason to sign up for Advantage is if you literally do not have the money to pay for Medicare Part B".
I just had cataract surgery and it cost me nothing so far with the gap insurance. The point is, no delay, no hassle, picked the best doctor.
You mean you signed up for Traditional Medicare, with a Supplement, right? I did the same thing and it is the only rational choice if you can afford it. Even if you THINK you can't afford it, realize that somewhere down the road with Advantage you will be forced to pay far more in the long run than if you had started with Traditional Medicare in the first place.
However there are gotchas in place for the Supplements too. They usually start you out with an introductory rate which will gradually sunset as you get older - mine was discounted 39%, which goes away entirely by age 81.
Additionally the rates you pay will go up even if you choose a "community" rate. Combining these factors, I did the math on mine - I estimated my premiums will go up about 2.5X from where I started at 67, assuming I somehow live till 95.
Also if you choose a Plan G Supplement, it does not cover the Medicare Part B deductible - which will most likely go up every year.
My providers are very happy when they see I am using Traditional Medicare and not Advantage. To me this is the most important reason for going Traditional, you can be confident that you will get the best and most expedient treatment. Of course you still have to do your due diligence in selecting physicians and facilities.
Last edited by GearHeadDave; 05-19-2024 at 08:13 PM..
I had a UHC PPO health insurance plan through my former employer since my retirement in my 50s. When a retiree turns 65, the employer requires that we sign up for Medicare and they pay for my out-of-state Medicare advantage plan through UHC. It's a weird sort of hybrid between an advantage plan and a PPO plan. It even says on my insurance card "UHC Medicare Advantage Plan (PPO)". The coverages are identical to that which I had while working and in my early retirement. I get no less, coverage than I did prior to Medicare. I pay the same co-pays, etc, except that I pay no premiums other than the deduction from my SS for part B. I compared the two coverages on paper, and they are identical. I suspect my former employer contracted with UHC for a plan specifically for us. Although my actual pension is managed through the state pension plan, it's separately funded, and we have a different health plan than state government retirees (like my spouse) who are covered by either a Kaiser Advantage HMO plan in-state, or a traditional Medicare BCBS plan if you live out-of-state. I can get the Silver Sneakers membership, and I get the odd little advantage plan perks, like a certain number of home health visits and a certain number of rides and meals when you are homebound, that are usually only for advantage plans, but it operates like a PPO rather than an HMO model plan. It doesn't cover dental, as those benefits are already provided by my employer through Delta. I've never had any coverage for anything refused yet, and I can go to any doctor that takes Medicare, and any hospital, with no referrals needed from my PCP.
Last edited by TheShadow; 05-20-2024 at 08:23 AM..
I had a UHC PPO health insurance plan through my former employer since my retirement in my 50s. When a retiree turns 65, the employer requires that we sign up for Medicare and they pay for my out-of-state Medicare advantage plan through UHC. It's a weird sort of hybrid between an advantage plan and a PPO plan. It even says on my insurance card "UHC Medicare Advantage Plan (PPO)". The coverages are identical to that which I had while working and in my early retirement. I get no less, coverage than I did prior to Medicare. I pay the same co-pays, etc, except that I pay no premiums other than the deduction from my SS for part B. I compared the two coverages on paper, and they are identical. I suspect my former employer contracted with UHC for a plan specifically for us. Although my actual pension is managed through the state pension plan, it's separately funded, and we have a different health plan than state government retirees (like my spouse) who are covered by either a Kaiser Advantage HMO plan in-state, or a traditional Medicare BCBS plan if you live out-of-state. I can get the Silver Sneakers membership, and I get the odd little advantage plan perks, like a certain number of home health visits and a certain number of rides and meals when you are homebound, that are usually only for advantage plans, but it operates like a PPO rather than an HMO model plan. It doesn't cover dental, as those benefits are already provided by my employer through Delta. I've never had any coverage for anything refused yet, and I can go to any doctor that takes Medicare, and any hospital, with no referrals needed from my PCP.
Individual Advantage plans available to anybody can also be PPOs. Not all Advantage plans are HMOs.
But employer or union retiree Advantage plans can be a different animal, as they are usually custom plans not available to the general public. Employer plans can often be superior in a number of ways to Advantage plans one would be able to find as an individual on their own. And an employer group PPO Advantage plan may be what's know as a "Passive PPO", in that the enrollee can visit providers out of network at the same copays as in-network, as long as the provider accepts original Medicare, and will agree to accept you as a patient.
You mean you signed up for Traditional Medicare, with a Supplement, right? I did the same thing and it is the only rational choice if you can afford it. Even if you THINK you can't afford it, realize that somewhere down the road with Advantage you will be forced to pay far more in the long run than if you had started with Traditional Medicare in the first place.
However there are gotchas in place for the Supplements too. They usually start you out with an introductory rate which will gradually sunset as you get older - mine was discounted 39%, which goes away entirely by age 81.
Additionally the rates you pay will go up even if you choose a "community" rate. Combining these factors, I did the math on mine - I estimated my premiums will go up about 2.5X from where I started at 67, assuming I somehow live till 95.
Also if you choose a Plan G Supplement, it does not cover the Medicare Part B deductible - which will most likely go up every year.
My providers are very happy when they see I am using Traditional Medicare and not Advantage. To me this is the most important reason for going Traditional, you can be confident that you will get the best and most expedient treatment. Of course you still have to do your due diligence in selecting physicians and facilities.
you are lucky. Not all of us who have the misfortune to have traditional medicare get the best and expedient treatment. Far far from it
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