Medicare Advantage Plans--good or a waste of money

Gofirstclass

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Apr 20, 2010
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Tri Cities, WA
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It seems every other ad on TV is for a Medicare Advantage Plan. The companies offering the plans use celebrities that promise huge benefits and make it sound too good to be true. Well, we all know the old saying, When It Sounds Too Good To Be True....

So, does anyone have any factual info on these MAP plans? Are the various companies all offering the same benefits under different names? Is one plan any better than another?

HELP
 
My wife and I have had Advantage Plans since being on Medicare. Our plan is very similar to the plan we had through work before retiring. It is with the same company; membership card looks the same except it has the words Medicare Advantage on it along with the insurance company’s name. Even the phone number for help is the same as before. The difference is the benefits are better than our company plan. Hearing aids for example are covered, and a gym membership is included as are drugs. West Michigan has great health care and all of the good doctors and hospitals participate so nothing changed for us after retirement. The University of Michigan Hospital is considered in network which is a plus. Hospitals in all states are covered if something happens while you are traveling. Medicare Advantage plans are required to cover all medically necessary services that traditional Medicare covers. They can offer more to attract new business. Only the benefits, prices and participating providers vary by plan. The level of claims processing service also varies by company. We have found our plan to be cheaper than others and the quality of claims processing is superb. This varies through out the country and by markets. They are called Advantage plans because there is no need to buy a supplemental Medicare policy for non covered services and there is no need to buy a separate drug policy . Advantage plans typically cover these services and drugs for one premium which is typically cheaper than typical health insurance policies.
 
I have been wondering about all of this. Since moving in a caring for my father, I was curious if he was getting the best he can. Having state Blue Cross along with Medicare covers all but meds. And the VA covers everything if we jump the hoops and dance the dance. We are going through the VA more now than anything else.
 
John, you and I are pretty much in the same boat in getting covered through the VA. I can't complain about the VA coverage. After they screwed up 5 years ago when I turned 70 by not doing a simple PSA test when I had blood drawn and I got cancer as a result, I have them pay for ALL my care.

I'm thinking more of additional coverage for my wife. She has the standard Medicare A + B coverage but I'm looking at what additional coverage would actually cover, and at what cost, and how much of it would be coverage for things she needs.
 
Well, I called one of those TV ad numbers and I swear I was speaking with an 18 year old female from SE Asia. She spoke so fast on the phone I had to ask her twice to speak more slowly and a bit louder.

She finally did and I explained to her that I was calling to check into a policy for my wife. She asked me my name and I reminded her this was a policy for my wife. OK, then she asked me for my SSAN.

I hung up.

So I tried Joe Namath's number and actually got to speak to a lady who spoke English and spoke cleary and distinctly. I explained what I was trying to accomplish and she said she would have to talk with my wife so she gave me her phone number and suggested I call back tomorrow. (My wife is flying home today from a trip to visit her kids.)

Will do.
 
Depends, If your doctors, facilities, and conditions are covered then you are good. You must read the fine print that tells you what you must do for your expenses to be covered. Some plans will limit the number of visits you can have per year for certain conditions.

If you should be diagnosed with a new medical condition during the year that can be a problem. You may or may not be happy with your plan’s benefits for your new condition. In order for your plan to cover the “best” treatment for your condition you may have to do a stepped treatment plan until you get to the “best” therapy.

Example, A person that is a brittle diabetic may need lots of medication above and beyond “normal” limits. Once the limits are exceeded you will have to accurately document your use and have your doctor fill out additional forms to have your medicine covered ad nauseam. There are other examples but most people know diabetics can have lots of challenges.

Three very positive things about these plans. If you do not currently need lots of medical care they are very cheap. If you do not like the plan you can always change your plan at annual enrollment. no questions asked. Lastly you can change the plan before annual enrollment if you meet certain conditions.
 
I am almost afraid to admit this (because I don't feel 66).......but I went through this in a comprehensive way when I started to receive Medicare benefits last year.

I looked at most of the highly rated plans and selected the AARP/United Healthcare Plan. I spoke to a US based agent who knew the options inside out and we worked out a Plan that included coverage for C and D. I have never had any prescriptions so I was reluctant to include part D but she said the "past is no predictor of the future when you are getting older". Fast forward 12 months and I now have three prescriptions that I pay almost nothing for.

https://www.aarpmedicareplans.com/l...fMbMeTk1LflMEU-iH0hoCTV0QAvD_BwE&gclsrc=aw.ds

Or give them a call:

Call UnitedHealthcare at:1-877-578-8305, TTY 711
Hours: 8 a.m. to 8 p.m., 7 days a week.*

AARP has a lot of great information and being a member is really inexpensive.
 
All of the people on TV are sales people period and just like boat brokers.... Go to Medicare.GOV to get the insurance companies phone numbers. Most states also have an agency you can call and they will help you. Sorry at the moment I can’t remember the name.

Medicare requires they know who they are Working with. They will ID you to cut down on fraud. Never give out your social security number, you did good. I handle my brothers disability, very sad. To get me established to handle his needs was very involved. To this day periodically I have to provide required documentation to show I am the person that helps him.
 
Don't you basically pay them the same amount as your Medicare deduction from your SS check? In our case IRMAA kills us...
The plans are paid for in two different ways. Social security deducts a monthly amount for the hospital portion and a separate amount for the drug portion. Every year SS sends recipients a letter outlining these basic deductions. The letter further explains the added surcharges for high income recipients. High income levels are based upon the sum of your adjusted gross income plus tax exempt income as reported on the prior year’s tax return. There are tiers of incomes and higher tiers mean larger deductions for Medicare. It is common for high income recipients to get a raise in their monthly social security benefit only to see their monthly payments go down due to greater Medicare deductions. Some Advantage plans accept these social security deductions as full payment for their enrolled members. Those plans who can not make a profit on the federal deductions charge an additional monthly premium to their enrollees. This is the second way plans are reimbursed. These premiums can change every year. Our plan began as a zero monthly premium plan years ago. It is now up to $13 per month. Some years the monthly premium goes up and some years it goes down based upon the company’s utilization experience.
 
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A lot of people overlook part D. Big mistake. If you do not have qualifying prescription coverage at initial enrollment you will be assessed a penalty compounded monthly until you get coverage. That can get expensive. If you are not taking prescriptions get the cheapest plan available at Medicare.GOV
 
Everybody’s circumstances are different, you need to do your homework on which plan is best for her. This is sign up season for the various plans which is why so many commercials. You won’t see anymore after December 9th.
You can change plans every year between Oct and Dec in case your medical needs change. There are free seminars you can attend to learn more. She needs to sign up for something as I understand it though as if she doesn’t get a part c or d, she could get penalized and that could cost her yearly permanently. I opt for a ppo med advantage plan because it has advantages for people who travel outside their area who otherwise would be out of network.
I don’t understand all the options that well, just the ones that pertain to our needs so again, everyone’s different, do your homework.
 
Guys, I really do appreciate all the info you are providing. I'm outa here on the way to the airport to pick her up, then stop somewhere to get a toddy, then back home. Tomorrow morning I'll check out Medicare.gov to see what I can find.

Keep the information coming please. I'm learning a lot tonight.
 
I am almost afraid to admit this (because I don't feel 66).......but I went through this in a comprehensive way when I started to receive Medicare benefits last year.

I looked at most of the highly rated plans and selected the AARP/United Healthcare Plan. I spoke to a US based agent who knew the options inside out and we worked out a Plan that included coverage for C and D. I have never had any prescriptions so I was reluctant to include part D but she said the "past is no predictor of the future when you are getting older". Fast forward 12 months and I now have three prescriptions that I pay almost nothing for.

https://www.aarpmedicareplans.com/lp/medicare-advantage-plans.html?WT.mc_id=8022424&mrcid=ps:google:ma|MA Core|AARP|Product:1.2.20:8022424&ds_rl=1283485&ds_rl=1283629&gclid=CjwKCAiAwKyNBhBfEiwA_mrUMmx4Vsb-0ZDQ9kDwmXYYlPuxoxd-7oGfJr1fMbMeTk1LflMEU-iH0hoCTV0QAvD_BwE&gclsrc=aw.ds

Or give them a call:

Call UnitedHealthcare at:1-877-578-8305, TTY 711
Hours: 8 a.m. to 8 p.m., 7 days a week.*

AARP has a lot of great information and being a member is really inexpensive.
My parents have had AARP United Healthcare for years. My father passed away in February but both he and my mom had many prescriptions and their monthly premiums were $330 a month each. I’m going to be 66 this year but still working full time so I’ll be watching this thread for more advice.
 
Another thing about Medicare Advantage plans to check is customer satisfaction. The government requires them to provide information from customers about complaints. When I call the insurance company with a question I get a phone survey following the call to find out how I was treated. Service is typically excellent. These companies are evaluated by customers on a regular basis and the information is available on government websites. Check it out when you shop.
 
Here is the agency I could not remember.

The SHINE program, Serving the Health Information Needs of Everyone, provides free, confidential, and unbiased health insurance counseling for Medicare beneficiaries. To reach a trained and certified counselor in your area, contact the regional office at 1-800-498-4232or 413-773-5555.

I did not try the phone numbers. Hope they are good.
 

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