Medicare Advantage Plans--good or a waste of money

Discussion in 'The Tiki Bar' started by Gofirstclass, Dec 4, 2021.

  1. Gofirstclass

    Gofirstclass Well-Known Member GOLD Sponsor

    Apr 20, 2010
    Tri Cities, WA
    1981 Boston Whaler 130 Sport
    40hp 2-Stroke Evinrude
    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
     
  2. sbw1

    sbw1 Well-Known Member

    Oct 10, 2006
    West Michigan
    This is listed in my signature
    This is listed in my signature
    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.
     
  3. carterchapman

    carterchapman Well-Known Member TECHNICAL Contributor SILVER Sponsor

    Mar 25, 2008
    Lake Chickamauga/Marietta, GA/Ft. Myers, FL
    2006 Sea Ray 58 DB
    MAN CRM V8-900s, Twin Disc Drives; Onan 21.5 Generator
    Don't you basically pay them the same amount as your Medicare deduction from your SS check? In our case IRMAA kills us...
     
  4. JHornsby3

    JHornsby3 Well-Known Member

    845
    Nov 10, 2020
    Sheridan Oregon
    "Steele'y Tutz"
    1992 300 Sundancer
    Twin 4.3L W/Alpha One Gen II
    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.
     
  5. Gofirstclass

    Gofirstclass Well-Known Member GOLD Sponsor

    Apr 20, 2010
    Tri Cities, WA
    1981 Boston Whaler 130 Sport
    40hp 2-Stroke Evinrude
    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.
     
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  6. Gofirstclass

    Gofirstclass Well-Known Member GOLD Sponsor

    Apr 20, 2010
    Tri Cities, WA
    1981 Boston Whaler 130 Sport
    40hp 2-Stroke Evinrude
    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.
     
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  7. SearayPaul

    SearayPaul Active Member

    924
    Oct 11, 2006
    Simpsonville, South Carolina
    34 Downeaster
    Cummins 5.9 480hp
    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.
     
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  8. PlayDate

    PlayDate Well-Known Member

    Dec 25, 2006
    Washington DC
    1994 370 Express Cruiser
    454 Mercruisers
    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.
     
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  9. SearayPaul

    SearayPaul Active Member

    924
    Oct 11, 2006
    Simpsonville, South Carolina
    34 Downeaster
    Cummins 5.9 480hp
    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.
     
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  10. sbw1

    sbw1 Well-Known Member

    Oct 10, 2006
    West Michigan
    This is listed in my signature
    This is listed in my signature
    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.
     
    Last edited: Dec 4, 2021
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  11. SearayPaul

    SearayPaul Active Member

    924
    Oct 11, 2006
    Simpsonville, South Carolina
    34 Downeaster
    Cummins 5.9 480hp
    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
     
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  12. my3sons

    my3sons Well-Known Member

    Feb 24, 2009
    NY (Lake Erie)
    2004 400DB, Onan 9 kw Gen, Highfield RIB,
    Cummins 6CTA M-3
    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.
     
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  13. Gofirstclass

    Gofirstclass Well-Known Member GOLD Sponsor

    Apr 20, 2010
    Tri Cities, WA
    1981 Boston Whaler 130 Sport
    40hp 2-Stroke Evinrude
    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.
     
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  14. Tripsdad

    Tripsdad Active Member GOLD Sponsor

    324
    Sep 27, 2019
    Long Island, NY
    2006 360 Sundancer
    T 8.1L Horizons
    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.
     
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  15. sbw1

    sbw1 Well-Known Member

    Oct 10, 2006
    West Michigan
    This is listed in my signature
    This is listed in my signature
    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.
     
  16. Nater Potater

    Nater Potater Well-Known Member GOLD Sponsor

    864
    Oct 19, 2020
    Southwest Idaho
    1992 300DA Sundancer
    Twin Merc Alpha Gen II I/O's with 5.7 V8's
    Ha-ha! I know just what channels you're watching! I get the same noise during my shows.
     
  17. Jus Cruisin

    Jus Cruisin Well-Known Member

    277
    Oct 6, 2021
    Lake St Clair - MI (Belle Maer Harbor)
    2004 390 DA
    8.1's
    AARP suplimental here. It's through United Healthcare.
     
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  18. Timeflys

    Timeflys Active Member

    429
    Dec 7, 2013
    Thousand Islands, Ontario, Canada
    "Frequent Flyer"
    2002 Sundancer 360
    Merc Horizon 8.1s
    As an aside, I laughed the other night watching Wheel of Fortune……Sajak quipped:
    “The only reason Shatner went to space was to sell insurance to the aliens!”.
     
    Last edited: Dec 5, 2021
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  19. techmitch

    techmitch Well-Known Member PLATINUM Sponsor

    May 1, 2008
    Chesapeake Bay, Middle River/Frog Mortar Creek MD.
    1999 270 DA
    Twin 4.3s W/Alpa I Gen II's
    Jeopardy……Sajak?
     
  20. SearayPaul

    SearayPaul Active Member

    924
    Oct 11, 2006
    Simpsonville, South Carolina
    34 Downeaster
    Cummins 5.9 480hp
    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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