Advantage vs Supplement

[John Galt III]

Msefren wrote :
The only thing we have found is "if you do not need to see a doctor often, then an Advantage Plan may be your best choice" and the fact that there is an out of pocket cap with Advantage plans, as we understand.

----------------------------------------------------------------------- I have a Medicare Advantage plan. The customer service rep said there is 20% coinsurance on certain drugs, and no cap on this 20% coinsurance, not even the $6,700 'max out of pocket'. I should call back and get a different rep (one of the flaws of MA plans is incompetent reps) and ask again.

[ShokWaveRider]

Quote:

Originally Posted by Dtail Just like the ACA, it depends where one lives. DGF has MA and has a wide choice of close to and in network doctors and hospitals with no premium, plus some eye and dental coverage.

Yes, Dtail, but remember we are not in a poorer rural area, we are in urban/semi urban Florida, in affluent counties. We are fortunate enough to trip over doctors bending over backwards to take most plans. I do not know anywhere Florida Blue is not taken. Others are not so fortunate. in our area they are talking about a new hospital an about a dozen additional healthcare facilities.

I personally would not want an MA plan, but again that is choice. My pretty affluent neighbor and his wife do, as it is covered 100% by his former employment. They get just as good service as I do on my AARP MS (Via Boomerbenefits).

DW is on ACA basically the same as an MA for pre-65's and she also gets top notch care for minimal costs. As I have said before now I am on Medicare my costs are more than triple hers. No I am not complaining before others chime in to say so, just stating the facts. As I have said before, mine now are predictable, currently the ACA still is not.

[mpeirce]

Quote:

Originally Posted by Bamaman Advantage looks great on paper. But in reality, it doesn't work that well.

Some people like advantage plans, some don’t.

My DWs advantage plan has worked out very well for her.

My DF too. And he’s been a pretty heavy user of healthcare: knee replacement, open heart surgery, and more.

Decide what’s important to you and check out your options. You might be surprised what is best for you.

[MichaelB]

One thing to keep in mind when comparing Original Medicare with Supplemental plans vs Medicare Advantage.

MediGap Supplemental plan coverage is regulated, so all plans with the same letter are exactly the same, and the networks are the same, which is all physicians, hospitals, labs and other service providers that participate in Medicare.

Medicare Advantage plans are all different. They all must cover Medicare A and B, but additional coverage can vary, the physicians and hospitals that participate can be limited and they can have HMO structure where preauthorization is required.

Medicare plus Supplemental plus Drug coverage offers more choices a bigger network of provides, and less cost sharing. That’s why it often costs more.

Medicare Advantage usually offers less choice, may have some restrictions, and has higher cost sharing. That’s why is might cost less.

[REWahoo]

Quote:

Originally Posted by MichaelB Medicare Advantage usually offers less choice, may have some restrictions, and has higher cost sharing.

These restrictions are why I've never considered a Medicare Advantage plan.

As an example, in this part of the world MD Anderson Cancer Center is considered to offer the best care for many types of cancer. I want the option of seeking treatment there for both DW and I should the need arise, but might not be able to do so if we were on an Advantage plan:

From the MD Anderson website:

Quote:

Medicare Part C, also known as the Medicare Advantage Plan, replaces traditional Medicare. Kelsey-Care Medicare Advantage is the only Medicare Advantage plan with which MD Anderson is contracted. However, we have a working relationship with some Medicare Advantage HMO and PPO plans. Please contact your plan to determine if they will work with MD Anderson.

[Which Roger]

From all I've learned so far, it seems the biggest factor in deciding between the two is whether one has a fairly extensive network that accepts an Advantage plan, and spends most of their time in the location that has that network. Small network or traveling a lot would seem to tilt heavily in favor of traditional Medicare + supplement.

[OldConch]

Quote:

Originally Posted by REWahoo +1 Many of us here have used BoomerBenefits.com to assist in choosing a supplement and I don't think I've heard anything but positive reviews on them.

Called Boomer Benefits 90 days prior to DW turning 65 and was surprised that they only write policies for Plans F and G. We ended with a Plan F HD through a local broker for 1/2 the cost of the lowest G. It includes Silver Sneakers which will save us about $15 so the net monthly cost is about $61.

BB was very responsive to my questions and followed up without being pushy.

[REWahoo]

Quote:

Originally Posted by OldConch Called Boomer Benefits 90 days prior to DW turning 65 and was surprised that they only write policies for Plans F and G.

While this may be true for your specific location, it isn't an accurate blanket statement. BB offered us a number of plans in addition to F and G to choose from and we went with Plan N.

[ivinsfan]

Quote:

Originally Posted by Dtail Just like the ACA, it depends where one lives. DGF has MA and has a wide choice of close to and in network doctors and hospitals with no premium, plus some eye and dental coverage.

True, yet always be aware the company sets the network and hospitals and there in no guarantee they won't change this at anytime they see fit. They can add and drop networks annually. That's a big problem for those of us out here in rural western MN...even the ACA plans are dropping networks in the MSP metro area, leaving us with west of here and going to SF, SD which is over 3 hours away...