Changes to BCBS Medicare Advantage

[Z3Dreamer]

Question is: Does anyone have experience with these issues?

Now, in North Carolina, BCBS has a "Blue-To-Blue" program where you can switch from Advantage to Supplement or Supplement to Advantage, without underwriting. Not one time but annually.

Now, in many BCBS Medicare Advantage plans, they have a "Travel Benefit" which means you can consider a BCBS provider in 44 states and Puerto Rico as in-network in your Advantage plan.

Since these have been the two drawbacks to Medicare Advantage plans. IMHO this is a game changer. And since I am turning 65 soon, it is an interesting option. And "No promotional fees were paid by BCBS."

Again, question is: Does anyone have experience with these issues?

 

[teej1985]

Unless North Carolina has legislated a mandatory requirement to switch been Advantage and supplement, it seems silly to expect that you'll always have that option.

 

[ivinsfan]

OP where are you finding this info?

 

[Dash man]

Medicare Advantage plans still give the power over your healthcare to the insurance company, while with supplements it is your doctor and you that make the decisions.

 

[Z3Dreamer]

OP where are you finding this info?

https://medicare.bluecrossnc.com/me...PO Travel,Shield Medicare Advantage PPO plans.

Their Advantage plans fall into 2 groups: HMO and PPO. The travel benefit is available in the PPO.

https://www.bluecrossnc.com/blue-blue

 

[Z3Dreamer]

Medicare Advantage plans still give the power over your healthcare to the insurance company, while with supplements it is your doctor and you that make the decisions.

Can you be more specific? Are you referring to the clause in some of the plans that some procedures require pre-approval or that the network is severely limited and therefore they have the power?

 

[Z3Dreamer]

Unless North Carolina has legislated a mandatory requirement to switch been Advantage and supplement, it seems silly to expect that you'll always have that option.

You bring up an excellent point. "Let's get you in the door while giving you the option to leave. Oh, you can no longer leave."

If there is nothing in the contract that discusses my options when they close the door, then I might ask the state department of insurance. Don't know what I will do if I can't close this loophole.

 

[Dash man]

Can you be more specific? Are you referring to the clause in some of the plans that some procedures require pre-approval or that the network is severely limited and therefore they have the power?

Yes, if the plans require referrals or pre approval it may delay the care you need while they make a decision and it might not be in your favor. Being limited to a network may make it harder to find an appointment with a specialist you need.
I’m a believer in getting the plan you want when you’re sick, not when you’re healthy.