Medicare 66 --- Health Issue What to expect ??

[LakeRat1]

DW is 66, very healthy woman got on Medicare at 65. About two weeks ago, she had extreme abdominal pain, went to the ER and had an emergency appendectomy surgery, then complications.......

FL residents with the Aetna Advantage Plan - This illness is all happening in Missouri not at our Florida home

Never utilized the insurance before, not sure what to expect

Does anyone on here have this plan, if so have you had to utilize?

[ivinsfan]

Quote:

Originally Posted by LakeRat1 DW is 66, very healthy woman got on Medicare at 65. About two weeks ago, she had extreme abdominal pain, went to the ER and had an emergency appendectomy surgery, then complications....... FL residents with the Aetna Advantage Plan - This illness is all happening in Missouri not at our Florida home Never utilized the insurance before, not sure what to expect Does anyone on here have this plan, if so have you had to utilize?

NO but it sounds like a true emergency so maybe it's covered. But since you split your time between two states a regular Medigap policy might have been better. I guess you won't know until you get the bills. I hope it works out and keep us up to date please. We like to do some snowbirding and have paid extra for Medigap so I'll be interested in your outcome.

[MissMolly]

Is it an HMO or a PPO?

[LakeRat1]

Quote:

Originally Posted by ivinsfan NO but it sounds like a true emergency so maybe it's covered. But since you split your time between two states a regular Medigap policy might have been better. I guess you won't know until you get the bills. I hope it works out and keep us up to date please. We like to do some snowbirding and have paid extra for Medigap so I'll be interested in your outcome.

--Our understanding with the Advantage Plan, no real need for a Medigap Policy

[LakeRat1]

Quote:

Originally Posted by MissMolly Is it an HMO or a PPO?

PPO

[ivinsfan]

Quote:

Originally Posted by LakeRat1 --Our understanding with the Advantage Plan, no real need for a Medigap Policy

You buy one or the other. Medigap gives you national coverage

[LakeRat1]

The Aetna Advantage plan gives you national coverage as well, is my understanding

[ivinsfan]

Quote:

Originally Posted by LakeRat1 The Aetna Advantage plan gives you national coverage as well, is my understanding

You should be good then. Let us know how it works out

[MissMolly]

Quote:

Originally Posted by LakeRat1 PPO

Well, then you should be good to go. PPO policies don't have networks. As long as the hospital accepts Medicare and the Aetna plan there shouldn't be any unforeseen problems. And Aetna's website even says that.

https://www.aetnamedicare.com/en/com...ppo-plans.html

[bizlady]

Friend on Medicare had stroke while out of state- 3 weeks in hospital and 2 surgeries along with helicopter ambulance-- all covered except the deductibles with Medicare and supplement

[Telly]

Quote:

Originally Posted by MissMolly Well, then you should be good to go. PPO policies don't have networks. As long as the hospital accepts Medicare and the Aetna plan there shouldn't be any unforeseen problems. And Aetna's website even says that. https://www.aetnamedicare.com/en/com...ppo-plans.html

Just to be clear, a PPO (Preferred Provider Organization) DOES have a network, it is integral to the PPO concept. You can go outside of the network, and be covered, but you will pay more than choosing in-network providers. In non-Medicare plans, out of network costs can and almost always have their own significantly higher $$ deductible.

With Original (also known as Traditional) Medicare, any provider who "accepts Medicare Assignment" (the magic words!) also implicitly accepts any Medicare Medigap Plan (also known as a Medicare Supplement Plan).

The link to the Aetna Medicare Advantage PPO has some wondrous semantics

I'm not getting into a Original Medicare vs. Medicare Advantage thing here, I'm only pointing out that a PPO is indeed a PPO.

[oldphd]

Quote:

Originally Posted by LakeRat1 --Our understanding with the Advantage Plan, no real need for a Medigap Policy

+1

DW is on Aetna Medicare Advantage through Ohio retirement plan, we relocated to CO last year. My understanding is the provider just needs to accept Medicare. We haven't run into anything that's not covered.

[kimcdougc]

Very useful information for those of us on the brink of Medicare.

[euro]

Thanks for thread - I will bookmark it as we are moving closer to medicare also.

As an aside, my DW also had a ruptured appendix last August - apparently, its fairly unusual to suffer from appendicitis at age >60 (!), so they should both feel special.... just kidding, of course! I hope your wife is well on her way to recovery!

[LakeRat1]

Thanks for all the feedback ..... I have been logging into the Aetna Portal Daily and I see they are paying for services..... It is a waiting game to see how this goes ..... A bit nervous to see how much we are going to be billed for