Medicare Advantage plan

[oldtrig]

I have looked at this for days. I would like things to be simple and this does look simple.


Since I turned 65 I have been on plan F . I just thought at the time it is what I needed. I am now 71.



I have never been in a hospital and very rare go to a doctor.



Now I am looking hard at going with a Medicare Advantage plan. Thoughts ?

 

[REWahoo]

A few threads on the subject:

http://www.early-retirement.org/forums/f38/medicare-advantage-plans-83345.html
http://www.early-retirement.org/forums/f38/medicare-vs-advantage-plans-comparisons-88463.html
http://www.early-retirement.org/for...age-vs-medicare-supplimental-plans-91960.html
http://www.early-retirement.org/forums/f38/why-not-medicare-advantage-ppo-89446.html

FWIW, I'm 72 and I have no interest in moving to an Advantage plan.

 

[VanWinkle]

Just remember that if you go to advantage, you will not be able to go back to Medigap without medical underwriting. If you develop a serious medical condition, you won't be able to get back to a Medigap plan.

 

[Katsmeow]

Just remember that if you go to advantage, you will not be able to go back to Medigap without medical underwriting. If you develop a serious medical condition, you won't be able to get back to a Medigap plan.

This.

There is a lot that is attractive about some Medicare Advantage plans particularly if it is a PPO where you have out of network coverage. The problem is that you don't know if that network will always be available. And you may want to go back to traditional Medicare. To my having to qualify for a supplement is a deal breaker. I am sufficiently risk averse that I would not want to take that risk.

I had 2 relatives this year with serious illnesses, both of which required rehab. One of the relatives was on traditional Medicare with Plan G. It was all very easy. She had no trouble getting care. Without exception people at hospitals and rehab facilities said "good" when they found out she was on traditional Medicare.

Another relative was on a Medicare Advantage plan. She didn't always get to go to the facility she would have preferred because it wasn't in network. At one point I found out that one of the family members had wanted her to go the same rehab facility as the relative above went to. But, that was out of network so she didn't have that option.

I've been on a PPO myself for years. It is a good PPO with out of network coverage. I am looking forward to being done with networks when I go on Medicare with a supplement.

 

[oldtrig]

Just remember that if you go to advantage, you will not be able to go back to Medigap without medical underwriting. If you develop a serious medical condition, you won't be able to get back to a Medigap plan.

Glad I asked. I didn't know this. I think I will stay with Medicap. I sure don't want to get locked out.

Thanks. Tom.

 

[davebarnes]

I have Kaiser Advantage.
Age 70.
Plan to die with it (at age 95.4 similar to my parents).
Service has been excellent. Including colon cancer surgery and chemo.

 

[REWahoo]

I have Kaiser Advantage.
Age 70.
Plan to die with it.
Service has been excellent. Including colon cancer surgery and chemo.

There are always a few exceptions.

I understand Kaiser is one of those, but the "I plan to die with it" comment might have an entirely different connotation with some of the advantage plans in my area.

 

[MBSC]

Since I turned 65 I have been on plan F. I have never been in a hospital and very rare go to a doctor.

Glad I asked. I didn't know this. I think I will stay with Medigap.

Good decision but are you aware that Plan F is closing to new enrollees in 2020? Some believe the lack of young, healthy members may cause Plan F premiums to increase. Because of this, many healthy persons like yourself are switching to Medigap Plan G.

With Plan G, you pay the Part B deductible ($185 in 2019) but the premium savings in most areas is usually greater than the deductible.

 

[Bamaman]

Remember that not all hospitals accept Medicare Advantage plans, where they just about all accept regular Medicare plans.
The dominant hospital chain in the area north of me refuses to accept Advantage. They manage control dozens of hospitals in 6 states and own clinics with over 1700 physicians and nurse practitioners. Those patients on Advantage have had to get new doctors and go to other hospitals--often out of their cities and counties--that may not be as good quality healthcare.

 

[Another Reader]

My guess is that to save costs, Medicare will eventually have only Advantage plans. The government will offload the healthcare job onto the insurance companies, who will "manage care" by making it difficult to get or denying it altogether. More hospitals and doctors will have to accept Advantage members because there are no higher paying customers and the insurance companies will hold all the cards.

 

[ivinsfan]

My guess is that to save costs, Medicare will eventually have only Advantage plans. The government will offload the healthcare job onto the insurance companies, who will "manage care" by making it difficult to get or denying it altogether. More hospitals and doctors will have to accept Advantage members because there are no higher paying customers and the insurance companies will hold all the cards.

I agree with this our state MN had a great assortment of so called "cost plans" where they payed more in network but if you left your area and needed medical care you got billed at Medicare rates. I think the cost was around 100 a month. Around 350K people in this state used that program. I would have used it myself but the government just made them against the law. The trigger was the amount of Advantage plans now available statewide. Once everyone had a choice of 2 or more Advantage plans the government did not want the cost plans competing with Advantage plans.

 

[Scuba]

Remember that not all hospitals accept Medicare Advantage plans, where they just about all accept regular Medicare plans.
The dominant hospital chain in the area north of me refuses to accept Advantage. They manage control dozens of hospitals in 6 states and own clinics with over 1700 physicians and nurse practitioners. Those patients on Advantage have had to get new doctors and go to other hospitals--often out of their cities and counties--that may not be as good quality healthcare.

This is also true of nursing homes if you need short-term rehab. They like traditional Medicare but some won’t admit Medicare Advantage as the reimbursement is much lower.

 

[oldtrig]

This is also true of nursing homes if you need short-term rehab. They like traditional Medicare but some won’t admit Medicare Advantage as the reimbursement is much lower.[/Q

Good point.


I have three good friends who are stuck on going with this lower cost Advantage insurance. One Advantage plan I looked at is offered here is $0 a month. The other is $47. I have looked at other plans. . Got until the 7th to make up my mind. I think I will stay will Plan F but not 100 % sure just yet.

 

[Moemg]

I have never been in a hospital and very rare go to a doctor.



Now I am looking hard at going with a Medicare Advantage plan. Thoughts ?

Do not use your past basis as a reason to look for cheaper insurance . Your health can change suddenly . Last year I got the flu and ended up in the hospital for 5 days and pulmonary rehab after . That little episode cost my insurance company over $60,000.

 

[oldtrig]

Here is Alabama the Advantage plan I have looked at is $0 per month. My worry would be if I did take it I might not get back into a Medigap plan if things turn.



Always good to ask. My wife had Kidney cancer last year. The hospital bill was over $100,000. We paid nothing with plan F.
Nobody knows what the future will bring on health.



My wife was a picture of health and with plain good luck she found out she has a tiny mass on her right Kidney.



A trace of blood in urine and a great Doctor set things in motion. Doc said it probably had not been there but a few months after he did the operation.
All is fine after 19 months.


Go Wednesday for a yearly checkup. Hope all is still good which I think it will be

 

[VanWinkle]

Here is Alabama the Advantage plan I have looked at is $0 per month. My worry would be if I did take it I might not get back into a Medigap plan if things turn.



Always good to ask. My wife had Kidney cancer last year. The hospital bill was over $100,000. We paid nothing with plan F.
Nobody knows what the future will bring on health.



My wife was a picture of health and with plain good luck she found out she has a tiny mass on her right Kidney.



A trace of blood in urine and a great Doctor set things in motion. Doc said it probably had not been there but a few months after he did the operation.
All is fine after 19 months.


Go Wednesday for a yearly checkup. Hope all is still good which I think it will be

Best wishes for a great check up. DW is starting treatment for the third type of cancer she has contracted. You are right about never knowing what lies ahead as my wife was a picture of health before all of this crap.

 

[oldtrig]

Thanks VanWinkle. My wife has good genes so this caught us off guard. She was back cutting grass in three weeks like nothing ever happened.





I think it aged me 10 years

A little worry here about Wednesday.



She feels great and never slows down. The most amazing lady I have ever known. We have been married 48 years this Friday..

 

[Dawg52]

Here is Alabama the Advantage plan I have looked at is $0 per month. My worry would be if I did take it I might not get back into a Medigap plan if things turn.



Always good to ask. My wife had Kidney cancer last year. The hospital bill was over $100,000. We paid nothing with plan F.
Nobody knows what the future will bring on health.



My wife was a picture of health and with plain good luck she found out she has a tiny mass on her right Kidney.



A trace of blood in urine and a great Doctor set things in motion. Doc said it probably had not been there but a few months after he did the operation.
All is fine after 19 months.


Go Wednesday for a yearly checkup. Hope all is still good which I think it will be

I have a golf buddy who had the same problem recently. A very small mass on his kidney that was discovered by accident. Had a scan for some other problem and was discovered there. He had laparoscopic surgery to remove 10% of his kidney and bounced back pretty quick. Had surgery about 2 months ago and now playing golf again.

 

[Ian S]

I'm glad that I went with a traditional Medigap plan instead of Medicare Advantage. Last year I required surgery for a torn rotator cuff in my right shoulder. With the surgery, MRI, shots, doctors' visits and months of physical therapy, I'd likely have racked up thousands in deductibles, co-pays and co-insurance with a Medicare Advantage plan. This year, with my colonoscopy and then a fall that tore the rotator cuff in my left shoulder (for which I'll have surgery this Thursday) I'd be looking at thousands out of pocket again and extending into next year with the physical therapy. Otherwise I'm pretty healthy and only take a ppi and statin. With a Plan G, my out of pocket is only around $180 per year.

 

[ShokWaveRider]

With a Plan G, my out of pocket is only around $180 per year.

Plus the premium. But still the way to go IMHO. 2019 is my first year on Medicare and I signed up for Plan G with BoomerBenefits.com. I can recommend them. Not for a Part D Drug plan though. I am using WellCare for that.

 

[Likes_to_Lurk]

I will be going on Medicare early next and have been doing a lot of research on this. I opted to enroll in a Plan G and a Part D drug plan.

My concerns with an Advantage plan were the scope of the network and changes to same and getting nickled and dimed on co-pays. While I can handle the paperwork now, what happens if I am very ill and have trouble writing checks etc?

I helped DM in her later years, when her health was failing. She had traditional Medicare and a supplement. Very few problems, despite multiple surgeries, hospitalizations, etc. I like the idea that I can put most of the payments (except the deductible) on autopilot.

I am really concerned about about the time when I will have limited ability to manage my affairs and traditional Medicare seems like the best option for me.

 

[Ian S]

Plus the premium. But still the way to go IMHO. 2019 is my first year on Medicare and I signed up for Plan G with BoomerBenefits.com. I can recommend them. Not for a Part D Drug plan though. I am using WellCare for that.

Yes, the premium adds about $1500/yr to that but it's still a lot less than I'd have shelled out for one of the $0 Medicare Advantage plans. My Part D plan is $12/mo and next year there is no cost at all for the statin and ppi I take.

 

[Ian S]

I am really concerned about about the time when I will have limited ability to manage my affairs and traditional Medicare seems like the best option for me.

Thanks! That's a great point.

 

[loganbailey]

I have looked at this for days. I would like things to be simple and this does look simple.


Since I turned 65 I have been on plan F . I just thought at the time it is what I needed. I am now 71.



I have never been in a hospital and very rare go to a doctor.



Now I am looking hard at going with a Medicare Advantage plan. Thoughts ?

Look man, YOU DO NOT WANT TO SWITCH TO AN ADVANTAGE PLAN.

But if you are still healthy you probably want to switch from plan F to Plan G ASAP. Plan G is typically much cheaper due to a healthier risk pool, plus the only thing it doesn't cover that F does is the $183 annual part B deductible.

It's a no brainer, especially if G saves you like $50-60/ month over your F plan.

Source: ind medicare broker