John Galt III
Thinks s/he gets paid by the post
- Joined
- Oct 19, 2008
- Messages
- 2,803
I know the vast majority of people opt to get additional ins to 'cover the 20%
that original medicare doesn't cover' . But..... it seems to me that the additional insurance really does not cover it.
If you don't want to read all the examples below, my main question is whether it really is better to have a Medicare Advantage plan than plain Medicare and why. I understand there is no cap on the Plan B 20% . Maybe that's the whole thing right there. lol.
I've been looking at the copays and coinsurances for Medicare Advantage plans, and realized they are about the same as original medicare would be.
I am not considering Medicare Supplements now since they have monthly premiums I want to avoid. I was hooked on plan N for a while which would be $97 per month plus $17 for Plan D, which is pretty cheap, but still.....
Getting back to orig medicare 20% thing:
For example, inpatient hospital stay is $300 per day for the first 5 days in many MA plans. In orig medicare it is whatever the medicare allowed amount is (my guess is $250 per day?) up to cap of $1,364 for the first 60 days. Looks cheaper with orig medicare. Actually, I think there is no 20% here since it is Part A.
Durable medical equipment is 20% coins in both orig med and in MA.
Chemo drugs are 20% coins in orig medicare and MA plans.
Primary care doc visit is 20% of allowed amt in orig med, which equals $20 approx.
Specialist visit is 20% of allowed amount, so maybe $30. Same as MA plans.
Ambulance in orig medicare is 20% of allowed amt, equals 20% of $400 equals $80. MA plans are charging $200 to $350 copays for one-way ambulance ride. So orig medicare is actually cheaper here.
Emerg Room. 20%. This could get high, even with low allowed amounts, since the hospitals like to do lots of different tests. MA copay is $90 for ER. I think MA comes out ahead here.
Diagnostic tests and procedures: 20% $100 and up for MA plans.
Lab services: 20% $5 to $30 for MA plans.
Diagnostic radiology services (e.g., MRI): 20% . $250 for many MA plans.
Outpatient x-rays: 20% $40 to $50 copay MA.
Outpatient hospital coverage. 20%. MA charges $350 per visit for outpatient hospital, but they don't say what it is. Murky area.
And so on..... I guess my point is that 20% of the medicare allowed amount is pretty low, and (often?) lower than what the MA plan copays are.
One advantage I do see in the MA plans is the cap on max out of pocket at $6,700. Chemo drugs at 20% could add up quickly.
Anyone out there know anyone with plain vanilla medicare and whether they like it?
Thanks
that original medicare doesn't cover' . But..... it seems to me that the additional insurance really does not cover it.
If you don't want to read all the examples below, my main question is whether it really is better to have a Medicare Advantage plan than plain Medicare and why. I understand there is no cap on the Plan B 20% . Maybe that's the whole thing right there. lol.
I've been looking at the copays and coinsurances for Medicare Advantage plans, and realized they are about the same as original medicare would be.
I am not considering Medicare Supplements now since they have monthly premiums I want to avoid. I was hooked on plan N for a while which would be $97 per month plus $17 for Plan D, which is pretty cheap, but still.....
Getting back to orig medicare 20% thing:
For example, inpatient hospital stay is $300 per day for the first 5 days in many MA plans. In orig medicare it is whatever the medicare allowed amount is (my guess is $250 per day?) up to cap of $1,364 for the first 60 days. Looks cheaper with orig medicare. Actually, I think there is no 20% here since it is Part A.
Durable medical equipment is 20% coins in both orig med and in MA.
Chemo drugs are 20% coins in orig medicare and MA plans.
Primary care doc visit is 20% of allowed amt in orig med, which equals $20 approx.
Specialist visit is 20% of allowed amount, so maybe $30. Same as MA plans.
Ambulance in orig medicare is 20% of allowed amt, equals 20% of $400 equals $80. MA plans are charging $200 to $350 copays for one-way ambulance ride. So orig medicare is actually cheaper here.
Emerg Room. 20%. This could get high, even with low allowed amounts, since the hospitals like to do lots of different tests. MA copay is $90 for ER. I think MA comes out ahead here.
Diagnostic tests and procedures: 20% $100 and up for MA plans.
Lab services: 20% $5 to $30 for MA plans.
Diagnostic radiology services (e.g., MRI): 20% . $250 for many MA plans.
Outpatient x-rays: 20% $40 to $50 copay MA.
Outpatient hospital coverage. 20%. MA charges $350 per visit for outpatient hospital, but they don't say what it is. Murky area.
And so on..... I guess my point is that 20% of the medicare allowed amount is pretty low, and (often?) lower than what the MA plan copays are.
One advantage I do see in the MA plans is the cap on max out of pocket at $6,700. Chemo drugs at 20% could add up quickly.
Anyone out there know anyone with plain vanilla medicare and whether they like it?
Thanks