SAY NO TO MEDICARE ADVANTAGE PLANS

The Medicare Advantage plans are starting up thier non-stop advertising trying to seduce Medicare recipients to switch or stay on their Advantage plan.  The provider organizations make way more money on these plans than they do on regular Medicare with a Plan F or Plan G supplement which is why the drumbeat goes on every few minutes on TV.  Don't do it.

There is an enormous amount of fine print on these plans.  You will have all kinds of deductibles, co-pays, and out of pocket expenses.  You will be so sorry if you bite on these sales pitches and later in the year need some kind of an expensive procedure like a new device or a lead extraction.  The cost could break the bank  When they say you will get all kinds of benefits like glasses, hearing aids, rides to medical appointments, home delivered means, this is only for the indigent on government Medicaid.  (If you are indigent then by all means call the number.)

The other problem is that you will have NO control over your body or your choices.  The organization who provides the Advantage plan will offer you what they think you should have by their providers.  You will not be able to go anywhere in the country to any provider who accepts Medicare like you would on a Plan F or Plan G supplement.  If you do not like the care you are getting you are stuck until 2022.  

This is open enrollment period.  Be smart.  The better choice is to take regular Medicare and then a supplement.  These are offered by many different insurance companies and have letters like Plan A, Plan N etc.  The best ones are Plan F and Plan G and have no copays and just a small deductible.  It doesn't matter which company offers it, all Plan G's are the same.  With these plans you can go to anyone in the country that accepts Medicare with no copays and no referrals.  If for instance you need a lead extraction you can go to a premier medical center like the Cleveland Clinic at no cost; you won't be stuck with whoever your Advantage Plan has on staff.

Yes, the Advantage all-in-one plans make it look simplier and easier and if you don't have any serious problems or complications in 2021you could save a few bucks, but those of us with these heart issues could be in for a sea of misery if we spin the roulette wheel and lose that bet.


7 Comments

Medigap

by AgentX86 - 2020-10-03 22:28:37

Note that Plan-F is not available to anyone who becomes medicare eligible after Jan-1 this year.  There is also a worry that as the people in the plan age and others die off that the payouts for the pool increase dramatically and pool for Plan-F gets smaller, causing the cost of the plan to skyrocket.  Note that changing plans may not be easy either.  Any change has to be medically underwritten.  Many of us wouldn't make the cut.  Plan-G is a safer bet, IMO.

The whole system is a mess.  An advisor is needed to negotiate the mess.  It is a government program designed by government beauracrats, after all.

Note that I'm not on medicare yet but will be some time next year. I'm still under my employer's insurance which is much better but I'm trying to budget for retirement and it's almost impossible to figure out by myself.

What a complex system

by Gemita - 2020-10-04 05:34:42

Hello Swangirl,

Your message goes a long way to restoring my faith in our own National Health Service in the UK with all its flaws !  I hope it never goes the same way although I fear it might.

How do ordinary folks cope with so much red tape to get through at a time when they are facing serious illness and needing urgent treatment I just cannot imagine.  It sounds a nightmare to cope with.  And then which hospital, which doctor to go to and that is if you have a choice.  Then what about the cost of medication and treatment which is spiralling out of control.  I can imagine a lot of folks are suffering and not seeking help when they most need it.

AgentX86, any chance of your staying under your employer's scheme and working from home as a "consultant" engineer occasionally ?  Make yourself really indispensable!  The alternative is Medicare

Gemita

by IAN MC - 2020-10-04 06:14:54

We have a  healthcare "system"  in the UK . Our friends on the other side of the pond have a healthcare " business"

I have  experienced both. We are very fortunate..

Ian

NHS

by Selwyn - 2020-10-04 09:12:53

I am so thankful for the NHS when I read of the difficulties that our friends experience across the pond.  The only problem. is travel insurance - lots of policies tend to exclude the USA without an additional premium ( if you can get insurance!).

Last Monday I  phoned the Liverpool Heart and Chest Hospital to see if I was due for a pacemaker check, they phoned back twice that day, organising a check up within 48 hours.  Yes, I did have my temperature checked on coming to the hospital and a quiz for symptoms, hand sanitiser, and the offer of a mask, sititng in a socially distanced waiting room ( the coffee shop is closed and there is no self check in machines, the receptionist is now behind a perspex screen).  Also, this week, I was phoned by the hospital  for a cardiomyopathy chat with a consultant cardiologist.  

This coming week I am invited to a routine health check up at my GPs.  All of this without cost ( as is my prescription that I order on-line and pick up from the chemist- though my Mother-in-law has her's delivered, and also had a hospital pacemaker check last week, in and out in 20 minutes).

We are really very fortunate to live in a country where there is equal opportunity for health care for all.  Perhaps it is something a lot of people   in the UK take for granted?  Reading about the problems of Plan F or G, I can only extend my sympathy, and I suspect you are the lucky ones!

complicated system

by AgentX86 - 2020-10-04 13:39:52

Yes Medicare, or more accurately Medicare extensions are complicated thanks to our hacks in Congress. Also note that we are NOT discussing Medicare itself, rather what you'd call "private insurance" that supplements Medicare coverage. The government prescribes what sorts of these supplemental insurance plans are allowed. There are only a few plans allowed and the been intentionally made complicated. It what bureaucrats do (aided by lawyers,  of course).

Study the Fine Print

by Swangirl - 2020-10-06 00:38:33

If you are 65 or older in the US you have no choice but to be on Medicare.  The medical groups however have cooked up an Advantage Plan which functions like an HMO so they can control their costs and make more money.  You however need control over your medical destiny which is why you want in addition to your Medicare a supplement like Plan G.  You might be paying a few more bucks up front but you will be able to choose your provider and you won't be having big deductibles and copays for every procedure.  

Small correction

by AgentX86 - 2020-10-06 13:42:57

At the risk of confusing things more, over the age of 65 we aren't required to be on Medicare. On the other hand, there are penalties for not signing up for the no cost part "Part-A" when one turns 65. . There is no reason not to but *I* get nothing out of it either. I'm 68 but don't have Medicare because my employer's plan is better and significantly cheaper.

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