Medicare with supplement
I just went through this with changing my mom over to straight Medicare with a supplement.
The Advantage Plan she had for years served her well UNTIL SHE GOT SICK! The dirty secret is that if you end up in rehab or need longer care than the ADVANTAGE plan has in their FINE print you are up a tree! My mom had a traumatic injury breaking her femur around an existing hip replacement. Her UHC Advantage plan issued a NOMNC - which is a termination of rehab coverage after 2 weeks! Short story is I learned that even though the Medicare guideline says you have 100 days in a rehab or nursing facility - UHC Advantage gives you 20 days and then they start sending you these notices!! We had to file appeals 6 different times to keep her in rehab without us having to be self pay. I can't even tell you what a pain in the @#$% this was!
I spoke with MANY medical professionals, facility professionals, social workers, nurses, and therapists and they ALL said there is NO advantage to an ADVANTAGE PLAN because Medicare gives them the power to dictate your coverage. With straight Medicare and a supplement Medicare allows the FACILITY that is treating you to determine when you are safe to go home within that 100 days!! What a novel idea!!
I disenrolled my mom from the Advantage Plan and enrolled her in supplement F with straight Medicare. "F" is the GOLDEN TICKET and is not available to all Medicare eligible individuals. With this combo we have received NO MORE "ousting notices" for my mom. She received 3 of those notices in the first 45 days she was in rehab before I made the switch back to straight Medicare and supplement F.
EVERY professional I spoke with told me they DO NOT recommend Advantage Plans for their aged relatives - that says a lot to me.
BTW - Moffit, SHANDS and Mayo Clinic ALL accept Advantage Plans - I know this first hand. Still easier to have straight Medicare with supplement.
|