[OrangeBlossomBaby]

Originally Posted by mtdjed

For some people it may truly an economical decision to get the Advantage program. For those who can afford a supplement, congratulations if you make the decision treat yourself to the best you can afford.

This, in spades. We're both using the Marketplace on a bronze plan, and there's a 9450 out of pocket expense for /each/ of us. This year hubby will get an Advantage plan - which will mean $174/month less in his social security check. Our bronze plan is much less than that for the two of us as long as we stay relatively healthy and don't need to see specialists too often (it's $85 co-pay per specialist visit), so we're already going to be paying more this year. Not a hardship, but that's 2 weeks worth of groceries. It's a lot of money for those of us who rely on our social security checks and a very modest pension to cover all our expenses.

In three years, I'll have to do the same, and it'll cost however much out of -my- social security check, significantly more than I'm paying now (more than ten times that).

There's no way we can afford part B, plus drug coverage, plus medigap. Just affording part B for two of us will make things tight.

[eweissenbach]

We took care of my father the last four years of his life. I took over his finances and he had Medicare and AARP United Healthcare plan F. He had numerous health problems and hospitalizations and never incurred an out of pocket expense. When I turned 65 and my wife a few months later we both enrolled in the same thing. (Plan F is no longer an option but we were grandfathered in it). My wife passed away four months ago and incurred several million dollars of health care expenses over the last three years with nary a penny owed by us. The premiums for the supplement are the best investment I have ever, or will ever, make.

[GoRedSox!]

For those who spend time in two different states, doesn't United Healthcare Medicare Advantage have a national provider network and you are covered under the in-network benefits in both states?

[rustyp]

Originally Posted by GoRedSox!

For those who spend time in two different states, doesn't United Healthcare Medicare Advantage have a national provider network and you are covered under the in-network benefits in both states?

YES. You probably want the PPO plan Vs HMO plan. Of course the Medicare with supplemental crowd has no idea what I'm talking about. Seven years plus now living your dual lifestyle with no issues of no coverage, needing to get a referral, or even being out of network for any procedure in either location (with 100's of thousands of dollars of claims).

[Indy-Guy]

Medicare plans explained in a 10 minute video


https://www.youtube.com/watch?v=oHdPlLUxx6I

[Indy-Guy]

Video about Medicare Advantage Plans. (may not start at beginning just reset back to beginning)

https://www.youtube.com/watch?v=ifkUn3NOT9w&t=520s

[rustyp]

Originally Posted by Indy-Guy

Medicare plans explained in a 10 minute video


https://www.youtube.com/watch?v=oHdPlLUxx6I

Originally Posted by Indy-Guy

Video about Medicare Advantage Plans. (may not start at beginning just reset back to beginning)

https://www.youtube.com/watch?v=ifkUn3NOT9w&t=520s

Marvin Musick - 5 reasons not to get a Medicare Supplemental Plan
https://www.youtube.com/watch?v=gNzqGYctWis

[gatorbill1]

Originally Posted by villagetinker

NO, you or your doctor will contact Medicare if there is an unusual treatment required, many treatments are typical and are covered. my previous point was there are situations where Medicare would be covered, but an advantage plan MAY require additional reviews and possible delays.

Originally Posted by OrangeBlossomBaby

This, in spades. We're both using the Marketplace on a bronze plan, and there's a 9450 out of pocket expense for /each/ of us. This year hubby will get an Advantage plan - which will mean $174/month less in his social security check. Our bronze plan is much less than that for the two of us as long as we stay relatively healthy and don't need to see specialists too often (it's $85 co-pay per specialist visit), so we're already going to be paying more this year. Not a hardship, but that's 2 weeks worth of groceries. It's a lot of money for those of us who rely on our social security checks and a very modest pension to cover all our expenses.

In three years, I'll have to do the same, and it'll cost however much out of -my- social security check, significantly more than I'm paying now (more than ten times that).

There's no way we can afford part B, plus drug coverage, plus medigap. Just affording part B for two of us will make things tight.

There are a lot of people in TV with more money than they know what to do with. I am with you as far as what is affordable. Supplement plan not in my budget.

[Justputt]

Originally Posted by gatorbill1

Medicare Advantage plans must cover whatever regular Medicare covers - no exceptions

That's not the case. We have Advantage plans say no to what Medicare would say yes to all to often.

[Justputt]

A lot of guesswork in these posts. The best thing is to sit down with someone that does this for a living. Rusty Nelson did a YouTube chat with someone that specializes in this near TV. There are a lot of if/and/but to what is best. IMO, if you are at TV fulltime, an Advantage Plan (limiting your referring physicians to local) may be a better bet, since they also cover eye, dental, gym, hearing aids. However, if you are a snowbird, your local Advantage Plan isn't going to cover you in-network in PA, MI, CO, etc. Also, Medicare doesn't require you to get a referral to a specialist, whereas Advantage plans do. Most patients we treat with Advantage Plans require preauthorization, when Medicare doesn't, and sometimes what the Advantage Plan authorizes isn't in the best interest of the patient, e.g. accelerated treatments so the plan doesn't have to pay for as many. You really should consult a specialist in these insurance products because they are very dependent on what you need.

[RPDaly]

///

[Jayhawk]

Originally Posted by Justputt

That's not the case. We have Advantage plans say no to what Medicare would say yes to all to often.

Someone is not being honest with you.

https://www.medicare.gov/sites/defau...8-07/11474.pdf

What do Medicare Advantage Plans cover?

Medicare Advantage Plans must cover all of the services that Original Medicare covers
except hospice care

[Dusty_Star]

Originally Posted by Jayhawk

Someone is not being honest with you.

Medicare Advantage Plans must cover all of the services that Original Medicare covers
except hospice care

& what they SHOULD & what they DO, are sometimes two very different things. Abuses often enough that Congress has started paying attention.

Bipartisan anger aimed at Medicare Advantage care denials

'''It was stunning''': Bipartisan anger aimed at Medicare Advantage care denials - POLITICO

[gatorbill1]

Originally Posted by Justputt

A lot of guesswork in these posts. The best thing is to sit down with someone that does this for a living. Rusty Nelson did a YouTube chat with someone that specializes in this near TV. There are a lot of if/and/but to what is best. IMO, if you are at TV fulltime, an Advantage Plan (limiting your referring physicians to local) may be a better bet, since they also cover eye, dental, gym, hearing aids. However, if you are a snowbird, your local Advantage Plan isn't going to cover you in-network in PA, MI, CO, etc. Also, Medicare doesn't require you to get a referral to a specialist, whereas Advantage plans do. Most patients we treat with Advantage Plans require preauthorization, when Medicare doesn't, and sometimes what the Advantage Plan authorizes isn't in the best interest of the patient, e.g. accelerated treatments so the plan doesn't have to pay for as many. You really should consult a specialist in these insurance products because they are very dependent on what you need.

UHC Advantage does not require referral for specialist. And Advantage plans must pay for anything Medicare pays for. That is facts.

[upstate]

We have traditional Medicare with a supplemental plan. No referrals are needed and we can choose our doctors and hospitals. Is it cheap, no, but for us it’s worth it. I should note, we are seasonal residents.