[rustyp]

Originally Posted by BrianL99

No they don't "differ by a lot". They all have the exact same premise. The Insured doesn't get to control their medical services, the Insurer does and they're a profit making entity.

Advantage Plans are cheaper & give away "freebies" as you mentioned.

The fact that SHINE said "they're a very good solution for you, doesn't make them better or even equal to Medicare + a Supplemental. It means that in your particular financial/health position, it's a good option.

They're a cost based solution, for folks trying to save money. There's nothing else anyone needs to know about them.

Most likely when you disclose to Shine your employer is paying for your supplement as part of your retirement package they will probably recommend medicare plus a supplement.

[tophcfa]

Originally Posted by golfing eagles

Amazing. I also have Florida Blue Bronze plan. $15,828/ month, single coverage, no significant health issues, $7,200 deductible and about $13,000 out of pocket max. Prescription meds run another $40/mo. Over the past 9 years I've put in about $110,000 into health insurance premiums and received back about $1.98 in benefits. Bottom line---better to be the insurer than the insured. At least I only have to pay April and May and then I'm on Medicare.

I have the Massachusetts Blue Bronze and pay about the same as you and am counting the days until turning 65. There is only one reason I’m happy to be getting older, healthcare.

[Dusty_Star]

Originally Posted by tophcfa

I have the Massachusetts Blue Bronze and pay about the same as you and am counting the days until turning 65. There is only one reason I’m happy to be getting older, healthcare.

Well, I'm happy to be getting older, because I don't care for the alternative.

[MX rider]

Originally Posted by BrianL99

No they don't "differ by a lot". They all have the exact same premise. The Insured doesn't get to control their medical services, the Insurer does and they're a profit making entity.

Advantage Plans are cheaper & give away "freebies" as you mentioned.

The fact that SHINE said "they're a very good solution for you, doesn't make them better or even equal to Medicare + a Supplemental. It means that in your particular financial/health position, it's a good option.

They're a cost based solution, for folks trying to save money. There's nothing else anyone needs to know about them.

You make a lot of assumptions, our decision was not cost based. We think our plan is best for us. It's not a one size fits all thing as you seem to be saying. Having options is a good thing.

I'll defer to Golfing Eagles, who by the way is a healthcare provider. I actually asked my longtime pcp in Indiana about this as well, he basically echoed golfing eagles.

Your commenting on something you really aren't up to speed on.
Again, how much actual research have you done on ALL the different advantage plans?
Btw, I know what SHINE was saying. Duh.

My point is you're trying to say all advantage plans are bad, and that's just flat wrong.
Over 50% of new medicare enrollees opt for advantage plans. Thats a lot of people. I don't think they're just blindly going that route for cost alone. I'm sure many did their homework and research just like we did.

But we can agree to disagree on this.

[BrianL99]

Originally Posted by tophcfa

I have the Massachusetts Blue Bronze and pay about the same as you and am counting the days until turning 65. There is only one reason I’m happy to be getting older, healthcare.

Yeah, I waited years to get my free Medicare, until I found out it costs me over $630/month. That took some of the fun out of turning 65.

[BigDawgInLakeDenham]

Originally Posted by tophcfa

Whoever said patients with Medigap plans don’t have a PCP who helps them manage their health care? With a Medigap plan, if you need to see a specialist for a life altering condition, the PCP can refer to a top specialist in the USA, not whoever is practicing and accepting patients in your local network. If you happen to live in a rural area, there may not be an experienced specialist in your network, so you have to roll the dice with a generalist and hope for the best. Not optimal at all.
Also, with a part g Medigap plan, if that condition runs up a million dollars in medical expenses, all you pay is your approximately $250 annual deductible and never see another bill.

How do you think a Physician becomes a "Specialist"? All Physicians are specialists in their area of practice that they spent many years of hands on training and even if they are in a shanty in East Bumfudge Egypt they're prepared to care for you. The variables here are people aka patients. Patients have no patience #1. Patients only think they are the one that matters because they only present in their time of need and expect immediate attention. Do you really believe that you're going to see a specialist while on vacation just because you want to? There are Patients that have never experienced pain, like the pain after hip or knee surgery. They transfer this pain onto the doctor because they may think another doctor could have done the surgery without postoperative pain. This false belief becomes a negative review of the doctor. They may never achieve full range of motion in their hip or knee because of the postoperative pain involved in physical therapy exercises and these exercises are the key to a successful joint replacement...... but this is not the doctor's fault yet the review will say it's the doctor's fault that the patient didn't complete PT. I could go on and on about people's distorted views of reality in the Healthcare system. Maybe you're saying that when you get cancer you're traveling to a big name hospital because you'll accept no less. Many affluent people do and it has sometimes worked out in the past. I will tell you that I'm coming from a recognized name in medicine and have seen that all hospitals bottom line is what's most important. The care environment in the hospital is dwindling since Covid, George Floyd and the nationwide HR push for diversity and inclusion. Recruitment and retention of quality patient care staff is more difficult as each day passes. Covid knocked out many quality caring Healthcare workers. If you remember, we HAD to work and it was a horrific time which led to many leaving the industry or seeking work outside hospitals. Don't be surprised now if your Nurse looks like Jellyroll with a nasty attitude. It pains me to say this because I poured my heart and soul into quality patient care because I loved the people we served and I loved my job and my coworkers. I can't say that to be so anymore and I'd be hesitant to jet off to a big name unless I needed a specialist and they were the only one, as Dr Ben Carson was. You're relationship with the doctor is paramount but hospital stays can taint your entire experience.

I'm ranting but there's a lot more to this than which insurance you pick. After my experiences and my knowledge base I don't have any problem with having a Villages UC Advantage Plan with HMO or PPO or AARP Advantage Plan. Not looking for the "freebies", but instead I feel confident that between what I know to be fact and a solid relationship with a PCP, I can get everything in Healthcare that I will need.

BrianL99....I've never had a PCP that worked for an insurance company. Physicians pick and choose which insurance companies they want to associate with after reading all the fine print. They choose to accept insurances that will let them operate with reasonable reimbursement while allowing their patients good benefits coverage. And then there's my Dermatologist that stopped taking Medicare patients because the reimbursement is so low and she wanted a bigger yacht and another rental property....true story

[golfing eagles]

Originally Posted by BrianL99

I'm not sure that anecdotal evidence, dispels anything. As with any business (& you surely know medicine has become a "business"), human nature and human competency, always trumps theory. In this case, the theory being that Advantage programs should be offering a level of medical care, consistent with other options. They all don't and at minimum, all depend on the competency, dedication and (your word) effort, of one's PCP.

As for "directing one's healthcare", I agree that folks shouldn't be relying on Google, but on a trusted, competent physician ... unencumbered by the corporate policy of a profit-making conglomerate.

(& I understand that Medicare has it's own standards and "rules", but manipulating and navigating Medicare rules, when the government is the overseer, seems much simpler to do, than negotiating/arguing/challenging/maneuvering through a structure controlled by competent, corporate America professionals.)

We can agree to disagree.

(& I'll bet a dollar, that the $1700/Month you're paying for your health insurance, with that huge deductible, allows you to see any physician you want and bet another dollar, it's a BCBS program!)

You'd win both bets, but I can't pay up since I'm spending 100x as much each month as OBB. (Actually, I think she owes me a thank you for subsidizing her premium)

But then riddle me this: With all my expertise, I get Medicare in 2 months and have already signed up for my advantage plan. Am I stupid? Ignorant? Gullible? (on second thought, don't answer that)

[Pugchief]

@golfing eagles and @BigDawgInLakeDenham thanks for your opinion. I, too, spent my entire career in health care delivery and have the opposite view: I would NEVER sign up for an HMO of any kind, including Medicare Advantage unless it was my only option. Yes, you will save some money. But you will also jump thru more hoops to go anywhere beyond PCP, and I have also heard horror stories of people being denied care they wanted/needed by the HMO. I'm sure it is a good option for many folks, but definitely not me.

[BigDawgInLakeDenham]

Originally Posted by Pugchief

@golfing eagles and @BigDawgInLakeDenham thanks for your opinion. I, too, spent my entire career in health care delivery and have the opposite view: I would NEVER sign up for an HMO of any kind, including Medicare Advantage unless it was my only option. Yes, you will save some money. But you will also jump thru more hoops to go anywhere beyond PCP, and I have also heard horror stories of people being denied care they wanted/needed by the HMO. I'm sure it is a good option for many folks, but definitely not me.

It's your prerogative to pay more for the same or less....but please do share your knowledge of horror stories of people not getting what they actually need. It's not reported by any news media so I for one would love to hear how insurance killed subscribers. It will be interesting to analyze if the insurance actually denied necessary procedures without being litigated and responsible for harm.

What kinda of Healthcare worker were you? I'm curious why you fear navagating the system and why you believe insurance companies like United Health Care are evil while the Government is your best friend. I've shocked folks back to life but I've also prepared them for a family viewing and a body bag. I've worked with my orthopedic surgeon on the Trauma Team, when he was a resident, years before having him do my surgery only because of the great respect I had for him and his wonderful humanity. Being a Healthcare Professional does help me navigate the system because I was part of it and I also helped family members to the end of their lives. I've buried my parents, my Brother, my Sister, and most recently my Daughter of 27 years. They all had everything they needed and HMOs were never an issue.

As a Frontline Healthcare Worker that participated in lifesaving procedures I had a HMO my entire Adult life and I have never been denied and I've never had to spend A LOT out of pocket and I've seen many "Specialists" without ever seeing a "Hoop". Can you explain how I pulled this off having the evil managed care insurance? I had bilateral knee replacements and my copay was $100. I won't get that much of a discount on an Advantage Plan because that was a benefit of my Employer's plan but withThe Villages United Healthcare Plan my out of pocket maximum for the year would be $2700, even if I had a $100,000 procedure, and that's with no monthly cost........talk about a freebie.....but to each his own..... I'm done

[Rainger99]

Originally Posted by golfing eagles

Amazing. I also have Florida Blue Bronze plan. $15,828/ month, single coverage, no significant health issues, $7,200 deductible and about $13,000 out of pocket max.

$15,828/ month!! That would be $189,936 a year!!

Please tell me that is a typo!

[CoachKandSportsguy]

Originally Posted by Pugchief

@golfing eagles and @BigDawgInLakeDenham thanks for your opinion. I, too, spent my entire career in health care delivery and have the opposite view: I would NEVER sign up for an HMO of any kind, including Medicare Advantage unless it was my only option. Yes, you will save some money. But you will also jump thru more hoops to go anywhere beyond PCP, and I have also heard horror stories of people being denied care they wanted/needed by the HMO. I'm sure it is a good option for many folks, but definitely not me.

Correct, currently BCBS MA is denying paying for cancer validating exam requested by one of CoachK's direct report's husband's doctors, who is forced to go onto Medicare to get the $7,000 validating exam paid for. . private employer provided insurance refused to pay. . .

Unfortunately, there are hospitals which has stopped taking UHC insurance plans as they don't pay promptly or at all. . another friend who's wife has been a nurse in administration for her whole life, had to switch to medicare to get his doctors' requests paid for after this heart by-pass operation which saved his life.

times are changing, and UHC is profit over patient. . don't believe anything to the contrary with UHC

Advantage plans only work for the healthy with no issues. . and when you do have issues, be sure they are regular everyday issues. .

[mtdjed]

[QUOTE=OrangeBlossomBaby;2305950]It's a crappy plan. The basics are covered, I have to pay $85 per treatment, test, and specialist visit, and I have to keep paying that until I've hit $9700 out of pocket [QUOTE]

I have had two episodes of skin cancer each requiring 22 daily treatments.

My only co pay was the initial diagnosis. There were no copays for the subsequent daily treatments. Do different providers have different options regarding copays or is it the insurance plan that determines that? I'm on regular Medicare with a Supplement Plan N. My plan has a $20 copay.

[BigDawgInLakeDenham]

Originally Posted by CoachKandSportsguy

Correct, currently BCBS MA is denying paying for cancer validating exam requested by one of CoachK's direct report's husband's doctors, who is forced to go onto Medicare to get the $7,000 validating exam paid for. . private employer provided insurance refused to pay. . .

Unfortunately, there are hospitals which has stopped taking UHC insurance plans as they don't pay promptly or at all. . another friend who's wife has been a nurse in administration for her whole life, had to switch to medicare to get his doctors' requests paid for after this heart by-pass operation which saved his life.

times are changing, and UHC is profit over patient. . don't believe anything to the contrary with UHC

Advantage plans only work for the healthy with no issues. . and when you do have issues, be sure they are regular everyday issues. .

Sorry but your story is BS. If RN wife switched to Medicare it has no impact and no coverage for anyone but her. Please provide factual personal experiences...please

Oh and mine is a Nurse Administrator and I would not want her to run my code

[BigDawgInLakeDenham]

Originally Posted by CoachKandSportsguy

Correct, currently BCBS MA is denying paying for cancer validating exam requested by one of CoachK's direct report's husband's doctors, who is forced to go onto Medicare to get the $7,000 validating exam paid for. . private employer provided insurance refused to pay. . .

Unfortunately, there are hospitals which has stopped taking UHC insurance plans as they don't pay promptly or at all. . another friend who's wife has been a nurse in administration for her whole life, had to switch to medicare to get his doctors' requests paid for after this heart by-pass operation which saved his life.

times are changing, and UHC is profit over patient. . don't believe anything to the contrary with UHC

Advantage plans only work for the healthy with no issues. . and when you do have issues, be sure they are regular everyday issues. .

You are Soooo wrong. So so wrong. I'm not going to reveal my PHI to make you look stupid....but....

[CoachKandSportsguy]

Originally Posted by BigDawgInLakeDenham

Sorry but your story is BS. If RN wife switched to Medicare it has no impact and no coverage for anyone but her. Please provide factual personal experiences...please

Oh and mine is a Nurse Administrator and I would not want her to run my code

nice try , I didn't give you any fine details, but yes, both stories are very very true for both nurse wives and husbands scenarios who work/worked at hospitals. Sorry, I can't give you names to counter your response for your assumed all knowing knowledge as well as highly judgmental typing.

but continue on, we will hang on every word you type. . .