[BrianL99]

Originally Posted by golfing eagles

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)

I know you're not stupid, nor gullible. I'm fairly certain we played golf together last month. I would have noticed those traits.

Obviously you're not the typical "patient" or insured, now are you? I suspect you signed up for an Advantage Plan, because you like the convenience and availability of The Villages Healthcare system and you're reasonably young and healthy.

[MX rider]

Originally Posted by CoachKandSportsguy

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. . .

You can't say all advantage plans are bad, anymore than you can say all doctors are good. You're totally avoiding all the posts from people that have UHC, have used it and like it.

As I've said, we did a ton of research and even talked to people on the plan. And no, they weren't all healthy.
SHINE said the UHC plan is very good, plus it's one of the highest rated advantage plans by Medicare.

Btw, my plan does not need pre-approvals for specialists.

Having choices is a good thing. There's no one size fits all.
But I guess you think the over 50% that choose advantage plans are not smart and only care about cost? Sure, some only look at cost, but I would argue many of them are like us, they did their research and made an educated decision.

[MX rider]

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. .

Yes UHC is for profit. So are most hospitals, clinics and every doctor I've ever known.

Just because it's for profit doesn't make it a bad choice. Medicare is not a one size fits all.

[tophcfa]

Originally Posted by BrianL99

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.

Ya, Medicare, Medigap, and Pard D prescription is going to cost my wife and I about $800 per month for great national coverage with about a $250 max out of pocket each per year. We now pay over twice that for our Obamacare plan with a limited local network and about $8,000 max out of pocket each per year. That makes Medicare look dam good compared to our current options.

[golfing eagles]

Originally Posted by Rainger99

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

Please tell me that is a typo!

$1588/mo. sorry.

[golfing eagles]

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.

The Plan I signed up for is a PPO, not an HMO. Big difference

[OrangeBlossomBaby]

Originally Posted by tophcfa

Ya, Medicare, Medigap, and Pard D prescription is going to cost my wife and I about $800 per month for great national coverage with about a $250 max out of pocket each per year. We now pay over twice that for our Obamacare plan with a limited local network and about $8,000 max out of pocket each per year. That makes Medicare look dam good compared to our current options.

For us, once we're on Medicare, our premiums will be higher than they are now because of our subsidies on the ACA marketplace. On the other hand, if we didn't have subsidies, we'd have to pay around $1800/month for insurance. That'd eat up one of our social security checks every month, and dip into another one by a few bucks. We'd have to do without insurance at all and just hope that we never need health care.

We paid in all our lives for Medicare, did everything we were supposed to do, but circumstances forced us into a much more modest retirement income than we were expecting.

To whoever was asking about co-pays - it's insurance-dependent. You pay whatever your insurance company says you pay. Mine says $85 per treatment, per specialist visit, per lab test. So treating my skin cancer will set us back around $2800, over a 6-week period Including the test/biopsy, consultation for treatment, weekly 10-second visit with the doctor who walks in, doesn't even come within 5 feet of me, says "looks good, see you next week" and walks out again. INFURIATING that they even have the right to bill anyone for that.

[westernrider75]

Originally Posted by rustyp

Here is a big one -TVHS only accepts advantage plans once one is medicare eligible

But there are many doctors here not associated with that plan that accept original Medicare. I for one have had no problems finding doctors since moving here full time and I have original Medicare.

[westernrider75]

Originally Posted by BigDawgInLakeDenham

Why are you all so worried about specialists? Why aren't you worried about a solid primary Care doctor that can get to know you and manage your needs? Are you those people that don't have a doctor but want a specialist when you're really f'ed up? I'm really interested in how you come up with your way of thinking because I spent a career working with people coming into the hospital because they believed themselves to be healthy and would see a specialist if they ever needed, but because they didn't pursue primary care, like managed care or an advantage plan, they were too far gone for any "specialist" to save. The general public knows nothing about navigating the Healthcare system. I had an HMO for 40 years of work and have always had everything I've needed because you can get "specialists" and I get all of the same in my "mistake" of an Advantage Plan. You never admit that you can choose a PPO that gives you more doctors to choose from or do you not understand that concept. Please do tell us your health history and how it's negatively been impacted by Advantage Plans and how traditional Medicare has saved your lives. Never once was I told not to do CPR on someone because they had an advantage plan. Never once did I not do labs on an advantage plan patient. Healthcare Professionals don't see insurance in that moment you really need them. Actually I never heard anyone mention a patient's insurance. Other people's health and lives is nothing to tinker with and insurance choices are and should be personal. Everyone needs a Primary Care Physician to manage their care and to recommend appropriate treatment including a specialist, only if necessary. Seeing a specialist unnecessarily is abusing and burdening the health care system but entitled people don't see it that way. I'm done for now

My only experience with an advantage plan was when both my parents, at separate times, needed to be in a nursing home. Because they had an advantage plan our choices were extremely limited where they could go, there were only 2 choices and neither were great. But those were the only homes that would accept their advantage plan.

[bowlingal]

talk to the people at SHINE- Serving Health Insurance Needs of Elders. They are Medicare people, NOT insurance people. Also, for your Part D, look into Wellcare. I just changed and have no premium and no charge for medications ( tier 1).

[bragones]

Originally Posted by BrianL99

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.

Sounds like you need a way to bring your income down. If that's the case, think growth stocks that don't pay a dividend.

[dolphin]

Originally Posted by TVTVTV

I am not yet eligible for Medicare, but will be early next year. Currently, my BCBS (FL Blue) individual Silver PPO medical insurance only covers specialists within the BCBS in-network list, so I am quite limited in my choices, and don't have my preferred specialist in the network. If I choose BCBS or any other supplement with original Medicare, am I understanding that as long as the specialist accepts original Medicare (which most do), that there is no more "in-network" to consider with a BCBS supplement? This would definitely widen the specialists I could see. I am specifically asking about supplements here, not advantage plans.

Keep your plan if iu can afford. Excellent

[biker1]

Yep. With Medicare and a Supplemental Plan (say Plan G, Plan N would be a bit less), you will pay about $8000 per year for the two of you but typically nothing more (after the Part B deductible and there can be copays with Plan N). With an Advantage Plan, you will pay about $4000 per year for the two of you but it could be more depending on what services you need and the Advantage Plan. For me, being on Medicare saved me money. For you, it may cost you additional money. Funny how that works.

Originally Posted by OrangeBlossomBaby

For us, once we're on Medicare, our premiums will be higher than they are now because of our subsidies on the ACA marketplace. On the other hand, if we didn't have subsidies, we'd have to pay around $1800/month for insurance. That'd eat up one of our social security checks every month, and dip into another one by a few bucks. We'd have to do without insurance at all and just hope that we never need health care.

We paid in all our lives for Medicare, did everything we were supposed to do, but circumstances forced us into a much more modest retirement income than we were expecting.

To whoever was asking about co-pays - it's insurance-dependent. You pay whatever your insurance company says you pay. Mine says $85 per treatment, per specialist visit, per lab test. So treating my skin cancer will set us back around $2800, over a 6-week period Including the test/biopsy, consultation for treatment, weekly 10-second visit with the doctor who walks in, doesn't even come within 5 feet of me, says "looks good, see you next week" and walks out again. INFURIATING that they even have the right to bill anyone for that.

[Eclas]

I currently have medicare and federal bcbs as my supplement. So I have my own primary care doctor and if I know I need a specialist I can go thru my primary or just go direct to the specialist. The only restriction for me is the doc has to be in the bcbs network. I have not had any problems with that.

[Marine1974]

Originally Posted by BigDawgInLakeDenham

Why are you all so worried about specialists? Why aren't you worried about a solid primary Care doctor that can get to know you and manage your needs? Are you those people that don't have a doctor but want a specialist when you're really f'ed up? I'm really interested in how you come up with your way of thinking because I spent a career working with people coming into the hospital because they believed themselves to be healthy and would see a specialist if they ever needed, but because they didn't pursue primary care, like managed care or an advantage plan, they were too far gone for any "specialist" to save. The general public knows nothing about navigating the Healthcare system. I had an HMO for 40 years of work and have always had everything I've needed because you can get "specialists" and I get all of the same in my "mistake" of an Advantage Plan. You never admit that you can choose a PPO that gives you more doctors to choose from or do you not understand that concept. Please do tell us your health history and how it's negatively been impacted by Advantage Plans and how traditional Medicare has saved your lives. Never once was I told not to do CPR on someone because they had an advantage plan. Never once did I not do labs on an advantage plan patient. Healthcare Professionals don't see insurance in that moment you really need them. Actually I never heard anyone mention a patient's insurance. Other people's health and lives is nothing to tinker with and insurance choices are and should be personal. Everyone needs a Primary Care Physician to manage their care and to recommend appropriate treatment including a specialist, only if necessary. Seeing a specialist unnecessarily is abusing and burdening the health care system but entitled people don't see it that way. I'm done for now

I’ll keep it short , why would I go to a primary care doctor if I have sciatica? Your burdening the healthcare system if you go to a primary care doctor and refers you to a orthopedic doctor which because I’m on regular Medicare
I don’t need a referral. My time is valuable. And I pay for regular Medicare and a supplemental insurance, which gives me a choice and I’m covered unlike
Medicare advantage plans which burden the healthcare system and make you see two doctors to get a referral before seeing a specialist. .