[Dusty_Star]

Originally Posted by retiredguy123

I think you are referring to Medicare Part D, not Plan D. Part D is a separate drug insurance plan, not a supplement plan for Medicare Parts A and B. Medicare Part A is for hospitalization, Part B is for doctor visits, labs, surgery, etc., and Part D is for prescription drugs. You can buy a supplement plan to cover your coinsurance for Parts A and B, but I don't think you can buy a supplement plan for Part D.

Right, for regular Medicare you can buy a supplement also called Medigap policies, but you also buy a Plan D - drug plan. Plan D is the supplement for drug coverage, without which prescription drugs can be very expensive. Plan D type coverage for prescription drugs is often included in Advantage plans.

[biker1]

Part D, not Plan D, as previously posted.

Originally Posted by Dusty_Star

Right, for regular Medicare you can buy a supplement also called Medigap policies, but you also buy a Plan D - drug plan. Plan D is the supplement for drug coverage, without which prescription drugs can be very expensive. Plan D type coverage for prescription drugs is often included in Advantage plans.

[MplsPete]

Just a moment...

[golfing eagles]

Originally Posted by Marine1974

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. .

I'll keep the answer short: Because the primary care doctor can diagnose and treat your sciatica just as well as an orthopedist, up to the point where you are in the 10% that need surgery.

[golfing eagles]

Originally Posted by Pugchief

Yes, it is a big difference. Maybe I misunderstood; didn't you say you had a Medicare Advantage plan? And if so, aren't those essentially HMOs?

Hallmarks of HMOs are:
limited network of providers, zero benefits out-of-network, and "gate keeping" by PCP. Please correct me if any of this is untrue.

Some advantage plans are HMOs, some are PPOs.

[SusanStCatherine]

To answer your original question, I believe getting regular Medicare with a Medigap policy, you will have a much wider network than you currently have. Medicare is widely accepted. I currently have Florida Blue from the healthcare exchange and almost no decent providers accept it. I asked my providers if they accept Medicare and they all do. And some providers I am trying to get in to see say they take Medicare. Hope this helps.

[BrianL99]

Originally Posted by golfing eagles

I'll keep the answer short: Because the primary care doctor can diagnose and treat your sciatica just as well as an orthopedist, up to the point where you are in the 10% that need surgery.

I knew the day would come, when I'd agree with you.

Orthopedist seem to want to do nothing but operate. I had two guys tell me they wanted to operate on both my shoulders, for torn rotator cuffs. Gave me cortisone shots and told me to get ready for surgery.

One of my golfing buddies (a chiropractor, actually), said: Are you serious? At your age? After all that golf? It will be like trying to sew 2 pieces of wet toilet paper together. Go get 3rd opinion, bilateral rotary cuff failure doesn't happen over-night.

I know you won't approve of this part, but ... with the help of Google, my daughter & I diagnosed the real problem that my PCP had missed. PMR. Went to a Rheumatologist and 3 years later I'm cured (or dormant) and didn't lose a day of golf.

[BrianL99]

Originally Posted by biker1

Just in case you didn't realize, all of the Supplemental Plans are identical in terms of coverage. In other words, one insurance company's Plan G is identical to another insurance company's Plan G. The cost, however, will vary. In addition, some of the insurance companies may allow you change from one plan to another (say move from Plan G to Plan N) without going through underwriting. For example, UHC in Florida allows this.

As I understand them, you're correct in all the plans are comparable. That said, not all plans are available in all states. Some states limit the Medicare Supplemental Plans that can be sold in their state.

In Massachusetts, there are only three plan types available: Core, Supplement 1 and Supplement 1A. There are other states (I believe) with similar standards.

To take it a step further, there are some regional agreements of some sort in place, for adjoining states. I had MA Medicare Supplemental and when I moved to NH, I was allowed to keep my MA Part A&B, but not Part D.

[golfing eagles]

Originally Posted by BrianL99

I knew the day would come, when I'd agree with you.

Orthopedist seem to want to do nothing but operate. I had two guys tell me they wanted to operate on both my shoulders, for torn rotator cuffs. Gave me cortisone shots and told me to get ready for surgery.

One of my golfing buddies (a chiropractor, actually), said: Are you serious? At your age? After all that golf? It will be like trying to sew 2 pieces of wet toilet paper together. Go get 3rd opinion, bilateral rotary cuff failure doesn't happen over-night.

I know you won't approve of this part, but ... with the help of Google, my daughter & I diagnosed the real problem that my PCP had missed. PMR. Went to a Rheumatologist and 3 years later I'm cured (or dormant) and didn't lose a day of golf.

Your PCP missed a diagnosis of PMR? Ouch. Usually pretty obvious, and when your ESR comes back 130, it's even more obvious. Low dose/alt day steroids for you????

[SusanStCatherine]

Do an internet search and you will find that doctors and hospitals are currently dropping Advantage plans. All hospitals take Medicare - every single one. If you have been on your Advantage plan for awhile (I think it's a year) you need to be medically underwritten to get regular Medicare/Medigap unless your policy is in CT, ME, MA, or NY. If you have a Medicare/Medigap policy you can jump to an Advantage plan with no questions asked. You just won't be able to get back.

[BrianL99]

Originally Posted by golfing eagles

Your PCP missed a diagnosis of PMR? Ouch. Usually pretty obvious, and when your ESR comes back 130, it's even more obvious. Low dose/alt day steroids for you????

ESR over 130. 1 year of almost debilitating pain. Had PCP do CRP (after our Google research). CRP was 100+..

20 mg of Prednisone every day, taper when the CRP# and pain reduces. Up down, up down, up down for 3 years. Tapered all the way down to 2mg/day (3 times) ... then had to go back up again.

At least I didn't get balloon face and tolerated the Prednisone well. My CRP still runs around 15 or so, but I guess that's just me. "Treat the patient, not the numbers" my Rheumatologist says they taught her in school.

[golfing eagles]

Originally Posted by BrianL99

ESR over 130. 1 year of almost debilitating pain. Had PCP do CRP (after our Google research). CRP was 100+..

20 mg of Prednisone every day, taper when the CRP# and pain reduces. Up down, up down, up down for 3 years. Tapered all the way down to 2mg/day (3 times) ... then had to go back up again.

At least I didn't get balloon face and tolerated the Prednisone well. My CRP still runs around 15 or so, but I guess that's just me. "Treat the patient, not the numbers" my Rheumatologist says they taught her in school.

Sorry you've had such a rough time of it---clearly you're in the worst 10% of PMR I've seen. The good news is that low dose and alternate day steroids are generally well tolerated, even for a long time. You will continue to have dosage adjustments, it's not an exact science. Hope you continue to get well.

[Pugchief]

Originally Posted by SusanStCatherine

To answer your original question, I believe getting regular Medicare with a Medigap policy, you will have a much wider network than you currently have. Medicare is widely accepted. I currently have Florida Blue from the healthcare exchange and almost no decent providers accept it. I asked my providers if they accept Medicare and they all do. And some providers I am trying to get in to see say they take Medicare. Hope this helps.

Weird. I have Blue Cross PPO from UpNorth thru the exchange and there are copious choices of in-network doctors down here.

[BrianL99]

Originally Posted by golfing eagles

Sorry you've had such a rough time of it---clearly you're in the worst 10% of PMR I've seen. The good news is that low dose and alternate day steroids are generally well tolerated, even for a long time. You will continue to have dosage adjustments, it's not an exact science. Hope you continue to get well.

Knock on wood, but I haven't touched Prednisone for about a year now. CRP stays around 15, but I feel great for 71. Now if I could just get my handicap back to where it was.

[OrangeBlossomBaby]

Originally Posted by SusanStCatherine

To answer your original question, I believe getting regular Medicare with a Medigap policy, you will have a much wider network than you currently have. Medicare is widely accepted. I currently have Florida Blue from the healthcare exchange and almost no decent providers accept it. I asked my providers if they accept Medicare and they all do. And some providers I am trying to get in to see say they take Medicare. Hope this helps.

Maybe almost no decent providers accept -your- plan. But FloridaBlue PPO marketplace (Bronze, Silver, Gold) plans have a nationwide network and MOST providers accept MOST FloridaBlue PPO plans. The HMOs are extremely limited.

Using the FloridaBlue provider directory /without/ logging in with my user name, I had no problem finding a dermatologist in Connecticut that accepts FloridaBlue insurance. Why? Because FloridaBlue is just Florida's Blue Cross Blue Shield affiliate.

But as I said - an HMO will be limited only to an exclusive list of providers and specialists, even if it's a national insurance company like BCBS. If you have a PPO, you'll have no trouble finding a doctor, group, specialist, hospital, that accepts FB. However, because of shortages of physicians, they might not be accepting new patients. But if they accept new patients, chances are they'll accept your insurance.