[CoachKandSportsguy]

Why am i posting this? Because the govt funding of MA plans final amount came in lower than the MA plans had requested, so expect higher rates and / or lower service / benefit levels.

from Eileen Appelbaum
Co-Director Center for Economic and Policy Research - Center for Economic and Policy Research
Former Professor Rutgers University and Temple University.

If you didn’t know it already, I have been studying profits in health care for the past decade Here I tell you what I learned about pitfalls of signing up for Medicare Advantage. Deny, delay, degrade services - that’s one way insurance companies make money owning MA plans

New eye-opening video from EileenAppelbaum on the pitfalls of #MedicareAdvantage.

The Medicare Maze | Institute for New Economic Thinking

MA plan will work until it doesn't. Had friends where it stopped working after heart bypass surgery. Most stuff works until it doesn't. . its about where you are when it stops working.

cheap is not always better, especially when commercial profits are involved...

YMMV

[Caymus]

They may have to replace Joe Namath as a spokesperson to save money.

[Boomer]

Yeah. Be careful what you wish for.

When you hear that bloated promise to “Save Medicare” you should NOT be reassured because the goal of that particular promiser is to force everybody onto Advantage Plans. No choice! Please pay attention. Read between the lines.

Plan F Boomer

[tophcfa]

Originally Posted by Boomer

Yeah. Be careful what you wish for.

When you hear that bloated promise to “Save Medicare” you should NOT be reassured because the goal of that particular promiser is to force everybody onto Advantage Plans. No choice! Please pay attention. Read between the lines.

Plan F Boomer

Very true, you’re a wise Boomer.

[Boomer]

Originally Posted by tophcfa

Very true, you’re a wise Boomer.

Thanks, we are paying through the nose for Plan F, but we see it as the cost of sleep. It has worked seamlessly in two situations, so far. The ROI has mostly had to do with the lack of aggravation because we did not need to jump through any hoops with insurance companies. If Medicare pays, the supplement follows suit. Medicare paid and so did Plan F. We never got a bill.

I never say anything critical when friends talk about their low premiums for their Advantage Plans because it is their choice…….

And I know in some circumstances their decision to go with the much lower premium of an Advantage Plan is necessarily budgetary — and I would never say anything critical or intrusive about someone’s money situation. I understand those — and it would be excruciatingly tacky and obnoxious of me to wax on about paying higher premiums. I don’t behave like that.

Outside of budgetary constraints, there are others who do not need to go for the lowest premium — but are wired to pinch that buffalo, no matter what.

Plan F is no longer available anyway. I think Plan G is the next one with the most coverage.

If I am asked by those who are getting to Medicare age about what they should do, I tell them what we do and explain the trade-offs so they can make their own decisions.

Everything is relative when it comes to money decisions. We each do what we need to do — or think we need to do — for whatever reasons.

But we boomers and beyond need to be especially aware of what those we give the power can do — and will do — to our choices. We are in a time when we just might find ourselves needing to look past our philosophies when it comes to things that will not affect us personally and stay aware of what’s in the cards for Medicare when we hear those “promises” — that never elaborate on the fact that the intention is to privatize it all. If that happens, the rich will get richer and the sick will get sicker while spending time and energy fighting insurance companies that will then be holding allll the cards.

Aging people are expensive to the government, but even so, we should at least be left with the right to choose our own type of coverage and not be thrown totally into Advantage Plans that are HMOs that put CEOs and stockholders above patient care.

I will also say though that our plan F is becoming ridiculously expensive, but we are not on the later end of the Boom, so we are just going to hold our noses and pay up. Like I said, everything is relative.

Boomer


.

[retiredguy123]

Originally Posted by Boomer

Thanks, we are paying through the nose for Plan F, but we see it as the cost of sleep. It has worked seamlessly in two situations, so far. The ROI has mostly had to do with the lack of aggravation because we did not need to jump through any hoops with insurance companies. If Medicare pays, the supplement follows suit. Medicare paid and so did Plan F. We never got a bill.

I never say anything critical when friends talk about their low premiums for their Advantage Plans because it is their choice…….

And I know in some circumstances their decision to go with the much lower premium of an Advantage Plan is necessarily budgetary — and I would never say anything critical or intrusive about someone’s money situation. I understand those — and it would be excruciatingly tacky and obnoxious of me to wax on about paying higher premiums. I don’t behave like that.

Outside of budgetary constraints, there are others who do not need to go for the lowest premium — but are wired to pinch that buffalo, no matter what.

Plan F is no longer available anyway. I think Plan G is the next one with the most coverage.

If I am asked by those who are getting to Medicare age about what they should do, I tell them what we do and explain the trade-offs so they can make their own decisions.

Everything is relative when it comes to money decisions. We each do what we need to do — or think we need to do — for whatever reasons.

But we boomers and beyond need to be especially aware of what those we give the power can do — and will do — to our choices. We are in a time when we just might find ourselves needing to look past our philosophies when it comes to things that will not affect us personally and stay aware of what’s in the cards for Medicare when we hear those “promises” — that never elaborate on the fact that the intention is to privatize it all. If that happens, the rich will get richer and the sick will get sicker while spending time and energy fighting insurance companies that will then be holding allll the cards.

Aging people are expensive to the government, but even so, we should at least be left with the right to choose our own type of coverage and not be thrown totally into Advantage Plans that are HMOs that put CEOs and stockholders above patient care.

I will also say though that our plan F is becoming ridiculously expensive, but we are not on the later end of the Boom, so we are just going to hold our noses and pay up. Like I said, everything is relative.

Boomer


.

I don't know much about Plan F, but, when comparing health insurance plans, you should always compare the total annual premiums to the catastrophic limit of your coverage. For example, the only health insurance I have is my Federal employee's Blue Cross plan that has a catastrophic limit of $6,000 per year. So, my maximum out-of-pocket health care expense is $6,000, after which everything is covered at 100 percent. This covers all costs, including prescription drugs. I would be crazy to buy Medicare Part B because the annual premiums would be almost $6,000 alone. So, basically, I would be paying for nothing. I have tried to explain this to other Federal retirees, but some of them will still pay for the optional Medicare Part B and a supplement because they don't have copays, even though they are wasting thousands of dollars in premiums.

[tophcfa]

Originally Posted by Boomer

Thanks, we are paying through the nose for Plan F, but we see it as the cost of sleep. It has worked seamlessly in two situations, so far. The ROI has mostly had to do with the lack of aggravation because we did not need to jump through any hoops with insurance companies. If Medicare pays, the supplement follows suit. Medicare paid and so did Plan F. We never got a bill.

I never say anything critical when friends talk about their low premiums for their Advantage Plans because it is their choice…….

And I know in some circumstances their decision to go with the much lower premium of an Advantage Plan is necessarily budgetary — and I would never say anything critical or intrusive about someone’s money situation. I understand those — and it would be excruciatingly tacky and obnoxious of me to wax on about paying higher premiums. I don’t behave like that.

Outside of budgetary constraints, there are others who do not need to go for the lowest premium — but are wired to pinch that buffalo, no matter what.

Plan F is no longer available anyway. I think Plan G is the next one with the most coverage.

If I am asked by those who are getting to Medicare age about what they should do, I tell them what we do and explain the trade-offs so they can make their own decisions.

Everything is relative when it comes to money decisions. We each do what we need to do — or think we need to do — for whatever reasons.

But we boomers and beyond need to be especially aware of what those we give the power can do — and will do — to our choices. We are in a time when we just might find ourselves needing to look past our philosophies when it comes to things that will not affect us personally and stay aware of what’s in the cards for Medicare when we hear those “promises” — that never elaborate on the fact that the intention is to privatize it all. If that happens, the rich will get richer and the sick will get sicker while spending time and energy fighting insurance companies that will then be holding allll the cards.

Aging people are expensive to the government, but even so, we should at least be left with the right to choose our own type of coverage and not be thrown totally into Advantage Plans that are HMOs that put CEOs and stockholders above patient care.

I will also say though that our plan F is becoming ridiculously expensive, but we are not on the later end of the Boom, so we are just going to hold our noses and pay up. Like I said, everything is relative.

Boomer


.

Totally agree with everything you stated. Plan G for us is a no brainer based on our particular situation. Yes, it’s more expensive than Advantage plans (with the huge assumption being that the insured stays healthy and doesn’t need any expensive medical care). On the other hand, it’s way less expensive than the woefully inferior Obamacare plans available before turning 65, if not on the subsidy train, and the national no hassle coverage blows away the alternatives. We will be extremely upset, and vote accordingly, if the politicians eliminate the supplement option and shoehorn us into Advantage plans.

[Boomer]

Originally Posted by retiredguy123

I don't know much about Plan F, but, when comparing health insurance plans, you should always compare the total annual premiums to the catastrophic limit of your coverage. For example, the only health insurance I have is my Federal employee's Blue Cross plan that has a catastrophic limit of $6,000 per year. So, my maximum out-of-pocket health care expense is $6,000, after which everything is covered at 100 percent. This covers all costs, including prescription drugs. I would be crazy to buy Medicare Part B because the annual premiums would be almost $6,000 alone. So, basically, I would be paying for nothing. I have tried to explain this to other Federal retirees, but some of them will still pay for the optional Medicare Part B and a supplement because they don't have copays, even though they are wasting thousands of dollars in premiums.

Retired Feds and some retired from state employment and also retired union members definitely can fall into a different category. (I thought about addressing that, but I did not have time — so thank you. )

My mama done told me that in a marriage one of you needs to work for a big company and the other one for the government and you will be well covered in retirement. My mom was a smart woman.

Boomer

[gatorbill1]

UHC has most doctors available

[CoachKandSportsguy]

Originally Posted by gatorbill1

UHC has most doctors available

So is that why some hospitals have stopped taking UHC insurance plans at the rates they reimburse / want to reimburse?

Is that why you selected UHC even though they will decide whether they will pay or not?

[biker1]

You might want to look at switching to Plan G. If you have UHC Medicare Supplemental (aka AARP) then you can switch without going through underwriting if you are enrolled in FL. Other plans may require underwriting. The only difference is that Plan F includes the $240 Part B annual deductible but Plan G doesn't. However, you will probably find that the Plan G annual premium cost is more than $240 less than Plan F. Plan N is even lower cost than Plan G but may have up to $20 copays and possibly "excess charges" but those are rare. It has the same $240 Part B deductible as Plan G.

Originally Posted by Boomer

Thanks, we are paying through the nose for Plan F, but we see it as the cost of sleep. It has worked seamlessly in two situations, so far. The ROI has mostly had to do with the lack of aggravation because we did not need to jump through any hoops with insurance companies. If Medicare pays, the supplement follows suit. Medicare paid and so did Plan F. We never got a bill.

I never say anything critical when friends talk about their low premiums for their Advantage Plans because it is their choice…….

And I know in some circumstances their decision to go with the much lower premium of an Advantage Plan is necessarily budgetary — and I would never say anything critical or intrusive about someone’s money situation. I understand those — and it would be excruciatingly tacky and obnoxious of me to wax on about paying higher premiums. I don’t behave like that.

Outside of budgetary constraints, there are others who do not need to go for the lowest premium — but are wired to pinch that buffalo, no matter what.

Plan F is no longer available anyway. I think Plan G is the next one with the most coverage.

If I am asked by those who are getting to Medicare age about what they should do, I tell them what we do and explain the trade-offs so they can make their own decisions.

Everything is relative when it comes to money decisions. We each do what we need to do — or think we need to do — for whatever reasons.

But we boomers and beyond need to be especially aware of what those we give the power can do — and will do — to our choices. We are in a time when we just might find ourselves needing to look past our philosophies when it comes to things that will not affect us personally and stay aware of what’s in the cards for Medicare when we hear those “promises” — that never elaborate on the fact that the intention is to privatize it all. If that happens, the rich will get richer and the sick will get sicker while spending time and energy fighting insurance companies that will then be holding allll the cards.

Aging people are expensive to the government, but even so, we should at least be left with the right to choose our own type of coverage and not be thrown totally into Advantage Plans that are HMOs that put CEOs and stockholders above patient care.

I will also say though that our plan F is becoming ridiculously expensive, but we are not on the later end of the Boom, so we are just going to hold our noses and pay up. Like I said, everything is relative.

Boomer


.

[Boomer]

Originally Posted by tophcfa

Totally agree with everything you stated. Plan G for us is a no brainer based on our particular situation. Yes, it’s more expensive than Advantage plans (with the huge assumption being that the insured stays healthy and doesn’t need any expensive medical care). On the other hand, it’s way less expensive than the woefully inferior Obamacare plans available before turning 65, if not on the subsidy train, and the national no hassle coverage blows away the alternatives. We will be extremely upset, and vote accordingly, if the politicians eliminate the supplement option and shoehorn us into Advantage plans.

People are forgetting how it used to be. It was the ACA (AKA Obamacare) that got rid of those draconian clauses about pre-existing conditions that were like landmines in some individual policies.

I sure don’t want a government that can put us up for grabs by insurance companies, whether before or after Medicare.

We have got to pay attention to what’s between the lines in those “promises” to save Medicare. Who for? The insurance companies, their CEOs and stockholders? That is exactly what will happen if Medicare is totally privatized. Our choice of plans will be gone forever. Insurance companies will have what is basically a monopoly. If that happens, we should then buy stock in ice floes……

Boomer.

[CoachKandSportsguy]

Originally Posted by Boomer

We have got to pay attention to what’s between the lines in those “promises” to save Medicare. Who for? The insurance companies, their CEOs and stockholders? That is exactly what will happen if Medicare is totally privatized. Our choice of plans will be gone forever. Insurance companies will have what is basically a monopoly. If that happens, we should then buy stock in ice floes……
Boomer.

To add a bit of support to the monopoly piece:
One of UHC's subsidiaries was the target of the hack which caused system validations to go down. UHC then offered loans to physician offices who were financially impacted from their issue. So trying to profit off of inconveniencing other groups. .

UHC tries to negotiate their reimbursement rates lower than the government medicare rates with hospitals, happened at CoachKs hospital, and the hospital refused to accept those rates. The retirees who had UHC health plans lost their doctors at the hospital.

These are signs of monopolistic behaviors: negotiating power to put hospitals out of business with below profitable rates, self dealing ie loaning money to physician groups which they caused profitability issues, ie profits before patients, etc.

If you understand hospital financials, you will know that medicare reimbursements are break even to very low margins, if lucky, many times losses, and the profitability has to be made up with private healthcare reimbursements. The government CMS also reimburses additional monies for improvements in various programs for improving outcomes and equality in healthcare, which is in addition to just patient care.

And for those who choose MA plans, just remember that everything may go fine, as long as you are healthy, until it doesn't, when you are now unhealthy and need additional services. just be forewarned about this possibility.

[Michael 61]

I’m with Villages Health currently, and am very happy with them. However, once I turn I turn 65 in a few years, I’ll have to find all new doctors elsewhere, since I am not going to choose Medicare Advantage, which is sadly a requirement at Villages Health. I’m aware of some good medical facilities that take Medicare in Wesley Chapel as well as Gainesville, but would rather have my doctors closer to home. Are there good doctors and facilities as good as or better than Villages Health close by?

[retiredguy123]

Originally Posted by Michael 61

I’m with Villages Health currently, and am very happy with them. However, once I turn I turn 65 in a few years, I’ll have to find all new doctors elsewhere, since I am not going to choose Medicare Advantage, which is sadly a requirement at Villages Health. I’m aware of some good medical facilities that take Medicare in Wesley Chapel as well as Gainesville, but would rather have my doctors closer to home. Are there good doctors and facilities as good as or better than Villages Health close by?

Yes, there are many. But, you may not need to change doctors, except for your primary care provider. The Villages health only requires that you use their primary care providers. You still may be able to use the specialists who are in The Villages health system if they accept original Medicare. I think that one of the reasons that The Villages health requires certain Medicare advantage plans to see their primary care doctors is to limit access to their Villages owned facilities, so that Villagers can get convenient access to health care. If they accepted original Medicare, they would be required to treat anyone within the Villages surrounding areas who has original Medicare. That could defeat the purpose of having Villages owned facilities within The Villages.