[rsmurano]

All advantage plans are very bad. There is a reason why they throw everything under the sun in them to entice you.
You might be healthy now but tomorrow you might not be. If you have been on an advantage plan for over a year, all the supplement plans can refuse you.

Have you investigated any advantage plan? If you have, you would have never joined 1. All advantage plans can refuse medical service because the insurance company are the 1’s that approve medical service to you, not Medicare. Medicare does not refuse any medical service, if a dr thinks you need help, you always get it. Why are advantage plans been talked about in congress for years? Because of the 60% refusal rate of coverage by advantage plans.

Also, your supplement plan covers everything that Medicare covers, there is no right of refusal of medical service from the supplement company.

Also, have you been seeing in the news that more and more hospitals are not accepting advantage plans? Right now your local hospital might cover your advantage plans, but don’t count on it tomorrow. I have Humana prescription plan and the salesman last year tried to get me to get their advantage plan so I asked him a couple of questions: do you refuse medical service even if a dr prescribes it? He said yes they can. A year ago, I had a medical device installed in me and the 1 I picked was $20,000 more than the cheaper device, so I asked the salesman if they would allow me to get their advantage plan device I wanted and he told me they would have recommended the cheaper unit if it did the job. Remember, these are insurance companies that make money when they don’t have to pay out.

What I don’t get is hearing about people taking a cheaper advantage plan that has many deficiencies to save a couple hundred $$$ when getting a much better supplement plan g/n/?? When overall you are saving hundreds of dollars a month compared to what you were paying when you were working with possibly better coverage.

[bowlingal]

SHINE.....Serving Health Insurance Needs of Elders. These are Medicare people, NOT insurance people. The best option for information. They meet at Eisenhower Rec Center, Lake Miona Rec Center, Chula Vista Rec Center and Lady Lake library. All at different days/times. No appointment needed. SHINE - Home

[jojo]

My mother had one of the upper end Advantage plans which was ok until she started needing rehab or worse skilled nursing after a hospital visit. We were limited to 2 facilities and both were nightmares. i have neighbors and friends who have recently discovered that their Advantage plans greatly limit their choices in rehab and skilled nursing. The facilities prioritize supplement plans in making intake decisions.

[RoseyRed]

Originally Posted by Rainger99

As far as I can tell, the main objection to advantage is that you are limited to in-network doctors while Medicare allows you to see any doctor. But in reality, can you see the best doctor in the USA or the best doctor in Florida? You can probably see the best doctor in Sumter County. I don’t think a doctor can see more than 32 people a day and that is probably generous. So your doctor is limited even with Medicare.

However, you are probably saving a lot of money every year with advantage.

And does the doctor make a difference? I have seen very wealthy people that have the best medical care in the world die from cancer or other diseases. And I have seen middle class people go to a regular doctor make miraculous recoveries.

Does anyone have any facts on whether people live longer under Medicare as opposed to those who have advantage?

Good Point! May also want to consider quality of life vs longevity!

[HJBeck]

I always thought that if an office visit cost $100 and Medicare says the office visit is only worth $50, Medicare will pay 80% of the $50 or $40. Your supplemental plan only pays the balance of what Medicare didn’t pay on the $50 that Medicare said the office visit was worth or $10. The medical provider has to eat the unpaid portion of the original office visit cost.

Originally Posted by MplsPete

To help the OP, in simple English, underwriting means that supplement plans will want you to have a physical exam by a doctor.
If you are not very healthy, they will reject you.

Hmmmm didn't they make healthcare required to no pre-existing conditions?? A quick google search reveiled info on that. Seems "Medigap" and a handful of states have the pre-existing on Medigap and certain enrollment periods as well as open enrollment times.

Medigap purchasing details: enrollment periods, guaranteed issue, and more - Medicare Interactive

[retiredguy123]

Originally Posted by HJBeck

I always thought that if an office visit cost $100 and Medicare says the office visit is only worth $50, Medicare will pay 80% of the $50 or $40. Your supplemental plan only pays the balance of what Medicare didn’t pay on the $50 that Medicare said the office visit was worth or $10. The medical provider has to eat the unpaid portion of the original office visit cost.

You are correct.

However, one rare exception is if the provider has totally opted out of Medicare. In that case, the provider can charge whatever they want.

[biker1]

When you become eligible for Medicare, you have an opportunity to enroll in a supplemental plan with no underwriting. They have to accept you regardless of your health situation. If you want to switch later on from an Advantage plan to a supplemental plan then you might be subject to underwriting. You can initially try out an Advantage plan for a year and then switch to a supplemental plan without underwriting.

Originally Posted by GizmoWhiskers

Hmmmm didn't they make healthcare required to no pre-existing conditions??

[Rainger99]

Originally Posted by biker1

When you become eligible for Medicare, you have an opportunity to enroll in a supplemental plan with no underwriting. They have to accept you regardless of your health situation. If you want to switch later on from an Advantage plan to a supplemental plan then you might be subject to underwriting.

Does anyone have any figures on what percentage of people are rejected by underwriting?

[Bkosloski]

I am 79 and paying $173 for Medigap Plan N. My partner, with many medical issues, pays about $245 for plan G, no deductibles, copays, etc and can go anywhere they accept Medicare. Has been to Shands, inpatient rehab 3 times, etc. and hasn’t paid a dime. We pay $0 this year for our drug plan, but drug plans are changing for everyone next year.

Medigap is the way to go when you get older. My opinion.

[Bay Kid]

Why is the government so tricky on health coverage?

[beckylou152]

We researched this extensively, and decided upon traditional Medicare with a supplement. A great resource is The Medicare School. Medicare advantage can refuse to approve care, and Medicare cannot if you go to a provider that accepts it. Here is a good video to start. I know people are very happy with their advantage plans but I also know people who have their care choices limited or denied. My husbands Medicare part D is free and he has yet to pay for any meds. https://youtu.be/5OmK94JRerc?si=d_AATncnyQvKmFNB

[retiredguy123]

Originally Posted by beckylou152

We researched this extensively, and decided upon traditional Medicare with a supplement. A great resource is The Medicare School. Medicare advantage can refuse to approve care, and Medicare cannot if you go to a provider that accepts it. Here is a good video to start. I know people are very happy with their advantage plans but I also know people who have their care choices limited or denied. My husbands Medicare part D is free and he has yet to pay for any meds. https://youtu.be/5OmK94JRerc?si=d_AATncnyQvKmFNB

Not exactly. Medicare can refuse to cover some treatments or drugs.

[msilagy]

Underwriting at Mutual of Omaha supplement meant answering health related questions when I had that supplement. No medical exam. However keep in mind it all depends on what you want concerning your health care. I have traditional medicare and a supplement and last year I broke my leg with surgery and rehab, had a macular hole in my eye w/treatment at Mayo Clinic in Rochester Mn. I had breast cancer with surgery and radiation. All paid 100%. I never ever considered an advantage plan no matter if it cost initially less.

[kendi]

Originally Posted by Rainger99

I am currently on Medicare with a UHC Advantage policy. For the most part, I am satisfied with Advantage but I am interested in possibly switching to a regular Medicare and I am trying to figure out how much that would cost.

Right now, I pay my Medicare premium and there is no deductible. The maximum out of pocket payment is $2700 a year. This is for co-pays. Primary doctor is $0 a visit and specialist is $30 a visit. Dental and Vision are included at no extra cost. I am in network but the network is not limited to Sumter County. It is a nationwide network. I can go to hospitals in New York or Los Angeles or Chicago or Orlando or Tampa. They even have a hospital in Alaska!

Fortunately, I have been healthy and my out of pocket expense has been less than $250 a year.

For those of you with regular Medicare, can you give me a ballpark estimate of how much a Medicare supplement policy costs and how much dental and vision cost? Do you also have a separate drug policy?

And has anyone switched from regular to advantage or from advantage to regular? If so, why did you switch and are you happy with the change? Thanks.

We steer clear of advantage plans because we don’t want an insurance company making our healthcare choices for us.


If you switch from an advantage plan you will need medigap which is supplemental and plan D also which is the drug plan.

As far as what it will cost you it depends on what plans you pick. But you will likely pay more than what you are now.

Go to Medicare.gov and you can find all the plans along with details. One thing to watch out for are plans that increase in cost based on your age. USAA is the worst.

Happy hunting