Medicare advice
 

I just started Medicare on October 1 - and I am baffled by the number of plans and options available. And every time I turn on television, I am inundated with commercials for Medicare plans. I would be interested in any advice on which plans to sign up for and perhaps more importantly - which plans to stay away from. I currently have United Healthcare The Villages Advantage (HMO). The enrollment period ends on December 7 so I have time to change plans. I am also surprised at how expensive "free healthcare" is. I am paying more for healthcare now that I was when I was working.

Try calling Blue Cross I’d stay away from The Village Insurance through UHC. I have UHC through AARP not an HMO currently on plan F which is no longer available for new subscribers it’s provided through my retiree health plan.

Contact an organization called SHINE. They provide free, unbiased information.

OP, contact SHINE, SHINE - Home, or (1-800-963-5337), for UNBIASED health care information. There are typically local meetings that you can talk to the reps directly. These people do NOT sell any insurance they will work with you to understand the various options.
Medicare and supplemental is the gold standard (IMHO), the part C ads for Medicare ADVANTAGE plans are NOT insurance plans these are managed care plans, you need to understand the difference. There can be significant limitations with these plans. SHINE will provide a lot of this info.

Reason you are paying more than when you were working is you employer was paying part of the cost. What you were paying was only part of the cost. It is not,"free healthcare," Medicare and Medicaid are paid by what you and the rest of us paid into Social Security. We went on cobra for I think it was 18 months and then had a choice self insure or 24,000 a year, for private health care insurance. My wife forced me to take private health care insurance-FORTUNATELY.
They settle bills for far less than you would pay. I spent 5 days at the Villages Hospital and the bill was 50,000 the insurance paid roughly 25,000 and covered the bill IN FULL.
You are forced to have insurance. If, you choose to self insure you will pay almost twice as much should you need any care.

Health care is expensive because the patient has little or no requirement to pay any of the cost of treatment. The only way to reduce the cost is to require patients to participate in the cost of treatment.

I highly recommend Glenn Ripoll: glenn@hcsinsured.com. I came across him by accident when I first started Medicare and he stepped me thru everything. He can set you up with any insurance company so what he does is look at your needs (medical, drugs, etc.) and then makes recommendations. He also lives in Florida and knows the area well.

I totally agree. When it is paid for by insurance or medicare/medicare. If, you ask if there is a less expensive option, the doctor will look at you like you are nuts. Years ago when I was on company paid health insurance, I had a doctor directly say to me,"What do you care, your insurance will pay for it." No matter what is done, medical care is a mess. Insurance company or medicare/medicaid the one paying the bill decides what care you will get.

United health TV has been excellent. No issues getting bills paid including ER visit

You can call any of the postcards. Have your local doctors names and all prescriptions. Then decide after talking with them and discovering if your doctors are on there list, is covered in network. Some will provide additional features like I care hearing and then Dental

While asking questions on social media sometimes is helpful----with yours, this time you'll only get MORE confused due to everyone's answer being different. As one other said, contact SHINE or an independent insurance agent whose not selling one kind. In that way you'll get unbiased information and they can walk you through what seems like a maize right now. I HATE the ads on t.v. as well as in the paper!!! They're all trying to sell! It gets tiresome---especially for those of us who already are set. Good luck in finding which is best for you. Once the selection is made you won't be so confused.

go to see a SHINE representative. SHINE stands for Serving Health Insurance Needs of the Elderly. They meet on different days in rec centers...Lake Miona, Eisenhower, Chula Vista, Lady Lake Library. A must go to for newbies. Medicare Advantage plans are good for healthy individuals, BUT if you get sick or hurt you will paying thru the nose. The ads sound so good, but health insurance is not free and you have to pay for it somehow. Get traditional medicare with United healthcare as a supplement and you won't have any expense except monthly premium which will end up being cheaper in the long run...no deductibles, no co-pays, no referrals and good though out the US. Medicare Advantage is not accepted everywhere.

You can call United Medicare Advisors @ 855-390-9791 and agents there are willing to advise you (not sell) what is available to you in your area. Was the easiest and best call I ever made. You are the one to make the decision. They can tell you price per month and even sign you up right then.

Welcome to the government and how everything they get their fingers into!

Be sure to understand the difference between "regular" medicare with a self pay supplement VS the myriad "advantage" plans.

In my opinion there is not enough information about "regular" medicare.

I have used a medicare broker. Brokers are free to you. You tell the broker your criterion, names of all your drs, health facilities & hospitals You want covered and are presented with plans to select from. It is so much less laborious. Two of my requirements are 1) no referrals required 2) must have free gym membership. Yours will be different.

Medicare will help you select a supplemental plan , call them . All the plans are published on a web site you can review .
Medicare charges me $148 a month . Supplemental from UHC plan G has a $208 yearly deductible for $138 a month . Medicare is going up to $170 a month next year . For $308 a month you have peace of mind your not going to go broke paying for healthcare costs . This does not include dental . Will pay
eye care if you have the beginning of cataracts . Why did you wait to start investigating health insurance?

My late mom was a Villages resident who got talked into switching from a "Medigap" (supplemental) plan to the Villages Medicare Advantage (aka "MA") plan. One of her doctors told her that was the only insurance they would take.

It was quite costly in the end. This plan would only cover in-patient hospital stays after the 3rd day. She had several in-patient hospital stays the year she had this MA plan. We had to essentially beg the Villages hospital to absorb her bills, as they were thousands of dollars.

There were rules about getting OUT of MA plans if you've been in one longer than a year. She couldn't switch back to a traditional medicare supplemental plan without going through a health exam - and if they even accepted her as a customer, her monthly supplemental premium would have been exorbitant. In other words, she no longer had "guaranteed acceptance" (no health exam) for supplemental coverage. The only way she was able to keep guaranteed acceptance and switch out of MA was to move out of the Villages to Crystal River - outside the Villages MA plan's coverage area.

So, good move trying to get off of MA, and you shouldn't have any problem switching since you just started on MA in October.

I would recommend you look at / investigate Medicare Supplemental Plan "G". Plan "F" is no longer available to new patients, but Plan "G" is, and covers everything Plan F did.

Good luck.

Another vote for SHINE! They meet at the local rec ctrs on a first come, first served basis. They won’t steer you to one insurance or the other, but will give you all the info you need to make a decision. Really helped us when we were in your position.

Get it in writing, these agents are SALESMEN, their salaries, (commissions) are paid for by UHC.

It's easier to understand Medicare if you know that there are two basic systems: 1) Original or Traditional Medicare, and 2) Medicare Advantage.

1) Original or Traditional Medicare plans are also called Supplemental or Medigap plans. In this scheme Medicare pays the doctor or provider 80% of what Medicare decides is a reasonable cost for the service you receive (not what the doctor bills). Medigap plans then pay the provider the remaining 20% of that "reasonable" cost. You can use any provider that accepts Medicare patients. This system is administered by the government.

2) Medicare Advantage plans are run by insurance companies. The gov't hands over the Medicare premium that you must pay to the insurance company and the company decides on the benefits they will offer their subscribers. The company contracts with certain providers that agree to offer services at an agreed-upon rate. You must use a provider that has a contract with that insurance company.

There are different levels of benefits offered within Original (prescribed by law) or Advantage (promoted) programs, but all plans are one of two basic types. The advertisements in the mail and on TV are all Advantage plans.

Personally I prefer straight Medicare with a supplemental insurance! You can go “anywhere and to any Doctor or hospital of your choice and you will be covered 100%. If you prefer an Advantage plan make sure it is a PPO NOT an HMO (you will have limited choices of Drs, Hospitals etc.) Aetna, UHC and Blue Cross would be the better choices but PPO. Check the plan you pick to see if all your doctors etc are on the plan you want to pick! Good Luck

Just do what Martha says
 

she knows what she's talking about :1rotfl:

Health care is expensive because 1. the high costs added by private insurance companies; 2. the ridiculously high fees charged by hospitals and doctors in the USA, and 3. you don't have public health care (unlike every other developed country)

The plan you select should match up with your current and near future medical condition. Since plans are selectable every year you can continue to match your plan to your medical needs. If you're very healthy your plan selection can be a lower cost limited benefit plan like an Advantage HMO. If you have serious health issues than opt for a more comprehensive plan. Bear in mind that all of the supplement plans ex. A,B,C,E,F,G,etc are all the same but can be priced differently by various insurance companies. Don't buy on price, buy the plan features.

Medicare Advice
 

It is critical to understand that the timeframe of the first 6 months you go onto Medicare is a guaranteed issue. This means that you cannot be denied coverage or charged more regardless of your health status or any pre-existing conditions. Therefore, it is very important to know whether you want traditional Medicare or an Advantage Plan. After the guaranteed issue period, it can be quite difficult for some to secure a supplemental plan, should you wish to switch back to traditional Medicare.

Just get traditional Medicare with plan G supplement from AARP. I’m going out State to see a specialist, no referral needed, and I can choose any Doctor that takes Medicare which most of them do. If you have an Advantage Plan the insurance company will manage your care not you. If you try and change to traditional Medicare later on you will pay more, and they will pre existing condition you, because you are out of your enrollment period.

FWIW: I assumed that if you had an Advantage plan the govt. gave the ins. co. your ~$150 monthly premium and I couldn't imagine how the ins. co. could make money on the deal. But I read the other day that the govt. actually gives them $750 to $1500 per month, depending on where you live.

kathy

Another way they make money is by denying fraudulent claims that would be routinely approved by original Medicare. Original Medicare claims are sent directly to the Government, many of which are fraudulent, but the Government just pays them. They don't care if they waste taxpayer money. But, Medicare Advantage claims are sent to the private insurance company who has a profit motive, and they will do what they can to ensure the claims are valid, and to create other efficiencies into their system to save money. That is why some medical providers are removed from their networks.

Another strong vote for SHINE!!!

The last time I saw it in the paper was Nov 30th at 9 AM, Lake Miona RC.

Dec 1st at Eisenhower RC. Call 800.963.5337.

They are extremely knowledgeable of all plans and don't have an ax to grind in whatever you select. They have been very helpful to me in the past.

I would go immediately because the deadline is December 7th and only you know what health concerns you have and what plan best suits your needs.

Good luck!

Medicare
 

In a nut shell, If you are always in great health, the Medicare Advantage plans look so attractive, and you get all kinds of stuff for free and added to your SS check etc.

But if you are sickly or don't want to be going through buyers remorse when something is not covered or you didn't get approval, We went for standard Medicare and BC/BS supplement with a D Prescription plan with Wellcare for $12 a months for the stuff we take, and it's like 15 prescriptions.

The ads are misleading and make it sound like a no-brainer. Use the references on this post to get advice. You never know when you will be real sick.

I also have United Health Advantage , no health issues at age 80 , needed pace maker , no charge normal doctor visits no charge, bloodwork no charge, My plan is perfect so far for me ,no premium , no charge for meds.

I am very happy for you, our several month adventure with an Advantage plan was the opposite, had to change doctors (all specialists), all new doctors had 2 month or more wait just for the initial visit and another month or 2 for the actual visit with the doctor, and NO coverage in the state of Colorado where the relatives live. We went back to Medicare and a supplemental plan.

Get help from a FREE independent medicare brokerage firm…boomer benefits
 

Several people I know have used the medicare consultants/agency “boomerbenefits.com” to help them select the best Medicare plan(s) for themselves. The company has outstanding reviews across financial and business sites.

Most of the referrals you have received are for individual plan providers or salespeople who represent one or two plans. If memory serves me, Shine educates on Medicare, but doesn’t help you shop for or compare the details of specific supplements and plans.

And if ever the devil were in the details, it is so true in medicare plan selection. Your good health and very life, along with your finances; depend heavily on making a good decision for your own specific circumstances.

The boomers site shops every A-rated plan available in your area, at the budget you have chosen, and with the medical criteria you provide.

They do this across entire country. It would take you several 40 hour work weeks to fully understand the intricacies of each supplemental plans basics, much less read the fine print of each and every plan (and all the choices within said plans) you have at your disposal.

My husband enters the medicare fray this year and we are absolutely going to let boomerbenefits do the research and pricing legwork for us, so we can focus on actually selecting the best plan for him. Just reading and reviewing the options they offer that meet our needs could be a weeks work!

Their website has excellent educational text and videos as well.

Good luck!

boomerbenefits.com

Please don't seek advise here for such an important decision. Seek out a professional insurance advisor to learn all the facts before you make up your mind. Rick

Read this short book
 

There is a significant amount of bad information about Medicare and the absolute worst places to get information is from the people selling Medicare plans.
The following easy reading short book will provide you all the essential information about Medicare:
MEDICARE Made Crystal Clear: Avoid the Many Pitfalls, Navigate the Landmines
If you will not be starting Medicare until October, I'd wait until February or March to get the book so the 2022 Medicare updates will be in the book. A couple of key notes:
If you go with original Medicare, then you'll likely want a Part B supplemental plan. Are you aware that ALL supplemental plans with the same letter are IDENTICAL! There is no difference from a part B supplemental plan G from Blue Cross, United Health Care or anyone else.

The answer is different for everyone. I love to travel. I also don’t like to pay out of pocket for anything. As a result, the advantage plans, and any that involve being in one place all the time to use their doctors, doesn’t work for me.

I ended up with Medicare that covers me no matter where I am at around $150/mo plus BCBS, $175/mo & Humana (drugs only) $15/mo.

I haven’t paid a penny for anything in 7 years, just the premiums.

Thanks to everyone for their advice and suggestions. It was really useful. I went to the SHINE meeting today and learned a lot - they are very knowledgeable and very helpful! But it is still complicated!!

i agree. i see lots of scare stories re: this plan, but so far has covered everything i needed. my spinal fusion done by an excellent neurosurgeon (Kaplan) @Orlando Health was covered, but for a $150 co-pay. that's it! no added Dr. bills or hosp. costs. i can go anywhere my docs advise me to go & it's covered. it's been 4yrs & haven't had an issue yet

let us know how you decide, if you'd be so kind.