Dr resorting to Name and Shame
 

Sux when you need it

Sux for a while after you have it done as well.

And yet people swear that the Medicare Advantage Plan is excellent. That because they haven't needed great care yet.

That is why I have UHC TV Advantage plan - have never had anything denied - and we have had A LOT done.

We’ve had a Florida Blue Advantage Plan for many tears. My wife has had stomach cancer surgery, a knee replacement and two hip replacements that were all easily approved, and with our PPO were able to get the facility and Dr’s she wanted. I’d consider that needed great care that was fulfilled.

You have to wonder how folks on an Advantage Plan, think it's great medical care, when the Insurance companies are offering so many incentives for folks to sign up. If it was any good, would they be offering all those "Freebies"?

I personally believe the plan is there to get the majority of seniors to fall for the advantage plan then state they are closing out original medicare and putting everyone on private insurance plans like advantage.

All those great coverages from advantage plan earlier years will be diminished or disappear and we will all be fighting the insurance companies for treatment or sub care. I personally believe it's in the works. Why else are they spamming us with those **** ads from August to December. Some providers are already refusing Advantage patients due to treatment restrictions.

To me, it kinda feels like someone offering to rake your lawn for nothing while you watch. In the interim, they have someone sneaking in the backdoor to rob you.

You never had anything denied, but how many things were never suggested or requested because the doc knew they would not be approved.

Did you have home care after all surgeries? Did you have PT after all injuries or surgeries? Were you given high quality, latest version of durable med equipment?

After knee replacement did you have to pay for the ice machine, the walker, the toilet riser?

These are things that some advantage plans deny.

You don’t know what you don’t know.

That’s my fear. If that happens, hopefully people already signed up for original Medicare, with a supplemental plan, will be grandfathered in for life?

Medicare Advantage vs Supplement
 

I like my Medicare Advantage plan.

Wifey will turn 65 in a few months and surprisingly got info in the mail from SS, including a roughly 12 page booklet describing what's what.
Jealous, I never got a booklet, I read it from cover to cover.
To my surprise, they were selling the reader on choosing a Medicare Advantage plan.

I wonder what all those 60,000 SS employees are gonna do when they no longer have to process payments ?
All work from home in their pajamas ?

when the for profit sector is involved, its all about profits, and sales for profit growth. When one profits from profit growth, its all about profits. When one gets fleeced for profits, its not so fun.

What good for profits is not good for customers/employees at times, what's good for customers/employees is not good for profits. . oldest cake and eating it too dilemma/enigma/conundrum

No, all those SS employees will be working for the private insurance industry squeezing every nickel your "wifey" needs for healthcare.

Makes me think of the old saying, "there are none so blind as those who will not see.."

I'm not sure what the long range goal is, but the cost to the government is about 6% more for Advantage Plans, over traditional Medicare ... all of which goes to the Insurance Companies. I guess that's an improvement, it was 17% more expensive, 15 years ago.

Advantage plans are not the same in different states
 

I have an advantage plan with BCBSNC and have had both knees done, back surgery, bunion surgery and currently scheduled for shoulder replacement. Nothing has ever been denied. Only $45 a month too! $20 Copay for specialist.

It’s an Aetna “thing.” I was still working and was covered by Aetna in 2020 and needed a hip replacement and was denied — bone on bone with 3 spurs. They demanded PT, which will do nothing for a non-regenerative situation. Took 2 attempts, but finally got approval. In 2021, same insurance coverage, my husband also needed a hip replacement. Again, denied by Aetna and demanded PT coverage. An appeal with a letter from a PT stating that therapy wouldn’t help the situation finally got the surgery. Our surgeon said that Aetna is one of the worst companies to get approval from. They will eventually approve.