[CFrance]

Originally Posted by mac9

The Advantage programs make some of their money because they are paid the last day of the quarter BEFORE and are able to keep that money and the interest accrued by it before they have to make any payments. Doesn't sound like it would be much to you or me, but it is garnering them millions. Also, not all Advantage programs are localized. Many of the larger insurance companies (Aetna, for instance) are nationwide as you can purchase an HMO version which is local, but they also have a PPO that is usually accepted by any Medicare certified physician throughout the country.

Yes, but the PPO part that you can buy is the supplemental, and it is the much higher price. My plan is Priority Health. The Advantage plan under Priority Health is specific to the Michigan area. The Priority Health Plan that I signed up for is actually a supplemental and is the PPO. It is a much higher price, and you have to buy your drug plan and dental plan separately, plus no silver sneakers, etc. But you can walk into any doctor anywhere who takes Medicare without a referral from a primary physician, and you won't be assessed a deductible like you would with a doctor out of your HMO in your advantage plan. Since we live in two different states and travel a lot, it's a price we choose to pay for peace of mind.

[wendyquat]

I think "healthy" is the key word! Keep in mind that at our age that can change overnight! I went from taking no meds at age 60 to 4 meds upon being diagnosed with type 2 diabetes! Maybe as a result of the diabetes (although I have always watched my diet and kept it under control) I have been diagnosed with a couple if other things that require doctor visits every few months. With everything under control I decided to look into a Medicare Advantage plan last year. I went to three different presentations and no one could answer my question, "if it doesn't work well for me and I need to change back to Medicare plus a supplement, will I be penalized for a pre-existing condition?" I can't afford to make that change not knowing if I would have to pay more if I needed to switch back. I finally asked one of my doctors about it and was told, "No, you don't want to do that!" I decided not to do it last year and am still undecided if it is for me. Keep in mind also that doctors can go off and on the provider list at will so you need to be flexible about changing doctors should this happen. I kind of like to stick with the same doctor. All this being said I think the Medicare Advantage plans work well for a relatively healthy person.

[Scott8147]

Best example I've heard is that supplemental programs are like buffets whereas Advantage plans are like a-la-carte. You pay one price for the buffet whether you eat a little or a lot, but you can have as much as you want (or need). The Advantage plans are cheaper if you don't go to the doctor or need other services much, but will cost you more if you "over order". Same as an a-la-carte restaurant. One other point: you can use Advantage plans out of your area, but then you are "out of network" and your co-pays and/or co-insurance will be more. It comes down to how much you are willing to insure yourself vs. paying the insurance company to take the risk. Tough call no matter which way you go. Do your research!

[Carla B]

A couple of years ago we decided to go from an employer-sponsored PPO plan to a supplemental plan. We dropped the employer plan due to the fact that we were out of network by living in FL. Anyway, in order to enroll in the Medigap we had to be able to answer certain health questions. It's my opinion (but I don't know for sure) that if someone wanted to switch from an Advantage plan back to Medigap they'd have to be able to answer those same health questions.

[CFrance]

Originally Posted by Carla B

A couple of years ago we decided to go from an employer-sponsored PPO plan to a supplemental plan. We dropped the employer plan due to the fact that we were out of network by living in FL. Anyway, in order to enroll in the Medigap we had to be able to answer certain health questions. It's my opinion (but I don't know for sure) that if someone wanted to switch from an Advantage plan back to Medigap they'd have to be able to answer those same health questions.

I believe you are correct about that. Our insurance broker told us that if we went with an advantage plan first upon turning 65, then tried to switch to a supplemental plan, the insurance companies could underwrite us, which means they could consider existing conditions and charge more than normal. This is supposed to end in 2014 under Obamacare, though, providing Obamacare is not repealed.

[Dr Winston O Boogie jr]

Originally Posted by Avista

We have had both original medicare with supplement and currently Medicare Advantage (Preferred Care Partners). We paid over $300/month for our supplement, plus our RX drugs another $80. Came close to $400/ month. Now we do not pay that plus get back $90.90 into,our Social Security. We save about $500/ month or $6000 per year. We like our doctors.

I just signed up for that plan and will be on it as of Jan 1, 2013. It sounds too good to be true, but I know a lot of people who are on it and they are very happy with it.

[Shirleevee]

Originally Posted by jblum315

Check with your doctor first Mine does not accept Medicare Advantage.

We had Preferred Care Partners.........my husband is keeping it for 2013 and I am NOT! I have health issues that require certain specialists. Not one of those specialists here in The Villages accepted PCP......I had to go way out of the Villages for care.......so Medicare and Medigap policy is my choice.

[Shirleevee]

Originally Posted by Scott8147

Best example I've heard is that supplemental programs are like buffets whereas Advantage plans are like a-la-carte. You pay one price for the buffet whether you eat a little or a lot, but you can have as much as you want (or need). The Advantage plans are cheaper if you don't go to the doctor or need other services much, but will cost you more if you "over order". Same as an a-la-carte restaurant. One other point: you can use Advantage plans out of your area, but then you are "out of network" and your co-pays and/or co-insurance will be more. It comes down to how much you are willing to insure yourself vs. paying the insurance company to take the risk. Tough call no matter which way you go. Do your research!

Correct......loved your analogy