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Heads up on Medicare Advantage plans #8983394 01/07/24 01:04 PM
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I posted several times during open enrollment about the downside to Medicare Advantage plans. The article below describes why there are many downsides to having this type of coverage. Medicare supplement plans are superior IMO. I sold health insurance for 43 years and now retired. IMO the best supplement plan is G. Keep in mind all the supplement plans have the same coverage by all insurance companies. Only difference is the premium - Aetna, Humana, United, and Blue Cross are solid companies IMO

https://finance.yahoo.com/news/older-americans-feel-trapped-medicare-094500659.html

Last edited by tlk; 01/07/24 02:27 PM.

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Re: Heads up on Medicare medical plans [Re: tlk] #8983400 01/07/24 01:22 PM
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Good read. I am just starting my second year on a Humana Medicare Advantage plan. My old Medigap insurer was raising premiums 10-15 percent per year and I finally had a belly full of that.

Re: Heads up on Medicare medical plans [Re: Nolanco] #8983418 01/07/24 02:29 PM
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This chart may help on the different supplement plans

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Re: Heads up on Medicare medical plans [Re: Nolanco] #8983440 01/07/24 03:22 PM
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Originally Posted by Nolanco
Good read. I am just starting my second year on a Humana Medicare Advantage plan. My old Medigap insurer was raising premiums 10-15 percent per year and I finally had a belly full of that.


Same here. Humana Advantage PPO. $0 premium. Thankfully, the wife and I are very healthy so don't use the system heavily. I have one generic prescription, she has two. This past year it covered all our prescription costs, dermatologist/dental/semiannual checkups, , etc. , with a a $25 copay. Has a low maximum out of pocket and great customer service. And a $50/quarter misc OTC account for pain relievers, toothpaste, skin lotions, etc. So far, so good....Much better than the insurance of my last employer.

Re: Heads up on Medicare medical plans [Re: tlk] #8983448 01/07/24 03:36 PM
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I would love to hear a testimonial from an older person who had been on the Advantage plan for several years and had lots of health issues, in and out of hospitals, and required seeing a specialist or 2.
My point is any insurance may seem to be the right decision based on price alone until you actually get sick and need it. Advantage plans are pushed really, really hard for a reason. Agents get way more commissions from those plans than a plan G, N or high deductible G. All those people on the Advantage plans will also have to go the medical underwriting if the ever want to get back on traditional Medicare someday. Good luck with that also.

Re: Heads up on Medicare medical plans [Re: TPACK] #8983459 01/07/24 03:50 PM
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Originally Posted by TPACK
I would love to hear a testimonial from an older person who had been on the Advantage plan for several years and had lots of health issues, in and out of hospitals, and required seeing a specialist or 2.
My point is any insurance may seem to be the right decision based on price alone until you actually get sick and need it. Advantage plans are pushed really, really hard for a reason. Agents get way more commissions from those plans than a plan G, N or high deductible G. All those people on the Advantage plans will also have to go the medical underwriting if the ever want to get back on traditional Medicare someday. Good luck with that also.



You are dead on. I tell people all of the time that Advantage plans are great until you get sick - in fact Congress has considered requiring insurance companies to change these types of plans


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Re: Heads up on Medicare medical plans [Re: tlk] #8983460 01/07/24 04:01 PM
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Originally Posted by tlk
Originally Posted by TPACK
I would love to hear a testimonial from an older person who had been on the Advantage plan for several years and had lots of health issues, in and out of hospitals, and required seeing a specialist or 2.
My point is any insurance may seem to be the right decision based on price alone until you actually get sick and need it. Advantage plans are pushed really, really hard for a reason. Agents get way more commissions from those plans than a plan G, N or high deductible G. All those people on the Advantage plans will also have to go the medical underwriting if the ever want to get back on traditional Medicare someday. Good luck with that also.



You are dead on. I tell people all of the time that Advantage plans are great until you get sick - in fact Congress has considered requiring insurance companies to change these types of plans


Re: Heads up on Medicare medical plans [Re: tlk] #8983463 01/07/24 04:05 PM
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Anybody have any experience with TRS United Healthcare plan, with health issues?



Re: Heads up on Medicare medical plans [Re: 68rustbucket] #8983471 01/07/24 04:19 PM
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Originally Posted by 68rustbucket
Anybody have any experience with TRS United Healthcare plan, with health issues?


I’m about to see. The wife fell the night of Dec. 28th and fractured her hip and had surgery on the 31st to secure it. We came home on the 2nd and had a nurse out from a Home Health agency to do the paperwork for PT. We were supposed to have some durable medical equipment but I haven’t heard anything on it yet.

Re: Heads up on Medicare medical plans [Re: tlk] #8983485 01/07/24 04:41 PM
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Medicare with BCBS of Texas supplement. I almost switched to an Advantage plan but I never have had any problems with my current plan. I see a bunch of doctors for all the OLD MAN stuff and the extra cost is worth it for me.


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Re: Heads up on Medicare medical plans [Re: tlk] #8983629 01/07/24 10:39 PM
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So if you have an Advantage Plan how come you can't get out of it and go back traditional Medicare?

Re: Heads up on Medicare medical plans [Re: angus1956] #8983640 01/07/24 11:08 PM
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Originally Posted by angus1956
So if you have an Advantage Plan how come you can't get out of it and go back traditional Medicare?


You can go back on traditional Medicare, but you will have to go though Medical Underwriting. There are no guarantees though. It will probably get harder the older you get also. I still thing that if money is the #1 reason to get the Advantage plan, you should look at the High Deductible Plan G. Very low monthly rates with a Yearly deductible. I almost took out this supplement plan, but opted for plan N instead. Talk to anyone in the medical field and they will probably tell you to RUN from an Advantage plan.

Medical underwriting refers to the process by which a life or health insurer uses an applicant's medical history to decide whether they can offer them a policy, and whether the policy will include pre-existing condition exclusions and/or a premium that's higher than the standard rate.


Re: Heads up on Medicare medical plans [Re: tlk] #8983650 01/07/24 11:39 PM
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I'll admit I have grown tired of $40 copays every time I see the Hendrick pain specialists in Abilene. I am "looking forward" to more spinal injections here shortly, and my copay there will probably be between $275 and $325. Still cheaper than the $140/month for Plan G. But ask me again after I have had the dreaded TURP after I can no longer stand it ... It really does suck getting old and falling apart. It's not just rumor.

Last edited by Nolanco; 01/07/24 11:39 PM.
Re: Heads up on Medicare medical plans [Re: Nolanco] #8983714 01/08/24 01:25 AM
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Originally Posted by Nolanco
I'll admit I have grown tired of $40 copays every time I see the Hendrick pain specialists in Abilene. I am "looking forward" to more spinal injections here shortly, and my copay there will probably be between $275 and $325. Still cheaper than the $140/month for Plan G. But ask me again after I have had the dreaded TURP after I can no longer stand it ... It really does suck getting old and falling apart. It's not just rumor.



With all due respect a $40 copay is not bad - the specialist are billing the insurance company for WAY more than $40 - seems to me like you have a pretty good deal


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Re: Heads up on Medicare medical plans [Re: tlk] #8983900 01/08/24 02:55 PM
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Yep and less money than the group plan thru my previous employer... The best deal was when we were self-insured thru my employer, but all that changed in 2008!


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Re: Heads up on Medicare medical plans [Re: angus1956] #8983907 01/08/24 03:05 PM
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Originally Posted by angus1956
So if you have an Advantage Plan how come you can't get out of it and go back traditional Medicare?

This is one of the disadvantages with Advantages.


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Re: Heads up on Medicare medical plans [Re: tlk] #8983939 01/08/24 03:48 PM
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I have been on Plan G from the start 5+ years ago. I picked Cigna at the time, but they were all close in cost.

While chasing some mystery symptoms, I have had two MRIs with/without contrast of my head, another of my lower spine, three echocardiograms, two CT angiograms, two renal artery dopplers and multiple other echos. Selection of primary care, cardiologist, pulmonologist, neurologist, ophthalmologist, neuro-ophthalmologist, ENT, dermatologist, and orthopedic specialist have all been my choice of doctors.

No hospital stays or inpatient surgeries so far. Cost for doctor visits, labs, and tests are covered with zero copay. Yes, the premiums have increased over time but my only out-of-pocket is limited to the annual medicare deductible of $ 240.00.

I am not a wealthy guy and I pinch pennies where I can, but I am very happy that I went the way I did.

Last edited by Marc K; 01/08/24 04:13 PM.

A Democracy is when two wolves and a lamb vote on the dinner menu. That is why this country was specifically not designed as a Democracy. We are a Constitutional Republic.
Re: Heads up on Medicare medical plans [Re: Marc K] #8983956 01/08/24 04:09 PM
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Originally Posted by Marc K
I have been on Plan G from the start 5+ years ago. I picked Cigna at the time, but they were all close.

While chasing some mystery symptoms, I have had two MRIs with/without contrast of my head, another of my lower spine, three echocardiograms, two CT angiograms, two renal artery dopplers and multiple other echos. Selection of primary care, cardiologist, neurologist, ophthalmologist, neuro-ophthalmologist, ENT, dermatologist, and orthopedic specialist have all been my choice of doctors.

No hospital stays or inpatient surgeries so far. Cost for doctor visits, labs, and tests are covered with zero copay. Yes, the premiums have increased over time but my only out-of-pocket is limited to the annual medicare deductible of $ 240.00.

I am not a wealthy guy and I pinch pennies where I can, but I am very happy that I went the way I did.

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Re: Heads up on Medicare medical plans [Re: Marc K] #8983976 01/08/24 04:38 PM
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Originally Posted by Marc K
I have been on Plan G from the start 5+ years ago. I picked Cigna at the time, but they were all close in cost.

While chasing some mystery symptoms, I have had two MRIs with/without contrast of my head, another of my lower spine, three echocardiograms, two CT angiograms, two renal artery dopplers and multiple other echos. Selection of primary care, cardiologist, pulmonologist, neurologist, ophthalmologist, neuro-ophthalmologist, ENT, dermatologist, and orthopedic specialist have all been my choice of doctors.

No hospital stays or inpatient surgeries so far. Cost for doctor visits, labs, and tests are covered with zero copay. Yes, the premiums have increased over time but my only out-of-pocket is limited to the annual medicare deductible of $ 240.00.

I am not a wealthy guy and I pinch pennies where I can, but I am very happy that I went the way I did.



Good for you. And folks need to remember that the Medicare Supplement premiums and deductibles are way less than when you bought it yourself prior to age 65. Even if your employer paid for your premiums you most likely came out of pocket for a spouse and kids. Most group employer plans have $5000 plus deductibles. So end of the day Medicare supplement plans are golden


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Re: Heads up on Medicare medical plans [Re: TPACK] #8983980 01/08/24 04:40 PM
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Originally Posted by TPACK
Originally Posted by Marc K
I have been on Plan G from the start 5+ years ago. I picked Cigna at the time, but they were all close.

While chasing some mystery symptoms, I have had two MRIs with/without contrast of my head, another of my lower spine, three echocardiograms, two CT angiograms, two renal artery dopplers and multiple other echos. Selection of primary care, cardiologist, neurologist, ophthalmologist, neuro-ophthalmologist, ENT, dermatologist, and orthopedic specialist have all been my choice of doctors.

No hospital stays or inpatient surgeries so far. Cost for doctor visits, labs, and tests are covered with zero copay. Yes, the premiums have increased over time but my only out-of-pocket is limited to the annual medicare deductible of $ 240.00.

I am not a wealthy guy and I pinch pennies where I can, but I am very happy that I went the way I did.

[Linked Image]


Pretty crazy to me too! I have spent a lifetime being very healthy until recent years, I have not even taken antibiotics in the last 20 years. I don't get colds and have never had the flu. Saw a doctor once every year or two for blood work and general a checkup and that's it for 60 years.

BUT, things changed rapidly in my late 60s! Still no diabetes, lipids look good, liver and kidney functions are solid, brain is clean, etc. But I have some world-class hypertension if unmedicated. Prior to taking five meds, doctors and nurses would panic when my BP was higher than they could read.

Marc


A Democracy is when two wolves and a lamb vote on the dinner menu. That is why this country was specifically not designed as a Democracy. We are a Constitutional Republic.
Re: Heads up on Medicare medical plans [Re: tlk] #8984004 01/08/24 05:15 PM
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Originally Posted by tlk
Originally Posted by Marc K
I have been on Plan G from the start 5+ years ago. I picked Cigna at the time, but they were all close in cost.

While chasing some mystery symptoms, I have had two MRIs with/without contrast of my head, another of my lower spine, three echocardiograms, two CT angiograms, two renal artery dopplers and multiple other echos. Selection of primary care, cardiologist, pulmonologist, neurologist, ophthalmologist, neuro-ophthalmologist, ENT, dermatologist, and orthopedic specialist have all been my choice of doctors.

No hospital stays or inpatient surgeries so far. Cost for doctor visits, labs, and tests are covered with zero copay. Yes, the premiums have increased over time but my only out-of-pocket is limited to the annual medicare deductible of $ 240.00.

I am not a wealthy guy and I pinch pennies where I can, but I am very happy that I went the way I did.



Good for you. And folks need to remember that the Medicare Supplement premiums and deductibles are way less than when you bought it yourself prior to age 65. Even if your employer paid for your premiums you most likely came out of pocket for a spouse and kids. Most group employer plans have $5000 plus deductibles. So end of the day Medicare supplement plans are golden


Believe me, I know! Being self-employed, we were paying $ 1,300. per month. Everyone told me that my wife and I were perfect candidates for an Advantage plan because money was tight and we never got sick. The risk-reward ratio of an Advantage plan just didn't pass the smell test and closer inspection made them look even more risky than I first realized

Just look at the money being spent on promoting these plans and the glittering language being used. There is a reason for this and it is not altruistic!





Last edited by Marc K; 01/08/24 05:20 PM.

A Democracy is when two wolves and a lamb vote on the dinner menu. That is why this country was specifically not designed as a Democracy. We are a Constitutional Republic.
Re: Heads up on Medicare medical plans [Re: Marc K] #8984249 01/09/24 12:40 AM
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Originally Posted by Marc K
Originally Posted by tlk
[quote=Marc K]I have been on Plan G from the start 5+ years ago. I picked Cigna at the time, but they were all close in cost.

While chasing some mystery symptoms, I have had two MRIs with/without contrast of my head, another of my lower spine, three echocardiograms, two CT angiograms, two renal artery dopplers and multiple other echos. Selection of primary care, cardiologist, pulmonologist, neurologist, ophthalmologist, neuro-ophthalmologist, ENT, dermatologist, and orthopedic specialist have all been my choice of doctors.

No hospital stays or inpatient surgeries so far. Cost for doctor visits, labs, and tests are covered with zero copay. Yes, the premiums have increased over time but my only out-of-pocket is limited to the annual medicare deductible of $ 240.00.

I am not a wealthy guy and I pinch pennies where I can, but I am very happy that I went the way I did.



Good for you. And folks need to remember that the Medicare Supplement premiums and deductibles are way less than when you bought it yourself prior to age 65. Even if your employer paid for your premiums you most likely came out of pocket for a spouse and kids. Most group employer plans have $5000 plus deductibles. So end of the day Medicare supplement plans are golden


Believe me, I know! Being self-employed, we were paying $ 1,300. per month. Everyone told me that my wife and I were perfect candidates for an Advantage plan because money was tight and we never got sick. The risk-reward ratio of an Advantage plan just didn't pass the smell test and closer inspection made them look even more risky than I first realized

Just look at the money being spent on promoting these plans and the glittering language being used. There is a reason for this and it is not altruistic!


yes Sir - you nailed it - they are promoting it on TV because they all make alot of money off of these plans - Congress needs to fix this - it is literally bordering on a scam from our government - very sad


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Re: Heads up on Medicare medical plans [Re: Marc K] #8984413 01/09/24 04:26 AM
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Originally Posted by Marc K
Just look at the money being spent on promoting these plans and the glittering language being used. There is a reason for this and it is not altruistic!



It's what drives all insurance companies. That is, the overall goal to maximize profits.

Last edited by Texas Dan; 01/09/24 04:38 AM.

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Re: Heads up on Medicare medical plans [Re: Texas Dan] #8984491 01/09/24 01:25 PM
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Originally Posted by Texas Dan
Originally Posted by Marc K
Just look at the money being spent on promoting these plans and the glittering language being used. There is a reason for this and it is not altruistic!



It's what drives all insurance companies. That is, the overall goal to maximize profits.


Yes, of course. Making money is the point of every company. I was pointing out the huge amount of money being spent on promotion, along with the language that is misleading at best.


A Democracy is when two wolves and a lamb vote on the dinner menu. That is why this country was specifically not designed as a Democracy. We are a Constitutional Republic.
Re: Heads up on Medicare medical plans [Re: Marc K] #8984524 01/09/24 02:25 PM
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Originally Posted by Marc K
Originally Posted by Texas Dan
Originally Posted by Marc K
Just look at the money being spent on promoting these plans and the glittering language being used. There is a reason for this and it is not altruistic!



It's what drives all insurance companies. That is, the overall goal to maximize profits.


Yes, of course. Making money is the point of every company. I was pointing out the huge amount of money being spent on promotion, along with the language that is misleading at best.


I was referring to why care gets squeezed after offering you all those services at a great price.


"Some people will never like you because your spirit irritates their demons."
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