Medicare Advantage Plans
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Find a trusted broker and use them. Everyone’s needs are different. This thread is closed for future replies. At least from me that is. Good night to all my forum members.
You just answer in circles. No you haven't read your policy. Have a nice evening dude.
Let me add this. I pay nothing for my Medicare advantage plan. I pay nothing for my 4 RX's when I get them from Costco. In May I had a partial knee replacement. The bills have all come in. They were billed $87k and I have to pay about $500 total. I can't complain at all.
Accident or illness in some Third World?
patient: "I have Medicare!"
Laughter throughout the Grass Hut. Even the Medicine man chuckled, and he is quite stoic.
They will demand cash PRIOR to procedure.
Or maybe if you are lucky, American Express travelers checques - the whole book of 'em
VAST majority of Advantage C plans have far greater coverage for out of the country emergency. Traditional Medicare has zero coverage, private medigap offers some and some Medigap policies are getting closer in payouts but not quite to Advantage C plans.Accident or illness in some Third World?
patient: "I have Medicare!"
Laughter throughout the Grass Hut. Even the Medicine man chuckled, and he is quite stoic.
They will demand cash PRIOR to procedure.
Or maybe if you are lucky, American Express travelers checques - the whole book of 'em
What plan do you have?
This is my Aetna Advantage C plan for out of the country. $250,000 with no co-pay.
My old UHC Advantage Plan may not even have a $ limit.
I posted the whole thing with Emergency care. In the USA it doesnt matter if the emergency care is in network or out of network. That goes for any of them. Once a doctor approves that you are stable at that point you can be moved to an in-network provider in the USA.
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That is why I wrapped my medicare plan with a medigap letter plan that had out of country medical coverage.
My medigap insurance costs me $1300 a year - which is much less than group plans when employed and I have zero co-insurance.
Again, you will likely have to pay medical hospital and treatment costs up front at the foreign facility and then try to recover costs later.
And you may max out your credit card and run out of available cash depending on costs of treatment.
Advice: Don't get sick or have an accident out of the country
Maybe some of our frequent travellers on BITOG have some good and bad anecdotes to share.
You will never have an issue with overseas payments in third world countries. IN fact once they know you are from the USA you will be in the best hospitals of that country. They know Americans can pay.That is why I wrapped my medicare plan with a medigap letter plan that had out of country medical coverage.
My medigap insurance costs me $1300 a year - which is much less than group plans when employed and I have zero co-insurance.
Again, you will likely have to pay medical hospital and treatment costs up front at the foreign facility and then try to recover costs later.
And you may max out your credit card and run out of available cash depending on costs of treatment.
Advice: Don't get sick or have an accident out of the country
Maybe some of our frequent travellers on BITOG have some good and bad anecdotes to share.
Furthermore irregardless of Medigap or Advantage C if unable to pay, your insurance company will work with them to get payment or guarantee payment.
I do agree the thought can be unsettling but just remember to most other counties Americans are gold compared to the local population, you will get treated. (and released *LOL*) Hopefully. Actually I know for fact, some countries you are taken to hospitals the locals dont often get taken too.
I did mention the Advantage C does cover more in most cases. For example my last United Health Care Advantage C covered up to one half million and I think this years plan has no limit (I just cant find one)
My Aetna Plan as posted above has $250,000 with NO deductible.
With the above said, if I was in United Health Care Medigap G plan I would only be covered for $50,000 dollars and would have to pay a 20% co-pay on that $50,000
Im NOT debating, just showing we pick what works best for us. IN this case IF and only IF you were concerned out of country. My Aetna Advantage C plan offers over $200,000 more in coverage than the Medigap G plan and there is no deductible,
Both Medigap and Advantage C plans are wonderful plans for people on Medicare. No right or wrong IF and ONLY IF you know what you are buying. Sadly many people IF ANYONE EXCEPT ME
, read the full over 200 pages of the evidence of coverage of these plans in order to know exactly what they are buying, sad but true. But then again, ain't that America. Good post BTW
I'm reading from my: Medicare & You 2024 The Official U.S. government Medicare handbook
In a Medicare Advantage (part C) section:
Some plans (part C) may have a $0 premium and may help pay all or part of your Part B premium.
So when I go on medicare, I want the Medicare Advantage (part C) that has a $0 premium and also pays 100% of the part B premium.
Anyone have that plan?
In a Medicare Advantage (part C) section:
Some plans (part C) may have a $0 premium and may help pay all or part of your Part B premium.
So when I go on medicare, I want the Medicare Advantage (part C) that has a $0 premium and also pays 100% of the part B premium.
Anyone have that plan?
Im in NC.
Remember the word "MAY" Chances are it wont, we are a HUGE country and that book covers the whole country but plans not only vary by state, they can cary by county/zip code that you are in.
I have never paid a premium on any Advantage C plan, except one from UHC (United Health Care) which was $29 a month and available to you, I didnt mind because they paid my $1,200 a year Orange Theory Gym cost, plus $200 contact lens plus at the time and $400 a year for over the counter health items and drug plan plus dentist. The $400 a year I think is down to $240 in NC.
My current Aetna Healthy Fit Advantage C plan which is also available to you is zero premium, zero primary doctor, $10 co-pay specialist, $300 for glasses or contact lens, $1,750 dentist, $180 for over the counter stuff which isnt great because you have to get it through CVS. You also get to spend $1,200 for any exercise type of equipment. For example they paid for my $100 Pickle Ball paddle and $375 for my Apple Watch 9. I need to spend another $700 on stuff. *LOL*
Both of the above plans have a $4000 to $5000 out of pocket limit which is hard to hit unless you start getting well over $100,000 a year in bills.
I would encourage you to check the websites of United Health Care, Aetna and Humana and put Advantage C in the search with each company name.
ALSO the government website is fantastic to find out all the companies in your zip code, from there you can go to the individual sites, you can spend months on this. I personally love it and in two states so far I never had a health network or doctor who did not accept it.
http://medicare.gov
Remember once you are in Advantage C plans you are most likely in them for life, it may not be easy to switch back to regular Medicare with Medigap part g or n plus part D except if you are in your first year of medicare you are allowed to switch back within ONE YEAR> so be cautious if it is something you are not sure of.
You can speak to a few specialists who sign people up. I guess they get a small fee from the company itself for doing so. But I suspect you do not want to pay $170 a month plus another $200 or more a month for Medigap, so if your sure that you want Advantage C, you can switch Advantage C plans every year both with eh same company and with other companies, no questions asked. It's all automatic. You just log into your medicare account, chose another Advantage C plan from your area, one click and your done, Medicare makes the change, you do nothing else. You can do this every year at the end of the year and once you are in the system for one year, you can do it at the end of the year or first 3 months of the new year.
Verify anything I say or anyone else says. medicare.gov is a fantastic source. One great thing that works in government.
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We are talking U.S travel- sorry if that wasn't clear. I'm going on a 70 day cruise- travel insurance NOT CHEAP for such a trip!Accident or illness in some Third World?
patient: "I have Medicare!"
Laughter throughout the Grass Hut. Even the Medicine man chuckled, and he is quite stoic.
They will demand cash PRIOR to procedure.
Or maybe if you are lucky, American Express travelers checques - the whole book of 'em
@Pablo (from what I remember I think you play)
Just ordered another pickleball paddle from Amazon that my Aetna Advantage C plan will pick up the cost for.
I currently have a Vatic Pro Prism Flash which I love and Aetna paid for. Im not all that great player, will only be a year in Sept. But I do think both my wife and I have really stepped up our game.
I have been curious about the Vatic Pro Flash and I have money left to burn out of my $1,200 that is allowed for exercise equipment. So far they paid for the Prism flash, a new Apple Watch 9 and I just ordered a Vatic Pro Flash (there is no "prism" in this model) to see how it plays, from what I understand its a little bit more of a power paddle but not to much more. I REALLY need to see what it's about. Not looking for a power paddle but maybe like this if just a little more, construction is different from the "PRISM FLASH"
So once it arrives, assuming I will keep it, I submit a reimbursement form for $149 which is the cost with tax. I cant swear or remember if they pay the sales tax or not. Typically the reimbursement check comes in about 4 to 5 weeks after submitted.
Hopefully with the $500 or so left to spend I will get back to Orange Theory and work out the remainder of the year. It's a bit of a trip from our new home but I miss the workouts.
Just ordered another pickleball paddle from Amazon that my Aetna Advantage C plan will pick up the cost for.
I currently have a Vatic Pro Prism Flash which I love and Aetna paid for. Im not all that great player, will only be a year in Sept. But I do think both my wife and I have really stepped up our game.
I have been curious about the Vatic Pro Flash and I have money left to burn out of my $1,200 that is allowed for exercise equipment. So far they paid for the Prism flash, a new Apple Watch 9 and I just ordered a Vatic Pro Flash (there is no "prism" in this model) to see how it plays, from what I understand its a little bit more of a power paddle but not to much more. I REALLY need to see what it's about. Not looking for a power paddle but maybe like this if just a little more, construction is different from the "PRISM FLASH"
So once it arrives, assuming I will keep it, I submit a reimbursement form for $149 which is the cost with tax. I cant swear or remember if they pay the sales tax or not. Typically the reimbursement check comes in about 4 to 5 weeks after submitted.
Hopefully with the $500 or so left to spend I will get back to Orange Theory and work out the remainder of the year. It's a bit of a trip from our new home but I miss the workouts.
The vast majority of out of the country situations will not bill a U.S. plan (regardless what plan it is--government or Advantage). You will need to pay cash and seek reimbursement. And in case of hospitalization-it will need to be paid before you leave.
Travel Insurance is a good idea. Care aboard a cruise ship is extremely expensive-and cost of drugs onboard go well beyond what is customary and reasonable. Travel Insurance will pay those.
Try to get your care billed to an insurance provider in the U.S. by any country in South America and see what happens.
I wouldn’t expect anything different as far as getting care outside the USA when you mention try getting it billed when outside the country. Though as posted some plans will help you make arrangements.
The key is you have substantial insurance at no additional cost built into your health insurance and will get reimbursed.
I wouldn’t be buying travel insurance because it’s included in my plan of 250k and no co-pay and can go as high as 500k to unlimited depending on Advantage C plan one carries. If you have a Medigap G or N plan with high co-pay it might be worth having a secondary plan to back it up. Seems cheap enough but should be because they carry exclusions where your regular plan does not.
Travel insurance might be good idea more so if no other choice or as a secondary to the Advantage C or Medigap N or G at least travel insurance provides coverage but it carries stipulations/exclusions on how you get hurt and/or if your intoxicated, possible pre-existing conditions and dangerous activities such as seemingly innocent parasailing as an example. It would be important to read the fine print.
The Medicare plans with travel insurance don’t have these stipulations.
It’s important for all to know traditional
Medicare does not provide coverage outside the USA. So I will agree travel insurance is MUCH better than nothing but not better than what I have and is included in my plan. Medicare Advantage C plan and also for some Medigap plans such as G and N.
Key is for all this stuff know what you have or know what you are buying.
This is what I quickly read and an option for those with no or limited out of the country coverage. I and many others don’t need it.
https://www.forbes.com/advisor/travel-insurance/travel-medical-insurance/
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I wish this discussion had occurred here 20 years ago and you were posting the same stuff. I would be $150,000+ wealthier today. The deniers who were like I was, may figure it out some day.
Only a fool would consider Joe Namath and Jimmy JJ Walker to be trusted authorities on medical insurance. It must be lucrative. Otherwise, I wouldn't be getting three call a day from so called "Advantage" plan sellers.
I appreciate your comment. It should be apparent to those who care to read my posts that I am not promoting anything other than not rolling over and letting mis-information and false arm chair comments disparage a good health insurance option for those who care to look into it.
So thank you!
What is it with people always telling other people what to do? Most always based on hearsay and lack of knowledge of a product.
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Medicare Advantage is basically for those with a clean bill of health who can milk the benefits like the OTC or dental care while avoiding the doctors.
The Dual programs are basically a "free healthcare" experiment.
You WILL be discriminated against if you have it and actually want to use it.
And if you pick UHC, you better be in tip top health because they're in it solely for profit. Meaning they'll deny on your end and deny on the provider side. Maximum paperwork=no one takes them or if they do, you are the lowest priority.
The Dual programs are basically a "free healthcare" experiment.
You WILL be discriminated against if you have it and actually want to use it.
And if you pick UHC, you better be in tip top health because they're in it solely for profit. Meaning they'll deny on your end and deny on the provider side. Maximum paperwork=no one takes them or if they do, you are the lowest priority.
