Ugh, worst thing you can do is get medical advice from an OCD motor oil forum. If you think that you’re one step ahead of the game because your Medicare advantage pays for your gym membership wait until you’re on the wrong side of 80 and you’re chasing co pays and referrals, while looking for a Doctor that accepts your Medicare advantage plan. You won’t need to buy a treadmill..you’ll be on one.
Medicare Advantage Plans
- Thread starter Donald
- Start date
I work at a University, about 1.5 to 2 years out from retirement, with a key feature that my excellent university health insurance CONTINUES for my lifetime. Whatever Medicare does not cover, my university health insurance takes over and covers. New hires no longer get this golden parachute. My pay is less than real world counterparts, but my benefits somewhat make up that difference.Nothing to worry about, best system in the world. Now that I have Medicare for the first time in my life I dont have to worry about medical insurance. Much of my life I have been self employed or an independent contractor. Now, for the rest of my life (finally and hopefully a long one) I need not worry about a thing, zero, nothing, nada
You will always be covered and no one can cancel you and every accepted medial procedure will be covered for the rest of your life. I you think about it, you can count on it more than anything else in the world, including your own family.
I have not studied every post here. My point is that EVERYONE has to assess their unique situation (like yours bolded above) and pick the best plan for them. What you are preaching from the pulpit* here may not be the best choice for someone else.
* No way intended to insult. Thank you very much for bringing very detailed discussion here on this difficult topic.
I understand being denied but my problem was with the company I worked for health insurance before I went on Medicare. Everything is a formula.
Anyway I was very stressed that CIGNA company provided insurance would not pay for an MRI as part of a procedure to start checking for if I had cancer. They demanded another 6 month wait for a new PSA test. I found out through an appeals process that Cigna and many others use/outsource the approval process and I did not meet the criteria.
Anyway, health advocates got involved all agreed with me but no go, I had to wait 6 months.
I do understand that feeling very much. Bottom line MRI led to biopsy and no cancer was found but they would not approve the testing until 1.5 years of higher PSA tests were recorded and my problem was at the time, one of those in the beginning came in lower like it was going down, it never did after but still no cancer.
That is the problem in here "preaching from the pulpit" I am not at all, where does that come from, please quote me if it was true. No one insurance is best for all.
Im curious why you think I am preaching? Because I am trying to counter/correct inaccurate information?
Maybe you should read the posts. (just discussing) Most in here are not even on Medicare and have no idea how things work. Why not listen to the ones on each type of plan?
How can I be preaching if I am in no way discounting traditional medicare? I am simply trying to correct false statements for those discounting Advantage C plans. I am saying nothing negative about either one. But many are saying negative things about Advantage plans without knowing anything.
and ... so ends my way to long day in BITOG
See, to me this is BeeEss. I'm NOT saying it didn't happen, I am saying it's not happening to ME.
So when I turn 80, I will have more co-pays referrals? Really?
I don't need nor require referrals to see a specialist now, so I better look out at 80 makes no sense to me at all.
Yes, there are some co-pays...........I just paid $30 yesterday for the dermatologist. Every two years, big hyped up whoop.
NOW stone COLD killer. My parents have traditional Medicare. They are in their 90's and have lots of issues. I've not needed referrals, but wow, co-pay on EVERYTHING. So I guess, not just a MA plan thing.
What plan do you have?
Ahh, yes, you are correct. The keyboard (mine) precedes my brain. I own this one. My internal hunch regarding "preaching" should have been followed. Your discussion has been excellent and very transparent. Again, a lot of myths and misconceptions are being addressed here with the excellent back and forth opinions shared here.That is the problem in here "preaching from the pulpit" I am not at all, where does that come from, please quote me if it was true. No one insurance is best for all.
Im curious why you think I am preaching? Because I am trying to counter/correct inaccurate information?
Maybe you should read the posts. (just discussing) Most in here are not even on Medicare and have no idea how things work. Why not listen to the ones on each type of plan?
How can I be preaching if I am in no way discounting traditional medicare? I am simply trying to correct false statements for those discounting Advantage C plans. I am saying nothing negative about either one. But many are saying negative things about Advantage plans without knowing anything.
and ... so ends my way to long day in BITOG
My apologies. (Foot in mouth emoji)
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Bottom line is everybody has a unique situation. And it’s constantly evolving. There’s no right or wrong. Wife has RA. She has to go to for monthly IV infusions.Cost to Medicare north of 4k. I have traditional Medicare with a medigap plan G. My point is, they don’t blink. They accept Medicare assignment and my Medigap insurer covers the rest. Am I overpaying? Sure. Have I overpaid for my homeowners insurance with no claims in 50 years? Sure. Have I overpaid for my car insurance with no chargeable collisions in 50 years ?Yep. But can my wife walk into any phlebotomist office, flash her Medicare card, and not have to go crazy finding someone who accepts my health plan.?Yes she can, and the older we get the more important that becomes.
Thank you, I do appreciate this in the sense that you can see I am TRULY trying to be sincere in my posts. Hey, we all mis-read what intentions are in any forum. I have done the same many times, again, thank you.
My Medicare Advantage Plan doesn't require a referral. More misinformation. BTW-Boomers are the largest customer base-yes some doctors more away from various insurance companies for whatever reasons. But running away from the biggest customer base is business suicide.
We get it you like to pay more for your coverage. But don't spread misinformation.
I’m thinking of going back to Medicare A + B and adding prescription drug coverage.
My Medicare Advantage plan is okay in my area. However, if some unforeseen illness or accident occurs outside of my PPO area, I may not even be covered.
My Medicare Advantage plan is okay in my area. However, if some unforeseen illness or accident occurs outside of my PPO area, I may not even be covered.
The problem is that most doctors would rather cater to traditional Medicare patients because they are tapped into a predictable payment flow. As a business person (a Doctor for instance) wouldn’t you opt for a patient knowing that your bill would be paid without fail, in two weeks or less after submitting it to Traditional Medicare. without having to track down each and every Advantage patient and have them nickel and dime you. Doctors have bills too.
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Again more misinformation. They don't have to "jump through hoops". I don't how long it takes them to get paid-you seem to think it only takes Medicare two weeks-OK. But Doctors do get paid from either source.
Again-51% of Americans at that stage in life have Advantage plans.
At least my Doctor does-I haven't received a bill from him yet.
Sure, you will be covered. Not only that, but in most cases if you check your coverage, you will see your Advantage
Plan most likely covers out of the country emergencies Medicare A and B does not.
I would encourage you to read your evidence of coverage for your plan. After all you should know what you’re buying.
Also, traditionally advantage plans provide more coverage with less deductible than Medigap G and N plans if you’re out of the country and need emergency care, of course check your individual plan and compare.
Medicare Advantage Plans realize "mature people" travel. There are provisions in my plan that addresses this. Are you sure about this? OR-are you speculating?
Quote-
With many Medicare Advantage plans, you’ll have emergency and urgent care coverage when traveling, so you can see out-of-network providers within the United States. That means you don’t have to worry about coverage if you get a sudden illness or break a bone while traveling. If you need non-emergency or non-urgent care while traveling, it may not be covered, and you’ll likely have to pay more out of pocket. That’s where a travel benefit can help.
https://www.healthpartners.com/blog/medicare-advantage-plans-for-travelers/
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I am so tired of ignorant people spewing completely false information on this subject. If guys don't know what they are talking about...stay quiet.
That's totally true. But they still have clauses for travel.Did you see my link above? I mean do you know what the details are?
Have you READ YOUR POLICY?
If your policy doesn't-yea you need to switch to another for sure.
GET A GOOD AGENT!
