Medicare Advantage Plan Advertising

[rotor]

I am just sick and tired of the Medicare advertising on TV that happens every year during this open enrollment period. If you are in that age group that will be on Medicare soon I urge you to not fall for the gimmicks of the Advantage plans and stick to regular Medicare, a Medicare supplement and a prescription drug plan. Not a gun topic but a scam topic.

 

[glenbo]

Unless someone also needs dental coverage without getting a separate policy. Then the advantage plans make sense, since many have some dental coverage without extra cost.

 

[rotor]

Unless someone also needs dental coverage without getting a separate policy. Then the advantage plans make sense, since many have some dental coverage without extra cost.

Make sense? Maybe. Does your hospital take it? Is your doctor enrolled? Can you travel to other areas and still get care? Do you need prior approval? How much is the copay?

Many people only find out after they get sick. Depending on where you live it may be a good deal?

I just got a list of plans accepted at my hospital, one plan is not accepted. ER doctors don't accept all plans, anesthesia doesn't accept all plans, critical care specialists don't accept all plans. Radiologists and pathologists did accept plans. This is my hospital and yours may be different. I called my hospital to find out but insurance people couldn't tell me. Wife found a spreadsheet on the internet. Current today but who knows next year.

Shop carefully friends. Advantage plans are THE big moneymaker for insurance companies and there is a reason for that, they make money by holding onto it.

Pitfalls of Medicare Advantage Plans

A Medicare Advantage plan may help you lower non-covered health costs, but there are definite tradeoffs compared to classic Medicare/Medigap.

www.investopedia.com

 

[Vaquero]

Joe and JJ need the money.

 

[Haystack]

I'm approaching that age, and the topic is quite confusing. I'm trying to read up and get educated, but it seems that everyone involved want's you to be confused and just trust them.

 

[rotor]

I'm approaching that age, and the topic is quite confusing. I'm trying to read up and get educated, but it seems that everyone involved want's you to be confused and just trust them.

I have had quite an experience with Medicare and the advantage plans and I will try to answer any questions you may have but I will tell you now that I recommend straight Medicare, a medicare supplement ( I use USAA) and a plan D prescription drug plan. Doesn't matter where you are if you get sick (in the U.S.), you are covered.

 

[WhiteLightning]

The only thing Texas teacher retirement offers is a medicare advantage plan or straight medicare. We took the Advantage plan and have been pretty happy. No drug donut hole, every place that takes medicare takes the advantage plan. Last year it was administered by Humana. This year it's United Healthcare. It's a PPO not a HMO. Like I said it works for us.

 

[candcallen]

No donut hole?

 

[TX OMFS]

Unless someone also needs dental coverage without getting a separate policy. Then the advantage plans make sense, since many have some dental coverage without extra cost.

Very few places accept the dental. It will be brand new graduates with very little experience. It's not worth it.

 

[rotor]

The only thing Texas teacher retirement offers is a medicare advantage plan or straight medicare. We took the Advantage plan and have been pretty happy. No drug donut hole, every place that takes medicare takes the advantage plan. Last year it was administered by Humana. This year it's United Healthcare. It's a PPO not a HMO. Like I said it works for us

My local hospital didn’t take Aetna Trs plan until last year. Glad you are happy but you really don’t know how you will do until you really need it. Will your plan work in a different city or state. Hard to say.

 

[glenbo]

Very few places accept the dental. It will be brand new graduates with very little experience. It's not worth it.

We have used Castle Dental, which is a fairly big outfit. But since you're the professional in this field, can you recommend dental insurance for those of us in our senior years who have medicare but don't have an advantage plan? Affordable would be nice, too. And I'm serious, not trying to be a snot or butthole.

 

[Texas42]

We have used Castle Dental, which is a fairly big outfit. But since you're the professional in this field, can you recommend dental insurance for those of us in our senior years who have medicare but don't have an advantage plan? Affordable would be nice, too. And I'm serious, not trying to be a snot or butthole.

The vast majority of dental insurance isn’t worth it. Insurance is always in the favor of the insurer.

You need medical because medical expenses can bankrupt you

 

[TX OMFS]

We have used Castle Dental, which is a fairly big outfit. But since you're the professional in this field, can you recommend dental insurance for those of us in our senior years who have medicare but don't have an advantage plan? Affordable would be nice, too. And I'm serious, not trying to be a snot or butthole.

I can't recommend an insurer. I don't think any of them are really good. I think finding an honest doctor is the most important. A doc with fair fees is a close second.

If you have insurance & walk into most offices they immediately discuss how to get all of the plan money. That discussion happens in the business office, not with you. There is lots of make work.

If you have good teeth and just need a regular cleaning here & there, it's easy to shop that.

If you have borderline teeth, you will spend a lot more money trying to piece those together everytime a problem pops up. It's like playing whack a mole.

If you want to PM me details of your situation & your location I could maybe give better specific guidance.

 

[striker55]

Very few places accept the dental. It will be brand new graduates with very little experience. It's not worth it.

The plan I'm on would allow for $2,000 per year for dental, I would pay out of pocket and send in the bill showing I paid. I would get reimbursed, didn't matter what I had done. Wasn't the greatest because a crown would eat up a lot. Then the plan got changed, had to go to in network and crown's weren't covered. Plus dentists didn't want to be in the network because insurance only paid a certain amount for a procedure.

 

[striker55]

I've noticed that since COVID more people aren't going to the doctor and doctors wanting to do online visits. Now that offices are opening up again the doctors need the business and now hire people to call patients to remind them they need a checkup. Drumming up business, and in turn doctors telling you to see a specialist for whatever, basically sending business to other doctors.

 

[rotor]

I've noticed that since COVID more people aren't going to the doctor and doctors wanting to do online visits. Now that offices are opening up again the doctors need the business and now hire people to call patients to remind them they need a checkup. Drumming up business, and in turn doctors telling you to see a specialist for whatever, basically sending business to other doctors.

Not my personal finding but perhaps yours. This thread was opened to try to educate people about the problems with Medicare Advantage plans especially since they are bombarding the airways.

 

[Texasjack]

I retired this year and have been shocked at the complexity and the number of scams associated with Medicare. Prescription prices are all over the place. They won't pay for a combo of 2 drugs, but they'll pay for the 2 drugs separately. Insulin is not covered unless you have an insulin pump. One drug will drop to $5 and another will jump to $5000. It's insane.

 

[msharley]

Make sense? Maybe. Does your hospital take it? Is your doctor enrolled? Can you travel to other areas and still get care? Do you need prior approval? How much is the copay?

Many people only find out after they get sick. Depending on where you live it may be a good deal?

I just got a list of plans accepted at my hospital, one plan is not accepted. ER doctors don't accept all plans, anesthesia doesn't accept all plans, critical care specialists don't accept all plans. Radiologists and pathologists did accept plans. This is my hospital and yours may be different. I called my hospital to find out but insurance people couldn't tell me. Wife found a spreadsheet on the internet. Current today but who knows next year.

Shop carefully friends. Advantage plans are THE big moneymaker for insurance companies and there is a reason for that, they make money by holding onto it.

Pitfalls of Medicare Advantage Plans

A Medicare Advantage plan may help you lower non-covered health costs, but there are definite tradeoffs compared to classic Medicare/Medigap.

www.investopedia.com

They (the insurance SCAM firms) get their YOUR MONEY the "Olde Fashioned Way"..........

They STEAL IT!

 

[rotor]

I retired this year and have been shocked at the complexity and the number of scams associated with Medicare. Prescription prices are all over the place. They won't pay for a combo of 2 drugs, but they'll pay for the 2 drugs separately. Insulin is not covered unless you have an insulin pump. One drug will drop to $5 and another will jump to $5000. It's insane.

I suggest getting an app called Goodrx to track down drug prices.

 

[TipBledsoe]

If I have to watch/hear Joe Namath advertise free Medicare helpline one more time I might loose my normal mild-manners