Medicare Options

I constantly see ads on TV for Medicare Advantage plans but can’t remember ever seeing an ad for a Medicare Supplement or Medigap plan for people who have traditional Medicare. Do you think this is because insurance companies make a lot more money on Medicare Advantage plans than they do on Medicare Supplement plans.

Absolutely. I think it also means that the plan brokers make a lot more money on Advantage plans than Supplemental plans. Medicare pays the Advantage plan $10-14,000/year per participant, and allows the plan to impose costs and conditions that would not be thee with Medicare. The benefits of Advantage plans vary by state. I have read too many stories of people believing the hype and being sorely disappointed. Here, they are not that good, so we’ve had a supplemental plan since going on Medicare.

I don’t pay anything for my Medicare Advantage plan. I know that they all say that with a supplement, you can get treatment at any doctor that takes Medicare while you can only use doctors in the network on the advantage plan. I guess that you have to get preapproved for certain procedures. But my plan is basically the same one that I had for 20 years and that I never had any problems with. The other thing is that supplement plans are good if you have a winter and summer home. I don’t, so my travel is limited, and my emergency coverage is good. I got the advantage plan because it included prescription drug coverage that is actually better than what my employers plan was. A supplement plan would have cost me around $200 per month. I am just putting that into a savings account. I’m pretty happy with mine.

I have senior advantage. I pay for part B every month, but Calpers reimburses me.

Doing a little shopping on this, and I am not sure that they get more selling advantage plans. The agent I talked to is not on any commission. Will talk to another in a couple of days, one who sold supplement to my wife.

Without getting into the “extra help” category, there seem to be a few different levels of care/cost. Also not sure how they correlate.

To me, bottom of barrel would be an HMO. They got you by the short ones with these. Everything must go thru PCP, and you have to pretty much stay in network.

Moving up, there is the PPO. These [deceitfully] claim you can use “any doctor” that will take medicare. They lie! Sure you can use them, but you stay in network or else you pay more!

Then there is straight medicare, with no insurance company to say what you may or may not do. Only the gubbermint. PPO and HMO plans allow a subset of what medicare says. In order to get most of your cost covered, adding a supplement will do it, picking up most of what straight medicare will allow but not pay for. These ALL cost more, on top of your regular A and B premiums, so I would think a broker would get better pay. Oh, and you also better take a plan D for drugs. Often advantage plans provide drug coverage.

Mine does and it is better that the plan I had when I was working. I also get a $1,000 for dental and hearing and I get $500 towards eyewear. I also get $100 every quarter for over the counter items.

One of the guys in my bike group retired from the health insurance industry. He said they offer the supplements to a person who likely won’t use it, or to people who travel a lot…such as a winter home in Arizona or a summer home here. Odds are that there won’t be doctors in any plan in both places, and while you CAN use a doctor not in the plan, you do pay more. Now…if I get cancer, odds are that I won’t be down at MD Anderson in Texas, but the University of Kansas has a fantastic cancer center just down the road. Initially, I did use a broker and got a supplement plan that claimed it was $145 per month. When I got the paperwork, it creeped up to $200 per month. Then I got something from Blue Cross, that I’ve been with for over 20 years. As I said, never a problem, so I went with their Advantage plan.

I had a medical emergency in 2018, was in the hospital 2 weeks. I have kaiser senior advantage that picked up what Medicare A&B didn’t cover.

I have had many patients on Advantage plans that could not get needed treatment. Patients say they cannot find physicians that will treat them on these plans. Reimbursements must be even worse than regular Medicrap.

Seems like many are run like Kaiser HMOs. I have told patients to threaten to sue if they are not given appropriate treatment.

Boys and girls, the Medicare crisis the Greenspan Commission is here now. Better tell the gooberment to nix Medicare non-participating price controls, or there will be little primary care for seniors available from anywhere except concierge providers.