Big Push for Medicare Advantage....

[kadee79]

Medicare is shaping up as one of the most important issues in the 2020 election, with several leading Democrats offering proposals that would significantly expand the program. President Trump jumped into the fray with an executive order last week that he claimed would protect and improve the Medicare system, in part by promoting broader use of private Medicare Advantage plans. Those plans are quite lucrative for the private insurers that sell them, Bloomberg’s John Tozzi said Wednesday, and they’ll be pushing hard to sell more of them when Medicare enrollment begins next week.

Enrollment in Medicare Advantage has more than tripled in the last 20 years, and now about a third of all Medicare beneficiaries get coverage through private plans. If current trends continue, more than half of all beneficiaries will be in Medicare Advantage by 2025, according to Tozzi.

How it works: Those who sign up for Medicare Advantage pay the same monthly premiums as regular plans but agree to certain limits imposed by the insurers, such as a restricted network of doctors, and also receive a wider range of benefits, which can include drugs plans and dental care. Insurers get a fee from the government for each person who signs up and are responsible for managing their plans to ensure a profit. In 2019, the average fee for each of the roughly 22 million participants was $11,545 – which comes to a total of about $254 billion.

news.yahoo.com/big-push-medicare-advantage-220100863.html

If anyone is considering this...find out both the advantages & some major pitfalls of it also.  Also, be sure a "network" is available in your immediate area.

[Tennesseer]

I have parts A, B, D, and F.  I went to a Medicare Advantage sale pitch last year and just am still not comfortable at this time.

[Gardening Grandma]

It’s not an option for us. Friends who live in Seattle have it and are happy with it.
But if they ever decide they want to go to traditional Medicare, they may be subject to underwriting. When you are  over 70, that can be a real issue

[Blonde Granny]

The advertising for MA plans is tempting, but if people read the fine print, they would see all the restrictions. Nothing could budge me from my Medicare and ChampVA for my supplement.

[buystoys]

It's the only option for us.  Fortunately, DH's doctors were all in network.  So far, so good.

[TheOtherMe]

I will stick with what I have.  I trust nothing this administration suggests.

[Deleted]

DH and I have had a Medicare Advantage plan from our local provider, Kelsey-Seybold, for more than 10 years.  We had been with Kelsey all of our working lives and stayed with them via traditional Medicare and a supplement until they decided not to accept traditional Medicare about 15 years ago.  For us, the transition was seamless.  We have access to the same clinics we've always used and the same quality of doctors.  The downside of an Advantage plan is, as others have pointed out, you can't take it with you if you move which is one of the factors we considered when we thought about leaving Houston several years ago.  Not only would we have had to pay for a supplement again, many local providers in the areas we visited do not accept traditional Medicare because of the low payment rates.  And a smaller community means a smaller pool of providers to start with, so our options would have been quite limited and pricy.

[Deleted]

I think what we have is a Medicare Advantage plan.  I know it is a Part C plan.  However, this is the plan sponsored by the Public Education Employees Health Insurance Program (Peehip) for Medicare retirees.  We've been testing the limits a lot lately, and it is extremely good.  Out-of-network is the same as in-network, and no doctor or hospital is refusing to take it.  Of course, DH had a team of doctors in place as did I.  It includes a prescription plan with no doughnut hole.  UAB Medicine threatened to stop taking United Health Care plans except for Peehip's version.  Peehip is changing to a Humana plan in January.  It sounds pretty much the same.

The way ours work, though, is that we still pay for regular Medicare.  Then we pay for this in addition.  For me, it is $35 a month.  For DH, it is $127 a month.  So a total of $162 a month plus regular Medicare.  DH has been hospitalized multiple times (three or four) in the past four months, gone to the ER several times, gone to specialists four or five times, had home health care, and so on.  We have spent less than $1000, which is amazing to us.  

And we don't even use some of the benefits.  I have yet to pay my Medicare copay because I only retired in June.  I made certain to do all my routine stuff before retiring. I wanted to do Silver Sneakers, etc., but I can't in light of DH's present health problems.  

We are very grateful.  I wish everyone had affordable health care like this.  Sure, we pay $430 something a month, which would be tough on some people's salaries.  But I can't explain the peace of mind it has given us.

[kadee79]

Oct 11, 2019 5:13:58 GMT -5 Blonde Granny said:

The advertising for MA plans is tempting, but if people read the fine print, they would see all the restrictions. Nothing could budge me from my Medicare and ChampVA for my supplement.

If you have ChampVA...you don't have any need for a supplemental plan.  I have it too...no bills what-so-ever along with regular Medicare and that includes specialists, etc. who might not be in an Advantage plan network.

That is what has really messed up some folks...when they needed a specialist that was not "in network".  It has caused some to have humongous medical bills piled on them...besides the premiums for the Advantage plans.
That was why I said to be careful & to read ALL the fine print.  You never know when something may happen that will require something "out of network".