MediCare advantage plan

jm. · Oct 19, 2020

Any one on here that is enroled in a MediCare advantage plan that you are really satisfied with. I
have standard MediCare with Blue Cross back up and went thru a 370,000 dollar 31 day hospital stay.
Was not out one dime and am really skeptical about making a change. My sister in law says I am
spending $300 a month that I could save.

retired farmer · Oct 19, 2020

I called my agent and he said I didn't need an Advantage plan for some reason. But I would call your insurance and ask questions before changing plans. Three hundred dollars won't get you thru the emergency room door here. Glad I got what I got when I did because I am like you, two days in the hospital and nine months of cancer drugs and I am sure the bill is well over a quarter million. Haven't received a full statement and haven't been charged a dime yet, fingers crossed.

tomNE · Oct 19, 2020

if u have an advantage policy, you will not be happy as quick as anything expensive happens! I had them for 12yrs as it was the only thing i could get. just a normal year was $3000 out of my pocket, with some years it being 5 times that amount!

sleepy1 · Oct 19, 2020

My sister and bil have a blue advantage plan and love it she had to have a redo on an knee replace last year she had 7 years ago.When it was all said and done they had a out of pocket payment of $100.They were expecting to pay more but that was it.

banjoman09 · Oct 19, 2020

If its working- keep it! I just called last week and the agent told me if you have the Advantage Plan it will NOT accept secondary insurance.... Blue Cross has treated me well.

Billy Shafer · Oct 19, 2020

I have tried to get a plan. But as soon as I say Agent Orange. They give me some wild price or hang up. I am still fighting the V A over it.

504 · Oct 19, 2020

I have private insurance(64) $5,000.00 deductible. I just saw the wifes pain stimulator install bill, $87,000 and we owe zero. We hit the 5,000 in mid February on meds alone.

Hoenes · Oct 19, 2020

Tom, I'm curious how your out of pocket can go to 15 k. I was looking at a Humana plan that claims out of pocket max to be around 4 k. This is a 0 premium advantage plan, that manages a medicare plan. I just turned 65, but I still have to insure the wife. For now, I stuck with my union plan, but it's very pricey. 1000 bucks a month for the 2 of us. Great platinum plan, all zero's on co - pays,but still looking for a way back to reality. 3 more years till she turns 65, then all should be well on the 0 premium advantage plans x 2.

gab · Oct 19, 2020

I was scared of those advantage plans, some I don't think cost anything. Something for nothing don't make sense to me. Every body in my family except me and my mother died from a heart attack. I've had five stents in my abdominal aorta, hernia surgery a year ago, my neck and back are used up so I took the Blue cross/shield plan F. Haven't paid a dime extra. Think it costs 230 a month.

My insurance woman said take the advantage plan if there's nothing wrong with you, If you know you have potential problems pick one of the other plans.

RedGreenGuy · Oct 19, 2020

Tried an advantage plan 10 yrs ago. It was total disaster. Very limited doctor selection and continuous fight to get med bills paid. Wife and I are on Medicare plan F and Blue Cross Blue Shield. Costs around $1000 a month together. Wife has had shoulder and knee replaced and heart attack with helicopter ride. We see doctors quite often. All NO CHARGE. We pay no copays, doctor bills or hospital bills. Yes $1000 month is a lot of money. Her heart attack was 3 day hospital stay $90,000, helicopter ride was $40,000. Shoulder and knee around $60,000 each. She is looking at new hip after new years and me 2 new knees. Can not afford an advantage plan with all the problems we had with ours.
Have friend who was talked out plan F and Blue Cross by an insurance agent and into a no pay advantage plan. He has given up trying to get medical care from local area doctors as most don't belong to his plan. He is now driving 1 1/2 hours to Iowa City VA for his needs. NO advantage plan for me.

MarkB_MI · Oct 20, 2020

As someone pointed out in an earlier thread on Tales, if you enroll in an Advantage plan you may not be able to switch to a Medigap plan in the future if you have an existing condition. That in itself is a good reason to stick with a Medicare Supplement plan.

M-MAN · Oct 20, 2020

You won't be happy with an advantage plan if you need it. Mom has one and they leave a lot to be desired when the bills come. When she broke her hip last year every step the hospital took they had to wait on approval from the insurance company. Her part of the hospital bill was $2,000. Then there was her part on the doctor bills and her part on the rehab bills. Approval for a walker came two weeks after she got home. We had to rent one for those two weeks. You can forget the maximum amount too. They go by "approved " charges so your maximum might be three times what they claim.

MarkB_MI · Oct 20, 2020

> I have tried to get a plan. But as soon as I say Agent Orange. They give me some wild price or hang up. I am still fighting the V A over it.

Help me out here. If I understand correctly, the VA insists you don't have any medical conditions caused by Agent Orange. Why would you tell an insurance company you have medical conditions caused by Agent Orange if the VA says you haven't? And why are you telling the insurance agent about a pre-existing condition when Medicare Advantage plans are required to accept people with pre-existing conditions?

John T · Oct 20, 2020

jm, it sounds like we may have somewhat similar plans. I have standard Medicare PLUS (retired DOD employee) "Federal" Blue Cross Blue Shield that I am extremely satisfied with and currently have no plans to change. However to each their own plans and choices best suited for THEIR needs and budgets.

John T

jm. · Oct 20, 2020

I agree I think I am staying put , sure have been satisfied with what I have

John T · Oct 20, 2020

As they say "If it aint broke don't fix it" right ?? lol Sure if something much better came along Id take a look at it..

John T God Bless America

Texasmark1 · Oct 20, 2020

Humana plan seems to work for a friend. Only dig is that the deductible on A charges is $6k. Other than that, lots of freebies and low cost co-pays when you have one.

WAYNE-N-TEXAS · Oct 20, 2020

I just don't understand why you have a such problem with the VA, I know how they are a pain to deal with. ( That place in Temple TX should be tore down and the rude people that work there should be on a soup line an moved to another state.)

I get up dates from the VA saying how many clear water vets they are helping. I had a problem for s while, no where near the problem you have had wet and talked to s guy in Lufkin that is with the Texas Veterans Commission. If you haven't gone to them, it might help. I just wish I knew something that would help you out.I'll keep my ears open.

wjytexas · Oct 20, 2020

check with your doctors before signing up with one. my GP who I have been with for 10 years only takes 2 and neither are options for me. I like Medicare with BC secondary.

jal-SD · Oct 20, 2020

We have a Mutual of Omaha plan that has paid everything that Medicare hasn't paid since this prostate issue that I'm fighting began in the fall of 2018. It even pays our Medicare deductible. We got a notice from the company when the "tax reform" act got passed in '17 that the type of Medicare supplement that we have that pays our Medicare deductible would no longer be available. However, if we choose to keep our policy, it could not be canceled. We kept it & I am really glad we did. I have never had one bill that was questioned & know of none that has never been paid. I was even reimbursed an ER "supply surcharge" when I smashed a thumb a couple of years ago, just before this whole prostate mess started. We see all the advertising "come-on's" at this time of the year & just laugh at them!

Gary Mitchell · Oct 20, 2020

Jal, my experience as well. I think the new version they're spending a fortune advertising, Joe Namath, etc. is a gimmick to suck one into the HMO version. gm

Bud Sather in MT · Oct 20, 2020

I have medicare and the Humana plan F value 65+. May 6 2020 I had brain sugury for a tumor. Last statement I remember it was close to $140,000. My share 0 (zero). My premium is $167.65 for health and $52.80 for the drug plan. I am 74 years young. Bud

GordoSD · Oct 20, 2020

Agent Orange use was discontinued a year before your ship, the USS Saratoga, arrived in the Tonkin Gulf. That's probably why your claims are denied.

Oliver 500 Wa · Oct 20, 2020

How well the advantage plans work may vary depending on what company backs it. My wife was on a Regence advantage plan. Cost about $30 per month. She got cancer and ultimately passed from it. The claims added up to just shy of $800,000 for her operations, hospitalizations, treatments, etc. My out-of-pocket was a little over $6,000. I could not expect better.

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