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desertjoe 
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Joined: 23 Sep 2013
Location: New mexico
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 Topic: Madicare Advantage Plans,,,
Posted: 07 Dec 2020 at 1:11pm |
signing ending today at midnight,,,,,, I know I should know a WHOLE lot more bout health insurance, but chit I always wait till last minute or forget altogether,,,,!!!
Not This Year,,,!! I've had a part D RX plan with Humana for several years and they contacted me Friday to ask if I wanted to SAVE MONEY and that right there got my attention pretty quick,,!! Anyway, I called and talked to an agent with New Mexico Medicare Advantage and they went over 3 of the plans that Humana offers and I'm even gonna get a "REFUND from Sociable Security on the plan I got now,,,PLUS,,the new plan is ZERO dollars plus many benefits I did NOT have before,,,!!! On Sunday, I called the company that has all the 367 Joe Namath commercials and she tells me the same thing!! This morning, I signed up my Wife and myself with Humana.
If anybody is like me and waitin for last minute or forgotten,,,you best gall your State Medicare Advantage division,,,,don't wait,,,!!!!! 
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DMiller
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Joined: 14 Sep 2009
Location: Hermann, Mo
Points: 33165
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Posted: 07 Dec 2020 at 1:19pm |
Careful Joe, that removal of your Medicare Premium means you No Longer receive FEDERAL Medicare, you will be on a Private Insurance known as Medicare Advantage that also requires that same Money value as a Premium for that insurance. Once off Medicare, you CANNOT go back on.
Two of my buddies made that error.
Edited by DMiller - 07 Dec 2020 at 1:21pm
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Coke-in-MN
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Joined: 12 Sep 2009
Location: Afton MN
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Posted: 07 Dec 2020 at 2:45pm |
Seems when the it's to good to be true part is looked at further - it turns out the scam is bigger that the true part . I have had U-Care here in MN since I finally retired and could get wife on her own Medicare plan through U-care , managed health plan PPO with Part D included and is $56 a month . See those adds every day on TV now with a pitch man saying you can get insurance and get your money back from Medicare Premiums - Somehow I figure those pitch guys are getting paid somehow and it has to be a profitable scam to hire them . Will stick with what i have - In 2014 in the 9 months before wife passed _ I got a summary of her account Hospital and Doctor billing along with recovery care in a facilities outside hospital came to $970,000 - after Medicare and U-care went over billing it was reduced to $430,000 - then I got a statement to close the account and listed my total payment other than premiums at $3,400 - for Meds , co-pays, hospital costs, and care facilities .
Edited by Coke-in-MN - 07 Dec 2020 at 2:50pm
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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steve(ill)
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Posted: 07 Dec 2020 at 2:48pm |
I dont know who wrote that story , but it is half bullsh*t..... You dont loose your Medicare if you sign up for an Advantage Plan.. Normally you have a MEDICARE plan with the govt that covers 80% of things and no drugs... You then can sign up for a "supplement" that covers some of the things that Medicare does not cover, ( part B) and then you sign up for a drug plan ( part D)..
What the advantage plan does is combine this all into one package. You still pay the govt the $144. a month for Medicare and they give a portion of that to the "advantage plan" group... If you make under a specific $$ INCOME per year, you can get your $144. monthly premium refunded from Medicare... i dont know what that income level is... i dont qualify.
I had an ADVANTAGE PLAN from Humana 2 years ago and it cost $97. a month for part B and D... and you still pay the $144. to the govt ( normally out of your social sec check).. Last year there was a plan in MY AREA from Aetna for $0. a month for the basic coverage... Yea, there is a MAX out of pocket of $5000. and covers basic glasses ($200. yr) and dentist ($500. yer) , etc.. Not all inclusive, but if you dont see the doctor much, its a good package...
You can also pay $200-300 per month for "better" part B and D if you use the doctor a BUNCH... at $300. a month that is $3600. per year... I didnt spend $200. at the "doctor" last year so the $0. Advanatage Plan is a good bet for me.
Your mileage may vary. If i had a previous heart attack, cancer, visit the doctor every month or 2 weeks... then the $0. plan might not be the best deal.
Edited by steve(ill) - 07 Dec 2020 at 2:50pm
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Like them all, but love the "B"s.
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steve(ill)
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Posted: 07 Dec 2020 at 2:55pm |
managed health plan PPO with Part D included
Coke, that is basically what mine is... and AETNA calls it an ADVANTAGE PLAN since the D is included..
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Like them all, but love the "B"s.
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Coke-in-MN
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Joined: 12 Sep 2009
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Posted: 07 Dec 2020 at 2:58pm |
This year there are changes in what plans cover and for what premium , my $56 a month use to have a co-pay of $20 to primary care doctor - this year that fee is dropped so no charge now , specialist stayed the same at $45 per visit , but basic plan now pays $600 per unit against hearing aids and $150 towards eyeglasses . I had a limited dental plan included before but when I went to dentist and asked for a cleaning got the answer , nope you need a deep cleaning and that will be $1200 and not covered . So this year adding dental + at $25 a month and will change dentists as felt like the last one was a rip off . Year before I went to a Aspen dental clinic - had x-rays and a plan made up by them , ONLY $10,500 cost and they would finance it at a low rate on their own credit card .. Hmm never went back there either !
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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steve(ill)
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Posted: 07 Dec 2020 at 2:59pm |
What is a Medicare Advantage plan and what does it cover?Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you're in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you're always covered for emergency and urgent care.
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Like them all, but love the "B"s.
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steve(ill)
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Posted: 07 Dec 2020 at 3:04pm |
From Blue Cross Blue Shield.......
You’re probably familiar with Original Medicare. You may know that when you turn 65 you'll get certain health care benefits from the government. You might not know as much about Medicare Advantage. Medicare Advantage got its start in 1995. The federal government created it as a way to give people more options. Private health insurance companies sell Medicare Advantage plans. The federal government regulates them. Before we get into how Medicare Advantage is different from Original Medicare, let’s look at how it’s the same. All Medicare Advantage plans have to offer at least the same benefits as Medicare Parts A and B. --- make sure yours included drugs also ( part D).. That means if Original Medicare covers hospital care at a certain level, so will every Medicare Advantage plan on the market. But the benefit of Medicare Advantage plans is that they offer more coverage than Original Medicare. Here are three key ways in which Medicare Advantage gives you more than Original Medicare: Original Medicare vs. Medicare Advantage| Overview | Original Medicare | Medicare Advantage |
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| Coverage | Covers medical and hospital costs only. | Many plans cover dental, vision, hearing and prescription drugs, in addition to medical and hospital costs. |
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| Cost | No cap on what you pay out of pocket. Medicare only pays for a certain number of days in the hospital or in a skilled nursing facility. | Has an out-of-pocket maximum each year. Once you hit a certain dollar amount, your plan pays 100% of the cost for most services it covers. |
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| Travel | Except in very rare cases, Medicare doesn't cover care you get when you're out of the country, even in an emergency. | May cover emergency care when you’re out of the country. Our plans cover emergency care with a $50,000 lifetime maximum. |
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Many Medicare Advantage plans offer even more benefits than those listed in the table above. Check out our Medicare Advantage plans to get a better idea of what you can get with these plans.
Edited by steve(ill) - 07 Dec 2020 at 3:08pm
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Like them all, but love the "B"s.
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Coke-in-MN
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Joined: 12 Sep 2009
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Posted: 07 Dec 2020 at 3:11pm |
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If your on Medicare the booklet they send out for your area lists most plans in your area and the costs and what each covers . It is a good reference and or starting point .
Listening to all the pitch things on TV one would think it's all free - but free things seem to always have hook somewhere that isn't mentioned .
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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steve(ill)
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Joined: 11 Sep 2009
Location: illinois
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Posted: 07 Dec 2020 at 3:17pm |
Agree... the "commercials" say you MAY not have to pay Medicare $144. and you MAY be able to get Advantage plan for $0.. YEP.. depends on your INCOME ( on the $144) , and how EXTENSIVE your coverage is so your Premium could be $0 , $50, $100, $300. a month.. DEPENDS on how much EXTRA you want covered. In "my area" (rural ill), they CHEAPEST cost was $97. two years ago.. Today there are packages for $0 . $25, and $50.... in addition to the $2-300. ones.
PER the FED GOVT........
Edited by steve(ill) - 07 Dec 2020 at 3:40pm
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Like them all, but love the "B"s.
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desertjoe
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Posted: 07 Dec 2020 at 7:32pm |
This is exactly what the agent from New Mexico Medicare told me as well as the agent from Humana did this morning. In my case I gain vision care, some dental and a $200 "service benefit" every 3 months for over the counter such as pain meds, Pepto Bismal, tooth brushes, tooth paste, ETC, ETC,,,what ever you deem necessary. Plus lots of other benefits,,,AND ,,AND,,I will receive a reduction of $45 on the original cost of my Part D from Humana!!!! I think it is a good plan for us but you CAN switch back if it does not work in your favor,.,,BOTH the New Mexico Medicare and the Humana agents assurred me of that.
What are Medicare Advantage Plans?A Medicare Advantage Plan is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). There are several types of Medicare Advantage Plans (see page 15). Each of these Medicare Advantage Plan types have special rules about how you get your Medicare covered Part A and B services and your plan’s supplemental benefits.If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. You must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. How do Medicare Advantage Plans work?When you join a Medicare Advantage Plan, Medicare pays a fixed amount for your coverage each month to the company offering your Medicare Advantage Plan. Companies that offer Medicare Advantage plans must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to doctors, facilities, or suppliers that belong to the plan’s network for non-emergency or non-urgent care). These rules can change each year. The plan must notify you about any changes before the start of the next enrollment year. If you join a Medicare Advantage Plan, you’ll have all of the same rights and protections that you would have under Original Medicare.
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shameless dude
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Joined: 10 Apr 2017
Location: east NE
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Posted: 07 Dec 2020 at 9:19pm |
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i called that phone number that POS Namuth advertises, they did all the talking and if i asked a question, they hung up on me, i called back and the same thing happened, i called again and asked for a supervisor, they gave me one (so said) and i asked the same qustion and they both hung up on me! PfffffT! seems to me that if they can't sell you some kinda coverage from anyone, they don't wanna waste their time!
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tomNE
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Posted: 07 Dec 2020 at 10:04pm |
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Sorry Joe; you got took. medicare is no longer your primary insurance. i had to use this type of insurance for 18yrs till i turned 65; get ready for high medical bills coming your way. the advantage program becomes your primary ins.
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AC from the start of my families farming career till the end!
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tomNE
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Posted: 07 Dec 2020 at 10:06pm |
I should have added that i never had to pay out Over $10,000 a year in out of pocket but some years it came damn close!
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AC from the start of my families farming career till the end!
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desertjoe
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Posted: 07 Dec 2020 at 11:08pm |
 tomNE wrote:
Sorry Joe; you got took. medicare is no longer your primary insurance. i had to use this type of insurance for 18yrs till i turned 65; get ready for high medical bills coming your way. the advantage program becomes your primary ins. |
Well, now,,Tom,,you didn't read the two paragraphs I just posted out of the MEDICARE AND YOU 2021 book, did you? Especially the last sentence? I'm not sure when the Medicare Advantage Plans started but don't think they were available 18 years ago when you say you had a Medicare Advantage Plan,,,,, 
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Roger (NE)
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Posted: 10 Dec 2020 at 8:52am |
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Advantage plans are a plus if you have zero or few medical issues as the premiums are low or in some cases non-existent. If you have pre-existing conditions or expect to have medical problems in the future, original medicare with a supplement and drug, vision and dental plans in place would probably be a better choice. Pay the monthly premiums and when the bills come in they are paid with no additional cost to you. Since there's no way of knowing what the future holds it's a crap shoot at best. I always tell people to find an independent insurance agent who is familiar with the system and doesn't represent just ONE company to advise you. My personal feeling on the advantage plans is that in the end the "advantage" will be to the insurance company...not to you. But I also understand that individual cases exist where it could save dollars. I know folks that say it works good for them and others who get locked into plans that they can't get out of.
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steve(ill)
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Posted: 10 Dec 2020 at 12:23pm |
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Before we get into how Medicare Advantage is different from Original Medicare, let’s look at how it’s the same. All Medicare Advantage plans have to offer at least the same benefits as Medicare Parts A and B. --- make sure yours included drugs also ( part D).. That means if Original Medicare covers hospital care at a certain level, so will every Medicare Advantage plan on the market.
Edited by steve(ill) - 10 Dec 2020 at 12:25pm
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Like them all, but love the "B"s.
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desertjoe
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Posted: 10 Dec 2020 at 1:35pm |
Many Thanks Steve,,,,whew,,,!!! Obviously you HAVE read all there is to know about the NEW Medicare Advantage Plans and I THANK you for helping me explain,,,cause I'm usually not too good with words,,,,, This one sentence from the MEDICARE HANDBOOK should help clear up some misunderstandings.
""Keep your red, white and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. ""
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steve(ill)
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Posted: 10 Dec 2020 at 2:27pm |
An ADVANTAGE PLAN is just a package deal of Medicare, part B and part D ( medicine) combined and implemented by an INSURANCE company instead of the GOVT... The INSURANCE company gets a portion of your $144. monthly payment that you give the GOVT... You can get a SUPLEMENT ( to part B) and an individual MEDICINE ( part D) to add to your MEDICARE... OR you can get a PACKAGE that covers it all thru and ADVANTAGE PLAN... Just like the SUPLEMENTS, you can get a BASIC or you can get a FULL COVERAGE type of Insurance....
As mentioned above, you can get SOME of the ADVANTAGE Plans for $0. a month... There are others that cost $2-300. per month and cover 100% OF EVERYTHING with no out of pocket to you.... All depends on what you NEED... ADVANTAGE PLANS are NOT inferior to basic MEDICARE... THey are an EXTENSION of MEDICARE... If you dont like it after a few years, you can switch back to GOVT COVERED part A and B, and then buy a SUPLEMENT for part B and individual Medicine (part D)....
Its just another way of accomplishing the same thing.
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Like them all, but love the "B"s.
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Coke-in-MN
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Posted: 10 Dec 2020 at 7:49pm |
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Using the U-Care plan I get a readout of every service and what is billed and what they paid , it also includes any other charges paid like my $25 office visit charge - but I never receive a actual bill .
Most times the clinic has any billing when I check out - like in past years I had to pay $15 for wrist braces I use for Carpel Tunnel - use them at night .
This year I got 2 new ones without the thumb brace and doctor just said I will list them as arthritis supports - NO CHARGE
I also switched my pharmacy over to Sam's Club and took out their premium card and it gives me a savings on drug costs below what my Part D amount normally is - what I have saved with that added cost has paid the difference in membership costs .
No matter which plan you have Medicare picks up the HOSPIC costs of drug, care, and nay other costs involved . Had it in force with wife , nurse came out every 2 days , personal assistant to help with bathing and other needs on the days when Nurse didn't come - NO CHARGE .
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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DMiller
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Posted: 29 Dec 2021 at 4:53am |
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I got lucky thru me retirement employer, specifically that the company insurance swaps to a supplement at 65 where mine had been under BCBS then the company brokerage set me up on Humana this turn in Nov.
The group insurance plan becomes less expensive by being group, where the company furnishes a blanket amount on 01/01 for the year and the insurance manages it.
Mine has a carry over if I do not use the benefits into the next year garnering eye and dental as a inclusion. IF however I use it all before end of year there is a cap for expenses I would pay.
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tomNE
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Posted: 29 Dec 2021 at 6:00am |
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I needed supplemental oxygen when i was on an advantage program. the plan i was on didn't cover oxygen. It was the only plan available in the county i lived in!
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Coke-in-MN
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Posted: 29 Dec 2021 at 2:33pm |
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The Oxygen is a big ripoff as wife was on 24/7 oxygen , and we paid $40 a month for the concentrator but when checking the bill they billed the Insurance $150 a month and my share came to the $40 - then they started charging for portable oxygen bottles as a monthly charge . Next was the regulator when I asked about a demand unit rather than a constant flow device . Wanted to charge more fir that until i contacted insurance co and got a letter from Doctor the wife could use the demand regulator - then no charge.
You can buy a 110 V concentrator for about $600 now or what I was paying for about a years co-pay .
What got me really steamed up was when wife and i were out for a meal and her oxygen tank ran out , so went to car and got one of the spares I kept there - ended up it was empty but still sealed , went back and got second spare , that one was also sealed and empty . Called supplier the next day and complained , they said on next delivery they would make up for the 2 empties but someone else fills them and not their fault.
After that I kept 10 A size bottles in car , and had backup of 6 C bottles here at all times .
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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PippaScott
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Posted: 08 Mar 2022 at 5:17pm |
You may be eligible for Medicare or have a plan through your employer. But not all health plans offer the same coverage. If you have certain health problems, you'll want to choose a plan that covers them. Some health plans include prescription drugs and dental care coverage. Others don't. If you have diabetes, it may be important to choose a plan that covers insulin and other diabetes-related services and supplies. If you need help choosing a plan, you can find a lot of information on https://www.remedigap.com/medicare-supplements/medicare-plan-n-vs-plan-g/.
Edited by PippaScott - 09 Mar 2022 at 7:23am
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steve(ill)
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Posted: 08 Mar 2022 at 5:46pm |
You may be eligible for Medicare or have a plan through your employer.--SPAMMER
Well, THATS FAKE NEWS.... Medicare is a GOVT program for people over 65 years old... NOT YOUR COMPANY !
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Like them all, but love the "B"s.
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Ray54
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Posted: 09 Mar 2022 at 10:46am |
steve(ill) wrote:
You may be eligible for Medicare or have a plan through your employer.--SPAMMER
Well, THATS FAKE NEWS.... Medicare is a GOVT program for people over 65 years old... NOT YOUR COMPANY ! |
But it is even better as the spammer claims he is from socialist Canada. I thought all  non government health insurance was a no no up there.  Or is he just hiding from a US jail by being up there. But has gold plated USA company that really wants to help us. But if your not as rich as Nancy you better read the contract before signing.
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nella(Pa)
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Posted: 09 Mar 2022 at 11:35am |
Well, THATS FAKE NEWS.... Medicare is a GOVT program for people over 65 years old... NOT YOUR COMPANY ![/QUOTE]
Yes Medicare is a government plan but Advantage plans are not, they are an insurance company plans.
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steve(ill)
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Posted: 09 Mar 2022 at 12:42pm |
Yes Medicare is a government plan but Advantage plans are not, they are an insurance company plans...........
thats right nella ..... BUT you have to be ELIGIBLE for Medicare ( over 65) ... and the Private Insurance company works with the GOVT to get the MONEY you have paid for the past 45 years to pay for the plan... thats why they can advertise "free" ... "covers eyes and dental"... etc......... because UNCLE SAM is paying them with YOUR MONEY.  
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Like them all, but love the "B"s.
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AndreMacdonald
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Posted: 08 Jun 2022 at 6:31pm |
In fact, in today's reality, we are always faced with health insurance. Medical costs are quite expensive. However, the benefits of health insurance are obvious. Before taking out health insurance, you should choose the right package of medical services. For the past few years, I have been purchasing Medicare Supplement Plan N. In case of an accident or detection of a serious illness, I will be safe. Recently, I have been hearing more and more stories about insurance scammers.
Edited by AndreMacdonald - 09 Jun 2022 at 7:31am
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jaybmiller
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Posted: 08 Jun 2022 at 6:48pm |
dang I got a huge headache just reading this !
Anyone know what'll cost me get buy a couple aspirins ??? 
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3 D-14s,A-C forklift, B-112
Kubota BX23S lil' TOOT( The Other Orange Tractor)
Never burn your bridges, unless you can walk on water
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