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In reply to the discussion: Holy shit. Be prepared for the consumer to get screwed on your healthcare advantage programs. [View all]
LauraInLA
(1,355 posts)103. Insurance companies make them, I guess. My mother, who died in 2009, had the United American supplemental plan,
which was fantastic. I don’t know if it’s still good or still exists.
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Holy shit. Be prepared for the consumer to get screwed on your healthcare advantage programs. [View all]
LilElf70
Sep 2024
OP
I've had an Advantage plan for five years. Costs me $0 additional. I love it.
Sibelius Fan
Sep 2024
#3
Clinic systems have contracts with insurers and the reimbursement rates are already negotiated
dflprincess
Sep 2024
#52
They get commissions on advantage and drug plans too, which are private insurers.
Silent Type
Sep 2024
#109
I have no copay for doctor visits. Generic drugs are $0. A three-month supply of
Sibelius Fan
Sep 2024
#181
I have $2000 worth of dental work that needs to be done next month which I now will get done
elocs
Sep 2024
#173
Humana has a plan which covers dental extensively in Ohio...I have never been on it but good reviews.
Demsrule86
Sep 2024
#188
"I know some people are limited financially and must go with what they can afford"
elocs
Sep 2024
#176
Yes - you have to be able to afford it. On the other hand, having to pay the 20% of B could be bankrupting.
kerry-is-my-prez
Sep 2024
#215
"Supplement" is the wrong term if you are talking about privatized Medicare
Jmb 4 Harris-Walz
Sep 2024
#192
If something seems too good to be true, it definitely is. We won't get Medicare Advantage either.
lostnfound
Sep 2024
#16
Yup, Medicare Advantage is privatized Medicare. My concierge dr won't take you if you have a disadvantage program
vapor2
Sep 2024
#50
Your concierge doc probably does not take traditional Medicare either, especially new patients.
Silent Type
Sep 2024
#110
You are initially, don't fall for advantage if you're going to be new to Medicare.
we can do it
Sep 2024
#97
I think it all depends on the Advantage Plan that was chosen. There are several to choose from; suggest you
Jmb 4 Harris-Walz
Sep 2024
#194
Max out-of-pocket for prescriptions drops to $2000 next year. That's $3,000 in savings.
Sibelius Fan
Sep 2024
#2
I think that's a big deal; however I'm not sure what that will do to premiums.
Silent Type
Sep 2024
#111
I spent 46 days in hospital, had open heart surgery, two subsequent heart surgeries and take Eliquis-
Demsrule86
Sep 2024
#46
Humana Gold Advantage PPR give back ( GB means I get just over 100 back monthly from part B)
Demsrule86
Sep 2024
#193
I have Humana Gold. You have regular Medicare. I couldn't afford it. I pay no premiums and get 100 + a month back in
Demsrule86
Sep 2024
#186
Part C is Advantage...you have traditional now. And Medigap covers the 20% Part B doesn't cover and insurance companies
Demsrule86
Sep 2024
#198
I have gym membership free with my supplement and can go to any doc who takes Medicare w/o asking insurance permission.
we can do it
Sep 2024
#100
Do you realize that Advantage plans are private plans and not Medicare plans?
Think. Again.
Sep 2024
#8
And insurance companies sell Medi-gap policies...so I don't see the difference.
Demsrule86
Sep 2024
#199
That is your opinion. I have advantage and I get 100 per month back on part B, no premium and everything is
Demsrule86
Sep 2024
#209
Medicare works with it, but doesn't administer it. Medicare gives Medicare Advantage
pnwmom
Sep 2024
#142
That's just a label -- it means it's approved by Medicare as an option, but it's not managed
pnwmom
Sep 2024
#135
Your drug and MediGap policy are private too. And private insurance companies do all the admin
Silent Type
Sep 2024
#113
So is Medi-gap coverage. I don't see the difference. Other than I pay more for traditional.
Demsrule86
Sep 2024
#195
The difference is Medicare is a government program while Advantage (and medi-gap) are corporate programs.
Think. Again.
Sep 2024
#200
No, they are private plans that Medicare regulates and pays on your behalf. The plans aren't run by Medicare.
pnwmom
Sep 2024
#83
That is BS. Unless you want to pay 20 % out of pocket, you have to get an additional plan with a commercial insurer
Demsrule86
Sep 2024
#49
That is not true. My sister in law had regular Medicare and she was denied care. They can and will deny you.
Demsrule86
Sep 2024
#204
Are you asking me how a federal plan is different from a commercial plan?
Think. Again.
Sep 2024
#56
You misinterpret...you pay Medi-gap plans for coverage..and these plans are insurance based...not different that
Demsrule86
Sep 2024
#210
The difference is whether your own doctors and hospital decide on the care you need,
pnwmom
Sep 2024
#87
You are kidding yourself if you think traditional Medicare doesn't deny certain procedures.
Demsrule86
Sep 2024
#206
Supplements are private insurance plans, though with little discretion. As are drug plans,
Silent Type
Sep 2024
#114
You need to take a look at original Medicare policies that limit all kinds of coverage for "excessive"
Silent Type
Sep 2024
#132
I'm really glad it's worked so well for you up to now. It appears less stellar in other regions. I'm sorry the
LauraInLA
Sep 2024
#98
Have you or your wife ever needed X-ray treatments that cost more than $10K each?
pnwmom
Sep 2024
#128
Bad news. Private insurers get paid billions to administer original Medicare too. So you
Silent Type
Sep 2024
#116
No, they don't. Medicare itself administers Parts A & b with the money people pay into it.
pnwmom
Sep 2024
#150
Absolutely wrong. Private insurers have subsidiaries that administer original Medicare. Give me your state and
Silent Type
Sep 2024
#165
Insurance companies make them, I guess. My mother, who died in 2009, had the United American supplemental plan,
LauraInLA
Sep 2024
#103
I live in Cleveland on my Advantage plan...I can us Cleveland Clinic, UH or Metro...all fine insurers.
Demsrule86
Sep 2024
#51
"No Democrat should be supporting or praising this right wing privatization scam, this assault on Medicare. "
MichMan
Sep 2024
#57
the 2025 changes that save the beneficiaries money shift the financial burden to the plans
Coexist
Sep 2024
#21
Once you get locked in, it may be difficult to go back to original Medicare. They now own you.
keithbvadu2
Sep 2024
#26
You can go back to original Medicare (parts a & b) at any time during open enrollment
hot2na
Sep 2024
#149
Rightly or wrongly, MA rates were cut. Personally, until our government-- regardless of party --
Silent Type
Sep 2024
#30
The issue is the trade-off. We turned down Advantage and its freebies (free dental, gym, etc)
pnwmom
Sep 2024
#80
Might be worth checking the AARP United HC Medicare Supplement. It provides gym memberships.
we can do it
Sep 2024
#104
I get it. Your situation like half of Medicare eligible people is unfortunate and you're right
Cheezoholic
Sep 2024
#85
Why now? Because they wait till it's too late for you to switch back to Medicare,
pnwmom
Sep 2024
#74
Well, CMS is cutting rates for next year. Whether that is justification for cutting "extra" benefits
Silent Type
Sep 2024
#123
Medicare Advantage is a ripoff, and I would never choose such a plan. Buyer beware!
Martin68
Sep 2024
#81
The private insurers running MA plans have been subsidized, to the disadvantage of regular Medicare.
Ms. Toad
Sep 2024
#93
No, I think people are just bringing it up, to shed medicare in a bad light during an election, and stoke discontent.
Think. Again.
Sep 2024
#122
I saw tens of thousands of my husband's co-retirees threatened with the loss of their doctors
pnwmom
Sep 2024
#134
The people screwed by advantage are dead...they aren't going to answer
questionseverything
Sep 2024
#155
One of the biggest providers in the city will not take Advantage anymore.
kerry-is-my-prez
Sep 2024
#202
Need advice! I have original Medicare and I want to add Medigap (in Minnesota) now
KatK
Sep 2024
#105
Lots of people are happy with MA. That's why 52% of Medicare beneficiaries choose it.
Silent Type
Sep 2024
#124
When they join they can only hope they'll be happy long term. And in most states, if you wait too long to switch back,
pnwmom
Sep 2024
#139
I know, some folks think that 52% are too stupid to make the right decision for them.
Silent Type
Sep 2024
#166
Medicare Disadvantage - 11 years ago when I was considering 'Advantage' plans, that's what an agent called it
GoneOffShore
Sep 2024
#148
hospitals and clinics are not getting adequate reimbursement from them
travelingthrulife
Sep 2024
#162
How did I know that the doom and gloom post would be from a relatively new member?
ZonkerHarris
Sep 2024
#196
In case you haven't noticed, the only significant upgrades to our healthcare system-- ACA, drug plans, Medicaid
Silent Type
Sep 2024
#220
There is nothing more confusing than Medicare. I still haven't wrapped my head around it but someone stopped me from
kerry-is-my-prez
Sep 2024
#213
I have Medicare and Tricare for Life so I don't need or want Medicare Advantage
LogDog75
Sep 2024
#221