Seniors with Medicare, is Mayo worth the hassle?

I have traditional Medicare and I get the same message each year. I'm also a Mayo Arizona patient and I like traditional Medicare and I have Tricare for life as secondary. They work well for me in my Heart Transplant followup appointments.each year.

You are so right! I comment frequently on the disadvantages of Advantage Plans. You might also mention that if someone has an Advantge Plan and then decides to go to Traditional Medicaare, they may have great difficulty in finding a Medigap plan to take them....because companies are no longer mandated to take you after the initial enrollment in Medicare.

I have Traditional Medicare with BCBS Medigap plan and have done 2 surgeries, cardiac stent, colonoscopy, many CT and PET scans etc. at Mayo Rochester, all with zero problems and I have never seen a bill

I have traditional Medicare with BCBS Medigap plan, I go to Mayo Rochester - I have never had a problem, never seen a bill except my monthly insurance premium. I worked in Corporate America and had good health beneifts, but Traditional Medicare is better and easier.
Things to know:
1) Medicare does not cover hearing test, but my Medigap policy does. Also because I had a device put in my ear, my hearing tests are not screening but coded differently.
2) My colonoscopies always covered because I had previous polyps. Check Medicare on "screening"
3) Medicare does not cover refractory exams for glasses, but my Medigap plan does. Medicare does cover annual exam for eye health however.

Vic83. What bcbs plan do you have? Mine has small copay. Do you know what your plan is called? Thank-you

My Minnesota BCBS plan is Senior Gold. I got it before they stopped covering the Part B deductible and was grandfathered in....but that deductible is only about $240. Check out the Medicare site to compare Medigap plans and their costs in your area. It is an excellent tool. Each plan has a letter so that one can compare "apples to apples".
I would never change my Senior Gold plan now, I was so happy I had it when all my health issues started. But each year I check my Part D drug plans to see which is cheaper. It is an easy thing to do. One puts in one's drugs and it pulls up all the plans one is eligible for and gives costs for each plan. I am used to computer tools because of my previous work...and Medicare has a great tool. They also answer the phone calls promptly.

Facts.... Traditional Medicare "supplemental" plan coverage is all the same regardless of provider or the "sexy name" they apply to them. "Medigap" plans are dictated by CMS and simply put "if medicare covers it, the supplemental plan covers it. Deductibles are based on criterial set by CMS. There is no "grandfather" plans, just the plan you signed up for that was available from CMS at your time of eligibility.

Plan F (no longer available) had no Part B deductible. Plan F is no longer an option. Plans G and N are now the most popular and both have high deductible options for those who are are disciplined enough to before need "self fund" the short fall.

If there was a discernable difference between insurance companies providing medigap plans its rates. Some start all low and gradually ramp up year over year....its the get you in the door plan. Others have higher initial rates but their historical year over year increases average lower and ultimately over time end up less expensive. Again, all medigap policies provide the same "CMS Dictated" coverage. Ask you broker to provide you a 10 or 20 year history of rate increases of all providers you are considering. The math doesn't lie...brokers do.

As to the "never change my senior gold plan"... unless you wish to have to go through a rating process with another provider, you can never leave the plan you have.

The entire "I am about to hit 65...Mcdicare" exercise is a decision that cannot be taken lightly. Your decisions are pretty much cast for the rest of your life.....so chose wisely. While "advantage plans" may look very attractive (Joe Nemeth driving you to bingo, get money back for "stuff" and more), advantage plans are not Medicare and shouldn't even be allowed to use the Medicare name. They are private insurance plans in which the government (ie CMS) pays for someone else, at a lower cost to CMS to provide your health care...you are not on Medicare.

Advantage plan providers can and do change the terms and conditions of their plans every year, up to and including removal of certain coverages that the bean counters may deem to be excess exposure... Insurance companies for the most part are "for profit" entities and regardless of some of the short comings and slightly higher cost for traditional Medicare, Advantage Plans are only for the advantage of the insurance company, not your health. Yes, there are some (few) reasonably good Advantage Plans out there but they are few and can change course at any time.

As I noted early on, this is a "once in a lifetime" decision so you must take the time to sort it out, as daunting as it is and get it right. Oh, brokers make more money selling Advantage Plans than traditional medigap plans. Some insurers (big brand) bonus their agents for pushing their medigap plans while there may be more "cost effect" option available. You have the right to ask the questions..... Is the agent paid more to sell one plan over another? Is the agent on a quota system with their firm?.....I could go on but suffice to say the field is by no means "level".

Different states have differing laws governing how you are rated (there are three types of "groupings" that can determine your rates. Also rates and availability can change literally by the Zip Code you live in...

Sorry for the long missive. I spent 6 months investigating my "65" medical transition. As a business owner with large numbers of employees across many states, I had to deal with the nuances of every flavor of insurance and how to best equitably provide for my employee without breaking the bank. I found dealing with my own Medicare transition in some cases more daunting due to the "once and done" nature as well as the exaggerated and false claims by agents, providers and insurers. Too much media and marketing setting false expectations of "everything is covered and it's cheap" was a common theme

One piece of anecdotal data... I queried nearly 100 "Smart" people I knew were of Medicare age and all but 7 were on traditional Medicare....there's a message in there somewhere.....

Mayo is not the only provider becoming more "fussy" about services, payments and coding. Mayo like any other provider is at the mercy of the Government and insurers' coding systems. Employees make mistakes, procedures are similar, but different....and on and on. If you are looking for "i don't have to do anything", times have changed. YOU and only you are responsible for your health, health care delivery and the "exercises" that go with it. If you are looking for "easy", you will get poor care, mistakes will be made and ultimately you will be worse off.

For us (primarily my wife), Mayo is worth any inconvenience thrown our way. We travel 6 hours 4 times (or more) a year and park for a week in our motorhome in JAX so we can accommodate any schedule Mayo throws our way. Have there been coding issues, yes, have there been billing issues, yes, has Traditional Medicare challenged us, yes.... But, we "manage" the situations and the reality is both Mayo and CMS have always been helpful at resolving the issues.....but YOU have to be an active participant!

As two very famous doctors with a great YouTube channel from Canada say at the end of every podcast....."You are in charge of your health".....!!!!!

You are right. People must consider carefully when they sign up for Medicare. It is not where one wants to save money, because one does not get healthier with age.
The most important differences for me between traditional Medicare and the Advantage plans is CHOICE OF DOCTOR and being able to self refer.
I have a Medigap Plan F which is no longer available (but if you had it you got to keep it=grandfathered in). I got it in 2009. I had started to research plans a little, but went with this plan because my brother was so happy with his and I could take it with me from Minnesota to Florida where I was retiring, and it offered some international coverage.

Regarding premiums, I asked the sales Rep how much it typically increased each year and he said 10%. Fortunaately with the passage of the ACA (Obamacare), those increases became more modest.
For those not familiar with the ACA (Obamacare): Under the Affordable Care Act (ACA), insurance companies are required to spend a significant portion of the premiums they collect on medical care and health care quality improvement. This is known as the Medical Loss Ratio (MLR). Specifically, insurers must spend at least 80% of premiums on medical care for individual and small group plans, and at least 85% for large group plans.
If insurance companies fail to meet these requirements, they must provide rebates to policyholders. For example, in 2019, insurance companies returned $1.37 billion in rebates to policyholders.
This applies to all insurance companies. My BCBS now limits increases so I see no rebate, but if one has insurnce from employer, the company may keep the rebate and the employee will not see it.

Agreed "you are in charge of your health...!!!!
It is really important to read the test reports and doctor's notes now mandated by law to be posted on the Internet. Apart from mistakes in records, the doctors also may not share everything. I research everything to be able to ask questions. It has made a signficant difference in my treatment at least twice.

@vic83 Thank you for reminding our members to read their test reports and provider notes. I do the same and use those documents to frame my questions that I send on the patient portal or ask at my next appointment.

I'd like to suggest a slight correction.

"now mandated by law to be posted on the Internet." I think you mean posted on your confidential patient portal". A patient portal does make use of the Internet but the Internet, as a whole, isn't confidential.