Medicare Advantage plans

Posted by howardrlewis @howardrlewis, 5 days ago

I live in Isanti Co (55008) and want to know what insurance companies Rochester Mayo will accept. Does anyone have information on that?

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Profile picture for gigipatula @gigipatula

@denisestlouie that is not true, for instance if you are insured in say Virginia and you find yourself living in North Carolilna, you probably will have no coverage with your Medicare advantage plan. Advantage plans run like HMO's and your coverage quality varies from state to state some states have great plans others not so much.

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@gigipatula pretty much true but no matter what advantage plan you are on they DO HAVE to cover in the USA ONLY any urgent or emergency care needs. I just confirmed this with our current advantage plan as they are dropping out of network coverage next year. So if we travel in the states and we need medical care we will be covered for only those 2 types of visits

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Profile picture for gravity3 @gravity3

@tsch

"on traditional Medicare there is no limit on what a person can owe for medical procedures.". This is not accurate.

I've had original Medicare with plan f supplemental through United health.

I've had knee replacement, polyp removal at Johns Hopkins, all my usual visits, tests, various MRI,
I have never received a bill. I am 78 and feel confident that as my health becomes more challenging I will need this reassurance. Yes, I know what the monthly bills are to keep this care with no additional cost going.

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@gravity3 Originally, I went with traditional Medicare and a Medigap plan because my sister-in-law commented how much she liked their plan, never saw a bill. I talked to Rep and he said I could travel with it so I went with it. I am so thankful I did, because after I really needed it. The Medigap plan pays the 20% Medicare does not cover, and I never see a bill, AND I SELF-REFER WHEN I WANT but the insurance company is still breaking even despite my many procedures.

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Profile picture for vic83 @vic83

@gravity3 Originally, I went with traditional Medicare and a Medigap plan because my sister-in-law commented how much she liked their plan, never saw a bill. I talked to Rep and he said I could travel with it so I went with it. I am so thankful I did, because after I really needed it. The Medigap plan pays the 20% Medicare does not cover, and I never see a bill, AND I SELF-REFER WHEN I WANT but the insurance company is still breaking even despite my many procedures.

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@vic83
I'm not sure what this means....

but the insurance company is still breaking even despite my many procedures.

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Profile picture for longboat1 @longboat1

@browndognotnow in my experience the only time my Advantage plan change the coverage is from year to year. The cap on out of pocket expense protects you.

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@longboat1

Protects you from......?

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There's a maximum out of pocket $ for all plans...MOOP.

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Also there are no premiums and some plans have a "give back" for part of your Medicare premium. I'm not advocating for Advantage plans...only stating what I know. There are many choices.

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Profile picture for gravity3 @gravity3

@vic83
I'm not sure what this means....

but the insurance company is still breaking even despite my many procedures.

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@gravity3 My premium and what the Medigap policy pays out are about the same even though I do a lot of things. Medicare Part B premium is half the price of my Medigap policy but pays 80% while private insurance premium is twice as high as Part B and only pays 20% . Lucky insurance company!

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Profile picture for tsch @tsch

@vic83
Sorry, but I disagree with your comments. I am a certified Medicare counselor (not a broker) and my husband and I have had advantage plans for a total of about 35 years and we have never had a problem. Also, in CT and a few other states a person can get a Medigap plan even after they first join Medicare. Your beware is unwarranted—we have never had a doctor leave our networks (currently Aetna.) For Mayo Clinic, having traditional medicare is better, apparently.

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@tsch It would be difficult to have Medicare plans for 35 years. They originated in 1997. They are not built for patients or providers. They were designed for for-profit companies like UHC and Anthem to make money for shareholders. They take way choice from the insured and put them in HMO environments. They are not good for anyone who could face a serious illness that has to be managed over time.

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Profile picture for Denise @denisestlouie

@tsch It would be difficult to have Medicare plans for 35 years. They originated in 1997. They are not built for patients or providers. They were designed for for-profit companies like UHC and Anthem to make money for shareholders. They take way choice from the insured and put them in HMO environments. They are not good for anyone who could face a serious illness that has to be managed over time.

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@denisestlouie
I think you misunderstood or I was not clear. My husband and I, each 83 now, have had advantage plans since age 65, in 2008. That is 18 years for each of us on an advantage plan. That is why I used the number 35 for our years with this insurance. I agree, advantage plans are not for everyone, but they have been fine for us, and we have always had a PPO, so our options are not as limited as with HMOs.

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People seem very confused to me about traditional Medicare and a Medigap (supplement) vs a Medicare Advantage plan. Every state has a program offering seniors free unbiased consultations and screenings of advantage plans and drug plans. It is called SHIP or State Health Insurance Program, and counselors are well trained and helpful. People who feel their costs are covered completely need to realize they pay premiums for that. Medical care outside the US is only covered by traditional Medicare or advantage plans when it is an emergency.

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