MBC and Going on Medicare soon, any advice.

PS- I take many prescription drugs now. I also use GoodRx if I can get a lower price.

Medicare advantage plans are good if you don't mind not being in complete control. It is government run because you are encouraged to use the Doctors they choose for you. You may see whom ever you wish but there will be co-pays and more. Add up the costs of each time you see the Doc as opposed to a plan that covers it. I researched the plan several times over a few years and decided I like being able to choose who to see and when. If you ask the doctors offices how they like it which I did and talked to the office staff. They are not big fans. Not knocking the plan as helpful but its matter of a choice. With my plan I have one deductible at start of year and then all is covered with no co-pays. It's all a choice at least for now.

Medicare Advantage is hooked up to federal funding but ADMINISTERED BY PRIVATE INSURANCE COMPANIES. They make a profit by requiring referrals, pre authorizations and denials.

Traditional Medicare is ALL FEDERAL… they do not make a profit and ALL doctors who accept Medicare ( all of mine do) accept this form of Medicare. NOT ALL DOCTORS who accept Medicare accept Medicare Advantage plans.

Buyer Beware!

Blue Cross Blue Shield is a non-profit, at least according to the Internet.

My Medicare Advantage Plan does not require referrals. Imaging (not x-rays) requires pre-authorizations but nothing else.

Most people I know on regular Medicare have expensive supplements and Rx plans. Again, I pay $79/month for everything, it is a PPO, and in 7 years have not run into any problems with coverage. I have "more than 5 serious health conditions." so am not a light user.

Half of people over 65 are on Advantage Plans. Every hospital financial counselor advised me to be on this plan (4 in all). I cannot generalize from state to state or company to company. I am on MA BC/BS.

I think we just need to be careful about the information we post. My info is admittedly specific to state and plan. Let's be specific- and accurate- about our info. This is a big decision and we need to take care with our advice.

ps for me the annual cap on out of pocket was a big factor

Supplemental to Traditional Medicare cost is directly linked to your reported income of the year before. I believe there are 3 levels. Add to that I pay a $240 Deductible once a year and $ 26.00 monthly drug plan ( Part D). I schedule an appointment with any nationwide doctor who accepts Medicare without any prior authorization.

This plan works well for me. I’m very happy that your plan works well for you. That said, I’m recently hearing , from friends and acquaintances, that their doctors are opting out of Medicare Advantage plans… many now corporate run “ advantage” plans are popping up and using only those docs in their system ( which can often be regional).

By buyer beware, I suggest checking in with your Medicare doctors and see if they have Medicare Advantage Plan exclusions. Nobody wants a surprise when it comes to medical bills!

BCBS MASS. Just paid an 11.3 million severance to one of their top people. It makes me wonder about non profit titles, which they absolutely state on their information.

Anyway… glad our choices are working for us. Thank you

Supplemental to Traditional Medicare cost is directly linked to your reported income of the year before. I believe there are 3 levels. Add to that I pay a $240 Deductible once a year and $ 26.00 monthly drug plan ( Part D). I schedule an appointment with any nationwide doctor who accepts Medicare without any prior authorization.

This plan works well for me. I’m very happy that your plan works well for you. That said, I’m recently hearing , from friends and acquaintances, that their doctors are opting out of Medicare Advantage plans… many now corporate run “ advantage” plans are popping up and using only those docs in their system ( which can often be regional).

By buyer beware, I suggest checking in with your Medicare doctors and see if they have Medicare Advantage Plan exclusions. Nobody wants a surprise when it comes to medical bills!

Anyway… glad each of our different choices are working out for us. Thank you

After one’s initial enrollment period, in most states it is very difficult to switch to a Medigap or Supplement. Medical underwriting is necessary and those of us with breast cancer would not be eligible. One can always downgrade to a Medical Advantage plan with no underwriting. This, along with no network or geographical restriction, made the choice obvious to me.
Additionally, if rehab is necessary after a hospital stay, there is a much wider freedom of choice with a Supplement. My friend had an Advantage Plan and was only able to find a bed in a terrible facility. My aunt had a supplement and we were easily able to secure her a spot in a top notch facility.
A Medicare Advantage Plan is less costly if you are relatively healthy and plan to only use network doctors and don’t need in patient rehab, but that can change so easily.

Again, I do not have a network that is limiting, and can go anywhere I like on my Advantage Plan. People need a PPO one, not an HMO. Not sure if states vary but mine is great.

I made it very clear that I have several serious conditions, including cancer, and the financial counselors- al 4 of them- recommended an Advantage Plan. I have no skin in this game other than accurate info going out.

Mayo in Rochester only accepts one Advantage Plan, to my knowledge. MD Anderson and Cleveland Clinic, none. Plus, that is subject to change at any time.
My employer offers a PPO at a very attractive rate for retirees. I decided against it, so I would not be subject to prior authorizations or limited in my physician choice. I have no skin in the game either, other than making sure that people understand that in most states, the decision to go with an Advantage Plan can not be easily reversed if they change their mind in the future. I have too many friends with regrets, and that makes me sad.

Sorry the MASS. BCBS payout was not recent. I apologize for not having read it more carefully.