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Choosing best insurance and insurance at Mayo
Visiting Mayo Clinic | Last Active: Jan 18 12:42pm | Replies (36)Comment receiving replies
Again I urge those who need Medicare/Medicaid to stay away from dis-advantage plans. [Beware of] private insurance compan[ies] that send you to an advantage or Supplemental plan. “Both are basically the same plan”. Many cases have cost these plans millions of dollars in fines for using their favorite plans to write the expenses by fraudulently double and tripling billing.
AARP is an example. They get a piece of the action from AARP or vica/versa. If you look at AARP plans they are all United Healthcare advantage plans if using AARP for your healthcare.
I was on UHP for a month and hated it and went back to my Neighborhood Health plan integrity.
Everything you can think of health wise is covered with no co-pays or deductibles.
I pay by Social Security. $160 a month for the dual Medicare-Medicaid plans and other than that premium $160.00 a month I have not paid anything for health care the past 10 years.
You name it, it’s paid for 100%. I think United is too big. I once received a bill for $600.00 for dental care because they said the dentist was out of network. I checked my policy and found her listed as “in network “ I had to call and eventually spoke on the phone to a person in Kansas who said that “ you can always appeal it”
I’m in RI, 1,000 miles from Kansas.
I told him that I wasn’t going to appeal anything because it’s covered. I never heard from them again and I disenrolled from United and went back to NHP. A local insurance company.
RI does have a remarkable Medicaid expansion program and it pays whatever Medicare won’t including copays and deductibles. You have to qualify though. Many states [...] get crumbs or low no Medicaid plans at all.
So do your homework and don’t let a friendly advantage plan salesman offer you an advantage or supplemental plan as they are both the same thing with little difference between them.
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Yes, "Medicare Advantage" plans are run by insurance companies, and the name is purely a marketing trick for there is no advantage in these plans!. But it is simple:
1) ORIGINAL MEDICARE (Part A, Part B, Part D) - Part A and Part B covers 80%. Part A is hospital, and there is no monthly premium. Part B covers doctors and tests and there is a monthly premium. It is taken out of your Social Security if you sign up. People with low income may have a reduction on cost.
2) With original Medicare, I bought a Medigap supplemental plan that covers the 20% that Medicare does not pay. I pay a monthly premium and I never see a bill. I self-refer and never need approval for tests, procedures or anything. I got the best one frankly and I can go anywhere in the US where they take Medicare, and I can take it to other States if I move. It also gives me Silver Sneakers, one vision exam, one hearing test year - Medicare covers one Health exam of eyes, just not the eye glass exam.
3) I also bought a cheap Part D plan for prescription drugs. Those plans depend on the State you live in. They are easy to change. Each year I go on the Medicare site where I have my drugs listed and it shows me the cost of each plan, I am eligible for. Good to check each year because plans change, so do your drugs so you may want to change plans. It is a great tool to use. Medicare really does a good job. And Medicare is far more cost effective than insurance companies for healthcare!
BUT
MEDICARE ADVANTAGE Part C - evil
1) The insurance companies take over. You will have copays, need to be referred to specialists, need approval for certain tests and treatments etc.
2) You must go to their network doctors who have agreed to take less that Medicare price
Many places are dropping Advantage plans. You risk not having right specialist.
Remember people:
You might look for a good deal on a used car, but you don't want to save money on the wheels. The same with Medicare. One gets sicker with age not healthier, and you will want the best doctors and not stress about waiting for approval for a cancer treatment. Get the best you can!