Anyone else have Medicare Advantage

I have Medicare Advantage with Kaiser. I had a RARP last year and things have been going well (so far). I had my choice of either radiation or surgery and chose the latter, for reasons I've previously explained.

My out-of-pocket cost was $258 (in addition to my normal Medicare and Kaiser premiums) for the 1 night hospital stay

Thanks for the reply Ken! I had Kaiser for years but switched to Blue Shield a few years ago.

@paulcalif, you may also be inteested in this related discussion:
- Best Medicare Advantage drug plan for Prostate Cancer?
https://connect.mayoclinic.org/discussion/best-ma-drug-plan-for-pc/

Maybe a decade ago I joined Anthem Blue Cross/Blue Shield. Yet since Medicare covers most hospital visits and stay-overs I wonder if I actually benefitted. I will say that in 2019 I was in the hospital's ER and CCU on 3 separate occasions. 2 years ago I had my prostate surgically removed because of prostate cancer. I thought I was done but the prostate cancer surgery caused an abdominal hernia. I had surgery for that last Fall. Then some tests that I don't even recall taking showed that the cancer had escaped from my now missing prostate into some lymph nodes. I have an appointment set for Valentine's Day with a radiation specialist to discuss the situation and my options.
The point that I wanted to make is that I did not pay anything for any of this. I'm a 71 year old man on Social Security (less than $1,000 a month) and Medicare. I don't have any income other than Social Security and a municipal pension that pays me $350 a month. I own no stocks, bonds, gold or silver. I do own a run down condo built in 1940. My car is a 2013 Hyundai.
I don't know if any of this is applicable to you. Good luck!

I also have a Medicare Advantage plan with Kaiser.
Other than a couple of $40 copays, my MRI, biopsies, and PSMA were covered.
I am being treated with ADT due to my age and Gleason of 4 + 3= 7. I am satisfied.

If you are thinking about going to Mayo for treatment, Mayo AZ doesn't accept ANY Medicare Advantage plans but MN and FL do accept some but not all.

Admission: I really dislike the name. Originally known as Medicare Part C plans.

Medicare Advantage (MA) Plans must cover everything that Traditional Medicare covers, and they generally offer some additional, minor benefits.

However, their roots are in the HMO model and they make their money (lots of money) through contracting with a network of providers and care management.
And, many MA plans dictate the choice of a Part D drug plan.

As medical costs increase, there are some Hospital systems, as well as some Physician practices, in some places that are declining to participate in contracts with some MA plans over reimbursement rates. And this trend is growing.

Was that gentle enough.

I have Traditional Medicare, Parts A & B, a Part D plan and the most comprehensive Medicare Supplement plan.

Yes, I pay more in total premiums than I would with a MA plan.

However, I received (am receiving) my PCa care out of my state of PA at Johns Hopkins in MD. And so far, I have only paid my annual deductibles for preop diagnosis, inpatient surgery, post op care and radiation treatment for recurrence.

And I can travel to seek care at/from any Institution/Provider that accepts Medicare.

Hopefully never needed, but if/when I have a 2d recurrence (G 9 unfortunately), there are Centers of Excellence in addition to Johns Hopkins with which I might want to consult.

And, Medicare Supplements purchased AFTER initial enrollment may be subject to medical qualification and higher premiums, or may be unavailable, if selected after initial enrollment/purchase (i.e., after my PCa diagnosis, I could have switched to Traditional Medicare, or tried to add a Medicare Supplement plan, but I may not have been able to purchase a Supplement, or the premium could be elevated).

Medicare Supplements can only be purchased together with Traditional Medicare.

All that said, MA plans still provide all Medicare covered services and can be an excellent choice for enrollees.
In general, the total premium costs can be less than Traditional Medicare and the additional benefits are nice. With MA plans, you cannot purchase, and may not need, a Medicare Supplement.

Drug coverages and costs are a topic all their own.

Well, now I need a nap after all that pontificating.

Best to you and all with your health, and your health care choices.

Fortunately, I switched from a medicare advantage [MA, aka medicare part C] plan when [five letters, starts with C, but used to start with A] refused to cover the first mpMRI. When I appealed the decision, they never even bothered to respond, even though the MRI clearly found cancer and guided treatment. Since I was within the 6 mos free switch window after turning 65, I could and did get a [high deductible G] supplemental insurance plan along with traditional medicare.
Recently I switched my 91y.o. quasi-dependent from an MA to traditional medicare. Why? 1) It actually saved money on premiums. While she isn't likely to get a good rate on a supplemental plan, she doesn't need one. 2) I find arguing with insurance companies about medical treatment questions an unproductive waste of time. I hope your experience differs if you are in that situation. Unfortunately I still have to argue over drug coverage, since all part D (drug) plans are privately administered by insurance companies.

Exactly. For the unsuspecting...Medicare Advantage plans (not original Medicare) require you go to their network of doctors/hospitals...and there is no guarantee that their network has right specialists or can offer one all treatment options. And specialists have subspecialties so even if they have a "specialist", there is a good chance that such "specialist" does not have the knowledge you require. That happened to me. But fortunately, I have original Medicare and I ordered specialist to send my records to Mayo. I can self-refer to any doctor in the US that takes Medicare. I pay my monthly premium and I never see a bill and I don't need any approval. Yes, my premium costs more...but that was before I was diagnosed with cancer. Now I am saving many thousands of dollars by NOT having an Advantage plan. And I have never had to worry about getting approval for anything!
Mayo Oncology Dept has brochure about how people should check their insurance, and what to do if insurance refuses cancer treatment!!!! It also states that people with original Medicare do not need to check insurance.
Because how do these Advantage plans work? Medicare sets the price they will pay for a procedure, so the insurance company doesn't have to do more. Then the Advantage insurance company finds doctors willing to take less that what Medicare has established. And they make their customers pay copays etc. and get approval for a procedure. Medicare Advantage plans advertise nonstop on TV with all these extra benefits. How do they make a profit and pay for all that advertising??? By limiting you to their network and requiring copays and approvals for any procedure and refusing many times. There are lots of complaints about this. Tragic when someone has cancer and is waiting for the insurance company to approve a test.
Frankly, we don't need a choice of plans...we need affordable coverage for any eventuality. Why should the insurance company be making big profits? Let Medicare offer the choice and collect. Also Medicare is more cost efficient than these insurance plans. Health insurance is not a "free market" situation because we have to have it!

Pretty much what I expected with medicare advantage. I think I'm stuck with my Advantage plan at this point, so original medicare is not an option. I think I can change to a different network if that might get me to a different medical facility, but I'm not even sure about that. Tuesday I'm scheduled for a PSMA Petscan and I have a video conference scheduled the following day with my GP. I'm hoping she'll have some insight into how referrals, second opinions and available proceedures work. Having info. about traditional Medicare is eye opening and a little depressing. I'm afraid it's too late to switch for me (I'm 68). So what I'm really looking for is how to navigate within my Advantage plan. It's starting to look as though I'm stuck with whatever my network offers me.