Medicare Advantage plans

Posted by howardrlewis @howardrlewis, 3 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 tsch @tsch

@marietter
Not sure what you are referring to. Have you had an advantage plan since 1997? We have not had problems and I wonder why there are many articles written which criticize advantage plans. They are not perfect for sure, but without a Medigap, on traditional Medicare there is no limit on what a person can owe for medical procedures. At least advantage plans have a cap.

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@tsch 29 years, since 1997 not 35 to be exact.
No big deal really.

But in answer to your question. I’ve worked in healthcare administration for over 45 years and chose Traditional Medicare for many coverage reasons that the managed care plans do not cover. (“Advantage care plans.”)
Health conditions, hospitalizations length of stay, physician specialists, medication coverage, skilled care, Medicare part A deductible, coverage outside the country, are some of the reasons I personally chose traditional Medicare.
But your selection works for you and that’s good. But what works for some may not be recommended for all.

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Profile picture for tsch @tsch

@marietter
Not sure what you are referring to. Have you had an advantage plan since 1997? We have not had problems and I wonder why there are many articles written which criticize advantage plans. They are not perfect for sure, but without a Medigap, on traditional Medicare there is no limit on what a person can owe for medical procedures. At least advantage plans have a cap.

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@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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Profile picture for Mariette R. @marietter

@tsch 29 years, since 1997 not 35 to be exact.
No big deal really.

But in answer to your question. I’ve worked in healthcare administration for over 45 years and chose Traditional Medicare for many coverage reasons that the managed care plans do not cover. (“Advantage care plans.”)
Health conditions, hospitalizations length of stay, physician specialists, medication coverage, skilled care, Medicare part A deductible, coverage outside the country, are some of the reasons I personally chose traditional Medicare.
But your selection works for you and that’s good. But what works for some may not be recommended for all.

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@marietter
Absolutely! There is no one size fits all, and people should choose based on their own circumstances. For us the advantage plans have been good, but they are not for everyone.

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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
There is no limit if a person does not have a supplement.

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Profile picture for Denise @denisestlouie

If you have traditional Medicare then that isn't a question you ever have to ask. If the facility accepts Medicare your covered

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@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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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 I said traditional Medicare. It covers you nationwide. The supplement you choose will cover the portion of the copay the contract agrees to. There are no prior approvals

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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
FYI, our Aetna plan in CT has covered us for care in Georgia. Most will not do this tho

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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
If you move from one state to another, you have a special enrollment period in which to change coverage to plans for the new location, if you have or prefer an advantage plan. You may be able to return to original Medicare as well. But it is risky not to have a Medigap. Also lower income people can qualify for the Medicare Savings Program- income levels vary by states, but it can be a generous benefit.

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Profile picture for browndognotnow @browndognotnow

@vic83 it appears there is a misunderstanding once u give yourself over to an Advantage Plan you are now under their private insurance and they can dictate the rules. Medicare has set rules across the board.

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@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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