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#1 Mike Patterson

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Posted 12 November 2017 - 10:02 PM

I'm not sure if this is the proper forum for this topic, but it is a general question. I'm getting ready to sign up for Medicare. Any thoughts on the differences between supplemental insurance vs. an Advantage plan?

 

I am hoping some of my fellow Olde Farts on here who have been there and done that, can offer some advice or warnings.


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#2 Dennis David

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Posted 12 November 2017 - 10:31 PM

Not an easy question.

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#3 Richard G With

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Posted 12 November 2017 - 11:04 PM

My advice is for you to meet with an insurance agent who handles one or more of the supplemental plans in your state. If you have an agent who already handles your insurance that would be a good starting point.

 

This stuff can present some pretty complex challenges and varies state to state.


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#4 Mattb

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Posted 12 November 2017 - 11:11 PM

We have plan "F' and like them. We pay nothing to go to any doctor of our choice, no referral needed. We are covered for any hospital charge above the Medicare payment amount. Basically we never have to pay any medical bill.     

 

The bad side is that F plans raise their cost with age. We are at $200 on one of our plans now. I have figured to stay with the "F" plans as long as the expense is acceptable with our income. If it becomes too much then we will switch to an Advantage plan and start doing co-payments, deductibles, and network doctors.   

 

If you can afford it, the "F" plans cover everything. We all know that a major medical event is probably going to happen to each one of us and the expense can be in the thousands of dollars if you are not fully covered by your supplement. It's a gamble, do you bet a major medical  event happens to you before you are 75 or so and the plan F pays a big bill for you, or do you bet that you stay healthy till  80s or 90s and by using an advantage plan yo have saved thousands of dollars.

 

I think it comes down to how comfortable you are with the monthly payment.

 

Plan D prescription insurance is even harder to figure!!


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#5 Mattb

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Posted 12 November 2017 - 11:13 PM

One other thing about "F" plans, they all have the exact same coverage. No matter how much you pay, the coverage is identical, so premium price and service are both important.


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#6 Ramcatlarry

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Posted 13 November 2017 - 12:53 AM

If you are poor enough, Medicare is OK. Many 'supplemental' plans are all scams to tax you out of your savings.

 

Any hospital or insurance that is 'for profit' is part of the problem.


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#7 Ecurie Martini

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Posted 13 November 2017 - 01:22 AM

I have been on Medicare for 16 years. In addition, I have a supplemental plan (coverage F) through AARP. I have never had a problem with it - no co-pays, co-insurance, or hassles.

 

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#8 Tex

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Posted 13 November 2017 - 07:55 AM

My urologist forewarned me about the advantage plan offered by my former employer; specifically, he said his office didn't take that particular insurance as administered by Humana. He didn't elaborate on what beef his office may have with Humana.

 

Since I want to continue seeing my urologist, I signed up with the other plan offered by my former employer (which my urologist does accept).


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#9 Ecurie Martini

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Posted 13 November 2017 - 08:58 AM

Humana started as a for-profit hospital management operation in Louisville, KY. I was teaching in the U of L medical school at the time.  Among my colleagues at the school, it was referred to as Inhumana.

 

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#10 Uncle Fred

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Posted 13 November 2017 - 09:14 AM

I originally signed up for an Advantage plan through UHG AARP but just changed to Humana because my new doctor won't take the UHG plan.  I suspect that these Advantage plans do not pay as much or as quickly as others. With these Advantage plans the government is basically buying you insurance with a major health insurance company.  With the Supplemental plans, Medicare still handles A and B coverage but Aetna, UHG, Humana, etc., handle everything else.

 

You have to check with you doctor's office manager to see which specific plans they accept. And don't think your doctor knows any more than you do. 

 

Why did I have to change doctors you ask? My doctor went to a "Concierge" plan where you had to pay $2,000 per person per year just to keep seeing him. His practice was too large, about 2,000 patients, so he was looking to cut back to 500. What does that mean? No waiting for appointments, 24/7 access to a doctor by phone, less work for him and his staff, and... $1,000,000 upfront for him every year!


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#11 n.elmholt

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Posted 13 November 2017 - 09:19 AM

A small beep from far away. :-)

 

In Denmark we have high taxes on everything and even 25% purchase tax, also on food. Cars not included as the taxes on these are 110-180%!!!

 

But I dont whine, because I had a major heart surgery when four years old and the state paid everything, I have since been visiting both "normal" and mental hospitals on several occasions, last time when I was diagnosed with prostate cancer (due to another checkup in December) - and again this is paid via the taxes. So I am a happy tax-payer and grateful for living in this small, weird, but wonderful country. :-) 

 

But everything is not rosy here all the time, I lost my job 12 years ago due to prolonged illness and that cost me both money and property, but still, due to state pension (and an insurance scheme), I was able to have a decent life afterwards.

 

I have now been retired due to my illness for 10 years and in spite of all the misery before that, I have now been able to obtain and move to a very small, old house on the Danish West Coast, 1,300 meters from the North Sea and 750 meters from Ringkøbing Fjord, partly thanks to an additional health insurance provided by LEGO where I spend my last four years in a job. Again, I am grateful.

Therefore it really hurts me, when people on this forum are forced to sell everything dear to them, to be able to pay medical bills, when they get seriously ill - so please get some insurance, even if it's expensive - when you get ill, you have enough to fill up your mind - you don't need serious economical worries on top of that.  

 

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#12 Racer36

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Posted 13 November 2017 - 11:18 AM

I read some of this stuff and frankly I am terrified for you guys. I am extremely fortunate to have been born in Canada where none of this is a concern, and frankly we take it for granted until we read what you guys have to navigate through. We buy supplemental insurance as well, but only to cover prescription drugs and things like physiotherapy and chiropractic.

Best of luck in finding plans that work well for your specific situations
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#13 Half Fast

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Posted 13 November 2017 - 11:56 AM

Why did I have to change doctors you ask? My doctor went to a "Concierge" plan where you had to pay $2,000 per person per year just to keep seeing him. His practice was too large, about 2,000 patients, so he was looking to cut back to 500. What does that mean? No waiting for appointments, 24/7 access to a doctor by phone, less work for him and his staff, and... $1,000,000 upfront for him every year!

 
What happens when you need to see a specialist other than the concierge doctor?
 
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#14 Cheater

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Posted 13 November 2017 - 11:59 AM

I read some of this stuff and frankly I am terrified for you guys.


The healthcare situation in the US is an international embarrassment IMO.
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#15 Gator Bob

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Posted 13 November 2017 - 12:12 PM

:bomb:  "Do Not Light Fuse"

 

Greg,

Let's not start getting all political... please play nice. :)  :sarcastic_hand:


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#16 Uncle Fred

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Posted 13 November 2017 - 12:14 PM

What happens when you need to see a specialist other than the concierge doctor?

 
He refers you to a specialist just as before.
 

The healthcare situation in the US is an international embarrassment IMO.

 
I just returned from Europe and spoke with several people about this situation and what you say is true.
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#17 Gator Bob

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Posted 13 November 2017 - 12:17 PM

A small beep from far away. :-)

 

In Denmark we have high taxes on everything and even 25% purchase tax, also on food. Cars not included as the taxes on these are 110-180%!!!

 

But I dont whine, because I had a major heart surgery when four years old and the state paid everything, I have since been visiting both "normal" and mental hospitals on several occasions, last time when I was diagnosed with prostate cancer (due to another checkup in December) - and again this is paid via the taxes. So I am a happy tax-payer and grateful for living in this small, weird, but wonderful country. :-) 

 

But everything is not rosy here all the time, I lost my job 12 years ago due to prolonged illness and that cost me both money and property, but still, due to state pension (and an insurance scheme), I was able to have a decent life afterwards.

 

I have now been retired due to my illness for 10 years and in spite of all the misery before that, I have now been able to obtain and move to a very small, old house on the Danish West Coast, 1,300 meters from the North Sea and 750 meters from Ringkøbing Fjord, partly thanks to an additional health insurance provided by LEGO where I spend my last four years in a job. Again, I am grateful.

Therefore it really hurts me, when people on this forum are forced to sell everything dear to them, to be able to pay medical bills, when they get seriously ill - so please get some insurance, even if it's expensive - when you get ill, you have enough to fill up your mind - you don't need serious economical worries on top of that.  

 

Niels, DK (Denmark)

 

Good to hear you're feeling better.

 

Insurance - It's a crazy game, selling dear treasures to pay for the insurance isn't a fun bargain ether.

A $100,000 hospital 'visit' is like 'chump change' these days.  

 

Pick your poison.


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#18 Dave Crevie

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Posted 13 November 2017 - 03:19 PM

I have regular Medicare. An Advantage plan might be nominally better, but it means dealing with an insurance company. My

experiences with insurance companies has not been good. I did opt in for a supplement and Part D.



#19 Phil Hackett

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Posted 13 November 2017 - 04:17 PM

Insurance (doesn't matter what it's written for) is a bet. Sometimes you're required to have it. Many times it's optional.

 

No matter what... the casino....errr.... the insurance company wins in the long run and they do everything possible (sometimes illegally) to keep that edge/hedge.


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#20 Mattb

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Posted 13 November 2017 - 04:33 PM

 Kind of hi-jacking this, hope that's OK. 

Our system has many problems, but I think most are because it's not simple and profit is the goal of most of the participants.      If we had  one basic type of supplement, one part "D" for drugs and the same plan for all,  it would make it better across the board and the cost about the same for everybody.    Of course, with many for profit insurance companies, medical supply and equipment manufacturers, many for profit hospitals,   for profit drug companies, lobbyists at every level, there is no way to rein this in.   We are stuck with with the system we have.   Any talk of  anything related to universal coverage and a segment of the gov't  yells communism and tells us how bad med care is in other countries.

 

I always like to hear the input from guys in other countries.   The guys here can talk about how it really is and won't shade it depending on their political party.   I had heard that in Canada, you are covered very well, but your surgery or appointment might be 3 months or more in the future.  I'd like to know if this is the fact or just an fake news.   I have heard from a guy in Oz quite a few years ago and he said insurance wasn't common there and most people had medical savings accounts.   How is  it down there guys?    Thanks to Niels for his input.

 

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#21 Uncle Fred

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Posted 13 November 2017 - 05:09 PM

I spent some time with a Canadian couple while in Europe and they said they had no problem with getting healthcare quickly.  If you need a surgery you get it. 

 

One thing that has not been mentioned in our Medicare discussion is, concerning medications, the dreaded "Donut Hole".......   The drug coverage will only cover a certain amount before it stops and does not start up again, as catastrophic coverage, until you have paid out $4950.  If you are on a variety of meds some are very expensive like Insulin for example might be $500 a month. This eats up the money allotted for meds very quickly and you enter the Donut Hole. 


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#22 Dennis David

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Posted 13 November 2017 - 06:15 PM

Yep and that's what you'll be living on as well, donuts.


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#23 Gator Bob

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Posted 13 November 2017 - 06:37 PM

Doesn't the 'donut hole' get filled (jelly, apple or cream?) if you order up some  "Part D" ?


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#24 Uncle Fred

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Posted 13 November 2017 - 06:46 PM

Dumpster donuts........   


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#25 Half Fast

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Posted 13 November 2017 - 06:50 PM

Doesn't the 'donut hole' get filled (jelly, apple or cream?) if you order up some  "Part D" ?

 

Nope the donut hole is part of Part D, it does not take much to get to it, if you have any non generic meds.

 

Cheers


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