Medicare ripoff

[GypsmJim]

I had a Medicare Advantage plan right from the beginning. I paid monthly. What I got in return was free visits to my PCP, free dental cleanings and eye visits, plus a discount on glasses, some meds free and others that were cheaper than Wellcare or other internet stuff, etc, etc.

Then they went to a ZERO monthly payment with all of the same benefits, and in some cases even more.

I say: "How can you beat that?".

I don't care if it's all a scam and my taxes are paying for it. If I chose not to take it, my taxes pay for it anyway.

So, what confuses me is that some of the responders in this thread say they will never accept it. Makes no sense.

 

[Denverd0n]

I don't care if it's all a scam and my taxes are paying for it. If I chose not to take it, my taxes pay for it anyway.

It's not a scam. Some of the companies offering Medicare Advantage plans may be committing fraud, as the article suggests, but the basic concept is not a scam in any way.

If you are in traditional Medicare with a supplement plan, then Medicare (the government) does all of the administration, keeps track of your prescriptions, doctor visits, and all of the other paperwork. With Advantage plans the company handles all of that administration and paperwork. As such, the government pays them a stipend for taking the cost of all of that off of their hands. Depending on various circumstances, sometimes the stipend that the government pays is enough that they can offer the insurance premium free.

It's written for people who are initially signing up for Medicare, but an excellent book, that explains how Medicare works, is "10 Costly Medicare Mistakes You Can't Afford to Make," by Danielle Roberts. Available from Amazon for only $10.

 

[STCM(SW)]

Well, with TriCare for life I don't even care about all that stuff!

 

[pawngal]

So, what confuses me is that some of the responders in this thread say they will never accept it. Makes no sense.

I stated my reason, I use a local small-town clinic for the yearly Medicare Wellness check and that is about all. Anything else I go to Mayo Clinic and they accept only a very few contracted Medicare Advantage plans. Nothing has to be pre-approved is another reason. Also, I travel a lot, original Medicare is accepted at basically every hospital & clinic.
John Hopkins only accepts their own Medicare Advantage plan.
Duke Health accepts only a few.

 

[LoboGunLeather]

And "your fair share" means you get to pay more than I do;

"my fair share" means I get to pay less than you do.

We heard a lot about a "single payer plan", which sounded like a good idea. Then I found out that I the single payer was me.

 

[46er]

I've got the Advantage plan, radiation treatment, a couple minor out patient surgeries and a pacemaker and shoulder surgery for the wife and basically just $10 co-pays. The ones getting hurt are the uninsured.

 

[AugieTN]

.......So, what confuses me is that some of the responders in this thread say they will never accept it. Makes no sense.

I understand what you're saying. If it works great for you that's fantastic, stick with it.

I stayed with regular Medicare & a supplement plan because:

1. My wife has relatives across the U.S. and we spend a lot of time on the road visiting her relatives and a few of mine. My concern was always being able to find hospitals or clinics that accepted my Medical Advantage Plan.

2. I didn't like the idea you may need get approval to see a specialist, and possible needing to get approval of a doctors or specialist treatment plan

I recently read that some Medicare Advantage Insurance companies are dropping coverage in certain areas where they are are not making enough money. Humana was one of the insurers dropping coverage in certain areas

 

[mtgianni]

With an advantage plan the closest Dr that accepts it is 35 miles away. If I call the local Dr and they cannot see me tomorrow, they apologize.

 

[AugieTN]

Here's something to watch out for. Hospitals in Bismark, North Dakota :no longer accept Humana Medicare Advantage plans in 2025

Hospitals no longer accept Humana Medicare Advantage plans in 2025

 

[ladder13]

According to Joe Namath everything is free. They'll even send a doctor to your house to cook you breakfast.

 

[WR Moore]

Some time back I read an article about how the Advantage plans are more rapidly drawing down the Medicare money box than regular Medicare. The Federal pols don't care because they've got their very own plan, funded by us too.

 

[Narragansett]

26 years ago we went on our first trip out west, final stop LasVegas. Two days before leaving my wife got weird muscle spasm in her stomach, sort of like waves at the shore.
We went to the ER to find out what was going on before heading home. They took her in and after a half hour gave her some muscle relaxant and told her it was only spasms and not serious.

Ok fine, we left a couple days later for home. A month later we get this bill for some "tests" they said they ran but they did not. I was there the whole time. My wife being an auditor for IBM, sort of their internal affairs catching the IBM employees padding their travel expenses, decided to call her insurance company.

She did, advised them that no tests were done, and not to pay the charges. Our costs would have been zero dollars. We could have just let it go because someone else was paying. It's the principal, some have it some don't.

We don't have an Advantage plan but damn sure would look at each charge and make sure it's legit.

I used to get worked up about padded charges, but not so much now. I had it out with a hospital administrator over this once. He said the emergency room is always half full of people that cannot pay. Do you really want us to reflect that in the rates we charge your insurance carrier so you an pay higher premiums? I figured let the govt sort it out, and they never will.

 

[LVSteve]

Here's something to watch out for. Hospitals in Bismark, North Dakota :no longer accept Humana Medicare Advantage plans in 2025

Hospitals no longer accept Humana Medicare Advantage plans in 2025

I wonder when and how widely this kind of information is issued by the hospitals and other healthcare providers. Bluntly, where do you look?

 

[AugieTN]

I wonder when and how widely this kind of information is issued by the hospitals and other healthcare providers. Bluntly, where do you look?

Good question. I would hope the healthcare provider would.

 

[Autonomous]

If you are considering moving after retirement you need to know the Advantage plans vary by your location.
In my county where we retired there is a good selection of plans. In the next county four miles away, there is only one plan available, and it is a bad one.

 

[LVSteve]

If you are considering moving after retirement you need to know the Advantage plans vary by your location.
In my county where we retired there is a good selection of plans. In the next county four miles away, there is only one plan available, and it is a bad one.

Good point in states with counties barely a good stone's throw or rifle shot across. We have counties the size of states here, so I won't worry about that too much.

 

[Onomea]

You can only purchase Medicare Advantage plans offered in your county of residence. The plans can be used elsewhere, of course.

Someone may find this helpful, a Medicare site which helps you to determine what Medicare Advantage plan would be best for you:

Find a Medicare plan

 

[Kinman]

My wife and I went through a woman that claimed to be some sort of advocate, at no charge to us she set us up with what has become the best insurance policies for our particular needs. I am at an advantage in that the VA covers everything I have needed so far with exception to hearing aids and cataract surgery which I elected to use Medicare or United Healthcare AARP. I could have gone through the VA but did not want to second guess these issues. I maintain my use of United Healthcare for use as based on personal decisions and desire to spend out of pocket.
I do understand that I am in a unique situation for which I am thankful and grateful to this country for providing me with the healthcare it bestows upon its disabled veterans of foreign wars in my case.
I do find it unfortunate that in a country as rich as this one is that better medical care is not readily available to everyone, regardless of whether or not one was willing to put their life on the line in service to the country.
Perhaps one day this may become a reality, I think that would be a good day. I think so highly of the idea that I would be willing to pay more in taxes to help afford that type of care to everyone, I would of course expect everyone to pay their fair share as well.

 

[GaryS]

The disadvantage of Advantage plans is is you move, your plan will not necessarily move with with.

If a medical facility accepts Medicare, they have to accept your supplement. Medical facilities do not have to accept Medicare and Texas and Florida lead the nation in facilities that don't.

Just another factor to keep in mind if you're thinking of moving and are on an Advantage plan.

 

[pasound]

Retired for a year, I have Medicare A&B, and my original WV State PEIA turned into Medicare part C. I'm paying about 70% more for the two together than I paid for just PEIA while working, but there are some differences. I have not had a co-pay for any medical visit. Regular Physician, Ophthalmologist, Dentist, and a couple of emergency Doc-in-the Box visits this year for scrapes that needed a look at. All of the bills paid this year are less than $150 total. I'm ok with it.