Medicare ripoff

ladder13

ladder13

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I simply don't understand any of this. I have willingly paid for Medicare Advantage ever since I retired. As did my parents and in-laws. It was a godsend whenever i needed care. Nothing is free, but it paid for most of it.

When they came out with a $0 premium, I said why not. The policy was even an improvement. Then, to add insult to injury, the new plan was $30 off Medicare and still a $0 premuim.

When I asked the consultant for my provider how can they do this she said she didn't have a clue either.

We both have had cancer in the past 3 years and only had to pay a few bucks. Without the Advantage plan we would be broke now.

So, taxpayers have to pay for it? Well, I'm a taxpayer too.
 
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.
 
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My wife retired from AT&T with 40 years . Within the last 2 years they've offered a Medicare Advantage which costs us just the medicare fee . We pay another $113 and we get optical , dental and a legal plan . Wherever we go the Dr offices claim we are very lucky to have such a great plan . Sure AT&T supplements , but where does the rest come from . I've already hit my max out of pocket , $10,000 , so you do the math . Somebodies getting the shaft and it's not the insurance companies with record profits , at least most of them .
 
It all depends on your personal circumstances. They are a deal for some, and not so much for some. A lot has to do with making sure you pick the right plan.

Unfortunately many of these plans were not profitable (or less profitable) and are going to be less generous next year. I'm losing $1,000 worth of dental benefits and another $2,000 in misc. benefits.

My issue is the provider group I like only takes their own branded Medicare Advantage. If you don't have theirs, they won't take you.
 
I pay the amount from my Socialized Insecurity that Congress says is my fair share. With no additional monthly payments.
I have an Advantage Plan direct with Presbyterian Medical Services.
Bottom line is I’m happier with this arrangement than many other things I’m involved in.
So please don’t ‘fix’ it for me!
 
I know individuals that have received more than 3 dozen COVID test kits.
No charge!
But, your Medicare account was billed.
I received several unsolicited. Called Medicare to report fraud.
They weren’t interested.
 
I do not have a Medicare Advantage plan, never will. Why? Mayo Clinic does not accept most plans, only a few select that they have contracted with. Originally they accepted none.
When my late hubby turned 65 he was already diagnosed with a State 4 cancer. I had been contacted directly by United of Omaha about a Medicare supplement which I signed him up for. Over 7 years of treatment at Mayo including, chemo, stem cell transplant, and major surgery and all the followups, I paid a total of $40. His total bills would have been in excess of a million $$.
So when I turned 65 I signed up for the same plan. Sure, it costs me a bunch but I know what it covers and no having to review every year.
Interesting, when I signed up for it, AARP was offering the same plan for considerably more money. I purchased direct from the company.
Edit to add: I am an established patient at Mayo and can book appointments without a referral. That won't happen with most Medicare Advantage plans.
 
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I currently have a 0$ advantage policy.

I've figured (guess) that the insurance companies pay the provider a 'negotiated' fee based on the code (look at the breakdown, charged x, insurance paid x/?). The insurance company then bills the gov't for the full amount and pocket the difference.
 
Here's what I know. Part C Medicare Advantage is not actually Medicare, it's private insurance that the Govt pays to provide healthcare for seniors. As noted above a hospital or clinic needs to accept your Medicare Advantage plan, or else you could end up paying a much larger sum for their services.

I've read a few negative things about Medicare Advantage, so I just stuck with regular Medicare and added a Medicare Supplemental and a Part D RX plan.
 
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I tried to keep my Medicare A&B with a supplement. Premium-$250/mo. Paid for Rx's, Dr visits, labs. No dental or vision. Went to "Advantage" (Part C) 2 years ago. No premium, no co-pay for Dr, "part D" covered for most Rx's. "Prophylactic dental" coverage, vision with glasses yearly. Lab work- no charge. $50/quarter OTC allowance. Such a deal, as long as you stay healthy. Joe
 
I recently went to a presentation on Medicare as my number is up next year. The presenter made a very eye-opening statement regarding Advantage plans in Nevada. Most, if not all are $0 premium because (hold tight, folks) Nevada is considered a healthy state. :eek::eek::eek: Yeah, color me shocked.
 
I have an Aetna advantage plan. Wifey has supplemental and script plans. I pay copays at the docs and she doesn't.. most of my scripts are free, she pays for some portion of most of hers until she hits the catastrophic amount, which she did in early October, now all her scripts are zero copay. We have thought about switching her to an Advantage plan, but just learned that they reduced the catastrophic amount for next year, so she will hit that by about June.

Robert
 
When I became eligible for Medicare, a good friend, retired firefighter, told me to go with United Healthcare Plan F, for my supplement so I did.


I have had several surgeries and hospital stays, and have never paid one dime for them or Dr. visits. I do pay for some prescriptions and have a dental & eye care plan too..


When I get a prescription that is costly, I go through the VA for them. Example: I was prescribed Spiriva for my COPD and it costs two or three hundred dollars for it. I contacted the VA and was told to have the Dr. send them something indicating I needed it, and they, the VA, would prescribe it for me. I now get the medication from the VA and cost is $0.
 
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