Banjo Hangout Logo
Banjo Hangout Logo

Premier Sponsors

720
Banjo Lovers Online


Page: 1  2   3   Next Page   Last Page (3) 

Oct 20, 2021 - 12:25:08 AM
likes this

Bill Rogers (Moderator)

USA

25405 posts since 6/25/2005

I know there are more than a few here on the Hangout who are, like me, on Medicare in one form or another. For the record, I'm on regular Medicare and have supplemental coverage for the 20% that Medicare doesn't cover. I write here about the annual bombardment of offers for the various "Medicare Advantage" programs from various insurers, HMOs and other medical provider organizations. All promise extra benefits at little or no cost. They take what the federal government takes out of your Social Security check (or what you pay as a premium to Medicare if you're not on SSA coverage) and provide comprehensive medical coverage. Sometimes they'll add dental coverage or other things Medicare does not cover. But one thing is clear, and it's the reason I stay with regular Medicare, even if the cost is more, : You don't get to choose any doctor who accepts Medicare. You can only see the providers on the insurer's official list. Since I have doctors who work for two different hospital organizations and at least one independent physician, handing doctor choice to an insurance company is a deal-breaker for me. Most of the mail solicitations I get are obvious, and hit the paper-recycle bag unopened. If I was using doctors who all belonged to the same group or hospital health-care operation, I'd look to an Advantage plan that covered that outfit. That won't before Lodi next goes down to 15 degrees in the winter, if then. [That's happened once in the 37 years I've lived here--and that was back in the early '90s.] I don't have to reevaluate my plan during the annual open enrollment period now under way. I want to avoid the verboten political discussion this topic could easily engender, but I am curious about how others have approached Medicare. That's enough from me; I get verbose when I'm on my desktop instead of the iPad.

Oct 20, 2021 - 12:39:31 AM

Tommy5

USA

3947 posts since 2/22/2009

I am on Medicare part A only as my wife still works and I am on her insurance.After she retires, I will have to go on part B and enroll in a supplemental insurance to make up the 20% Medicare doesn’t pay just like Bill. At that time, I will have to compare various Medicare advantage plans and see which one is best for me, my pension also helps with Medicare premiums so I will have to carefully study which is best. The advantage plans maybe cheaper, especially if you don’t have any medical issues and want the cheapest insurance possible. You can get a Medical Advantage plan that is a ppo and let’s you chose your own doctors unlike a HMO, of course it is more expensive. Medical insurance is complicated, and a lot depends on your current medical conditions, unfortunately as we age our medical health can change for the worse at any moment., If you have a chronic condition like my wife has , it can be a real pain to have to get a referral from a GP doctor before getting treatments and test from a specialist every single time it is necessary.

Oct 20, 2021 - 1:38:05 AM

figmo59

USA

34454 posts since 3/5/2008

I am getting bombarded...
Great thread topic....

How do I Handel it?
Liz reads all this crap...they send...cyphers it..
As of late tho the have been cell phone callin me...

I do have folks at Hartford Hospitol that I can get real answers from tho...

Oct 20, 2021 - 3:49:15 AM

1394 posts since 9/6/2019

I'm getting drilled with letters and calls. I bet I get 4-5 calls every day and 3-4 letters a week. The thing is, I can't even sign up for Medicare for almost 15 more years.

Oct 20, 2021 - 3:50 AM
Players Union Member

OM45GE

USA

110608 posts since 11/7/2007

I have a Medicare Advantage plan through my former employer’s retiree program. Providers bill the plan and the plan gets reimbursed from Medicare. With premiums about $600 a month, it’s not cheap, but I’m being treated for an aggressive prostate cancer. My medical bills so far are well over $100,000 with lots more to come. My cost so far? Under $300. I say thank you every time I pay the premium.

Those mailed solicitations go into the recycle bin unopened.

Oct 20, 2021 - 4:14:51 AM
Players Union Member

rinemb

USA

14128 posts since 5/24/2005

My wife and I are both on Medicare, Part D, and a platinum supplemental. Neither of us have paid a dime for five years, except a very nominal drug refill charge, where I pay about 12 bucks every 3 months. Its not free, and I paid into the gov for 50 years for the benefit. but it sure is nice to walk away from the doctor's office etc with a smile and a thank you.

And, yes, I am tired of the open enrollment season we are presently in. Brad

Oct 20, 2021 - 4:22:25 AM
like this

Buddur

USA

3102 posts since 10/23/2004

Political.

This thread is locked.

Oct 20, 2021 - 4:30:47 AM
like this
Players Union Member

rinemb

USA

14128 posts since 5/24/2005

quote:
Originally posted by Buddur

Political.

This thread is locked.


Is this like a citizen's arrest?  ;-)    Brad

Oct 20, 2021 - 4:53:06 AM

Texasbanjo (Moderator)

USA

26546 posts since 8/3/2003

I'm also on Medicare, have a secondary policy and prescription Plan D. I prefer the original Medicare where I can go to whatever doctor I choose, whenever I can get an appointment.

My sister is on a Medicare Advantage Plan and is told what doctor she can see, what procedures she can have (or not have). She thought it was going to be a great money saver but, for her, it's just been one hassle after another trying to see a specialist eor even trying to see her own doctor. She's changing back as soon as she can.

If I get e-mails about Medicare advantage plans, I just hit delete, don't even open them.  I never answer the telephone if I don't recognize the caller, so that usually takes care of any problems with telemarketers.

And this topic isn't political unless people make it political.

Edited by - Texasbanjo on 10/20/2021 04:59:23

Oct 20, 2021 - 5:04:20 AM
like this
Players Union Member

DC5

USA

21274 posts since 6/30/2015

The thing I hate most about open enrollment is it is all confusing, and as we get older, we are more easily confused. I get my supplemental insurance through my former employer. My beloved wife has worked in health insurance for over 30 years, and she is the one who understands everything so I just do what she tells me, and so far I'm happy with that. If anything ever happens to her, I'm in deep doo-doo so I also pay for her health insurance through my former employer until she goes on medicare. She foolishly married someone much older than she is. I, on the other hand, lucked out by getting to marry someone much younger than I am.

Oct 20, 2021 - 5:53:18 AM
Players Union Member

rinemb

USA

14128 posts since 5/24/2005

quote:
Originally posted by DC5

The thing I hate most about open enrollment is it is all confusing, and as we get older, we are more easily confused. I get my supplemental insurance through my former employer. My beloved wife has worked in health insurance for over 30 years, and she is the one who understands everything so I just do what she tells me, and so far I'm happy with that. If anything ever happens to her, I'm in deep doo-doo so I also pay for her health insurance through my former employer until she goes on medicare. She foolishly married someone much older than she is. I, on the other hand, lucked out by getting to marry someone much younger than I am.


My wife is older than me, yet I am thoroughly confident I will be first in the dirt...if someone is keeping score-up there.  brad

Oct 20, 2021 - 6:23:18 AM

7056 posts since 9/5/2006

how much do these supplemental ins policies cost anyway ?...i will be in the medicare zone next year.

Oct 20, 2021 - 6:26:34 AM

58488 posts since 12/14/2005

Hey, Brad!
If there was a NICENESS score which determined who dies first, I would not have outlived Irene, nor would I have outlived Alice.

(And possibly not outlived Alice's mother, or even the dog)     wink


Edited by - mike gregory on 10/20/2021 06:28:16

Oct 20, 2021 - 6:40:24 AM

12704 posts since 1/15/2005

quote:
Originally posted by 1935tb-11

how much do these supplemental ins policies cost anyway ?...i will be in the medicare zone next year.


Terry .... my wife and I have Aetna and mine is $188 and hers $138 per month.  Our Part D cost about $23 per month for each of us.  Our supplement, I think is Plan E, which is either the best of right one step below the best.  There is also a one-time deductible .... not sure what it is byt several hundred dollars.  Part D is complicated and although we supposedly save a lot of money, we also pay a pretty good bit for drugs.  I only take one prescription drug, but my wife takes several ...... some pretty expensive.

Oct 20, 2021 - 6:46:12 AM

75136 posts since 5/9/2007

Over the course of the summer I got 4 telephone calls in the early evenings by a "representative" from Medicare.He wanted the numbers off my original paper Medicare card and went on about when the next person called for me to say I needed a knee brace for my ailing legs.
I told him I had no pain in my legs and didn't need a brace.He then tried to get me to say that I needed a back brace for my ailing back.
I told him I would not lie to the next caller and didn't want any kind of braces.He told me I was being "unco-operative".

I told him to label me however he pleased and hung up on him.
I am so happy with my VA sending me anywhere in the world for whatever I might need.I go to them for a consult in November for plastic surgery to restore symmetry to my face and deviated septum.

Oct 20, 2021 - 7:09:48 AM

12704 posts since 1/15/2005

Bill, this stuff is not easy to figure out. Once you think you have it solved a monkey wrench is thrown into it!

When I first went on Medicare I had zero medical issues so I decided to go with a Medicare Advantage plan. As you stated the only issue was that to see my family doctor I had something like a $40 co-pay rather than maybe $10.00 from the doctor that I got to choose from their approved list. That was not really a too big of a deal as I did not go to my family doctor too often, but as it turned out I never went to see my assigned doctor, so I might as well not of even had one. After about 3 years on this plan I had problems with my shoulder and went to the doctor where he had to x-ray my shoulder to find out that I had a calcium build-up in the joint. Ultimately the company that I had the Advantage Plan with denied the claim saying that the x-ray was not a necessary medical procedure. Basically, I could see that it was going to turn into a fight every time I tried to make a claim with the insurance company.

About the same time as this was happening I went with my wife to see her agent who handled her insurance and asked him about my current plan. He said the big problem with them is that as along as you are healthy they are fine, but once you have a significant problem and then try and buy a supplemental policy the price is going to be through the roof. It did not take a lot to convince me that I would be better off with a good supplemental plan. Thus both my wife and I are on an Aetna (Plan E I think) ($138 for her, $188 for me) with Part D with other companies (about $23 a month). Every Fall, during open enrollment, he reviews our policies and compares them to other companies and comes back to us with the most advantageous plan ....... usually just for Part D, as Aetna has always been the best for us.

This year however, we got a letter from our primary health provider (big outfit) regarding us considering Aetna's Advantage Plan. Since they are our primary provider and have also teamed up with our insurance carrier, I am going to take a close look at what they have to offer. It may be OK .... not sure.

My only real complaint is that although the Part D is relatively inexpensive, we still have to spend a considerable amount of money on drugs. Right now I am in Stage 2 of my drug coverage which means that the plan pays all cost for Level 1 & 2 drugs. After I have paid $355 for my Level 3, 4 & 5 drugs the plan pays for "it's share" (whatever that is) of the Level 3, 4 & 5 drugs. Then you move to Stage 3 ..... only after you have paid $3,557.57 in "total drug costs". The bottom line is that you can pay for a lot of money for drugs under this plan. It may keep you from going bankrupt, but it is still a significan amount of money!

Oct 20, 2021 - 7:29:45 AM

7056 posts since 9/5/2006

i am on her insurance at the moment,, i think it runs her about 110 dollars extra every 2 weeks ,,but its pretty good insurance. and with her working for the hospital that its insured thru i get in to any of their doctors real quick if needed. she has about 7 more years until retirement... i may be better off staying on hers after 65. ????

Oct 20, 2021 - 8:34:31 AM

banjo bill-e

Tuvalu

11700 posts since 2/22/2007

I do see some Medicare Advantage plans as scams in the sense that they have a lot of clauses that most would never read or understand, and the ones that I looked at limited my health care choices to the county that I lived in. They are a local HMO plan, so you can only use their approved doctors/hospitals/labs and only in the county where you reside. Some had NO coverage if outside that county! So travel much? Plan to ever move? If you move you can get whatever is offered wherever you move, but that is a lot of uncertainty about the future for anyone with serious health issues.
They are scams in the sense that they advertise that you are getting all of these new benefits----rides to the doctor!-----Meals delivered!----dental, and vision and more!---and all for Free. They should be required to disclose that you are giving up CHOICE of health care provider and the ability to travel or move as you require.
And the biggie, at least for me locally, if I did not get a regular Medicare Supplement plan as soon as I qualified for Medicare then I would NEVER again be eligible. Choose Advantage up front and that is all that you will be allowed to ever have. This sucks, like every other aspect of our insurance and health care systems

Oct 20, 2021 - 9:58:08 AM

12704 posts since 1/15/2005

quote:
Originally posted by banjo bill-e

I do see some Medicare Advantage plans as scams in the sense that they have a lot of clauses that most would never read or understand, and the ones that I looked at limited my health care choices to the county that I lived in. They are a local HMO plan, so you can only use their approved doctors/hospitals/labs and only in the county where you reside. Some had NO coverage if outside that county! So travel much? Plan to ever move? If you move you can get whatever is offered wherever you move, but that is a lot of uncertainty about the future for anyone with serious health issues.
They are scams in the sense that they advertise that you are getting all of these new benefits----rides to the doctor!-----Meals delivered!----dental, and vision and more!---and all for Free. They should be required to disclose that you are giving up CHOICE of health care provider and the ability to travel or move as you require.
And the biggie, at least for me locally, if I did not get a regular Medicare Supplement plan as soon as I qualified for Medicare then I would NEVER again be eligible. Choose Advantage up front and that is all that you will be allowed to ever have. This sucks, like every other aspect of our insurance and health care systems


Bill .... I think to receive all of those "extra benefits" you also have to eligible for Medicaid .... not sure but that is what I heard from somewhere.

Oct 20, 2021 - 10:14:13 AM
like this

chuckv97

Canada

60501 posts since 10/5/2013

Move to Canada…. we have (gasp!) socialized health care
I had surgery and now chemo,,, cost me nuttin... ('cept higher taxes for 50 years laugh)

Edited by - chuckv97 on 10/20/2021 10:15:29

Oct 20, 2021 - 10:30:25 AM

dat

USA

31575 posts since 7/26/2006

I hear about Canadians coming down here to get health care in a timely manner, hope your 50 years of higher taxes have worked better than some ive heard about

Oct 20, 2021 - 10:33:07 AM

Owen

Canada

9820 posts since 6/5/2011

Part A? .... Bart B> .... Part E? .........etc. ...

When does Part KISS kick in?

I'm might be an oddball, but for comparison's sake, IF getting screwed-over is a must, I'd sooner it be through incompetence than by having it planned up front by somebody.

Edit: Dat, do you have any stats on the proportion of Canadians that go to the U.S. for non-insured health care?    ...or what their income level is?   ... or what proportion prefer the US system?

Edited by - Owen on 10/20/2021 10:44:40

Oct 20, 2021 - 10:37:09 AM
likes this

dat

USA

31575 posts since 7/26/2006

My grandfather on my mothers side was from Quebec, he came to the states in the late 30’s early 40’s not sure exactly, was proud to become a citizen and to learn to speak English, good thing though, he moved to south Louisiana, the French wasn’t the same, but close enough to make it work, was a pilot in WWII in the US Army Air Corp

Oct 20, 2021 - 10:46:05 AM
like this

chuckv97

Canada

60501 posts since 10/5/2013

quote:
Originally posted by dat

I hear about Canadians coming down here to get health care in a timely manner, hope your 50 years of higher taxes have worked better than some ive heard about


There always lots of noise about the very few problems

Oct 20, 2021 - 10:48:53 AM
like this

dat

USA

31575 posts since 7/26/2006

I can understand that, even when everything is going great, somebody is going to complain

Oct 20, 2021 - 10:50:41 AM
likes this

chuckv97

Canada

60501 posts since 10/5/2013

I go to Arizona a lot in the winters,,, yep, a banjo-pickin snowbird. I buy health insurance ,, went to a hospital emergency for a kidney stone 2 years ago ,, they tried to weasel out of paying the $13,000 for the 2 hour visit (including an MRI) ,, said it was a pre-existing condition. Cut my holiday short and vamoosed back to Canuckland,, got a lithotripsy gratis, thank you. After months of back & forth the insurance co. finally paid it, but never gave me a refund for my shorter stay in the U.S. (But I love going down there, despite the possible hassle,,, have made many friends in Arizona)

Edited by - chuckv97 on 10/20/2021 10:55:02

Page: 1  2   3   Next Page   Last Page (3) 

Hangout Network Help

View All Topics  |  View Categories

0.25