[Babubhat]

United healthcare has been excellent. All claims paid promptly

[tophcfa]

Originally Posted by Michael 61

Not 65 yet, but doing the homework now - when that time comes I think Original Medicare + Supplement will be the way to go. I’m healthy now, but who knows what the future holds - need to plan long-term. Don’t want my health “managed” by a medical insurance claims adjuster.

I’m in the same boat you, turning 65 soon. I have a habit of researching the hell out of things I deem important, and making the correct Medicare decisions was high on my list. I have recently read two updated books from highly regarded sources on making the best Medicare decisions and have also concluded that selecting original Medicare with a supplemental Medigap plan is the best way to go. I’m planning on getting a Part G Supplement plan and a Part D prescription plan. Unfortunately, I’ll be out of pocket for dental, vision, and hearing unless original Medicare is someday revised to include those. There is no way I want to go with an Advantage plan and be constrained by a limited network of providers, be out of network when at one of our two homes, have to get referrals to see a specialist, and deal with deductible and co-pays every time I go to the doctors. For me, the decision is a no brainer.

[tophcfa]

Originally Posted by Dusty_Star

I too did research before I turned 65, visited the library & read books about Medicare. I was really glad I took that approach. When you near 65 the Advantage plans bombard your mail with glossy, sophisticated, entreaties to purchase their plans. Due to my research, I decided on original Medicare with a supplement plan & plan D, the drug plan. I am in good health, & take no medications. But signing up for a plan D is crucial as the government penalizes those who don't sign up & the penalty is lifelong. I felt that without doing the research it would have been really easy to join an Advantage plan, & that would not have been in my long term best interests.
Good luck with your homework 👍

Totally agree

[Smalley]

Originally Posted by tophcfa

Totally agree

Traditional Medicare with CareFirst supplement and Part D was our decision as well. We need all the freedom possible as we are in the old years when things deteriorate if they haven't already!

[villagetinker]

Originally Posted by Rainger99

So does that mean that Medicare will pay any medical bill - or is there some oversight?

NO, you or your doctor will contact Medicare if there is an unusual treatment required, many treatments are typical and are covered. my previous point was there are situations where Medicare would be covered, but an advantage plan MAY require additional reviews and possible delays.

[OrangeBlossomBaby]

Originally Posted by kkingston57

Also have Florida Blue. Was told that I could see any doctor but would have to pay out of network price. Noted that a lot of Advantage plans are paying for unusual items like groceries, These are health insurances.

They're not "paying for" those items. If you qualify due to being low-income and a senior, they provide you with a modest stipend intended to help you pay for food. Many low-income seniors eat less in order to keep their heat on in the winter and AC running in the summer. It's a pretty big deal in this country. Nutrition is a health matter, and the insurance companies want their members to be healthy. The healthier the member is, the less likely the member will need expensive care that the insurance has to cover.

It's cheaper to let a low-income senior buy a bag of groceries every month courtesy of the insurance company, than it is to treat the senior for illnesses caused by malnutrition.

[Hape2Bhr]

Originally Posted by tophcfa

I’m in the same boat you, turning 65 soon. I have a habit of researching the hell out of things I deem important, and making the correct Medicare decisions was high on my list. I have recently read two updated books from highly regarded sources on making the best Medicare decisions and have also concluded that selecting original Medicare with a supplemental Medigap plan is the best way to go. I’m planning on getting a Part G Supplement plan and a Part D prescription plan. Unfortunately, I’ll be out of pocket for dental, vision, and hearing unless original Medicare is someday revised to include those. There is no way I want to go with an Advantage plan and be constrained by a limited network of providers, be out of network when at one of our two homes, have to get referrals to see a specialist, and deal with deductible and co-pays every time I go to the doctors. For me, the decision is a no brainer.

If you've had cataract surgery, Medicare/supplemental will cover annual checkups with the ophthalmologist.

[kingofbeer]

Originally Posted by Dusty_Star

An interesting article about Medicare Advantage plans. "It's one of those things that people might like them on the front end because of their low to zero premiums and if they are getting a couple of these extra benefits — the vision, dental, that kind of thing," says Christine Huberty, a lead benefit specialist supervising attorney for the Greater Wisconsin Agency on Aging Resources.

"But it's when they actually need to use it for these bigger issues," Huberty says, "that's when people realize, 'Oh no, this isn't going to help me at all.'"

Medicare Advantage plans are popular, but some seniors feel trapped when ill : Shots - Health News : NPR

If you have chronic conditions, you should consider a Medicare supplement, if you are able to afford it. I do not have chronic conditions and will be selecting a Medicare Advantage plan when I turn 65. The Villages Health system does not accept traditional medicare. They do accept certain advantage plans. And I want to use the Villages Health system.

[kingofbeer]

Originally Posted by Rainger99

So does that mean that Medicare will pay any medical bill - or is there some oversight?

There is oversight. Your advantage plan would need to pre-approve certain procedures. You might need referral to go to specialists.

[gatorbill1]

Originally Posted by villagetinker

NO, you or your doctor will contact Medicare if there is an unusual treatment required, many treatments are typical and are covered. my previous point was there are situations where Medicare would be covered, but an advantage plan MAY require additional reviews and possible delays.

Medicare Advantage plans must cover whatever regular Medicare covers - no exceptions

[rustyp]

Originally Posted by gatorbill1

Medicare Advantage plans must cover whatever regular Medicare covers - no exceptions

Can you imagine that - As us north country boys say driving in a snowstorm - hold my beer and watch this !

[Debfrommaine]

Originally Posted by kkingston57

Also have Florida Blue. Was told that I could see any doctor but would have to pay out of network price. Noted that a lot of Advantage plans are paying for unusual items like groceries, These are health insurances.

Regarding the groceries, our plan does not specifically pay for groceries in particular. For example, incentives can be earned monthly (it's a very small AMT but nonetheless) for completing exercise programs and such. Members can "spend" the earned money at Publix, Walgreens, Walmart or other participating vendors.

[villagetinker]

Originally Posted by gatorbill1

Medicare Advantage plans must cover whatever regular Medicare covers - no exceptions

I agree completely, but (big but) you must use THEIR doctors and you must go by their schedule. Under the heading of been there done that, this did not work for us. Remember, yes you are covered, BUT under their schedule, this is a managed care system. This woks for a lot of people, but IMHO you need to see more than one specialist you may want to consider regular Medicare, this also applies if you already have a specialist and want to stay with the doctor.

[tophcfa]

Originally Posted by villagetinker

I agree completely, but (big but) you must use THEIR doctors and you must go by their schedule. Under the heading of been there done that, this did not work for us. Remember, yes you are covered, BUT under their schedule, this is a managed care system. This woks for a lot of people, but IMHO you need to see more than one specialist you may want to consider regular Medicare, this also applies if you already have a specialist and want to stay with the doctor.

Absolutely agree, and Advantage plans have their managed care networks limited to a specific geographic region. Original Medicare, with a Medigap Supplemental plan, are accepted throughout the USA without the need for a referral. This is extremely important for those who travel frequently or have two homes in different states.

[mtdjed]

Originally Posted by Michael 61

Not 65 yet, but doing the homework now - when that time comes I think Original Medicare + Supplement will be the way to go. I’m healthy now, but who knows what the future holds - need to plan long-term. Don’t want my health “managed” by a medical insurance claims adjuster.

For some people it may truly an economical decision to get the Advantage program. For those who can afford a supplement, congratulations if you make the decision treat yourself to the best you can afford.