My MA advantage plan can be used in any state. It is a plan negotiated by teachers retirement (and it’s NOT FREE) and one condition of the contract is that this be the case…because many of our teachers do relocate. We know folks in a bunch of other states, or who are snowbirds, and they have had no difficulty.
Of course, YMMV depending on your particular policy. Mine is a PPO.
Will people have trouble finding in-network providers if their insurers are OOS?
My MA plan doesn’t have in and out of network. It is taken by all folks who take Medicare…that’s the network…Medicare providers.
That is something to review with the various plans – and that is ‘the devil in the details’
We have traditional Medicare with Medicare B supplement Blue Cross Blue Shield. We haven’t filed anything OOS, but don’t expect any trouble. But we also have to determine how we continue our traditional Medicare with supplement when we move OOS.
Thats a big reason we went traditional Medicare. We only need to make sure a provider takes medicare so it’s easy to travel. We don’t need referrals to specialists and don’t have to worry about staying in network.
My MA plan has the same provisions…but I will acknowledge that all MA plans are not as robust as mine.
People need to do their own due diligence when choosing any kind of health insurance.
It may be that you might have to file your supplement, but I believe with a network like BCBS, most OOS places would also file that as well. Accepting the traditional Medicare is handling most of the medical costs.
If I travel out of the country, I will get covered for the time through an extra period supplement for that with BCBS.
The MA plan I’d have available through my employer/retiree benefits is a PPO. Seems to have more flexiblity than HMO
from The difference between Medicare HMO and PPO plans | News & articles | UnitedHealthcare
@goug78 My MA is a PPO and as I posted before will cover up to 12 months in a different state and will provide me with a PCP while there.
I am not debating. Just don’t want lurkers to get the wrong idea. Absolutely check details because states, companies and plans vary. But I would not assume that traditional Medicare or Medicare Advantage is better without exploring those details or meeting with someone who knows a lot about them (in my case the SHINE program and hospital financial counseling offices).
Since drug prices were mentioned here, hope for realistic pricing of drugs in the US. Here is some fact finding with real people, real circumstances. This is a FB reel. I imagine you need to be on Facebook to be able to pull up.
Right. Great idea to consult with medicare broker or SHINE etc.
The part I’ll struggle with (still a few years out) is the uncertainty in future years.
What will my health be like in 10 years? 20? maybe even 30? I guess need to assume worst case (except on Drug plan, which can be changed annually - I am more willing to gamble year by year). There is a good likelihood that I will need help from children in final years - my gut says traditional medicare will be simplest for them to manage (if rehab needed etc)… but still researching.
If I pick the employer retiree option (a decent MA PPO plan that local friends like)… what happens when/if they don’t renew that corporate contract?
I guess every year you say to yourself “If I had to make the decision today, weighing out what the future might be” and see how the price difference versus peace of mind will work out. Every year can have changes that might affect your decision. Then when you finally make your decision and go ahead, you did the best you could on the decision-making.
For 2. A great question to ask your employer’s plan representative as well as a Medicare broker!
gift link
People enrolled in traditional Medicare who live in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington State will be included in the experiment, which is expected to start in January and last for six years
I will be mighty perturbed if I spend extra for my supplement every month only to be stuck down the road with the issues that caused me to avoid the less expensive advantage. 
I wonder if part of the experiment is to see how the policy impacts the percentage of people chosing Medicare vs MA. Of course my concerns are more down the road, in later years… so
From article - my concerns about MA (though the PPO MA retiree plan currently offered by my employee gets a lot of good feedback from former coworkers)
”Dr. Vinay Rathi, an Ohio surgeon and an expert in Medicare payment policy, warned that the experiment could recreate the same hurdles that exist with Medicare Advantage, where people enroll in private plans. “It’s basically the same set of financial incentives that has created issues in Medicare Advantage and drawn so much scrutiny,” he said. “It directly puts them at odds with the clinicians.”
That’s my fear. I am aware that there are decent MA plans out there, particularly those sponsored by employers or unions, as well as those in states that have more stringent requirements of insurers. But when the AI turn-downs become “just the way things are,” old folks will suffer and/or die as a result.
I do not care to be their guinea pig - for the next SIX years.
Our traditional medicare starts next week. I, too would be skeeved if I suddenly need prior approval.
We needed pre approval on both my and my husband’s employee sponsored health insurance. But the medical providers took care of that.
Lots of employee sponsored plans have pre approval…
So why would this be an issue for Medicare folks?
I will say, I’m concerned about future denials of claims or lack of pre approval…is that what everyone is concerned about?
