No, but my friend’s husband on the same plan had back surgery in Florida. Not an emergency. I posted this up thread.
Humana has faced significant losses on their MA plans. Healthcare journals are indicating costs will go up and care could suffer. Medicare Advantage May Face Big Plan Cuts, Price Hikes in 2025 | ThinkAdvisor
MA plans are heavily advertised in the Philadelphia market and they promise no cost to you, plus dental and vision, ymca membership and rides to doctors offices. I can’t figure out how the math works. I signed up for Medicare and a supplemental plan, then six months later got diagnosed with cancer. Its a good thing I like my plan, because I’m stuck with it now!
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Cigna sold both its Medicare advantage AND supplement plans this week.
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Wow. Who did they sell to?
I’m another one who is very happy with my MA plan, but so far I’ve been pretty healthy so I’ve had to spend very little. But I’m curious…does it matter if the company offering the plan is non-profit? My plan is with a company that claims to be “…the largest consumer-governed, nonprofit health care organization in the nation…”
I wanted to bump up this topic and link an article that I found interesting.
If you have an advantage plan that you love and works for you, that’s great. This article is reporting some of the ways advantage plans may cut benefits in the future and the disadvantages of them. For some people. And yes, I am aware that some states, the law is such that moving to a traditional plan is possible.
I hope I mentioned all of the ways that advantage plans work for some people. While also linking an article for why they don’t for others.
One thing I found interesting is that advantage plans can pay 20% less than traditional Medicare.
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I have a few years to decide. I could opt for an employer/retiree PPO Medicare Advantage plan - some friends seem to like it, lots of acceptance by local doctors and hospitals. But I’ll likely stick with traditional Medicare because 1) in most states, including mine, you’d need underwriting review to switch out of MA after the first year 2) I’m not convinced that MA will give as good coverage in the later years when there might be need for hospitalizations, rehab etc.
I can understand your first point, but at least in Maine, coverage is good for hospitalizations, rehab, etc. The husband of my long-time running partner has many major health issues. Diabetes, serious back issues, etc. He has been hospitalized and in rehab centers multiple times over the last few years. The coverage has been excellent.
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I’m new to MA and so far it’s fine (and I have health issues). My mother (and father) were on the private medicare for years and paid about $250/ea per month. When Rocky Mountain Health closed they switched to United MA and liked it a LOT more and was a lot cheaper for them ($44/mo). Both were in their 80’s and had many medical problems. The only issue my mother had was falling into the doughnut hole in her last year and she was really mad about it but she showed them by dying a week later! I also have a friend that chose traditional because of the cost of medication, but she really takes a lot of expensive drugs, and still has to pay a lot for prescriptions even on her plan, plus pay the premium. All this in Colorado.
Not sure there is a ‘good’ solution.
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We just got a check from our Advantage plan for $639.99 to reimburse DH for his scuba diving refresher course and four dives.
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This is the kind of thing that concerns me (though I am trying to keep an open mind) - Nursing Home Surprise: Advantage Plans May Shorten Stays to Less Time Than Medicare Covers - KFF Health News
It’s pretty much a lifetime decision about MA at age 65. (There is a year trial period, but my concerns are more in later years when kids may be helping me deal with things) . But MA might over future years have declining coverage. Same too for Medicare, though my gut says it is more likely to keep same over time.
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My brothers mother in law has an advantage plan in nyc. They are very happy with it. She is in her 90s now. She never leaves NYC.
I think if you are active - traveling to see family friends or abroad, an advantage plan may not be the best option. I plan on taking the traditional Medicare first and possibly switch to an advantage plan when I get older.
My Ma has the traditional plan plus a BCBS plan. She is moving in few weeks, and all we’ll have to do is to notify the SS office.
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Thanks for the feedback.
Part of my concern about MA plans comes from monitoring FB page with large corporate retiree membership. Many younger retirees are doing a MA PPO plan, mainly because their vintage of future health account balance can only be used for that purpose. Lots of good feedback, mostly from younger retirees. (Older retirees were on a different healthcare method. Many of them opted to loose their $3k/year benefit to stay on traditional medicare.) BUT it sounds like in some locations UHC has gone out-of-network or caused turmoil when threatening to do so. For example, at least one Mayo hospital location reportedly stopped being in UHC network. Hoping that this kind of wrinkle gets ironed out before I need to choose.
Other than with Kaiser plans, providers moving in and out of networks is something to watch for with any PPO or HMO plan (not just Medicare Advantage plans). With Kaiser plans, the provider network is obvious, though there is the possibility that a given individual provider (e.g. a physician) may leave Kaiser.
Traditional Medicare’s “network” (i.e. providers who accept traditional Medicare) is still very large, but it is still a possibility that a provider who accepts traditional Medicare may choose not to do so in the future.
Well, if you’re abroad, I don’t think anyone is covered. And my friend who needed major surgery (not emergency) in Florida had no problem being covered by the same MA plan DH has.
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Its quite possible that since there are so many snowbirds in FL that the docs there take many of the northern plans. Also, without knowing the plan policies, it is hard to know what surgeries are considered elective vs non-elective. A surgery doesn’t have to be an emergency to be considered non-elective. Some orthopedic issues, if they interfere with quality of life, it would probably be considered medically necessary.
I’m posting this article because it includes some of my concerns. (Hmmm… the first time I could read the full article, but now it wants subscription). However I will say that MA feedback I’ve heard (mostly on a PPO MA plan I’ll be eligible for) says it does NOT nickel and dime them as claimed in the article. One friend kept dreading the bills after surgery… but they never came.
All state plans are, well, state plans. I doubt they are going to have contracts with Florida providers although their parent companies MAY have cross agreements and of course all treat for emergencies.
Buy travel insurance for other trips.