Yes, that was discussed upthread.
And if a person has traditional Medicare and a supplemental that pays their copay, they should have only the $240 deductible to pay (assuming whatever they are having is something that is covered by Medicare as the supplemental doesnât pay if Medicare doesnât pay)
What is missing from teh âarticleâ is any discussion of whether Timmins received the proper care. Yes, itâs an HMO plan, and specialists can require pre-auth, which takes time, and for that is what he signed up for because âit made economic senseâ for his family at that time.
But at least NPR should have asked the questions, how long did it take to see the Derm? Were you âcuredâ? (Likely they did ask but ignore those simple facts in their article bcos it doesnât support their pov.)
yeah, donât get that either. But then Uber-wealthy can always âmoveâ to another state which can give them an open enrollment period.
True, on Plan G, but then they also have to pay a couple of hundred dollars per month in Medigap premium, while many MA plans costs zero per month
btw: back issues are really tough. Not much different in outcomes from surgery today vs. long-time PT and strenghtening (which Public Health says is the first recommendation.)
When I turned 65, I got a Medicare supplement plan through Anthem. In the last 18 months, I have had very serious medical issues and hospital stays and (other than the premiums) I have paid zero. I go to whatever facility or doctor I want. I donât have to deal with prior authorizations from the insurance company.
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DH has never had to deal with prior authorizations on his Advantage plan. Maybe theyâre going on behind the scenes and he doesnât know about it, but itâs never been an issue.
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How much are the supplement premiums?
It varies widely by area, by company and by age. And you donât know how much increases will be or whether the company will stop writing new policies. H pays $142/month right now, plus his Part B & the Part B deductible. After a lot of research, we do feel that it was the best choice for him. We donât live in a state that allows people to switch from Advantage to Supplement without underwriting, and we have a number of friends whose family members regretted choosing Advantage. The latest was a friend whose brother couldnât get the care he needed because the Advantage plan would not approve it, and he died. He would have been able to get the care had he been in a Supplement. As with so many things in life, we have to make the best decisions for ourselves based on what we experience and on our situation.
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Yes, each person has to decide whatâs best. So far, I see no reason to switch from the Advantage plan, especially since it has no additional premiums. $1,700/year would pay a lot more copays than he has.
me neither.
The good news is that the coverage for ER example would have been excellent with traditional medicare too (abeit pricier premiums than MA).
For me when I decide in a few years, it wonât be just about copays and small-ish difference in premiums. Iâll want to understand the potential downsides of MA-for-life (in CO, we can only switch back within 12 months w/o risk of underwriting changes). It will help to have local feedback from older friends, but Iâm not sure if Iâll be in same location in my final years.
It does seem like my Dadâs hospital/rehab/etc expenses have excellent coverage with traditional Medicare. Hopefully it would be similar with MA, but that is the type of situation that worries me long term. If my kids are handling my paperwork someday, I want it to be as easy as possible. And it does seem like his wifeâs dealings with nursing home is straightforward with traditional medicare. Maybe same will be more true down the road with MA plans too.
I recently met with a Medicare consultant about my options when I retire. I am in NYC area. His advice to me was to get Medicare supplements rather than Advantage. Maybe it was discussed up thread, but I understand most Advantage plans do not cover outside of service area, except for emergency. I know many retirees have multiple homes (NY/FL). I assume they are do not have Advantage plans. I will do more traveling abroad when I retire. I will need to take out travel insurance when I go abroad.
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Donât believe any Medicare plan covers care out of the country. Most older adults I know who are on Medicare purchase travel insurance that has primary medical coverage
My friendâs husband has exactly the same Advantage plan my husband does, and his back surgery in Florida was covered. It wasnât an emergency.
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This is not unique to Medicare. Many regular health insurance plans cover only emergency care out of the country.
That was not a metric we used when choosing our retiree health insurance. Out of the countryâŠwe buy medical insurance.
I just want to mention that the choice is not as simple as MA vs Medicare + Supplement. Supplemental plans range from A through G, and they cover different things at different levels of coverage.
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I read that Medicare may cover an injury that occurs in Canada when a citizen is en route to Alaska from the lower 48. Fun fact 
What, traveling on the AlCan Highway? Thatâs kind of funny!
Iâm a provider. My last two advantage plan patients have given me trouble. With both, I have to go thru audits. Another denied all but two sessions, saying the rest submitted too late, after six months. I had only seen patient 6 months. I appealed, sending proof of when each session billed and denied. After hours of phone calls, Iâll walk away with a loss.
I have no trouble with the former teacherâs plan, though I have to submit notes on every session. My rant
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What state?
Florida
My friends in Ma donât face this
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