Endless TV commercials for those with Medicare but without Part C. Sounds like a sales pitch to me, but anyone know about this?
1 Like
At age 65 you can have Medicare part A that pays 80% your approved hospital costs. And you can have Medicare part B that pays 80% of your approved doctor and lab costs.
Or you can have Medicare Part C also known as Medicare Advantage plans. These plans are administered by private insurance companies. As a minimum they must provide the same coverage as Medicare A and B. They can offer more benefits, and can charge an additional premium. Advantage plans often include Medicare part D, prescription plans.
Advantage plans sometimes include Eye Care insurance, a Dental Insurance, Gym memberships, and a few other perks that are needed for your health care.
2 Likes
Well…when you get on Medicare (A/B), you generally either get a Medicare Supplement and a Part D Rx plan, or you go the “Joe Namath approach” and get a Part C plan (MAPD = Medicare Advantage with Prescription Drugs)
There are pros and cons to both options, but the TV commercials sadly do not list the cons of the MAPD plans…so you would always be better off talking to an experienced agent who offers all options, and not to Joe Namath.
2 Likes
Thanks all. The TV ads are a bit misleading, as if someone on Medicare A/B can ALSO get C. But it’s actually A/B OR C. Makes more sense now.
3 Likes
The accompanying dental plans are universally crap, with one exception: Cigna. This plan lets you go to any dentist and has no fee limits- the $1000 yearly maximum is the only limitation. Those seniors on Medicaid get a $2000 annual maximum. Go figure.
1 Like
I think people miss the real point about Medicare Advantage… they dangle low-cost bright shiny objects in front of you… the vision, the dental… in order to distract you, and then they make it up on the back end by denying you access to the expensive stuff. My wife could not access MD Anderson Cancer Center if we were on Medicare Part C ! She’s probably be a lot worse off than she is now.
“Fill them up on bread and salad” - the restaurateur’s secret to higher profits.
Car sales - give them a good sales price, then soak them on the financing, the trade-in, and the after-market crap.
Medicare Advantage… {fill in the blank}
2 Likes
Get this book “Medicare for the Lazy Man 2022: Simplest & Easiest Guide Ever!” He explains everything.
1 Like
Does the book go through how to selected Medigap if you or your spouse has a complicated and extremely expensive blood cancer? This isn’t a “lazy man’s” situation, this is an all-hands-on-deck decision for us. If we screw it up, we have to live with the decision for a year until the next open enrollment.
1 Like
Yankee466 is the insurance expert on this forum.
Personally, i dont trust Advantage plans to give equal or better coverage than A + B and a supplement. If you never have significant health issues, sure, Advantage will provide more things, but for any long term or serious conditiins and diseases, which become more likely as we age, i believe you’rr better off with original medicare and a supplement.
1 Like
I didn’t ask about Medicare Advantage, I asked about Medigap to supplement Parts A, B, and D. Thank you
1 Like
You can contact him by email and he will probably give you his phone number. His website https://www.medicareforthelazyman.com/
Basically he says that Medicare Advantage is bad recommends Part G or High Deductible Part G plus a Part D drug plan. In your case he would probably recommend Part G. All Part G plans cover the same, just as all Part X plans.
1 Like
All Medigap plans with the same letter work the same. A G is a G is a G for example. There is technically no homework to be done otherthan understanding what medicare covers and how the supplement plugs the holes. If the doctor takes Medicare, the doctor takes whatever supplement you show up with… .Medicare determines what is covered, not the supplement carrier. Only Advantage plans can deny…not a supplement carrier.
The only thing different from one med sup to another with the same letter is the name on the card, the premium, and the rate stabililty history. Sometimes you can pick up a Silver Sneakers gym membership too. United Health Care, Anthem, Humana, Aetna, etc, etc all have a variety of plans depending in where you are
Hope this helps
2 Likes
My MAPD client is currently being treated at MD Anderson. She is also welcome at Mayo. Both in Jax
1 Like
Wow, this really puts my heart at ease. Thank you guys. We’ve had more than $1,000,000 in services billed to insurance in 2022 alone, I have been staying up so many nights worried about how it will be for us after we retire.
1 Like
It also depends on your location with all plans and some, also your age. I was looking at supplemental plans and saw G is not a choice for anyone born after a certain date. With advantage (C) plans you can see what’s available by your zip code. Some places have many choices and some have few options. Plus, if you spend time away from home it might be out of network with a c plan. I’m pretty sure that the most attractive thing about c plans is the no additional cost that includes a required drug plan. You know they’re making a ton of money and they also can monitor everything about you, with the included OTC catalog and gym plans. I heard they push extra treatments but haven’t seen that. You also might not be able to switch to original Medicare once you have an Advantage (C) plan unless you move to a different state or have medical costs above a certain amount. It’s very confusing and even if you go to an insurance person some of them steer you towards their preferred plan. My husband and I do have an Advantage plan and we haven’t had any problems, but no serious health concerns so can’t really judge. I didn’t know about the difficulty in switching when we picked it.
Probably if you can afford it, a supplement plan with Medicare would be a better choice for flexibility.
You likey meant to say Plan F, not G, is not available for anyone born after a certain date. G & N are the two popular Med sup plans that anyone can purchase, regardless of their age.
Supplements are always the safest…but Advantage plans are not always the worst thing that could ever happen to you. Not having LTC insurance is likely the worst thing that can happen to you.
You could be right, I don’t have paperwork to look at right now. I just remember seeing someone saying they liked g and I saw that birthdate thing. I suppose I could have been in the wrong column.
The biggest difference between Medicare advantage and Medicare supplement plans is networks (HMO & PPO = advantage plan VS supplement plan NO NETWORKS!!! And also pre-approvals needed for most procedures= advantage plans. While supplement plan the doctor makes the decision.
You pretty much nailed. it. Physicians take such a big hit on fees with Medicare, that very few of them want to take a bigger hit fooling with Medicare Advantage plans. So they dangle a bunch of crappy dental and vision plans in front of you to sell the plan. How many patients have complained to me that they couldn’t get physicians to do their procedures once they were on a Medicare Advantage plan?
1 Like
Whether you choose C (Advantage) or Medigap (supplement), you must have A & B. You cannot have C without having A & B. So, unless you have an Advantage plan that pays part of B, you will have a monthly $164 bill for B. (2023 rates)