Doctors are usually sensitive to the cost of one medicine vs its alternatives. Sometimes the alternates are an equally good choice; other times they are not.
Apparently, I am not allowed to exchange contact info in order to provide you with a product brochure, which I think would have been much more helpful than callously throwing out the name of the company offering the plan and expecting you to do the research yourself.
Just never forget if you do not get Medicap during the window you will have an exposure to going through underwriting. This means if you have issues already this will be added into you premiums. I believe the reason the advantage plans are marketed is the insurance companies make monies on these plans and know even if you go back to traditional Medicare you will be forced to go through underwriting. Advantage stops covering something important to you, you go back to traditional and get hit on the Medicap. In our case we definitely stayed with traditional, despite the insurance agent repeated sell that we save money, likely a bigger commission for selling Advantage. Note I really like United Health Care. Although a few years ago when I had MANY bills they updated their contracts with their providers, their process re-created all the co pays I had already paid, but not Medicare an employee plan.
Better yet go to Medicare dot Gov site and compare plans yourself with no chance of bias. That āexperienced agentā is at best going to guide you to what hey think is best -and may be limited in what they can offer and influenced if not commissions by spiffs or loss of job if tehy donāt sign up x folks.
My agents are pushing adding cancer coverage @ $35/mo to my Medicare C (that has $0/mo premiums). It would cover up to $10,000 in costs. I want to compare this pitch to Original Medicare + Gap coverage. Thankfully itās hypothetical at this point, IF I got cancer . . . The agents warn me that once I received a diagnosis it would be too late to get coverage. I am suspicious. From what you all have said my coverage would be better with Original Medicare + Gap. If I received a diagnosis, couldnāt I switch to Original Medicare + Gap during the annual enrollment windowāor is there an exclusion for pre-existing conditions?
You can always switch to original medicare, but whether a supplement plan will accept you is another matter once you are past your original enrollment period at age 65.
I believe you can switch but you are subject to medical underwriting. The reason you decided to switch is usually due to something medical.
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Because you have not yet had a serious downturn in health.
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But many times we have no idea what the medicinesā retail costs are. Even the cost of generics surprise me sometimes. We know they will be less if no longer under patent.
I think people hear a pitch on these Advantage plans and think they can go to any doctor or facility but they didnāt hear the part about āif an emergencyā. What if it is not an emergency?
I managed all my motherās bills over about a 15 year period when she couldnāt do it. She was on Traditional Medicare with a supplement. There was never any copays or coinsurance and no Networks. And she went to the doctor frequently with many health issues and had numerous hospital stays and emergency room visits. But there were never any bills from these providers that we saw because Traditional Medicare and her Supplement paid it all.
In the meantime my health insurance was one disappointment after another trying to figure out if my providers were in networks, what are copays, what are coinsurances.
Traditional Medicare is simple, simple, simple. The entire USA is your network.
I studied very hard when it was time for my Medicare decision and I had the experience of seeing all of my motherās medical needs. I am thankful for the education momās care offered me. It was a no brainer when you start to visualize how your mailbox will be stuffed with copay and coinsurance bills as you age and require more and more care.
When you choose a Supplement (also called a Medicap Plan) for Traditional Medicare it is really not difficult. If Traditional Medicare pays 80% then the Supplement has to pay the other 20%. No ifs or ands about it!
One thing to look for in choosing a Supplement is choosing a plan that the premium is based on issue age or attained age. Issue age freezes the premium at the age when bought and only increases with inflation. Attained age starts with a lower premium and will increase each year as you age.
I wish insurance companies would have kept their noses out of our Medicare. It has created way too much confusion as they all try to grab $ intended for the health care of seniors using smoke and mirrors (networks, copays, coinsurance, dental plans that are worthless, health club memberships). I am sure our forefathers that set up Medicare did not have that in mind.
Another thing I am becoming more and more aware of is the amount of seniors in health clubs because their Medicare Advantage Plans are offering memberships free. So now our government is supplementing health clubs with money intended for Medicare?
Another point to make is there is only one time in your life when you can purchase any Traditional Medicare Supplement available in your area with no upcharge or denial even with pre-existing conditions. Thatās the time you turn 65. After that, they have the right to either deny you or charge more.
If you do not know who the supplent companies are, go to the department of insurance in your state (search the internet for your state website and it will be listed somewhere). They know who the supplements are because they have to be approved and registered with the state. They donāt advertise much because they donāt make enough money on supplements to chase after it.
Why did Medicare Advantage plans come about?
Well you have to remember the late 1980s. Two magic words were all the buzz. They would supposedly save us from rising health care costs. The words were āmanaged care.ā
Somehow corporate suits would āmanageā the delivery of care better than MDs. It was never explained how. State Medicaid plans were farmed out to āmanaged careā outfits, with decreases in providers resulting.
It was thought that managed care would save Medicare recipients tons of money through the same magic. Thus Congress enabled Medicare part C plans.
There was no magic. All that happened is corporate suits restricted treatment and ratcheted down fees so almost no MDs participated.
There is no magic bullet in reducing health care costs. Ration care with waiting lists for non-emergency surgeries, as most socialist systems do, or pay MDs very little for procedures, which mean MDs will just choose not to do many procedures.
By the way, many traditional Medicare supplement policies also pay for gym membership under the guise of improving patient fitness.
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My doctor is far more conversant of retail costs of various prescription meds than I am.