I have much respect for Clark’s advice in general. One topic I am currently questioning his judgement is on the topic of Medicare and his advice on not getting Advantage. I live in Alabama where BCBS has been dominant in all areas of health insurance and have many, many friends and ex-co-workers telling me how wonderful BCBS Advantage has been for them–and some have experienced significant health issues including cancer, broken hip, etc. I’m usually pretty good sorting out these financial issues, but everything I read seems to come down on one side of the issue or the other. Is there anyone that I can trust that will look at individual circumstances and advise me of the right choice for our situation, locale?
2 Likes
Consumer reports discusses the options of using your State Health Insurance Assistance Program (SHIP) for additional information or contacting an independent Medicare broker. The article from Fortune provides information about brokers.
At a high level, its a simple answer for most people.
If you can afford the premium for a Medicare supplement, and want the best and safest coverage possible… you get a supplement. If you are low income, low asset…or you are perfectly healthy and your crystal ball says you will stay that way…then you will likely get an Advantage plan. Joe Namath only tells you what’s good about them, not what the pitfalls are. If you get an Advantage plan, I would at least suggest a PPO plan in most areas.
If you already have an Advantage plan, you may not be able to get a supplement without health qualifying. So when turning 65, its imporant to make a good decision for your situation.
Best you talk to an independent agent who offers both, and if they are reasonably ethical, they should go over all the pros and cons. Agents that are only in it for the money may push Advantage plans due to the large up front commissions involved…but every year the freebie addons to Medicare Advantage get more and more attractive.
2 Likes
I’ve been on Medicare Advantage (CIGNA) in Alabama for almost 4 years. Never a problem finding a provider, No co-pay for routine care, $10 co-pay for a specialist., and they pay $50 a month of my Part B premium. I also get $1500 for dental -no copay for almost any dental procedure, vison exam and glasses allowance, hearing, gym membership, $300 in OTC -vitamins, pain relievers, band aids, toothpaste, etc., $50,000 Overseas emergency medical treatment and or evacuation, along with several other benefits. Plans do vary by zip code, but for Huntsville area greatest thing I ever did was enrolling in Advantage. Rather than a broker or agent I’d go to the Medicare dot gov site and take compare plans.
1 Like
Absolutely! My parents both signed up for Medicare Advantage beginning 20 years ago in So. CA. They have had excellent coverage at very, very low copays, if any. No problem with approvals for procedures nor medications even with various comorbidities. Even getting nearly all Medicare premium back last year with Wellcare Giveback plan. This year over $130 per quarter given for OTC products. Also very good coverage for dental, vision and hearing. They have loved their plans. But, but you need to evaluate YOUR area as MA plans vary by location. Our area has great medical groups, top doctors and awarded hospitals that cater to the high numbers of seniors in our population.
My wife would be blocked out of access to MD Anderson Cancer Center if she were on Advantage. Advantage doesn’t work for the most challenging situations.
My MAPD client was welcomed and treated at MD Anderson in Jacksonville recently.
My understanding is that the MD Anderson joint ventures don’t change what your local hospital policies are… but 100% sure that the MD Anderson home base in Houston only accepts Kelsey Seybold MA, and even that’s subject to change.
Mayo Clinic doesnt take Advantage plans either.
I think yankee466 stated it best. The real problems occur when you have current medical problems. Additionally if your family has a history and later on you want/need to go back, then you are contained because you have to go through medical underwriting for your supplemental. It is those same insurance companies who underwrote you that had the advantage plan where the switched something which caused you to go back to traditional. Your contained in the advantage plan or your contained by biting the hook and later on contained by the cost of the supplemental. With this mind set they dangle bells and whistles in front of us and pay a lot to the agents so they push the product. The insurance companies think of the big picture. It is all about money. I would like to see the payments to the agents the same weather they sign someone up for Advantage or traditional….if after 1 or 2 questions they would be shown to be less smart if they still pushed advantage plans.
Agents I’ve tried to discuss this with seem to focus on the sale not the issues with getting older and having medical issues even when I explain we have the medical issues. They get more money if you go for the advantage plan (can’t confirm).
Any discussion should start out with current medical conditions, family history as well as financial resources.
They dangle bread and salad and skimp on the meat. Free glasses free dental, good luck getting really good chemotherapy with some Advantage plans.