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steve(ill) 
Orange Level Access
Joined: 11 Sep 2009
Location: illinois
Points: 80038
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 Topic: Medicare Advantage Plans
Posted: 10 Mar 2022 at 1:18pm |
Seems like a LOT of Medicare commercials on TV. I thought the SIGN UP was done 2 months ago !!... So i looked on the "internet" and apparently you have till March 31 to CHANGE your plan if you want... You have to ALREADY be signed up, but you can CHANGE.
Medicare is run the Fed Govt... That allow Medicare ADVANTAGE plans to be handled by Independant Insurance Companies.... Most of those plans cover a wide variety of coverage under ONE plan... I also "internet" to see why so many commericals are made. It seems that the GOVT pays the Insurance Company around $1000. (per month) for each person that signs up with them and moves away from the "standard medicare" run by the GOVT... The Advantage plans are "regulated" by the GOVT and must include the same coverage ( or more)... Seems to be real competative right now as they start to include eyes / ears / teeth in order to attract more people... They said the plans change state by state or county by county depending on what is the "reasonable cost" for coverage in your area...
Edited by steve(ill) - 10 Mar 2022 at 1:19pm
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Like them all, but love the "B"s.
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Coke-in-MN
Orange Level Access
Joined: 12 Sep 2009
Location: Afton MN
Points: 41466
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Posted: 10 Mar 2022 at 10:20pm |
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They are fishing for people just turning 65 , moving to different locations , or have not signed up yet .
I didn't sign into Medicare at 65 as had a group policy and wife was on it , if I had changed to Medicare she would have been dropped, would have had to find a policy for her and she would have had pre-existing conditions .
As long as my policy met or exceeded coverage offered by Medicare i could stay on it , when I did sign up for Medicare when she reached 65 I just had to submit proof that my policy met the requirements .
Here in MN I went with Ucare and a Advantage plan - all wifes present doctors were in plan so no changes needed .
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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Ray54
Orange Level Access
Joined: 22 Nov 2009
Location: Paso Robles, Ca
Points: 4460
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Posted: 18 Jun 2024 at 11:11am |
Gee what a topic to turn up today. We have an Advantage plan, testing it out right now. My wife had a hip replacement yesterday. Time to finish up chores and be there when the doc checks in at noon, and if things are good bring her home.
The same doctor has performed 2 knee replacement on her and a hip on me. But then we were covered by her school insurance she had until she turned 65 at which point you are kicked off for Medicare to be your insurance. So the bills will roll in soon, then we will know how our current coverage is.
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TramwayGuy
Orange Level Access
Joined: 19 Jan 2010
Location: Northern NY
Points: 11435
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Posted: 18 Jun 2024 at 9:22pm |
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Out of network can be a problem with advantage plans. And also they tend to deny coverage more often than conventional Medicare. Why wouldn’t they— they get paid whether your provider does or not.
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tadams(OH)
Orange Level Access
Joined: 17 Sep 2009
Location: Jeromesville, O
Points: 10005
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Posted: 19 Jun 2024 at 12:59pm |
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My wife and I have been with Medical Mutual and it has served us well.
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Coke-in-MN
Orange Level Access
Joined: 12 Sep 2009
Location: Afton MN
Points: 41466
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Posted: 19 Jun 2024 at 4:51pm |
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Most Advantage plans have a limit on out of pocket , U Care was $3,500 max out of pocket . Anything beyond that was $ 0 co-pay .
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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DMiller
Orange Level Access
Joined: 14 Sep 2009
Location: Hermann, Mo
Points: 30607
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Posted: 19 Jun 2024 at 6:03pm |
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Currently on AETNA, not seeing a issue, YET, but only had since January. DO cover more aspects than base Medicare, as well the Parts C&D, so far spent $40 in visit copays, NOTHING more.
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steve(ill)
Orange Level Access
Joined: 11 Sep 2009
Location: illinois
Points: 80038
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Posted: 19 Jun 2024 at 8:17pm |
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I have had AETNA ADVANTAGE for 3 years.... Seems GREAT to me.. I have paid very little if anything.. but my bills probably dont amount to $1000. a year. ....They paid $500. for a complex tooth extraction one year and $250. for a checkup / x-ray this year... They cover $1000. in dental and vision i think as part of the STANDARD plan...Yearly Dr visit was no cost.. he wanted me to prick my finger and take blook glucose readings for 90 days.. equip was all free.... im on some daily pills to help your prostrate so you piss better... no cost... My monthly Premium is $0.0
Edited by steve(ill) - 19 Jun 2024 at 8:20pm
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Like them all, but love the "B"s.
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DMiller
Orange Level Access
Joined: 14 Sep 2009
Location: Hermann, Mo
Points: 30607
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Posted: 20 Jun 2024 at 4:27am |
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My monthly is also paid by my Medicare benefit, company I retired from ‘gifts’ $3500 against dental or vision expenses per year and will allow one year carry over so has been hanging at $7000 since my last major work last year.
Edited by DMiller - 23 Jun 2024 at 1:39pm
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Coke-in-MN
Orange Level Access
Joined: 12 Sep 2009
Location: Afton MN
Points: 41466
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Posted: 23 Jun 2024 at 12:03pm |
https://www.facebook.com/reel/1892378757877425
Kind of explains how MEDICARE works and costs
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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Steelawin
Bronze Level
Joined: 25 May 2023
Location: Texas
Points: 3
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Posted: 27 Jun 2024 at 5:00am |
Navigating Medicare Advantage plans can be overwhelming with all the TV ads, right? Turns out, you can switch plans if you're already enrolled. These plans, managed by private insurers but regulated by the government, offer comprehensive coverage like dental, vision, and hearing—sometimes more than standard Medicare. The government pays insurers about $1000 per person monthly to draw people away from traditional Medicare. It's a competitive market, varying by location for cost-effective coverage. For more info on insurance, I've found Aseguradora Sagicor to be quite informative.
Edited by Steelawin - 30 Jun 2024 at 5:21am
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Dale (Stonelick)
Bronze Level
Joined: 13 Jun 2019
Location: Stonelick, Ohio
Points: 179
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Posted: 28 Jun 2024 at 9:10am |
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My wife & I have the Aetna Medicare Advantage plan. It has zero monthly premium and some nice extra benefits: some dental & eyecare, we each receive $600 annually for online CVS (they own Aetna) health related items (we quarterly order a lot of stuff we don't need), and each can receive up to $600 reimbursement annually for healthy activities (just got a $600 check for reimbursed golf green fees). Assume there is a lot of money made in the insurance & pharma industries based on all the tv advertising.
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1951 CA - 1944 C - 1949 B - Kubota M6800
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steve(ill)
Orange Level Access
Joined: 11 Sep 2009
Location: illinois
Points: 80038
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Posted: 28 Jun 2024 at 9:33am |
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Dale, that shows the variation in plans between different States.. I have the same plan as you, but in our zip code, we get $300. from CVS.. ($75. per quarter)... they do cover $1000. for basic eyes, hearing, dental per year (each).. for for Zero monthly payment..
Edited by steve(ill) - 28 Jun 2024 at 9:34am
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Like them all, but love the "B"s.
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john2189
Silver Level
Joined: 11 Sep 2009
Location: Minerva,Ohio
Points: 303
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Posted: 28 Jun 2024 at 10:56am |
 steve(ill) wrote:
I have had AETNA ADVANTAGE for 3 years.... Seems GREAT to me.. I have paid very little if anything.. but my bills probably dont amount to $1000. a year. ....They paid $500. for a complex tooth extraction one year and $250. for a checkup / x-ray this year... They cover $1000. in dental and vision i think as part of the STANDARD plan...Yearly Dr visit was no cost.. he wanted me to prick my finger and take blook glucose readings for 90 days.. equip was all free.... im on some daily pills to help your prostrate so you piss better... no cost... My monthly Premium is $0.0
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Steve, watch those piss pills, i was on doxizosin mesylate and it lowered my blood pressure enough that when I swallowed food, id get dizzy enough that I would pass out. The dr took me off of them. Stopped getting dizzy, and I couldn’t tell any difference in my pissing
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'41 Allis B
'45 Allis B
'49 Farmall Cub
'72 IH Cub
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steve(ill)
Orange Level Access
Joined: 11 Sep 2009
Location: illinois
Points: 80038
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Posted: 28 Jun 2024 at 12:35pm |
im on tamsulosin... been over 100 days now.. Seems to help me 75% better... Dont have any side effects.... if it lowered by PB 10 points i would not complain !! 
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Like them all, but love the "B"s.
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john2189
Silver Level
Joined: 11 Sep 2009
Location: Minerva,Ohio
Points: 303
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Posted: 28 Jun 2024 at 1:52pm |
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Good 😊
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'41 Allis B
'45 Allis B
'49 Farmall Cub
'72 IH Cub
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Ray54
Orange Level Access
Joined: 22 Nov 2009
Location: Paso Robles, Ca
Points: 4460
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Posted: 01 Sep 2024 at 5:30pm |
A happy ending to the story finally. My wife had a hip replaced June 17. She had problem with the anesthesia and spend 3 nights in the hospital. Did wonderfully felt better than in a year or 2 once home. On July 1 she turned her upper body to reach for something. Had a pop and sudden pain in the hip. Got back on the bed and did not tell me until she need help to the bathroom. In the morning called doctor. He was out of town for the Holladay weekend. He did call back and say get it X-rayed. Pain was getting better. V-ray showed a crack in the bone. On the 5th Doctor called and said see me at the office in 2 hours. Office closed but he checked everything and said take it easy and all should be good.
He saw her twice more and released her in early August. Still doing fiscal therapy once a week for 2 more weeks.
Well yesterday the bill came. Be sitting down, in the area of $250,000 all added up. Our part to pay $70 for the X-ray at the hospital ER. That is standard Medicare with an Advantage plan supplement. We work with an agent that only does Medicare supplements. Most all the medical specialties are covered by local doctors so it is real easy to stay in network with our advantage plan. And as insurance companies merged and declared bankruptcies, our agent seems to have always steered us in the right direction. So both the medical procedures and the cost have worked out to give us success.
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jdeere562
Bronze Level
Joined: 02 Oct 2023
Location: SW Iowa
Points: 30
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Posted: 01 Sep 2024 at 10:31pm |
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Go to a local insurance expert and throw away all that garbage they send in the mail.
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DMiller
Orange Level Access
Joined: 14 Sep 2009
Location: Hermann, Mo
Points: 30607
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Posted: 10 Sep 2024 at 6:40pm |
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Perhaps a New Wrinkle in this
On STL News Mercy System hospitals and clinics just dumped Anthem BCBS, any and ALL policies from Medicare advantage to employer supploed health care and ACA plans. No Longer in contract with Anthem BCBS at Mercy.
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steve(ill)
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Joined: 11 Sep 2009
Location: illinois
Points: 80038
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Posted: 11 Sep 2024 at 8:01am |
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I will stick with the AETNA Advantage Plan for 2025.... Their coverage in our area is geat and the cost is still $0. per month..
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Like them all, but love the "B"s.
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DMiller
Orange Level Access
Joined: 14 Sep 2009
Location: Hermann, Mo
Points: 30607
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Posted: 11 Sep 2024 at 8:38am |
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My own is AETNA, my Wife's company policy is Anthem, she is wound tight.
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Coke-in-MN
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Joined: 12 Sep 2009
Location: Afton MN
Points: 41466
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Posted: 11 Sep 2024 at 10:43pm |
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Friend is retired St Paul fireman and his insurance is partially paid by city yet but he has co=pay on premium / problem is since city pension its part of MN State pension fund for his retirement as no SS was taken out but same amount was put into State Fund
Now what he earned outside of Fire Dept was not enough to cover Medicare fee - so he has to pay into Medicare but get no coverage from it .
NEXT St Paul is dropping his present insurance and has a new insurer who only uses 2 healthcare providers and 1 hospital - so his full medical coverage has to change as his present clinic will not honor new insurance nor will local hospitals .
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Faith isn't a jump in the dark. It is a walk in the light. Faith is not guessing; it is knowing something.
"Challenges are what make life interesting; overcoming them is what makes life meaningful."
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DMiller
Orange Level Access
Joined: 14 Sep 2009
Location: Hermann, Mo
Points: 30607
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Posted: 12 Sep 2024 at 4:36am |
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This house of cards is rapidly collapsing.
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steve(ill)
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Joined: 11 Sep 2009
Location: illinois
Points: 80038
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Posted: 12 Sep 2024 at 7:31am |
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The problem in not the Advantage Plans.. The problem is Medical Cost... Private Health Insurance has risen 7-8% the last couple years. If your 40- 60 year oldl your going to see your premium GO UP...... If your on Medicare, you basically pay a fixed cost, but the actual costs are going UP.... SO WHO IS PAYING ?? Some of the Advantage Plans or "Part B" Plans need to make up the difference in the cost.... How that happens or who drops out of the market remains to be seen..
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Like them all, but love the "B"s.
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