Beware Medicare Advantage Plans

[mzfroggez]

I have a medicare advantage plan that works under the private fee for service option - I'm not in an HMO and instead ask physicians etc if they accept private fee for service when i make an appt. so far, i've had to use physicians in two different states, and several different cities as well as one hospital visit. I've also used my RX benefit in several different locations. It's been very easy/no issues at all and my co-pay has been reasonable, in fact surprisingly reasonable. My thoughts thus far are that the medicare advantage system has worked very well/low premium each month in addition to my standard medicare deduction and like someone said, i know what my cost is up front. I purposely did avoid one that locked me into an HMO because I knew that I am constantly in different places and could not be tied down to a small area.

[Robyn55]

Originally Posted by MadManofBethesda

I can't speak for their overall quality, but I know that the MD-DC operation isn't thought of very highly, especially in comparison to some of the world-reknowned health services that are available in the surrounding communities. Their medical facility was only about 4-5 miles from my house, but I can't imagine being limited to their specialists when I had Johns Hopkins and their state-of-the-art facility only about 30 minutes further down the road.

Actually, that's my concern with any HMO. As someone who's had some serious health problems in the past, i want to have the ability to go to JHU, Mayo, Cleveland Clinic, etc. if need be, and have my expenses covered by my health care provider.

I feel the same way you do (with Mayo JAX 10 minutes away from us). Robyn

[Huckleberry3911948]

i cant wait to be 65. senior advantage. i love kaiser, no more bill collectors bek some clerk did not cross the T or dot the I when they did the specialist referral.
no more appeals.

[Anthony Pepperoni]

Originally Posted by Robyn55

My understanding of Medicare Advantage HMOs is kind of limited. The basic outline best I can understand it is that people get more basic services (for example - some basic eye care that Medicare doesn't provide) - but give up stuff when they need more exotic specialized care (for example - they're limited in terms of doctors/hospitals). I don't understand why anyone would choose a Medicare Advantage plan as opposed to traditional Medicare unless they have absolutely no money to pay for basic health care needs (in which case - they'd probably qualify for Medicaid). Robyn

In most cases MA enrollee's get a free prescription drug plan included for free (MAPD). This would cost them 40 dollars on average. Seniors are requred to get a prescription drug plan or pay a penalty if they put off that choice.

They don't give up any exotic services. Medicare HMO's are requred to provide all the services needed. If they don't have it in their network, it will be provided outside of it. Most plans include a free health club membership as well. Most plans make the need for a medicare supplement unnecessary. Medicars supplement policys cost 200 a month on average. Many of these plans in states like Florida have no monthly premium.

[snowchoux]

I think that most of these plans are run by corrupt individuals. In my case, I feel that the customer service personnel are either stupid or instructed to lie to me. I had an appointment with a doctor, she was list on the website. And a call to them confirmed that, I went to that doctor. One week later they denied the doctor was in the plan. They run me in circles until I give up. They do this with the gym memberships and co-pays also. I just have my plan for the drug coverage or if I get sick.