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We had Kaiser through our employment and will not even consider using them in retirement (poor doctors and union staff do not make for good patient care). It is like a breath of fresh air to be out of their system; to be able to chose who we want to see as well as access to much higher rated hospitals.
I have had excellent doctors and excellent patient care from Kaiser in Los Angeles County. I speak from approximately 30 years of experience, during which time I had two surgeries (both hernias - first on one side then about 25 years later on the other side) and also the need to see a specialist at least a half dozen times. As far as their hospitals, they are teaching hospitals (at least here) which says a lot. The nurses and check-in staff have been friendly and helpful.
The way Kaiser is structured gives them a financial incentive to take good care of you and do it right the first time. If they fail to catch something early it is usually more expensive to treat - and that means expensive for them, not for the patient (because our patient co-pays are so low). I get reminders when certain checks are due, so they are pro-active about it. One example of that is Rx refills - if their records show you are due for a refill and you haven't done it, you receive an automated telephone reminder and/or email. Ditto if it's been a year since my last retinal photo (which is a way of checking for diabetic retinopathy).
I'm sitting here with my wife comparing her med advantage plan with my plan C supplemental medicare insurance. Hers has a good deal of benefit except for the SNF coverage and some other areas where she could expect co-pays of 20%, she pays no premiums, I pay 173.00 a month. We were trying to figure the potential for either of us being very ill and needing possible longer term skilled nursing care seeing as how hospitals shoo you out pretty quick nowadays.
I guess it's a toss as far as the money is concerned, my plan would allow for very little cost for that long term nursing care but at over 2,000 a year the cost of five years of good health leaves me short ten grand, and that would go a long way toward paying the dif in a advantage plan..So far her plan has cost us less for services (2yrs) rendered, I've had a few CAT scans, X rays, meds, and a rush to emergency but three years of my plan has cost me over six grand. So the advantage plan has a lot of merit as does the Cadillac plan I have, it's a matter of which suits you best I guess......
Yup, the Medigaps are costly v. Advantage. As I recall, here in WI you can buy a separate optional SNF rider for the Medigaps. They aren't expensive, at all. So, if one was paying for Medigap, may as well have SNF. Guess the ins. cos. figure SNF is low-risk for them.
I'm sitting here with my wife comparing her med advantage plan with my plan C supplemental medicare insurance. Hers has a good deal of benefit except for the SNF coverage and some other areas where she could expect co-pays of 20%, she pays no premiums, I pay 173.00 a month. We were trying to figure the potential for either of us being very ill and needing possible longer term skilled nursing care seeing as how hospitals shoo you out pretty quick nowadays.
I guess it's a toss as far as the money is concerned, my plan would allow for very little cost for that long term nursing care but at over 2,000 a year the cost of five years of good health leaves me short ten grand, and that would go a long way toward paying the dif in a advantage plan..So far her plan has cost us less for services (2yrs) rendered, I've had a few CAT scans, X rays, meds, and a rush to emergency but three years of my plan has cost me over six grand. So the advantage plan has a lot of merit as does the Cadillac plan I have, it's a matter of which suits you best I guess......
Medical plans are not designed to cover SNF. There is limited coverage in the plans for temporary care, say after a major surgery, but not much more than that. Dr visits, etc. would still be covered but what you need is a long term care insurance plan to pay for your stay--or better yet, pay someone to come into your home instead.
People can also get some good information from You Tube. Just do a search on Medicare Advantage or Medicare Supplements plans. As some people who are retired do travel or plan to travel you must also consider the potential need for health care when your away from home.
Also as a side note. Please at the very least have an up to date Will, health care directives and up to date beneficiary designations. Let someone know where all the important papers are located..
Let me stress this one more time especially for those who have been married or are married to someone who has been married before. Make sure all beneficiary designations are up to date. I would suck if at the death of a spouse to find out the ex-wife was still the beneficiary on a life insurance policy or a pension or whatever and they have been divorced for yearssssssssss. All those years of washing his underwear and you get nothing.
People can also get some good information from You Tube. Just do a search on Medicare Advantage or Medicare Supplements plans. As some people who are retired do travel or plan to travel you must also consider the potential need for health care when your away from home.
Also as a side note. Please at the very least have an up to date Will, health care directives and up to date beneficiary designations. Let someone know where all the important papers are located..
Let me stress this one more time especially for those who have been married or are married to someone who has been married before. Make sure all beneficiary designations are up to date. I would suck if at the death of a spouse to find out the ex-wife was still the beneficiary on a life insurance policy or a pension or whatever and they have been divorced for yearssssssssss. All those years of washing his underwear and you get nothing.
Please check the laws for your states about setting up a will too...often just a will is not enough and make sure it's a LEGAL will.....going through probate with a family member that printed a will off the internet...
People can also get some good information from You Tube. Just do a search on Medicare Advantage or Medicare Supplements plans. As some people who are retired do travel or plan to travel you must also consider the potential need for health care when your away from home...
Medicare doesn't cover medical care outside the US (except under some extremely limited circumstances which wouldn't apply to 99.999% of travelers). Some Medigap plans offer very limited amounts of coverage. When we leave the country - we buy a supplemental policy from InsureMyTrip: Travel Insurance - Compare & Review. Robyn
Since he wrote nothing more than good advice about the caution one should exercise if comparing plans why object to his posting?
In regards to the comment about higher commissions ,in actuality, I find 100% of solicitations via mail or otherwise are for Advantage plans which indicate
that 's where the 'money' is.
I agree. I think a decent agent can be worth his/her weight in gold in terms of comparing plans/providers/etc. and what might or might not make sense for a particular individual in light of his/her health situation/financial circumstances/etc.
I also agree that most of my solicitations come from MA providers - not Medigap providers. Most of the ads in our local newspaper are for those too.
BTW - I think the easiest way to compare MA and Medigap plans (apart from cost) comes down to the issue of choice when it comes to providers. If - like Escort Rider - you're satisfied with a closed network of providers you like - fine - go with the MA plan that provides it. OTOH - I think ER's experience with the Kaiser network is pretty limited in terms of geography. I know that for many people - including myself - the networks that are available through MA plans are fairly unappealing. Robyn
In defense of Kaiser, they are really good about preventative care such as giving flu shots and immunizations.
However, getting past their gate keeper primary care can be very difficult as their priority is only toss prescriptions at symptoms while lacking the ability to analyze the entire person. For a higher level of qualified care one needs to avoid the HMO system, in my opinion.
Exercise caution when it comes to comparing the Medicare solicitations. There are some new options popping up, at least in California. If we are fortunate enough to live long enough to make it to Medicare, we also know that there is no such thing as a free lunch and that you get what you pay for in this world. I wish we had a better system in this country but until that happens we have to exercise our best judgement.
Thanks to those on these threads who offer intelligent conversation to help others understand a complex system.
...For a higher level of qualified care one needs to avoid the HMO system, in my opinion...
That's my personal opinion too. And you don't have to be chronically ill to need a specialist. It can be a "once-in-a-lifetime" thing. E.g., many older women - especially those who've had children - can tend to sag "down there" - resulting in discomfort/urinary incontinence/etc. There's a medical sub-specialty for this - urogynecology. If I needed surgery along these lines - I'd want a urogynecologist to do it (my basic theory - as always - is the more frequently a doctor does something - the better he/she tends to be in terms of doing it). Robyn
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