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Old 01-22-2017, 12:00 PM
249 posts, read 196,990 times
Reputation: 492


I too thought medicare was confusing when my DH was months away from getting it, I'm the insurance person in our family so the task fell to me.

Throwing out all the marketing mailings every year is my first simplification, they only contain simple advertising not essential details. I also never go to the many offered "free luncheon" seminars, again its only long winded marketing.

I go online to the medicare.gov website which tells me what plans are available for my zip, I can also input any medications to help decide Part C coverage. You may or may not want an Advantage plan, you can review the coverage and premiums to decide. If you decide to get a Medigap (supplement) plan, you can review each plan and companies providing it. As already said, all plans under the same coverage (such as all Plan F) give the same coverage, some companies give more added benefits (like Silver Sneakers)but never less. If you work through each step it really isn't as complicated as it sounds just listening to all our comments.

It is also like any insurance, one can choose a lower premium with higher deductibles to save money, but risk an unknown expense. Risk adverse, get plan F pay more in premiums. Low income can choose an HMO, less choice, but less money out of pocket.

Last edited by cmarlin20; 01-22-2017 at 12:19 PM..
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Old 01-22-2017, 12:10 PM
Location: RVA
2,164 posts, read 1,265,616 times
Reputation: 4451
Thank you all for the Medicare clarifications. You seemed to have hit the nail on the head. That was extremely helpful for me, though I will not be eligible for 6 more years. DW will be in 1 year, but will stick with mine until I retire in 3. This was a great example of the negatives of privatization for many.
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Old 01-22-2017, 01:12 PM
Location: Lakewood OH
21,699 posts, read 23,661,739 times
Reputation: 35449
Originally Posted by fallstaff View Post
I'll bet it's 50/50 he was
Yeah, that's possible too. When some people can't understand something, rather than asking for help they would rather rant and rave and blame others for their lack of comprehension ability. This guy could always have been this way.
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Old 01-22-2017, 01:23 PM
3,455 posts, read 2,326,093 times
Reputation: 6998
I work in Philadelphia. The Medicare Advantage plans take out giant billboard ads and plaster the SEPTA buses with ads touting how great they are, how much money you'll save, how big their network is, etc. If someone has even mild cognitive impairment (like perhaps Mr. Grouchy does) how are they supposed to cut through the BS and figure out it's all marketing hype? I thank my lucky stars that when my husband signed up for Medicare, I had a long conversation with my then-employer's insurance broker. She gave me the low-down on Advantage plans and told me to steer clear of them. (She had nothing to gain or lose by this conversation, as she was not going to make a penny off my husband, no matter what type of Medicare we chose. He was not covered by my employer's plan.)
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Old 01-22-2017, 02:52 PM
Location: Lakewood OH
21,699 posts, read 23,661,739 times
Reputation: 35449
I used to pay health insurance claims for a living so I was pretty savvy as to how health insurance works. Still when it came time to sign up for Medicare I consulted the experts at the Medicare advisory office in my city that's set up to help people figure it all out.

They're not trying to sell you anything. They will give the best advice needed tailored to the individual's needs and budget.
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Old 01-22-2017, 04:07 PM
Location: Texas
1,971 posts, read 1,373,867 times
Reputation: 6740
This scenario plays out everyday somewhere in a doctors office. The patient received a mailer, explaining all the great benefits plus a free meal if he attended. He not only ate the free meal, but also the BS that they fed him, that all doctors must, or will accept this great insurance policy. So he signs at the dotted line without calling his doctors office.

His long time doctor will not take patients with this HMO policy and he is informed so by the receptionist. The patient knows this canít be correct, he was told last month that all doctors will or must take his new insurance.

The patient is now confused, did someone lie to me, am I stupid, or confused and the receptionist says the same thing over and over again, and Iím getting angry. From his past experience, he knows some receptionists are twits, some just want to blow you off, and a some are helpful, and she is the only one behind the counter that will talk to him.

A word to the few people here that want to inject themselves into the argument between the patient and the receptionist, Donít. Not only is he angry, but now someone from the peanut gallery want to shame and embarrass him, not a pretty picture, nor is the outcome.

The receptionist has complete control of the situation. All she has to say is Ďwe are finished, have a good dayí and walk away.
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Old 01-22-2017, 04:09 PM
Location: Greenville, SC
4,640 posts, read 3,699,524 times
Reputation: 8618
I'm 70, still working, and have been navigating the Social Security/Medicare maze over the past year as I prepare to transition to part-time employment. It's a very bureaucratic process, and IMHO overly complex (even for someone like me who is so far with it cognitively, and sporting multiple graduate degrees). It sounds like the "belligerent old man" had his fill of the process and couldn't take any more.

If you have someone approaching retirement age in your family or among your friends who is easily confused by all the B.S. and doublespeak, don't let them go it alone; the best gift you can give them is helping them navigate the complex decisions required. These include Social Security, 401K distributions, Medicare supplementary plans, and taxes. Some of the decisions once made aren't reversible following retirement. The quality of information I've received from government employees as well as insurance providers has been inconsistent; it can be a real crapshoot.
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Old 01-22-2017, 04:16 PM
249 posts, read 196,990 times
Reputation: 492
My first year on Medicare I had an Advantage plan I liked. It was a PPO so I had my choice of doctors, good deductible, etc. The next year it was cancelled for my zip, my only Advantage choice was HMO's, I wont do those so I went to a Medigap for a little more money and a little more in deductibles.
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Old 01-22-2017, 04:32 PM
3,455 posts, read 2,326,093 times
Reputation: 6998
Wish I could rep you again, txfriend!
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Old 01-22-2017, 05:27 PM
30,082 posts, read 47,327,614 times
Reputation: 16026
Originally Posted by Perryinva View Post
I had to get a cortisone shot in my foot to shrink a Mortons neuroma. I have a high deductible health plan, and paid the $56 with a credit card. After me, in line was an Ed Asner look alike, so maybe late 70s? Age doesn't really matter except that he was not foreign and well over 65. He was one of the rudest, most belligerent seniors I have seen in action to date. He literally walked in to the office a few minutes before his 9:00 appt. and started complaining at 9:05 as to why he had to wait when he had an appointment!

Then, while the receptionist was going over the usual "Identification and Insurance card, please", she told the man that they don't accept his insurance at this office. He had some United Healthcare version. The man went insane. He did not drop to expletives but kept insisting, very very loudly, that he was told his insurance was good everywhere, and they HAD to take it. She replied, no, they didn't and that many doctors don't take many types of insurance, including Medicare. She told him that they had treated him in the past when he had Medicare, but could only now, if he wanted to pay out of pocket. I listened while she patiently explained the same things over and over and he kept insisting she "Get on the phone, and make this right!" She even called a similar orthopedic surgeon/dr thta DID take his insurance and they offered him a later same day appointment. He would have none of it! He only wanted a Dr that he knew, and actually said "for all I know, this guy is a veterinarian!" Then he told the receptionist he wanted all his medical records "RIGHT NOW". He wasn't leaving his records at a Drs office that was no good and worthless. I left before it was totally resolved, but wow.

Anyway, my question is, are there actually cheaper alternatives to Medicare, with less coverage that one can get instead? This was news to me. She specifically told him to call all his doctors and tell them he does not have Medicare, but has the United Healthcare plan he specified. I thought everyone after 65 and not under an employers plan had Medicare. I thought maybe it was possible he WAS retired, and on Medicare, then went back to work and this was his work plan? But Medicare would still be cheaper, so that is unlikely.
Likely he had some dementia---should not have been allowed out especially to a doctor's office w/o a competent adult to oversee---but maybe doesn't have anyone...
Not reading the other posts to thread but maybe others suggested this

I have seen similar instances in my doctor's office where the patient is unusually rude and demanding--and 9/10 times I would think there are cognitive issues...
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