[RedneckRebel]

Originally Posted by chopchop0

Supposedly it's more expensive than traditional Medicare to the government, but does provide other benefits in some cases, we shall see.

In traditional Medicare, you don't have the narrow networks and authorization hassles to deal with

lol since when did cost ever come into a factor with the Federal government?

The market is speaking, and they want Medicare Advantage. My customers are consistently leaning toward Medicare Advantage more and more often. They don't want the high monthly premiums associated with a MEdicare Supplement, and Prescription Drug Plan.

In the first five months alone, nationwide, health plans added 583,407 lives to the Medicare Advantage insurance rolls. Compare that to Medicare Supplements with added a total of 729,495 in all of 2015.
All in all Medicare Supplements insure 11,922,000 lives nationwide, and Medicare Advantage enrollment sits at 18,344,445 as of June 1, 2016. Considering that Medicare Advantage has only been around since 2003 those are remarkable numbers.

It is probably only a matter of 10 years before Medicare Advantage completely dominates the market in most states.

[expatCA]

Originally Posted by RedneckRebel

lol since when did cost ever come into a factor with the Federal government?

The market is speaking, and they want Medicare Advantage. My customers are consistently leaning toward Medicare Advantage more and more often. They don't want the high monthly premiums associated with a MEdicare Supplement, and Prescription Drug Plan.

In the first five months alone, nationwide, health plans added 583,407 lives to the Medicare Advantage insurance rolls. Compare that to Medicare Supplements with added a total of 729,495 in all of 2015.
All in all Medicare Supplements insure 11,922,000 lives nationwide, and Medicare Advantage enrollment sits at 18,344,445 as of June 1, 2016. Considering that Medicare Advantage has only been around since 2003 those are remarkable numbers.

It is probably only a matter of 10 years before Medicare Advantage completely dominates the market in most states.

So what are the actual benefits of the Advantage plan and negatives?

[dothetwist]

Originally Posted by expatCA

So what are the actual benefits of the Advantage plan and negatives?

Advantage plans are cheaper. However, they are HMO/PPO models, meaning you have to see a doctor in their network, which is local, not nationwide. If you travel a lot, have a 2nd vacation home outside your 'home'' area, you will find it a hassle.

With a Medigap plan, you can see any doctor who accepts Medicare, including specialists with no referral.

As with most things in life, you get what you pay for. Advantage plans are restrictive in scope to keep costs down; you will not have many choices in doctors, facilities, etc.

[chopchop0]

Originally Posted by dothetwist

Advantage plans are cheaper. However, they are HMO/PPO models, meaning you have to see a doctor in their network, which is local, not nationwide. If you travel a lot, have a 2nd vacation home outside your 'home'' area, you will find it a hassle.

With a Medigap plan, you can see any doctor who accepts Medicare, including specialists with no referral.

As with most things in life, you get what you pay for. Advantage plans are restrictive in scope to keep costs down; you will not have many choices in doctors, facilities, etc.

Many things also require an authorization, either from your pcp or the insurance company such as procedures, xrays etc. Straight Medicare with a secondary insurance allows you to schedule pretty much anything right away, no authorization or referral needed from your primary care doc.

The between the narrow network and authorizations needed, some people prefer to stick with straight Medicare and pay the 20% themselves or pay the premium for a secondary insurance

[RedneckRebel]

Originally Posted by expatCA

So what are the actual benefits of the Advantage plan and negatives?

There are definitely pros and cons of both. It really depends on what your risk tolerance is. In a nutshell I like to describe it like this:
Medicare Advantage is like going to to the county fair. You get in for free, but all the rides cost money. (Rides being doctors and hospitals)
Medsupps are like going to Disney. It costs a lot to get in, but all the rides are free, once you do.

For for Med-Advantage:
Pros:
- typically no monthly premium on top of your Pt B premium (and in some cases the Pt B is refunded to you)
- extra benefits that Original Medicare dont cover (eyeglasses, dental, OTC, silver sneakers etc..)

Cons:
- Networks
- On some plans you have to get referrals


Its certainly not for everybody, which is why about 50% of my book of business does not have a Medicare Advantage plan. But it is undeniably growing in popularity. And since most people have had an HMO or PPO in the past, they are already used to the coordinated care concept, and it doesn't bother them.

[RedneckRebel]

Originally Posted by dothetwist

Advantage plans are cheaper. However, they are HMO/PPO models, meaning you have to see a doctor in their network, which is local, not nationwide. If you travel a lot, have a 2nd vacation home outside your 'home'' area, you will find it a hassle.

With a Medigap plan, you can see any doctor who accepts Medicare, including specialists with no referral.

As with most things in life, you get what you pay for. Advantage plans are restrictive in scope to keep costs down; you will not have many choices in doctors, facilities, etc.

Actually many plans have nationwide networks, which you can, and often are, still in network in other states. Also, all Medicare Advantage plans have world wide Emergency and Urgent care coverage.

However, for snowbirds, it is usually a better idea to be on Original Medicare with a supplement, but not always.

[chopchop0]

Originally Posted by RedneckRebel

Actually many plans have nationwide networks, which you can, and often are, still in network in other states. Also, all Medicare Advantage plans have world wide Emergency and Urgent care coverage.

However, for snowbirds, it is usually a better idea to be on Original Medicare with a supplement, but not always.

Depends where. In Tennessee, I've heard Humana Medicare has great coverage and availability but when you travel to FL with it, can be harder to find providers.

That's why I agree with your advice for snowbirds to stick with straight Medicare/supplementary insurance

[Lee W.]

I've heard that some doctors don't accept Medicare Advantage because its payment to them is lower than that for straight Medicare.

[chopchop0]

Originally Posted by Lee W.

I've heard that some doctors don't accept Medicare Advantage because its payment to them is lower than that for straight Medicare.

Yes, it can be hence they won't accept contract and you'd likely pay a higher "out of network"rate to see them

[RedneckRebel]

Originally Posted by Lee W.

I've heard that some doctors don't accept Medicare Advantage because its payment to them is lower than that for straight Medicare.

That is true with both original Medicare and Medicare Advantage.
It is wise to know what plans your doctors accept before choosing what insurance you will have. A good broker will verify that your doctor accepts the coverage selected before enrolling you.