U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > General Forums > Health and Wellness > Health Insurance
 [Register]
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
View detailed profile (Advanced) or search
site with Google Custom Search

Search Forums  (Advanced)
 
 
Old 10-10-2018, 02:44 PM
 
767 posts, read 2,130,453 times
Reputation: 1176

Advertisements

AARP does not sell health insurance as far as I know. How can anyone have an AARP plan?
Rate this post positively Quick reply to this message

 
Old 10-10-2018, 02:51 PM
 
12,619 posts, read 10,277,114 times
Reputation: 32860
Quote:
Originally Posted by Nausikaa View Post
AARP does not sell health insurance as far as I know. How can anyone have an AARP plan?
AARP will endorse or sponsor insurance plans. The actual plans are underwritten and administered by legitimate insurance companies
Rate this post positively Quick reply to this message
 
Old 10-10-2018, 02:52 PM
 
6,506 posts, read 4,354,537 times
Reputation: 17392
Quote:
Originally Posted by Nausikaa View Post

AARP does not sell health insurance as far as I know. How can anyone have an AARP plan?
https://www.aarpmedicareplans.com

https://www.aarp.org/benefits-discou...care-complete/

https://www.aarp.org/benefits-discou...re-supplement/
Rate this post positively Quick reply to this message
 
Old 10-10-2018, 04:35 PM
 
4,401 posts, read 1,949,293 times
Reputation: 11321
Quote:
Originally Posted by Nausikaa View Post
AARP does not sell health insurance as far as I know. How can anyone have an AARP plan?
You're correct- AARP is not an insurance company and a few of the posts above implied that they were. They certainly DO endorse the insurance provided by certain companies for their members- in my state it's United Healthcare for their Medicare supplement and the Hartford for home and auto.

I don't like AARP and get tired of their whiny e-mails exhorting me to contact my representative for every single issue, but DH had their Medicare supplement for the two years between when he signed up for Medicare and when he died and I was perfectly happy with UHC. He had ongoing medical issues, a few acute episodes (one fall that required vertebroplasty) and eventually died of acute myeloid leukemia. I was very impressed with UHC and the coverage and I did the same when I was eligible for Medicare this year. Very little personal experience- thank heaven, I'm a lot healthier than DH was.
Rate this post positively Quick reply to this message
 
Old 10-10-2018, 07:43 PM
 
Location: Wisconsin
23,546 posts, read 50,140,471 times
Reputation: 18197
Quote:
Originally Posted by charlygal View Post
Did you shop around for the best rates? Did you understand your policy terms?

All insurance companies are in business to make profits.
Absolutely. Best rates are not necessarily the "best" after six or seven years - and then it may be too late, depending on state.

After age 77, because of community rating, UHC does not raise rates because of age, only claims experience for the group in the region insured. Attained-age policies, on the other hand, close their book of business after a few years, some subjecting insureds to higher percentage premium increases due to age up to age 85.

Good discussion of how policy pricing methodologies differ, here:

//www.city-data.com/forum/healt...alth-care.html

Premiums for attained-age policies can get pretty outlandish over time.

Last edited by Ariadne22; 10-10-2018 at 08:19 PM..
Rate this post positively Quick reply to this message
 
Old 10-11-2018, 04:25 AM
 
85,775 posts, read 83,257,557 times
Reputation: 61469
Quote:
Originally Posted by BBCjunkie View Post
You either have traditional Medicare + a Part D policy, and then an extra Supplement plan if you want, OR you have an Advantage plan. It's an either/or thing on the consumer end.

Technically the Advantage plans are just a bundling of the three separate Medicare coverages (Part A, Part B, and Part D) under a single premium and with the difference that once the basic coverages are factored in, the bells and whistles (and restrictions) are up to the Advantage plan's insurance carrier.

In other words someone wouldn't be able to enroll in traditional Medicare and then "add" an Advantage plan on top of it.

Out of curiosity I looked in the back of the new 2019 Medicare book that came recently, to see what the UHC Advantage PPO plans in my area cover (not that I'd ever get one myself.) There are some pretty noticeable copays, particularly in chemo drugs. My friend who had cancer while on an Advantage plan could not afford the 40% copays for all of her chemo treatments. She paid the first few, borrowed from family members for the next few, and then simply didn't get the last two infusions because the money just wasn't there for the copays.

After treatment she switched to traditional Medicare because of all the 'serious' stuff that her $50/month Advantage plan didn't cover. She was terrified of needing more treatment (her cancer was aggressive) in the future and running into the same lack of coverage.

Like mathjak said: Advantage plans are fine until they're not.
many states will not allow a shift from advantage to medicare after the fact without medical underwriting , you can only go advantage to advantage.

you really have to very careful with those advantage ppo's. they still base what they pay on the rates they pay their preferred doctors . if you see a nonparticipating doctor regardless of what they charge , the ppo will only pay up to the rate they pay a participating doctor and you have to eat the difference.

this can be a big issue when traveling and the preferred doctors are local to you so where you are has only non participating doctors .

that is a big deal compared to medicare .

we have a friend who had pituitary gland cancer. their advantage plan would only approve removing 1/2 the gland even though her doctors want the entire thing removed . the doctors said medicare always pays for the full removal . but since our friend has an advantage plan and not medicare there is no way to show that in this case medicare would cover both halves .

so while advantage plan literature states they cover what medicare does , they really don't . once you get in to the nitty gritty of procedures they can do as they please with you and you have no way of showing what medicare would have done in your case as they know you don't have medicare .

Last edited by mathjak107; 10-11-2018 at 04:36 AM..
Rate this post positively Quick reply to this message
 
Old 10-11-2018, 09:11 AM
 
2,759 posts, read 1,233,338 times
Reputation: 4969
Quote:
Originally Posted by mathjak107 View Post
many states will not allow a shift from advantage to medicare after the fact without medical underwriting , you can only go advantage to advantage.
I'm lucky that my state (NY) is very consumer-friendly when it comes to insurance (note: It's not cheap but it IS consumer-friendly, lol).... more so than Medicare itself is.

Medical underwriting isn't used by traditional (govt-run) Medicare; it's only used by private insurance companies, which regular Medicare isn't. Advantage plans and Medigap/supplement plans can use it (where allowed by particular states) because they are private insurers. But regular Medicare isn't, and thus can't.

The only "medical underwriting" that kind of applies to regular Medicare is if the person has End Stage Renal Disease, which allows certain coverage protections that other people do not have. Those work in favor of the patient (making coverage easier) rather than restricting it.

My friend went from her Empire Blue Cross advantage plan to regular Medicare at the next enrollment period without a problem. She wasn't asked anything about her health history other than if she has ESRD.

I can't see how any state could make regular Medicare availablity more restrictive, because the only entity that can set parameters for that is CMS. States can make availability less restrictive, however, as my state does in allowing people to add and drop supplement policies at any time.
Rate this post positively Quick reply to this message
 
Old 10-11-2018, 09:35 AM
 
85,775 posts, read 83,257,557 times
Reputation: 61469
yes ,we pay more here in ny since we are community based not age based as well as we can go back and forth between plans. we pay quite a bit more here compared to other states
Rate this post positively Quick reply to this message
 
Old 10-11-2018, 12:25 PM
 
Location: Charleston, SC
2,064 posts, read 1,175,703 times
Reputation: 3654
Quote:
Originally Posted by BBCjunkie View Post
You either have traditional Medicare + a Part D policy, and then an extra Supplement plan if you want, OR you have an Advantage plan. It's an either/or thing on the consumer end.

Technically the Advantage plans are just a bundling of the three separate Medicare coverages (Part A, Part B, and Part D) under a single premium and with the difference that once the basic coverages are factored in, the bells and whistles (and restrictions) are up to the Advantage plan's insurance carrier.

In other words someone wouldn't be able to enroll in traditional Medicare and then "add" an Advantage plan on top of it.


I'm not sure I described my situation correctly, but I don't think the above is correct either.

I have Traditional Medicare Part A & B, Hospital & Doctor premium deducted from my SS check, about $134 per month. Instead of a Medigap Supplement, I have a Medicare Advantage PPO plan that covers my doctor visits and generic drugs. At this stage of the game, I only go to my Primary every 6 months ($5 co-pay) and get a Sunscreen checkup once a year, and maybe a Colonoscopy every other year......all fully covered. The scripts I take are both Tier 1 generics and also fully covered.

At some future date, I may move into a Medigap Plan G or whatever, but for now.....I find this is sufficient.
Rate this post positively Quick reply to this message
 
Old 10-11-2018, 12:46 PM
 
85,775 posts, read 83,257,557 times
Reputation: 61469
if you have an advantage plan you don't have medicare as a gate keeper . you pay the premiums the same way through your check . but it is administered through a private insurer who controls who you see , what your deductibles are , what facilities you can use and on many procedures , what they will allow .

they have a contract with medicare but they are in the drivers seat and regulate what your benefits are and whether hmo or ppo , those at medicare who make decisions on things have nothing to do with you . your gate keeper controls things . if they wont allow something they get the final say not medicare . there can be a big difference as i pointed out above in course of treatments granted between a for profit insurer vs non profit medicare .

in the case above i mentioned the doctors said medicare always pays to remove both haves of the pituitary gland if one side is cancerous . the advantage plan gate keepers denied both halves and only approved the 1/2 .

you may not be able to go from advantage to medicare in many states without underwriting based on your history .

"The Medicare Advantage program (also known as Medicare Part C) provides the means for Medicare beneficiaries to receive Medicare Part A and Part B benefits from a Medicare Advantage plan rather than from the government-administered Medicare program. Medicare Advantage doesn’t replace Original Medicare Part A and Part B coverage; it simply delivers these benefits through an alternative channel: private insurance companies. Medicare Advantage plans are offered by private insurance companies that contract with Medicare. Medicare Advantage plans must offer at least the same benefits as provided under Medicare Part A and Part B (with the exception of hospice care, which continues to be covered by Part A). Many Medicare Advantage plans offer extra benefits not available from Original Medicare. Therefore, to enroll in a Medicare Advantage plan, you must be enrolled in both Medicare Part A and Part B. You must also reside in the plan’s service area"


https://www.planprescriber.com/medic...are-advantage/

Last edited by mathjak107; 10-11-2018 at 02:13 PM..
Rate this post positively Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


 
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:
Over $104,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > General Forums > Health and Wellness > Health Insurance

All times are GMT -6.

© 2005-2021, Advameg, Inc. · Please obey Forum Rules · Terms of Use and Privacy Policy · Bug Bounty

City-Data.com - Contact Us - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37 - Top