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Old 09-09-2019, 04:39 PM
 
Location: Wisconsin
23,573 posts, read 50,242,219 times
Reputation: 18227

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Re Advantage - it all depends.

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$999 MOP is unheard of for an MA. Sounds like an HMO with a restricted network. That network may be large enough that it isn't a problem for you right now. Beware should a disaster occur while traveling. We had a case in WI - man required heart surgery while wintering in TX. He didn't know the terms of his policy. UHC Advantage (HMO) would pay for surgery and hospitalization. When time came for discharge to an SNF for rehab, UHC Advantage refused to approve. Said he needed to return to WI for rehab at an in-network facility. Unless one knows they will never be out of their service area, better choice would be a PPO Advantage. PPO's will still pay something.
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Old 09-09-2019, 10:23 PM
 
944 posts, read 880,532 times
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I've had Medicare for a couple of years now and for about two years I was on an Advantage plan. The low monthly premium seemed like a good idea but then I had to pay all these co-pays. I got sick of always having to pay these amounts so I switched to original Medicare and a Supplement. I pay one premium for the supplement and everything is taken care of. I have never been billed for anything. I just like the convenience of having this type of plan.

I have the original Medicare and like others, my supplement is through AARP/UHC. I had checked with a doctors office before choosing UHC to see what they thought and they said UHC was very easy for them to work with. I have never had any procedures questioned or denied.

I would like to have coverage for dental, vision and hearing but I checked into several dental plans and as others have mentioned you really need to read what is covered. The ones I looked into didn't sound as though they really covered very much.

With vision, I am currently going to the eye doctor for visits to watch the progression of cataracts and probably will have surgery in the future. Medicare has always paid for these appointments and my understanding is they will pay for the surgery. I believe they will pay for one pair of eyeglasses after the surgery but I'm not absolutely certain about that. There are a lot of places around here that have specials on glasses and frames all the time. I'm not too concerned about having to pay for my own glasses.

The only thing that really irritates me is that Medicare does not pay for hearing aids. So many people talk about how great Costco is for hearing aids but, unfortunately, there isn't a Costco near where I live.
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Old 09-12-2019, 08:32 AM
 
1,616 posts, read 1,438,005 times
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I spoke to a Medicare supplement sales person and he suggested the N plan over the G. A different sales person suggested the high deductible G, which isn’t available until January 2020.
None of them offer BCBS, I wonder why. I asked about the UHC community based plan and the guy said the cost increase comes out the same as for the attained age. He was pushing Aetna, Mutual of Omaha and Cigna.
I don’t trust sales people, but Ships Won’t give any advice.
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Old 09-12-2019, 12:07 PM
 
Location: Wisconsin
23,573 posts, read 50,242,219 times
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Quote:
Originally Posted by organic_donna View Post
I spoke to a Medicare supplement sales person and he suggested the N plan over the G. A different sales person suggested the high deductible G, which isn’t available until January 2020.

None of them offer BCBS, I wonder why. I asked about the UHC community based plan and the guy said the cost increase comes out the same as for the attained age. He was pushing Aetna, Mutual of Omaha and Cigna.

I don’t trust sales people, but Ships Won’t give any advice.
If you are healthy, a high-deductible G is a great choice and may not pay anything for you for years. Replaces high-deductible plan F, premiums will be very low and remain low. You still have catastrophic coverage for Medicare without the ongoing high price. Many here purchase the high-deductible plan. I think it's a smart choice if you have good health.

Plan N is fine if you don't expect excess charges. Premiums are lower, copays minimal. Plan N would be fine for me, as I don't expect at my age and health (rarely doctor) to ever need to visit a place like Mayo - a nonparticipating Medicare provider which can charge 15% more. Plan G will pay that 15%, as will a high-deductible F/G. Plan N will not. A recent poster chose Plan G because he didn't want to exclude the possibility he might need to visit a nonparticipating Medicare provider.

The guy was not correct that the cost comes out the same. The first five years you may be slightly ahead w/an attained age plan, but after that age-based premium increases continue until age 85. In Wisconsin, Aetna, MOO, BCBS, and Cigna all continue age-based rate increases to age 85.

We have several reports here from people on attained-age plans costing well over $400/mo. I attended an Advantage plan seminar ten years ago. An elderly couple in early 80's could no longer afford their Medigaps, so the healthier one was switching to Advantage. Ten years ago, each of them was paying $300/mo., today that premium would be over $450/mo., easily.

I've said many times - most recently upthread - my sister's attained age plan went up $90 in four years and would have continued that way until age 85. Whereas, anyone her age buying an Aetna policy today would be paying - to start - $167. So, why isn't her premium $167 instead of the $235 she was paying? Because she is in a closed risk pool. The agent cannot possibly know what your premium on an attained-age plan will be ten years from now. We have an entire thread on MOO - they are the most egregious offender on closing books of business early, locking in the risk pool, exposing that risk pool to higher premiums. Community-rating plans do not do that.

Fwiw, BCBS is also very expensive when one gets older as their policies are also attained-age.

Only UHC sells community-rated plans - except in FL where all plans are issue-age rated - and one or two other states.

The other option is to look at issue-age plans. Somewhat more costly to start than community-rated, but low base rate is locked in at purchase and not subject to change because of age. Your only exposure is inflation.

Last edited by Ariadne22; 09-12-2019 at 12:42 PM..
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Old 09-12-2019, 01:59 PM
 
30 posts, read 24,443 times
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Ariadne22, you might add that in Wisconsin we have the option of choosing to add a Part B excess rider. I have the AARP/UHC co-pay plan which is essentially a Plan N(up to $20 co-pay and $50 ER co-pay unless admitted) except with the Part B excess rider, it is exactly like a Plan G....except for the $20/$50 co-pay. Additionally, in the 4 years I've had the medigap plan I've only been charged the co-pay twice..both times only $9, and the rates have only gone from $110 to $131/mth in those 4 years.
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Old 09-12-2019, 02:02 PM
 
1,616 posts, read 1,438,005 times
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Thank you so much for your reply. I found one of your older posts and it explained everything. I had UHC when I was working and they were terrible, but it sounds like they are my best option. I live in NC. I will probably go with UHC G plan. I turn 65 in December, and the high deductible G isn’t offered yet.
My sister lives in AZ and has an Advantage PPO. We keep arguing because she doesn’t understand that it’s not Medicare. She called her carrier and they told her they pay the exact same benefits as traditional Medicare. It’s so frustrating trying to get her to understand.
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Old 09-12-2019, 02:16 PM
 
1,616 posts, read 1,438,005 times
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Ariadne22,
In NC we have two companies that offer issued age plans, Transamerica Life Insurance ($143.84) and Old Surety Life Insurance. Trans America has only sold these plans for 5 years.
These are Transamerica’s increases:
2015 124.23
2016 no increase
2017 129.94
2018 133.19
2019 143.84
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Old 09-12-2019, 04:29 PM
 
Location: Wisconsin
23,573 posts, read 50,242,219 times
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Quote:
Originally Posted by organic_donna View Post
Thank you so much for your reply. I found one of your older posts and it explained everything. I had UHC when I was working and they were terrible, but it sounds like they are my best option. I live in NC. I will probably go with UHC G plan. I turn 65 in December, and the high deductible G isn’t offered yet.

My sister lives in AZ and has an Advantage PPO. We keep arguing because she doesn’t understand that it’s not Medicare. She called her carrier and they told her they pay the exact same benefits as traditional Medicare. It’s so frustrating trying to get her to understand.
You might want her to read this - or copy/paste and email it to her:

//www.city-data.com/forum/43835454-post8.html

UHC can be problematic - as you've found. I left a UHC Advantage plan for that reason - claim denials/wouldn't pay without a fight. However, UHC performs admirably on its Medigaps. UHC must pay, no questions asked, its share of any Medicare-approved expense. So, no worries there.

UHC does not sell HD plans. You can wait until Jan. 2020 to purchase a high-deductible Plan G from another carrier, if you're willing to risk one month with no Medigap. You are given a guaranteed issue period of six months beginning when you turn age 65 to choose a Medigap.

https://www.medicare.gov/supplements...-i-buy-medigap

I would do that. Because of the high deductible, attained-age pricing doesn't have the risk of outlandlish premium increases, so you're safe there. BCBS had offered an HD plan in WI at a very reasonable premium, since discontinued in this state but existing policyholders are grandfathered. I would go with BCBS or Humana or another known name for an HD plan. If your health holds, you can always switch to Plan G later - or not. Meanwhile, you've saved quite a bit on premium and are still covered worst case.

Quote:
Originally Posted by organic_donna View Post
Ariadne22,
In NC we have two companies that offer issued age plans, Transamerica Life Insurance ($143.84) and Old Surety Life Insurance. Trans America has only sold these plans for 5 years.
These are Transamerica’s increases:
2015 124.23
2016 no increase
2017 129.94
2018 133.19
2019 143.84
Yes - and the reason for those low increases are medical inflation/claims experience only - b/c the rate based on age purchased never changes. How do those rates compare to the UHC Plan G? If you can live with the possibly higher premium on an issue-age plan now, in the very long run you will be happy with this choice. You are fortunate to be in NC. In WI, issue-age plans F for those 65 start at about $200/mo.

Last edited by Ariadne22; 09-12-2019 at 04:43 PM..
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Old 09-12-2019, 05:28 PM
 
1,616 posts, read 1,438,005 times
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I understand what you are explaining to me, but I still don’t know which is the better deal. I can afford the higher initial premium and I don’t necessarily have to get a high deductible G plan.
I have never heard of these companies that offer the issued age plans. What if they were to go out of business or stop offering these plans?
So my 3 choices are:
1) a company that is age attained with a high deductible G plan like BCBS, Aetna or Cigna @ $38.00 or choose their regular G plan @ $100.00,
2) UHC with a community G plan @ $107.00,
3) Transamerica Life Insurance or Surety Insurance with the age issued G plan @ $143.00.
It also saves me $60.00 a month if they offer Silver and Fit.
My concerns are that they pay without a fight, the premiums don’t go up too much and too fast, and they are A rated companies.

Last edited by organic_donna; 09-12-2019 at 05:39 PM..
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Old 09-12-2019, 08:23 PM
JRR
 
Location: Middle Tennessee
5,505 posts, read 3,204,326 times
Reputation: 9054
Quote:
Originally Posted by organic_donna View Post
I understand what you are explaining to me, but I still don’t know which is the better deal. I can afford the higher initial premium and I don’t necessarily have to get a high deductible G plan.
I have never heard of these companies that offer the issued age plans. What if they were to go out of business or stop offering these plans?
So my 3 choices are:
1) a company that is age attained with a high deductible G plan like BCBS, Aetna or Cigna @ $38.00 or choose their regular G plan @ $100.00,
2) UHC with a community G plan @ $107.00,
3) Transamerica Life Insurance or Surety Insurance with the age issued G plan @ $143.00.
It also saves me $60.00 a month if they offer Silver and Fit.
My concerns are that they pay without a fight, the premiums don’t go up too much and too fast, and they are A rated companies.
There is no fighting about paying with a medicare supplement. If medicare approves an expense, the medicare supplement company has to pay their share. No ifs, ands or buts.
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