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Quality of care isn't the issue. ACCESS TO CARE is. Some MAs put hurdles to access. People with experience with certain advantage plans call them DIS-advantage plans.
Not all perform this way, but many do. If one is the unlucky enrollee of an MA which is a bad actor, too bad for you.
This does not happen with a Medigap.
One again, Lillie, is yours a retiree Advantage plan? Retiree Advantage plans usually perform better. If not a retiree plan, who is the carrier and what state are you in? I think you currently live in FL? I have asked you this at least three times. Either you don't revisit the threads on which you post or for some reason you are ignoring the question.
Exactly 1 year ago when I signed up with MA I asked the agent if the doctors I saw were in the network and they all were. I think it's important to ask a lot of questions with your agent(s) before signing up with any plan. Make sure the doctors you want to see are in the network before signing up.
Exactly 1 year ago when I signed up with MA I asked the agent if the doctors I saw were in the network and they all were. I think it's important to ask a lot of questions with your agent(s) before signing up with any plan. Make sure the doctors you want to see are in the network before signing up.
Thanks Ariadne - I'm still slogging through the mud on this lol. When you say the Medicare copays are teeny, can you give me an example? Say for a typical primary care visit? I can't for the life of me find a published list of any kind of what Medicare pays for different types of routine visits. Primary care, specialist visits (various types) etc. I did find coverage amounts for surgical procedures but it's annoying that the info is not more accessible.
PCP reimbursements vary between $122-184 depending on complexity.
Medicare requires you pay $233 Part B deductible first. Then Medicare pays its 80%. So, for a PCP visit, under an HD-G, after satisfaction of $233, your copay would range between $24-$36, approximately. The Part B deductible of $233 plus additional copays you might incur, go toward satisfaction of the $2,490 deductible. So, for budget purposes, add the premium for the HD plan of about $600/year, with perhaps $100-200 max add'l copays, or a total annual out-of-pocket of $1,000 ($600+ $333/$433) for premium and copays assuming you don't doctor much.
Quote:
Originally Posted by Teacher Terry
Between Medicare and my supplement I don’t pay any copays. I think it’s only plan N that allows small copays such as 20 for a doctor.
If you get sick two years from now, how do you know what doctors you want to see? Crystal ball? As far as moving to another country, it would be hard to do if you had suffered a debilitating stroke, etc. Just sayin.....
As you know nobody has a crystal ball, lol! One day when I was 17 years old I was run over by a speeding car that hit me in my legs as I was crossing a street. Someone must have been looking over me because a doctor stopped and worked on me for about 1 hour as I was laying on the road next to the ambulance. I never found out the name of that doctor that saved my life.
So here I am many years later to talk about it. Sure, I lost my upper teeth, broke my jaw, had over 300 stitches in my scalp and I can tell you more but I don't want to freak anyone out. The hospital doctors called me a miracle case as I was out of the hospital 1 week later.
My philosophy? I can only take 1 day at a time, sometimes 1 hour at a time (especially being a caregiver for my elderly Mom). I consider myself a positive person.
I wish everyone who is reading this the best of health!
My wife had cataract surgery this morning and she has regular Medicare and a plan N supplement. So when she checked in nothing needed to be paid up front because everything would be covered.
While I was waiting for her, another very elderly lady came in for cataract surgery. When she checked in, she was told that with her insurance, she had a copay of $1100 that would need to be paid up front. She said that she didn't have that much money, so they worked it out to pay 1/2 down and the rest in payments.
Makes me really appreciate the Medicare insurance we have.
Congress isn't even making these changes, CMS is doing it with the blessing of the administration. Seema Verma is the one who decided that step therapy can be used by medicare insurance companies, that has the potential of killing people but Congress didn't get to vote on it. Congress doesn't vote on how much the Government will pay providers for medicare advantage plans either, that's done by agreement between the insurer and CMS.
And I will just point out this happened under a GOP president
And the country is in a struggle between GOP and Democratic leadership when stories like this really need to be the focus of the media
I just wonder how many Advantage members who are unhappy with their plan voted in the last presidential or midterm election…
Actions have consequences
I have a medicare advantage PPO plan. I can go out of my network if I choose to and I can pay up to the policy limits if I need to. And its my plan, in a serious situation I would do so.
I have a medicare advantage PPO plan. I can go out of my network if I choose to and I can pay up to the policy limits if I need to. And its my plan, in a serious situation I would do so.
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