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Many don't have a choice any longer, my neighbor is a retired life insurance salesman, he used to have a choice between Original Medicare and Medicare Advantage, but no longer, he is forced to get Medicare Advantage, but he hasn't complained about the coverage. I'm on Medicare Advantage, but I still have the choice of Original Medicare, I'm thinking about switching back in November since I'm getting up there in age, I worry about not be able to go to rehab facilities if I get injured, I think Advantage only puts you in nursing home rehab, but I have no complaints about Medicare Advantage. If your plan is a Medicare Advantage PPO, it's not a bad plan, you can see doctors in and out of network as long as they accept Medicare.
I'm on Aetna Dental DMO, I have to see dentists in the network, but it's been a great savings, I only paid $300 out of pocket for a root canal by a good in-network endodontist in NYC, the other plan available to me allows me to see any dentist/endo, but their bills are more expensive, a root canal would cost me over $1200 out of pocket!
There is a thread about the government possibly going to a gatekeeper for Original Medicare, so if that comes to fruition, it would make Original Medicare like Medicare Advantage, you should read that thread.
Retiree Advantage plans generally are not as problematic as retail plans which have no employer accountability. Often, retiree plans are supported/funded financially by the employer and only administered by Aetna/UHC, etc. There is some accountability to the actual insured - a pr thing, if you will. This funding is why OP started this thread. Employer is looking to cut costs - at the expense of the retiree.
I get the sense the j.i.g. is getting close to being up for some of the retail Advantage plans - the word is getting out and finally being believed - about the gamesmanship employed by these insurers to enhance their bottom lines - denials of care, doctors jumping through hoops just to get treatment approvals and/or getting paid. So, some are behaving a bit better - maybe. But they are finding other ways to get the revenue - upcoding, etc.
Nothing I read on this issue has changed my view that this is yet another attempt to siphon money from Medicare into the pockets of a private entity which will be looking over the shoulder of and second-guessing medical care providers under the guise of accountable care.
At this point, presumably, those on Original Medicare plus supplement are not affected - but that can change. Also, presumably, the medical provider needs to inform the patient of their participation in a DCE and the patient can opt out. I suppose the doc can then say if you don't agree to this, he can't see you.
Until DCEs are mandated, I wouldn't move from Original Medicare to Advantage without a significant motivating event.
Retiree Advantage plans generally are not as problematic as retail plans which have no employer accountability. Often, retiree plans are supported/funded financially by the employer and only administered by Aetna/UHC, etc. There is some accountability to the actual insured - a pr thing, if you will. This funding is why OP started this thread. Employer is looking to cut costs - at the expense of the retiree.
I get the sense the j.i.g. is getting close to being up for some of the retail Advantage plans - the word is getting out and finally being believed - about the gamesmanship employed by these insurers to enhance their bottom lines - denials of care, doctors jumping through hoops just to get treatment approvals and/or getting paid. So, some are behaving a bit better - maybe. But they are finding other ways to get the revenue - upcoding, etc.
Nothing I read on this issue has changed my view that this is yet another attempt to siphon money from Medicare into the pockets of a private entity which will be looking over the shoulder of and second-guessing medical care providers under the guise of accountable care.
At this point, presumably, those on Original Medicare plus supplement are not affected - but that can change. Also, presumably, the medical provider needs to inform the patient of their participation in a DCE and the patient can opt out. I suppose the doc can then say if you don't agree to this, he can't see you.
Until DCEs are mandated, I wouldn't move from Original Medicare to Advantage without a significant motivating event.
Thanks for posting the link regarding DCE's for the OP, I couldn't remember what it was called, and the rest of the info you posted. Thankfully you are very knowledgeable about this subject and help everyone understand it better.
Sorry, I will attempt to clarify that statement. The contract I retired under guarantees lifetime retiree health benefits,,but they are only offering a single mandatory change to a Medicare Advantage plan,,no other options. And hence, in my case, the paying of $499 per month(Will go up in the future I'm sure) Medicare premium for Part A.
If you have to pay $$$ for Part A, it probably means that you did not pay the Medicare Tax throughout your career, which seems odd since you're expected by your employer to take Medicare insurance.
whether it is Medicare or Medicare advantage,OP would still have to pay,since he has never paid for SS/Medicare while employed.
There is no way out of it,is there?
OCA if he qualifies OR marry someone who qualifies for Medicare,after one year of marriage,he would qualify .
Or leave the country and live in a country where healthcare is free or cheaper?
If you have to pay $$$ for Part A, it probably means that you did not pay the Medicare Tax throughout your career, which seems odd since you're expected by your employer to take Medicare insurance.
This is an excellent synopsis of the situation. Which begs the question - how is the employer justifying this betrayal to its retirees?
This is an excellent synopsis of the situation. Which begs the question - how is the employer justifying this betrayal to its retirees?
Yup. The OP says "lifetime health care coverage guaranteed by employer". If you have to buy into medicare upon becoming eligible for it, then it's not lifetime coverage.
Quote:
turning 65 yrs. old in the next few months
-being forced/changed into a Medicate Avantage plan by Aetna
-Lifetime health benefits guatanteed by my retirement contract, but this is only option -the plan requires I be fully enrolled in Medicare parts A and B.
-Never paid into Social Security/Medicare, instead only into Police and Fire pension fund.
-for the last 13 years my retiree health insurance coverage was great and never cost me a dime.
-No option to stay with current health plan.
-I will have to pay a $499 per month premium for Medicare Part A due to lack of SS quarters/credits
The bolded does not describe a lifetime health care coverage plan.
At my first reading of it, my first thought was: lawyer up! Breach of contract by the employer! Possible class action suit?
Yup. The OP says "lifetime health care coverage guaranteed by employer". If you have to buy into medicare upon becoming eligible for it, then it's not lifetime coverage.
The bolded does not describe a lifetime health care coverage plan.
At my first reading of it, my first thought was: lawyer up! Breach of contract by the employer! Possible class action suit?
There is a lifetime guarantee.
However, all that is guaranteed is (1) access to a retiree health insurance plan and (2) a subsidy by the employer. And that's quite a lot.
That is more than almost all retirees receive unless you are a public service retiree or teacher. Most retirees do not receive any subsidy for their retiree medical insurance.
Most other people contributed a considerable amount throughout their working career for Medicare coverage.
I retired many years ago but the total contributions to Medicare for me exceed $100,000. I paid this throughout my working career. You will be paying a hurry-up premium.
it is unusual that the employer did not withhold Medicare tax - I've heard of employers not withholding Social Security (typically state and local governments that have a pension plan) - but most of those government entities still will withhold for Medicare.
However, all that is guaranteed is (1) access to a retiree health insurance plan and (2) a subsidy by the employer. And that's quite a lot.
That is more than almost all retirees receive unless you are a public service retiree or teacher. Most retirees do not receive any subsidy for their retiree medical insurance.
Most other people contributed a considerable amount throughout their working career for Medicare coverage.
I retired many years ago but the total contributions to Medicare for me exceed $100,000. I paid this throughout my working career. You will be paying a hurry-up premium.
A friend of mine retired from a property and casualty company,it gives her $99 a month to pay for PART B,another worked for a company which was bought by Mobil Oil which was bought by Exxon,so he enjoyed whatever benefits EXXON retirees enjoy,I think it pays for his Part B.
But you are right,more employers offer nothing.
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