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Valued Social Butterfly
Posts: 5,564
Registered: ‎07-20-2010

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 11 of 25 (175 Views)

GailL1 wrote:

MaVolta wrote:

@john258 - Thank you for the link. This is a good page to bookmark.

 

I presently live where my MA plan provides an extensive network of providers and services, plus some additional benefits. In 2018, the plan is adding a few more benefits to the package. I've been quite happy with it.

 

My concern is if I should move to an area without a large network, would I still be able to get a Medigap policy? It appears that I can per #1 on the chart. I'm still going to speak with my agent, but that seems to alleviate the problem. 


That was my link to the Medicare Guaranteed Issue Rights, not john258 -'he has NEVER posted any links to back up what he types in the response box.  He just wants to talk to local experts - personally, even when consulting an expert, it is good to know and understand the details.

 

Those are the items which trigger a guaranteed issue right and as long as you fit into one or more of those conditions, you should be good to go.

 

It is those many that don't who have the problem and many people won't go to the extreme to move to trigger a guaranteed issue right -although depending upon the healthcare priority of getting a Medicap plan, it might be something they would consider.

 

I had had a friend who was involved in #3 - she signed up for a Medicare Select plan because it was cheaper on the pocketbook but you can only see certain providers and after a few 60,70, 80 mile round trips convinced her this plan was not for her.  Even if you live in a surrounding zip code, with traffic, miles, parking, etc. it does not seem to be a local provider plan especially in areas that are really spread out.  Might be OK for city dwellers.


Really got you that someone else was given credit for what you did. Are you going to stand up like that when one of the people you gave help to comes back as to how they were hurt? You just proved the point I have been trying to make. You really are doing this advice giving for your own sake, not the person in need sake, and that is why it is wrong. You refuse to tell them to see a local expert who can help them so if you were only providing information you would do that so that they are helped.

Valued Social Butterfly
Posts: 8,626
Registered: ‎08-18-2008

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 12 of 25 (161 Views)

MaVolta wrote:

@john258 - Thank you for the link. This is a good page to bookmark.

 

I presently live where my MA plan provides an extensive network of providers and services, plus some additional benefits. In 2018, the plan is adding a few more benefits to the package. I've been quite happy with it.

 

My concern is if I should move to an area without a large network, would I still be able to get a Medigap policy? It appears that I can per #1 on the chart. I'm still going to speak with my agent, but that seems to alleviate the problem. 


That was my link to the Medicare Guaranteed Issue Rights, not john258 -'he has NEVER posted any links to back up what he types in the response box.  He just wants to talk to local experts - personally, even when consulting an expert, it is good to know and understand the details.

 

Those are the items which trigger a guaranteed issue right and as long as you fit into one or more of those conditions, you should be good to go.

 

It is those many that don't who have the problem and many people won't go to the extreme to move to trigger a guaranteed issue right -although depending upon the healthcare priority of getting a Medicap plan, it might be something they would consider.

 

I had had a friend who was involved in #3 - she signed up for a Medicare Select plan because it was cheaper on the pocketbook but you can only see certain providers and after a few 60,70, 80 mile round trips convinced her this plan was not for her.  Even if you live in a surrounding zip code, with traffic, miles, parking, etc. it does not seem to be a local provider plan especially in areas that are really spread out.  Might be OK for city dwellers.

Valued Social Butterfly
Posts: 1,460
Registered: ‎10-09-2009

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 13 of 25 (144 Views)

@john258 - Thank you for the link. This is a good page to bookmark.

 

I presently live where my MA plan provides an extensive network of providers and services, plus some additional benefits. In 2018, the plan is adding a few more benefits to the package. I've been quite happy with it.

 

My concern is if I should move to an area without a large network, would I still be able to get a Medigap policy? It appears that I can per #1 on the chart. I'm still going to speak with my agent, but that seems to alleviate the problem. 

Valued Social Butterfly
Posts: 5,564
Registered: ‎07-20-2010

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 14 of 25 (145 Views)

GailL1 wrote:

john258 wrote:

 

 

 

Read your support article and you say this is a pitfall when you go back to Original Medicare. The friend I have talked about in here went from Original Medcare to an MA plan in CA, then back to original Medicare. He got local help and they were able to find a way to get around that problem. That is why a person should seek a local expert when they have a problem, and you should tell everyone that. He had no pitfall as you say. There are ways around a lot of regulations which the local expert will know about. When you do not tell people that you are giving them bad advice.


There are any number of conditions which would trigger a guaranteed issue status.  They are enumerated and described on the Medicare.gov site.

 

You can always go back to original Medicare from a Medicare Advantage plan.

 

It is the guaranteed issue rights which determines whether or not you will have access to Medigap coverage without underwriting.

 

I bet if you contact your friend he can describe his situation when that occurred and you can see how it happened, if that is what happened.

 

Not everybody can fall within these special rules.  Thus you may return to original Medicare from a Medicare Advantage plan but you might not be able to get a supplemental plan unless you meet a guaranteed issue stipulation or IF you are approved for a Medigap plan, there maybe a timed stipulation on a pre-existing conditon and most likely a heft premium.

 

Medicare.gov - Guaranteed Issue Rights for Medigap coverage


You still do not understand how Medicare works. You post more so called rules, which like the rest a local expert a good number of times can get a person around. When you only can read material and not understand how to apply it, you can not advise people.

Recognized Social Butterfly
Posts: 838
Registered: ‎09-03-2011

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 15 of 25 (161 Views)

When you consider how you want to get you Medicare health coverage consider not how healthy you are the day you purchase a plan but consider long term what your health could be like in the future. Because you may not be able to switch back to a better plan due to being underwritten or denied coverage.

 

If you chose a Medicare Advantage plan and then decide later to switch to Original Medicare and a Supplement plan outside of Medicare Supplement open enrollment and Guaranteed Issue Situations, Supplement plans may medically underwrite policies and turn you down.

 

 

Valued Social Butterfly
Posts: 8,626
Registered: ‎08-18-2008

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 16 of 25 (170 Views)

john258 wrote:

 

 

 

Read your support article and you say this is a pitfall when you go back to Original Medicare. The friend I have talked about in here went from Original Medcare to an MA plan in CA, then back to original Medicare. He got local help and they were able to find a way to get around that problem. That is why a person should seek a local expert when they have a problem, and you should tell everyone that. He had no pitfall as you say. There are ways around a lot of regulations which the local expert will know about. When you do not tell people that you are giving them bad advice.


There are any number of conditions which would trigger a guaranteed issue status.  They are enumerated and described on the Medicare.gov site.

 

You can always go back to original Medicare from a Medicare Advantage plan.

 

It is the guaranteed issue rights which determines whether or not you will have access to Medigap coverage without underwriting.

 

I bet if you contact your friend he can describe his situation when that occurred and you can see how it happened, if that is what happened.

 

Not everybody can fall within these special rules.  Thus you may return to original Medicare from a Medicare Advantage plan but you might not be able to get a supplemental plan unless you meet a guaranteed issue stipulation or IF you are approved for a Medigap plan, there maybe a timed stipulation on a pre-existing conditon and most likely a heft premium.

 

Medicare.gov - Guaranteed Issue Rights for Medigap coverage

Valued Social Butterfly
Posts: 5,564
Registered: ‎07-20-2010

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 17 of 25 (179 Views)

GailL1 wrote:

Sorry for the delay in continuing this IMPORTANT discussion for all seniors.

 

Mavolta wrote:

Yes, I can change plans or return to Original Medicare A + B + D + Supplement Plan.

 

-----------------------------------------------------

 

There are pitfalls in Medicare when choosing a MA plan initially and then later on (after a year) deciding to go on Original Medicare and purchase a Medigap plan to help cover your cost of medical care since Original Medicare has NO annual out of pocket limit.

 

Kaiser Family Foundation 2016 - Traditional Medicare . . . . Disadvantages?


Read your support article and you say this is a pitfall when you go back to Original Medicare. The friend I have talked about in here went from Original Medcare to an MA plan in CA, then back to original Medicare. He got local help and they were able to find a way to get around that problem. That is why a person should seek a local expert when they have a problem, and you should tell everyone that. He had no pitfall as you say. There are ways around a lot of regulations which the local expert will know about. When you do not tell people that you are giving them bad advice.

Valued Social Butterfly
Posts: 1,460
Registered: ‎10-09-2009

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 18 of 25 (181 Views)

oudeman wrote:
What insurance specialist did you speak to? I need one ...

The first thing that I did was to call my state's SHIP office (look for the number on the back of your new Medicare book). They provided additional information and answered many of my questions about enrolling in Medicare for the first time. I read the information in the Medicare book, and then went to the Medicare.gov website and compared plans, and also the insurance company Medicare websites. With so much information, I decided to sign up for a free Medicare presentation by an independent insurance agent who specializes in Medicare. He helped me narrow my choices and I came to a decision. 

Info Seeker
Posts: 1
Registered: ‎08-03-2012

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 19 of 25 (175 Views)
What insurance specialist did you speak to? I need one ...
Highlighted
Valued Social Butterfly
Posts: 1,460
Registered: ‎10-09-2009

Re: Why did you choose a Medicare Advantage Plan over Original Medicare?

Message 20 of 25 (369 Views)

GailL1 wrote:

Sorry for the delay in continuing this IMPORTANT discussion for all seniors.

 

Mavolta wrote:

Yes, I can change plans or return to Original Medicare A + B + D + Supplement Plan.

 

-----------------------------------------------------

 

There are pitfalls in Medicare when choosing a MA plan initially and then later on (after a year) deciding to go on Original Medicare and purchase a Medigap plan to help cover your cost of medical care since Original Medicare has NO annual out of pocket limit.

 

Kaiser Family Foundation 2016 - Traditional Medicare . . . . Disadvantages?


Yes, that's true. It is also true, according to my insurance rep, that if one changes back to Original Medicare and wishes to buy a supplemental plan, the premiums may be higher than those offered originally. 

 

It is highly unlikely that I would ever want to change back to Original Medicare since I live in a place where there are at least two competing companies with extensive networks. If I ever want to move, I would have to carefully weigh the options available, or choose to stay put.

 

This is why, IMHO, Medicare is so unfair. There are too many pitfalls, including the lack of portability, and lack of protective coverage, for openers. Even with expert guidance, one still has to choose what risks one is willing to take.