AARP Members Enjoy Exclusive Discounts on Travel, Dining and More. Join Today

Reply
Valued Social Butterfly
Posts: 1,431
Registered: ‎10-09-2009

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

Message 1 of 6 (187 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.

 

Valued Social Butterfly
Posts: 8,596
Registered: ‎08-18-2008

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

Message 2 of 6 (198 Views)

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?

Valued Social Butterfly
Posts: 1,431
Registered: ‎10-09-2009

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

Message 3 of 6 (278 Views)

GailL1 wrote:

Good answer, Mavolta - sounds like you understand the difference and weighed your preferences.

 

Medicare can seem overwhelming to a newcomer. I would advise speaking with a professional. They can help you find and compare the plans available in your zip code.

 

So every year, you can look at the plan to make sure it is giving you what you want as you describes and if not you can decide if you want to switch to another.

 

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

 

Would you think that a person who has a lot of health care cost would like your MA plan and be pretty well off with it rather than Original Medicare, with a supplemental and a prescription drug plan?

 

Advantage does provide a good amount of coverage in network, however, most plans are HMO and require a PCP. In my area, the PPO plans have pretty much disappeared.

 

A person with health issues that requires specialists, are probably better suited to Original Medicare w/supplement, since it does not require them to have a PCP or involve any network. They would need to confirm that their doctors or specialists accept Medicare. Likewise, they may need a Part D that best covers the drugs that they need.

 

Many people new to Medicare like Medicare Advantage plans especially if they are relatively healthy - guess that is why the numbers keep going up on participation.

 

Yes. My insurance guy said that he has signed up a lot of new retirees with Advantage plans. These are typically people with minimal health issues, and live in areas with large networks available to them. People like $0 premiums! 

 

Also, if I travel on an extended vacation, or out of country, I take out travel insurance with a health rider. People who travel a lot might prefer Original Medicare for the flexibility.

 


 

Valued Social Butterfly
Posts: 8,596
Registered: ‎08-18-2008

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

Message 4 of 6 (311 Views)

Good answer, Mavolta - sounds like you understand the difference and weighed your preferences.

 

So every year, you can look at the plan to make sure it is giving you what you want as you describes and if not you can decide if you want to switch to another.

 

Would you think that a person who has a lot of health care cost would like your MA plan and be pretty well off with it rather than Original Medicare, with a supplemental and a prescription drug plan?

 

Many people new to Medicare like Medicare Advantage plans especially if they are relatively healthy - guess that is why the numbers keep going up on participation.

Valued Social Butterfly
Posts: 1,431
Registered: ‎10-09-2009

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

Message 5 of 6 (325 Views)

Yes, I chose the Medicare Advantage Plan. This has been my first year in Medicare, and it has worked out well for me. I live in a large urban area with a large network of health care providers, and that includes my PCP, and all of the services (lab, x-ray, all local hospitals) that she typically uses. It also provides prescription drug coverage. I only have one, and it is a very low cost one at that. 

 

I went over all of the plans with an insurance professional who specializes in Medicare. He explained the premium supports for Advantage by the federal government, so I have $0 in premiums. The benefits are adequate to meet my needs, and there is a max annual in-network out of pocket limit that suits me. Hospital copays are reasonable, and limited to 5 days. 

 

Had I gone the alphabet soup route, it would have cost me around $280-ish per month for a supplemental policy, plus around $20 or so per month for Part D. While it allowed for more flexibility, the benefit coverage was similiar.

 

 

Valued Social Butterfly
Posts: 8,596
Registered: ‎08-18-2008

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

Message 6 of 6 (354 Views)

And do you know the difference?

 

Have you always had a Medicare Advantage plan or did you switch to a Medicare Advantage plan from Original Medicare, if so, generally why?

 

I chose Original Medicare because my Other Health Insurance (OHI) only works with the original program.