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I would never get a Medicare Advantage plan - too many loopholes.
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?? Is there a question?
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Santalynn Sep 2021
The topic is (so-called) Medicare Advantage plans; sorry it wasn't clear in the initial post but in the forum topics list! I learned the hard way when I took the bait for 'dental! vision!' etc., but luckily because of my age and how quickly I caught the problem when a favorite provider wouldn't take the 'advantage plan' I called Medicare and they let me back in the fold! Some folks are not so lucky, get penalties, have to wait for the next enrollment, etc. Like the old saying 'If it sounds too good to be true, it probably is'!
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I agree, think really hard about getting a MA plan. My daughter has a problem in her Woundcare unit having them pay and leaves the patient paying out of pocket. Medicare contracts out to these companies but they have their own network of doctors you need to go to. Then they are State based. Meaning you can't travel and be covered. If you move to another state, you have to enroll in a plan that state has. My DHs Union has been trying to get members to move to an MA but we have kept with the Traditional plan. We pay out of pocket for Drs and have deductibles but better that then the hassle of an MA. They used to be HMOs but I see some have changed to PPOs. This means there is still a network and there are financial advantages staying in Network but if you need a Dr. out of network (needs to except medicare) they will still pay something towards his service.

Not sure how Medicare pays these MA companies. Maybe just a flat rate for every client? For me, I have been leery of them from the beginning. And now my daughter has called saying she has problems with getting paid, I know I will not join one.

And those commercials make it sound so good. I have had to work with one of those agencies when Dad's employer gave each retiree a certain amount of money a month towards their medical and the retiree had to pick what they needed in an insurance company. I knew exactly what my Mom needed, Medigap. She had Medicare and she had a state prescription policy. I actually had an argument with one of the agencies reps. I told him exactly what Mom needed but he tried to talk me into an MA. I said no, Medigap. When he wouldn't budge, I hung up on him. Then called back and got a rep who gave me no problems. Must get more commission when u push MAs.
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Santalynn Sep 2021
Not only that but the 'Advantage' plans (whose advantage? lol) are private companies, not part of Medicare at all. They hitch a ride on the trusted name of Medicare and profit hugely while being part of an effort to privatize Medicare and really make it hard for folks to get care.
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This is another reason why selecting anything, whether Medicare supplemental insurance or other services, need to be thoroughly researched before purchasing.

AAA provided road services long before some of the ones now advertising heavily are doing, yet the latter are inferring they're  the ideal choice for something AAA has managed for years if not decades.

Santalynn, your question is exactly why people need to research any kind of purchases very thoroughly.    Starting a business doesn't always require verifiable knowledge, or experience, or honesty.   We never even considered any of these when shopping for Medigap programs - too many restrictions.
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Are you talking about Medicare Advantage plans?
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Santalynn Sep 2021
Yes, Barb, but they only sound like they are part of Medicare when they are not at all; I urge everyone to research and also look into Thom Hartmann for his in depth explanation of the pitfalls of these plans. They were created as a way to eventually privatize Medicare and set up all sorts of restrictions as one ages and needs more care, under the guise of offering all sorts of 'goodies' to join. I jokingly say 'to whose advantage', lol. But, seriously, they are essentially a kind of HMO and come with similar pitfalls. Medicare Supplement plans are far better if needed for the 'donut hole' and if you are not eligible for Medicaid as a supplement. I now get sort of annoyed when I get constantly 'pitched' these 'dis'-advantage plans, feeling if all these goodies won't cost me anything extra why not plop 'em on my Medicare already?! Answer: because they're not what they seem; buyer beware! You would have trouble switching back to 'regular Medicare' in many cases, so educate yourselves, friends!
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Some people get very good care and are happy with their Medicare Advantage insurance. Check out what you're buying, good advice for any product.
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