Medicare Advantage question

[walkingman]

I have a question - my friend tells me he signed up for a Medicare Advantage plan. I posted this on an older topic but posting again to see if anyone knows anything about it. I know the enrollment period is over but it sounds too good to be truth.

He says his new plan is going to give back his Medicare premium that he has been paying every month. I know the cost is going up to $185 next year and the company (Insignia) told him it would take 3 months for the change to take place but he would get a check for his Jan - Mar payments and then he would not have to pay Medicare premiums after than?

I find that hard to believe?

Has anyone else ever heard of this?

[leftieNanner]

1. Medicare Advantage is fine

As long as you don't need any medical care. It's "free" but run by for profit insurance companies. As you age and your medical issues start to cost real money, they may deny your claim.

How do you think they can afford all those expensive TV commercials and mailers?

[magicarpet]

2. Is he ultra low income ?

He may have qualified for a Medicaid (Not Medicare) Advantage Plan. He maybe in a plan where his income is so low the government pays for his monthly Medicare premium and likely some other stuff so he is covered by Medicare and Medicaid. To qualify for this you income needs to be poverty levels.

[choie]

14. That's that's the Medicare Savings program

which is paid by Medicaid.

[Silent Type]

3. Following article says about 19% of MA plans offer some "give back" of the Part B premium.

I don’t think many MA plans return the whole Part B premium anymore, but I suppose a plan could return the full amount if they reduced other so-called “extra” benefits— like limited dental, vision, grocery cards, gym memberships, etc., and maybe the MA plan increases their premium to beneficiaries. Kind of smoke and mirrors, though.

https://www.ehealthinsurance.com/medicare/managing-medicare/how-do-you-get-144-back-from-medicare/

[walkingman]

9. I think this must be it? It's sounds too good to be true but I guess it is. My wife and I

have a MA plan from my previous employer which has proven to be good. It is the kind where I can go to any Doctor that accepts Medicare. It is a PPO that has a $3000 max out-of-pocket cap and I had cancer a few years ago and paid the $3000 the first month of the Chemo and nothing from that point on for the rest of the year.

I guess I'll stick with it because I know it works but out drug plan does have a high deductable ($450) but neither of us uses any drugs except glucoma drops and they are cheap.

Thank you for this info - I had no idea?

[sinkingfeeling]

4. Kind of. My ex-employer (I retired 20 years ago) gives me a pool of

money to 'make up' for the cost of Medicare and has us enrolled in an UnitedHealth Care Medicare Advantage plan that I pay $0 for.

[Jacson6]

5. Yes, You do get pay backs and buy backs.

But this is a private health insurance. If you end up in a out of network hospital or need health care that is not in network you could end up owing tens of thousands of dollars . You will be billed for it or have to pay a pre treatment fee. For example I had to make a $2k deposit to get an angiogram many years ago. After that I just enrolled in Medicare only.

IMHO MA is a scam by the health insurance industry. YMMV.

The politicos get "donations" from the HI industry.

[Skittles]

6. it's just plain wrong to profit by denying healthcare

MA is the privatization of Medicare

when most seniors are on it, they will do away with Medicare completely

only then will some people grasp the true cost of those "freebies"

[Silent Type]

7. 51% (most) are on MA now. When original Medicare denies claims, do we consider as profiting or

just saving money for the good of Medicare/government?

[bluestarone]

8. Just letting you know that here in North Dakota news yesterday

It was Humana Medicare Advantage will no longer be accepted at Sanford health hospitals or clinics. (that's what i understand is going on) If i'm wrong maybe someone could let us know?

[dalton99a]

11. +1. The largest rural health system in the United States

SIOUX FALLS, S.D. —Sanford Health will end participation with Humana Medicare Advantage on Dec. 31 due to ongoing challenges and concerns that negatively affect patients including ongoing denials of coverage and delays accessing care.

https://news.sanfordhealth.org/news-release/sanford-to-end-contract-with-humana-medicare-advantage/

[bluestarone]

12. TY TY TY for this site!

[J_William_Ryan]

10. "Medicare Advantage is fine as long as you don't need any medical care."

Not exactly.

Medicare Advantage is fine if you’re generally healthy and don’t have any serious chronic health issues where you need treatment once a month or more, need to see a battery of specialists, and take a lot of medications needed to keep you alive.

Medicare Advantage works great if you see a doctor three times a year or so, if you take one or two prescriptions a month, or if you need short-term treatment if you get in a car accident, for example.

The problem with Medicare Advantage is that the deductibles and co-payments will bankrupt you if you do need frequent medical treatments and are constantly seeing doctors.

[choie]

13. Your friend might have applied and found eligible for

the Medicare Savings Program, which pays for the Medicare Part B premium. You can get it thru some Medicare Advantage plans or you can apply for it separately. The Medicare Savings Program usually takes a couple of months to kick in so they'd get a retroactive payment check representing the first three months of Medicare Part B premiums that will be taken out of their SS benefits.

[walkingman]

16. Aha - this might be it? He is 66, took SS at age 62 , only gets about $1250 per month,

and is very much struggling month to month. He does work for cash these days so doesn't show any earned income and is really in a desperate situation. I feel for him because he is divorced and has made some bad choices in his life but there doesn't seem to be a solution for him. So I'm glad he might be getting some kind of assistance even though it is not much - it helps.

A lot of people never thought they would get old (myself included) and it seems to come quickly and if you haven't prepared it is sometimes too late. I'm 8 years older and I worry about when he gets older and is less able to work.

I have helped him out multiple times but it is a never ending cycle and I just cannot continue indefinitely.

[choie]

17. With an income of $1,250 that

Definitely makes him eligible for the Medicare Savings Program.

[Wonder Why]

15. They will get the money out of him in more ways than one. And it will

also be in blood.