Health
Related: About this forumAnyone really happy on traditional Medicare?
One of the happiest days was getting my card in the mail. Its nice to go to see a Dr and not pay $60 upfront co-pay. I can't afford a Medigap.
Anyone else so happy with Medicare? Thank you Dems
ETA several Drs warned me about Advantage and keep traditional. I know some here just love their MA plans, that's great, but I'm following my Drs" advice
flying_wahini
(8,043 posts)Just wished they covered eyes and teeth.
XanaDUer2
(14,346 posts)I've spent a LIT on tmj
leftieNanner
(15,724 posts)vapor2
(1,589 posts)Glorfindel
(9,941 posts)I had laser surgery for cataracts on both eyes last year. Traditional Medicare paid very well. I think I was out of pocket about $150.00 altogether.
XanaDUer2
(14,346 posts)I was paying more for work insurance. I was supposed to get physican therapy three times a week, but couldn't afford it on my work insurance. Itd b $720 a month
KarenS
(4,670 posts)also have a supplemental.
multigraincracker
(34,208 posts)My Union/Company plan covers about everything. Didnt have to change a thing. I paid about 10% for the cost of my drugs last year, a little over $200. Paid $600 in deductibles and was in the ER several times and lots of office visits.
Ocelot II
(121,236 posts)Back in the '60s when Medicare was first introduced, I remember my Republican parents grumbling about "socialized medicine." Fast-forward about 40 years, when my dad was pushing 90 and had developed some serious and expensive health problems. I was handling his bills and expenses by then, but he wanted to know what all this was costing him and I told him, nothing. And he said, "Thank God for Medicare!" I thought, but didn't say, "Don't thank God; thank Democrats."
XanaDUer2
(14,346 posts)Id be in real trouble wo it, I think. Looking to see a gastroenterologist now due to pain
Irish_Dem
(58,840 posts)But I also have a secondary insurance.
I never pay any medical bills at all.
But I have some expensive medication not covered very well.
And have had some big dental bills, not covered very well either.
XanaDUer2
(14,346 posts)I have monster bills not covered by insurance
Irish_Dem
(58,840 posts)Expensive, painful and frustrating.
Give Peace A Chance
(75 posts)Have you looked into GoodRX.Com ?
Hubby & I have been using them for 10+ years
and saved thousands $$$$.
Pharma prices vary widely, so all you need to do
is go online & see who has the best price for the specific med.
I hope this helps.
Irish_Dem
(58,840 posts)But Krogers no longer takes Good RX and that is the least expensive source of my one expensive medication.
Thanks for the tip.
My doctor told me last week in a visit his other patients are complaining about the price of this specific medication and he is telling us to get a OTC substitute on Amazon!
So I am trying some of those, but having some problems with them.
But I am going to work on the Amazon list to find something I can tolerate physically.
It will save me a lot of money.
(I have pancreatic insufficiency so need special enzymes to digest food.)
amuse bouche
(3,665 posts)Ojerly
(70 posts)is cheap for prescriptions for members, and cost just a little more for non-members. I'd you have a lot of them it may pay you to join just for them
babsbunny
(8,507 posts)No co-pay to see our Primary care Dr., 35.00 co-pay for a specialist, 120.00 for emergency room, urgent care is 60.00. We haven't had to use most of the things that are covered yet. Having Humana has no out of pocket monthly charge or anything, and hubby gets all of his meds free, and he has many meds. My colonoscopy was free and my mammogram was free. I haven't been without Humana since I've been on Medicare, so I can't really compare the two, but so far we are pleased.
XanaDUer2
(14,346 posts)montanacowboy
(6,332 posts)best deal ever
Freddie
(9,725 posts)DH was hospitalized 2x this past year and I think I paid $111 out of pocket for it. Physical therapy was all covered.
My daughter is an RN Case Manager and strongly discouraged us from the Medicare Advantage plans. Said they are constantly fighting the providers so they can pay for less care, regardless of what the patient really needs.
XanaDUer2
(14,346 posts)No. I'm done with them after working
soldierant
(7,945 posts)That's why i consider it a scam. Too many horror stories about denied claims.
I do have Humana for my part D and I'm not unhappy with that.
XanaDUer2
(14,346 posts)I doubt my life is worth 1 million to a company
Mr.Bill
(24,830 posts)She says pretty much the same thing.
arkielib
(373 posts)My MIL was talked into getting a Medicare advantage policy (by an aggressive and misleading salesman) and had a bad experience.
XanaDUer2
(14,346 posts)I've heard some horror stories. I think its fine if you're healthy, but I wouldn't want to be facing down a serious illness on it.
If its working for others, hooray for them
QED
(2,969 posts)I've been fine with these so far - I haven't had big expenses or procedures. My pension plan covers my dental insurance but the coverage for that is pretty standard.
MOMFUDSKI
(7,080 posts)I am spending my $400/mo on fun stuff. To each his own.
Glad its working for you
Katinfl
(264 posts)We are anticipating a move to NC and we know we will not have the options (too many to list) that we have in FL. We have been fortunate to not have alot of issues but I know many people who have and they have MA and they are pleased with it. We are resigned to the fact that medical will cost us more when we move. The only good thing about FL is the choices.
XanaDUer2
(14,346 posts)Good to hear a positive insurance story
unc70
(6,329 posts)In most areas of NC, you should be able to find reasonable MA plans at little or no cost. My brother, his wife, and I are on three different plans. Each of us happy with our choices. They have significant health challenges (e.g. Krohns). We are in NC different parts of the state.
Good luck with your move and your Medicare.
Katinfl
(264 posts)Moved from there to FL in 2005 and now its time to go back. Our son lives there. I need to be doing some research on MA plans in that area.
Silent Type
(7,199 posts)That and a few limited perks -- that might add up to several thousand dollars a year -- are why retired people select Medicare Advantage plans.
MOMFUDSKI
(7,080 posts)and it cost me $88. MA Plan.
XanaDUer2
(14,346 posts)Been having abdominal pain this last week..
Demobrat
(9,922 posts)But I would rather do without something I want to pay for something I need - peace of mind.
I had a bad experience with an HMO when I was working. Medicare was my ticket OUT of that nightmare.
duckworth969
(966 posts)But adding dental to Medicare would be very welcome.
XanaDUer2
(14,346 posts)LetMyPeopleVote
(155,122 posts)As a partner in my law firm, I paid the full cost of my insurance coverage. All of my law partners who are over 65 are on Medicare and I changed on my 65th birthday. I am very happy. I have a schedule g supplement and a prescription drug plan. I am now paying one-third of what I was paying for coverage before Medicare.
Lonestarblue
(11,932 posts)I do not need referrals from my doctor to see other doctors, such as dermatologists. I have a Medicare supplement and drug plan, and except for those premiums and the Medicare premium I pay very little for healthcare. And I can see any doctor that accepts Medicare without having to just see doctors within an insurance companys network or having to see just the specialists in their network.
XanaDUer2
(14,346 posts)So, as long as they accept Medicare, I can seek them out directly?
Lonestarblue
(11,932 posts)I never check with my doctor for a dermatologist, nor a podiatrist. Ive never had any difficulty with Medicare payments. However, if you do not have a Medigap policy, you might have some charges. Medigap picks up co-pay costs and deductibles.
XanaDUer2
(14,346 posts)But i can email him. He pulls up my EMR. I may need imaging
Demobrat
(9,922 posts)and love knowing that I can go anywhere and it will cost me nothing, especially when traveling. But I can understand why people go with Advantage plans. They are a better choice, financially speaking, than OM with no supplements. Thats a scary way to go.
keithbvadu2
(40,327 posts)The few free groceries were not worth the limitations of MA.
DownriverDem
(6,671 posts)My MA plan covers eye, hearing & dental besides medical benefits. Also I have an over the counter card that allows $125 for vitamin supplements, pain relievers, oral stuff, heart burn meds, eye care etc. (So my husband & I get $250 every 3 months) It does not cover food. I think it does for folks on both Medicare & Medicaid. Not everone can afford a Gap policy & a prescription drug plan. Glad its worked out for you.
Medicare is terrific. Advantage is a scam. If we did not have Advantage, dental and vision would be covered for Medicare patients.
infullview
(1,059 posts)The only expense is a $20 copay for doctor. Everything else is covered. BTW I have the AARP supplemental (I think its plan N)
XanaDUer2
(14,346 posts)How much a month is it? How do you get aarp medigap can I call them. Does the premium come directly out of my SS payment?
Demobrat
(9,922 posts)member ($12/year) to sign up. The premium is separate from SS. I have it automatically deducted from my checking account, but you dont have to do that. The premium depends on your age. It does go up as you get older.
I love it. Everyone takes it, and there are never any hassles.
Arne
(3,607 posts)Medicare covered over half a million for having a colon removal.
My payment for the year was $2900.
So considering I'm alive still, it's not bad.
Half a mil.
Demobrat
(9,922 posts)He had to see multiple specialists. They saved his life. He ended up paying about $250. I did not leave off a zero.
He has OM with a supplement. Thank God. If he was limited to a network he would be dead.
XanaDUer2
(14,346 posts)Mr X got his cataracts removed ( he's on traditional) for a couple of hundred.
Wow that's amazing! I think I made the best decision for me
Demobrat
(9,922 posts)XanaDUer2
(14,346 posts)That's my worry if I get something serious. Private insurance companies are about money, of course. I don't want to argue with insurance companies while under treatment.
Demobrat
(9,922 posts)She has an eye infection.
She was receiving good care, until the specialist who was treating her was dropped from the MA network. Now, the closest doctor in the network who can help her is over 50 miles away. My sister cannot drive, because of the eye infection.
There are good doctors who are closer. My sister lives in Chicago, not rural Arkansas. But they are not in her MA network. So she cannot get an appointment, even if she offers to pay cash. She just doesnt have the right insurance.
So no, she has not been specifically denied care, but her MA plan has successfully prevented her from receiving any.
XanaDUer2
(14,346 posts)Yes, indeed
Voltaire2
(14,807 posts)We need one comprehensive universal public non-profit healthcare system.
XanaDUer2
(14,346 posts)I worry they want a majority of ppl to move to ma, stop traditional, then reduce benefits. I do not trust anything a Republican would propose
The way I see it, Medicare Advantage plans toss a few bones to people in order to bribe them into defending MA at all costs - I see it on here on every post about Medicare. Someone always posts, without fail, that they pay nothing (which I cant really believe) and that they get some kind of freebie with their plan. Of course, the money to pay for that plan is taken from the Medicare trust fund.
XanaDUer2
(14,346 posts)Ive seen some contentious back and forth about it. Hey, if you like MA, go for it! Some ppl can't afford TM. but I'm still very leery of private insurance. And that its taking money from TM pisses me off
Demobrat
(9,922 posts)as long as the care you need is in the network, and the insurance company agrees that you need the care.
The upfront costs are less. Premiums are lower. If you manage to die without ever needing to go out of network, you win.
XanaDUer2
(14,346 posts)Exactly. That's where my concern comes in. I wonder if Humana would lay out 1 million for me without an argument
Demobrat
(9,922 posts)Also, I am a single who lives alone. I dont have anyone to do the fighting for me. Fighting with an insurance company while battling a major illness is NOT on my bucket list.
XanaDUer2
(14,346 posts)I'm easily overwhelmed now. Id rather KISS esp about my health care
Timeflyer
(2,691 posts)Auggie
(31,850 posts)llmart
(16,331 posts)I am so glad I have the United Healthcare/AARP Plan G. Last summer I had a surgery and I added up what the cost would have been without Medicare and Medigap and it was almost $70,000. I paid nothing. I do not begrudge paying a monthly premium for the Medigap plan. I can choose my doctors. They also paid for the second opinions I got from the Mayo Clinic and University of Michigan Hospitals.
At 75 years old, I will scrimp on a lot of things but not my healthcare and quality, nutritious food. I am a very healthy and fit person, but no one, and I mean NO ONE gets older without having some medical episode(s) that could bankrupt them.
Auggie
(31,850 posts)It's great coverage, but even the supplemental plan premiums and deductibles will continue to rise in coming years. I want to be able to afford it ... while being able to choose my own doctor and without waiting for insurance company approval.
Anthem is my insurer.
dpibel
(3,416 posts)You're saying if you'd been on a Medicare Advantage plan you'd have paid $70,000?
You do know about annual limits, no?
Or you're just assuming all your care would have been out of network?
Something needs clarification here.
llmart
(16,331 posts)I'm just stating the facts about why I would never leave a Medigap Plan G.
dpibel
(3,416 posts)These threads are generally about how Advantage is a total ripoff, dude, and Trad Medicare plus a little bit of supplemental gets you everything for free.
If you're not comparing your results with what you would have paid with Advantage, I'm not sure what your point is. The thread is the usual "why Advantage will kill you."
Other than, of course, that Medicare plus gap coverage is really good.
Can't argue with that.
llmart
(16,331 posts)And many of us said we were. The thread title isn't "what do you think is better, Medicare Advantage or traditional Medicare."
You seem to be itching for an argument and all I was doing was weighing in with my opinion and experience with Medicare.
DownriverDem
(6,671 posts)is that you need a GAP plan and a prescription plan. Too many folks can't afford that.
XanaDUer2
(14,346 posts)I'm paying over 40 bucks for D.
But to each their own. Medicare can and should be improved..
elleng
(136,606 posts)(Fortunate to have a 'supplemental' due to pension benefits, Federal employees health benefits, so prescriptions included.)
XanaDUer2
(14,346 posts)Dan
(4,123 posts)Im sure that the wife and I have incurred huge medical expenses over the past two years, and havent paid a cent. And can receive treatment anywhere .love it.
kwijybo
(265 posts)She has Medicare, a Part D supplement, and possibly a Medigap Supplement.
She is only moderately happy with her Part D: they are messing with the prices of some of her meds. Farxiga, Eliquis, and some others increased a lot.
Do NOT ask her about getting Medicare Advantage, or you'll get an earful. Some of it vulgar (she Never swears, but for them she makes an exception. She hates them).
nature-lover
(1,712 posts)Pharmacies automatically use your insurance unless you ask. I have saved up to half of what insurance would charge,
XanaDUer2
(14,346 posts)On my Rxes and I get the lower price
nature-lover
(1,712 posts)Demovictory9
(33,874 posts)XanaDUer2
(14,346 posts)MaryMagdaline
(7,912 posts)I elected to take Medicare A, B and G even though Im still working. Its expensive but no crazy deductibles.
NGeorgian
(90 posts)doctors didn't have to get permission all the time. I have heard many nightmarish stories from friends on "disAdvantage". One example is a friend was told she could not get any more shots in her knee. She had a replacement surgery last month. My orthopedist said every six months when I saw him last week.
Tree Lady
(12,205 posts)But we also have supplement through hubby's old job.
ampm
(344 posts)Some Dr in Northern Nevada are starting not to take Medicare Advantage and some aren't taking Humana
Hope22
(3,042 posts)The doc was so excited that she would be dealing with regular Medicare. It enabled her to chose certain tests that would be covered completely. She said Medicare Advantage would not have covered the tests she had selected and that advantage programs are complicated to work with.
Demobrat
(9,922 posts)when I hand over my Medicare and AARP cards. Yes - you do need two cards. They know they are going to get paid without any hassle.
snowybirdie
(5,665 posts)it is more expensive and keeps rising annually. But, we never see a bill or have a copay. Our doc can order any procedure or any referral, and we don't pay. Hassle free, but expensive.
Bobstandard
(1,691 posts)So its constantly under threat. Theyre dying to take it away or screw it up. Vote the bums out
XanaDUer2
(14,346 posts)I do not trust them at all about any kind of healthcare..
dlk
(12,459 posts)Advantage plans are privatized Medicare
You can look at the Advantage plans available in your zip code. on Medicare.gov. They have star ratings and 5-star plans are the best. Medicare rates the plans every year, using multiple criteria.
Advantage plans have $0 premium plans and do have lots of co-pays, so its helpful to review the summary of benefits for a plan you are interested in enrolling with.
You can change your Advantage plan every year during the Annual Election Period, October 15 through December 7th.
You can also change your Advantage plan during the Advantage Special Enrollment Period every January 1st through March 31st.
Susan Calvin
(2,140 posts)I also have Tricare for Life, so I am in absolute heaven as healthcare goes in this country.
Quanto Magnus
(1,024 posts)I'm in California and on SSDI (I'm not if the SSDI puts me in a different Medicare category or...?). The supplemental helps cover (mostly) the 20% I'd owe in co-pay and covers prescriptions and dental.
It would be nice to have Medicare cover everything.
Turbineguy
(38,448 posts)and I wish it for everybody. After all, this is not supposed to be a shithole country.
XanaDUer2
(14,346 posts)et tu
(1,885 posts)add vision and dental and then universal!!!!
XanaDUer2
(14,346 posts)Will do everything to stop him..i hope he can
soldierant
(7,945 posts)not life/health, but property casualty, but I have friends. I wouldn't touch Advantage even if it were free. I consider it a scam. I am very happy with Medicare A and B. Also with Part D, which I do carry.
Ojerly
(70 posts)It indicated that most of the advantage plans were not worth the cost. I'm okay with the traditional too as I also can't afford to pay more. My hope is that some day soon they'll fix the healthcare system and cover everything retirees need. That's why we must vote BLUE 💙.
mahina
(18,989 posts)Good info!
keithbvadu2
(40,327 posts)Katie Porter leads letter urging Biden not to dump more money into Medicare Advantage
After reading up on it, MA is more of a HMO and it was less risky to pay the Part B for better coverage.
2428 https://www.democraticunderground.com/10142909182
Medicare Advantage Plans Often Deny Needed Care, Federal Report Finds
---------
2501 https://www.democraticunderground.com/1017732643
Get Medicare! No to Medicare Advantage. It's perfume-covered doo-doo that'll bankrupt or kill you.
https://egbertowillies.com/2022/04/30/get-medicare-no-to-medicare-advantage-its-perfume-covered-doo-doo-thatll-bankrupt-or-kill-you/
--------------------
2501 https://www.democraticunderground.com/1261935
advice
XanaDUer2
(14,346 posts)pamdb
(1,378 posts)We're pretty happy with Medicare and our Mutual of Omaha supplemental. Problem is my husband had a blood clot a few years ago so he will be on Eliquis the rest of his life and so he can't really go for a supplemental anywhere else and Mutual keeps raising their prices every year. I pay about $140 a month and he pays over $200, because of the blood clot. We both us Breo inhalers because we both have asthma and that's kind of expensive. The good news is that Eliquis is at the top of the list for hopefully (if Biden wins) to cut the prices of some drugs. At least neither one of us is diabetic. My brother will be turning 65 this year and I keep telling him (cause he's really cheap) to NOT get sucked into the Medicare Advantage crap. I've never heard one good thing about that and people are always having problems with them.
kairos12
(13,269 posts)vapor2
(1,589 posts)This year's deductible = $240. Doctors in Las Vegas are just awful so drove to Los Angeles for a few routine tests and Medicare covers. Convinced a friend to opt for traditional Medicare.
Silent Type
(7,199 posts)beneficiaries who choose it PRIMARILY BECAUSE THEY ARE FORCED TO BY COST of traditional Medicare, supplement, and drug plan.
It's a cost issue that forces people to make the decision for MA.
XanaDUer2
(14,346 posts)I feel if it works for the insuree, go for it
SupportSanity
(1,163 posts)Lots of great information here. All appreciated. Thanks.
Desert grandma
(1,055 posts)The problem as I see it, is that there is not enough information given to new retirees that will allow them to make an informed choice. IMO original medicare is the best option because you are not limited by networks and needed authorizations. What is not known is that those supplemental "medigap" policies are themselves rated. "Age attained" is the most commonly rated policy which guarantees that the premium will increase each year as you age in addition to any rise in medical costs. These type of policies can end up being the most expensive over time. "Age issued" is far less common (only 2 rated this way in our state this year) and it will NOT increase due to age increases. It only goes up if medical costs increase a lot in your region due to inflation. Ours has stayed relatively stable over the 10 years we have had it. It has gone up only between 10 and 15 dollars per month TOTAL in all that time. The important thing with this plan is to get it as soon as you are eligible for Medicare. The third rating system is called community rated and in that plan, everyone regardless of age pays the same as everyone else in that "community".AARP is the only community rated plan.
We are covered for dental care with my previous employers Delta dental coverage. In addition, my husband is a veteran and both of us are covered on the VADIP dental plan with Metlife. Any veteran and spouse can get this plan as long as the veteran gets some of his/her healthcare at the VA. If Medicare could negotiate drug prices like the VA, we would all benefit. Until then, I have checked each year to see which plan D will work best for me. Hubby gets all of his meds through the VA.