An Antidote to Corporate Media
1,070,266 comments by 12,468 users -
"Medicare Advantage" Plans Are Private Insurance, Not The Government’s Medicare
2022 Oct 29, 8:37am 278 views 6 comments
($0.10 in tips)
"Seniors buying "Medicare Advantage" plans think, even though they know they’re getting the plan through an insurance company, they’re somehow still in Medicare or backstopped by Medicare. The reality is neither.
With a "Medicare Advantage" plan, the private insurance company has control and you are at their mercy. The companies can deny care (and frequently do), refuse to pay for tests, and even refuse to authorize or pay for surgeries and other life-saving procedures...
"Medicare Advantage" plans also don’t offer seniors the financial security of being able to get a Medigap plan like traditional Medicare does. Medigap plans are those plans that cover the 20% that Medicare doesn’t pay. When you first sign up for Medicare, many people also sign up for a Medigap plan – when you first sign up, Medigap plans can’t refuse you because of preexisting conditions. However, if you shift to a "Medicare Advantage" plan and then try to go back to traditional."
Comments 1 - 6 of 6
2022 Oct 29, 3:44pm
Hey, Joe Namath and Tom Selleck say its a great deal.
2022 Oct 29, 4:28pm
Should be banned. Tricks older people. Scam that saves you nothing and you just pay more for what you can get for much less by searching the best deals out here yourself, and spends huge bucks to flood you with promotional ads. A joke.
2022 Oct 29, 6:35pm
In fairness, Medicare Advantage pays 100% for many things (or a token co-pay) for most of the shit that can really go wrong.
The old "J" or "H" - I forget - Medigap Plans have been legacy for a decade or more now, no longer sold. There are no more of the kind of Medigap Plans that your grandpa or father had, at least at an affordable price to most retirees.
MA also pays for most drugs 100% or with a token copay. Many offer dental benefits that Medicare doesn't pay a dollar for. Also, no difference for your age, sex, tobacco use - unlike Medigap. Also, most of them are free in most areas except in rural or very expensive urban areas.
You have to shop carefully, and the choices do suck in rural areas but access and choice is always more limited for everything in rural areas.
Remember, you can drop the plans for various reasons and in the 4th Qtr of the year, so you can strategize. You can also get a plan with a shitload of dental work, use it, then next year shift to a more flexible plan that is less of an HMO and gives you more choice.
2022 Oct 29, 7:37pm
I have experience with both kinds of plans.
The plans that offer total flexibility are like my father's Transamerica insurance. It was about $250/month.
I have had 2 medicare advantage plans.
I have United Healthcare insurance.
In Santa Cruz I paid $80/month, and it was an HMO.
HMO means you need your primary care physician to send you to a specialist.
In Florida I have a PPO for $0/month.
PPOs are better. United pays for my gym membership.
I can walk into any specialist office and see the doctor for $35.
I chose the dermatologist to see my skin cancer and do Mohs surgery and it cost me $35.
Someday I might splurge on my health insurance but I'm very happy for now.
It's interesting that in California I paid $80 for worse insurance than I pay $0 in Florida from the same company.
Medicare takes out $248 from my social security each month.
Edit: My friend in Florida has Humana; she tried to go the outstanding orthopaedic hospital I told her about, and her insurance was no good there.
It's HSS=Hospital for Special Surgery.
My United Healthcare insurance was accepted there.
2022 Oct 30, 4:24am
The best option varies.
Location, IRMA status, LIS status, Medicaid status, and health all matter.
The TV commercials engage grandma to call a churn-and-burn type medicare enrollment call center. FWIW those businesses are suffering from collapsing long term value of their clients as they swap and replace policies amongst the same small group of TV buying grandma's.
2022 Oct 30, 4:31am
GOCO is one of them.
These companies can spend anywhere from $100 to $1000 per CPA, depending on their business model and required scale.
Gohealth and a few others raised money back in 2018 - 2020 using $1400+ expected client values. They are now empirically seeing somewhere around $750 per client which isnt profitable.
Please register to comment:
one year ago