Asking For Opinions

wolfen
wolfen Member Posts: 1,324 Member
in Head and Neck Cancer #1

Hello All,

Just looking for opinions and/or our resident insurance guru, if we have one. As many others have done, my former company has decided to no longer be directly involved with supplemental health insurance for those of us on Medicare. I have received & tried to interpret(Ha, Ha!) all the new info. as well as attending an informational(NOT) metting  concerning this action. Have also been perusing the related website, trying to get a feel for the different plans offered in my area. There are 14 Medicare Advantage(which includes scripts), 10 Medigap(no scripts), & 10 Drug Plans. Mind boggling!! If you don't have a headache when you start reading, you will soon after.

My son is coming by Thursday to help me go through all this & try to make a choice, but in the meantime, I'm just wondering if any of you have experience with Medicare Advantage or Medigap plans & the pros & cons of each.

Thanks,

Wolfen

Comments

  • CivilMatt
    CivilMatt Member Posts: 4,722 Member
    #2
    not much to offer

    Karen,

    I have a (better than general) understanding on most aspects of life, but choose to (happily) have my wife be the chief CFO, in-charge of just about everything. 

    On the occasion when stress enters my life I use every resource available to seek relief (much of how you are doing here).  My best suggestions are as you have already done; research and find a knowledgeable person.

    Also, a quiet room helps me.

    Good luck,

    Matt

  • Ladylacy
    Ladylacy Member Posts: 773 Member
    #3
    Insurance

    Please be careful of Medicare Advantage Programs.  There are big cuts coming to them.  Yes they are good right now.  My husband has Humana Medicare Advantage.  They go up every year in your co-pays.  You have a co-pay for everything that you do and I mean everything.  When he was undergoing radiation treatments, we had co-pays for each treatment, same as for his chemo.  They have also changed their drug tiers.  What was once on Tier 1 for generics are for many now Tier 2 and cost more.  But he is on a plan that he can see any doctor, go to any hospital with no referrals from a referring doctor as long as they take his plan.  Yes the cost is much less than a supplemental plan.

    I on the other hand have a supplemental plan with BCBS and pay thru my teeth for it.  I had thought of changing over to a Medicare Advantage Program but after reading about major cuts coming to these programs have decided not to change.  Thank you Obamacare.  Plus many companies are dropping out of the medicare advantage programs.  I have a friend who has Kaiser and she says she has no problems other than all the co-pays.  

    I have had to appeal many of my husband's claims thru the program too but always have won.  Many suppliers don't take the medicare advantage programs either.  Sometimes I think what we have to pay for any of these plans it is just as cheap to stick with straight Medicare because no plan will pay what Medicare doesn't allow.  It is confusing.  Whatever you decide make sure your doctors and hospitals take the medicare advantage program and if it is a HMO many doctors aren't taking them now.  

    Sharon

  • jcortney
    jcortney Member Posts: 503
    #4
    Ladylacy said:

    Insurance

    Please be careful of Medicare Advantage Programs.  There are big cuts coming to them.  Yes they are good right now.  My husband has Humana Medicare Advantage.  They go up every year in your co-pays.  You have a co-pay for everything that you do and I mean everything.  When he was undergoing radiation treatments, we had co-pays for each treatment, same as for his chemo.  They have also changed their drug tiers.  What was once on Tier 1 for generics are for many now Tier 2 and cost more.  But he is on a plan that he can see any doctor, go to any hospital with no referrals from a referring doctor as long as they take his plan.  Yes the cost is much less than a supplemental plan.

    I on the other hand have a supplemental plan with BCBS and pay thru my teeth for it.  I had thought of changing over to a Medicare Advantage Program but after reading about major cuts coming to these programs have decided not to change.  Thank you Obamacare.  Plus many companies are dropping out of the medicare advantage programs.  I have a friend who has Kaiser and she says she has no problems other than all the co-pays.  

    I have had to appeal many of my husband's claims thru the program too but always have won.  Many suppliers don't take the medicare advantage programs either.  Sometimes I think what we have to pay for any of these plans it is just as cheap to stick with straight Medicare because no plan will pay what Medicare doesn't allow.  It is confusing.  Whatever you decide make sure your doctors and hospitals take the medicare advantage program and if it is a HMO many doctors aren't taking them now.  

    Sharon

    I've just started the process myself

    And confusing doesn't even begin to cover it.  Here are my impressions so far.  For me, Advantage programs are out.  Baylor Hospital and ALL OF MY DOC'S won't take the insurance.  Looks like I'm going for the most expensive plan (Plan F) from either BCBS or United.  Plan F (for me) is going to cost about $180 a month plus regular medicare costs but there are NO deductables or copay's.

    That's my experience, your results may vary :) and, don't get me started on ObamaCare.  

    Joe

  • jim and i
    jim and i Member Posts: 1,788 Member
    #5
    Keeping politics out of this

    Keeping politics out of this discussion is a good idea. Jim has been on Medicare Advantage through United Healthcare until this year because they dropped all his doctors but his oncologist. We went on Humana Medicare Advantage PPO, we hate HMOs. We were told his oncologist was on their plan, he was even in their book of approved doctors, but we found out later he wasn't. We have had more problems with them than we ever had with United. I go on Medicare next year and I will have to investigate the options anew at that time. Good luck in your search.

    Debbie

     

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