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Advantages and disadvantages?
Old 10-28-2020, 07:22 AM
 
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Medicare supplement vs Advantage plans...

I have had the AARP United Health care supplement plus a part D supplement and I am not unhappy with them...but I think it’s smart to look into other options occasionally, and ‘tis the season!

I see so many ads for Advantage plans and wonder if one might be a better choice, so I would love to hear your experience.

As far as I can tell, an Advantage plan offers more services (vision, dental, maybe hearing) and you pay one price that might be the same or lower than purchasing plans separately, but you have to stay “in network”, which might make getting care while traveling difficult. What else should I consider?

I will try to get an appointment with someone at the local senior center to discuss as well...but tell me your experience!


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Advantage
Old 10-28-2020, 07:32 AM
 
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It was the “in network” language that was the deciding factor for my husband.

We live in a very rural area where health care is limited; leaving the area for specialized care is the norm. We also have a cabin in another state. He also travels to other states on hunting trips. Because of those, it was not in his best interest to go the advantage route.

Our financial advisor hooked us up with a great insurance guy who really took time to go through the options.
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Old 10-28-2020, 08:18 AM
 
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We chose a Regence/Blue Shield supplement to Medicare part A & B. It was more expensive than other options but it worked better for us when we winter in Arizona. Also Medicare is only good for the US and prior to Covid we traveled out of country where our supplement would become our primary coverage if needed. Im sorry but I dont really know how any of this compares to advantage plans because we didnt explore those.
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I chose supplemental plan (plan g)
Old 10-28-2020, 08:33 AM
 
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At first I was dazzled by the “extras” offered by Advantage plans—drug coverage, naturopathic medicine, massages, etc. but choose a supplemental plan because of:

Freedom to choose doctors/specialists as long as they accepted Medicare
No copays or out of pocket for office visits or hospitalizations

An Advantage plan may be cheaper in a year where you don’t require a lot of medical care beyond somewhat routine stuff but those copays do add up if you are seeing various medical specialists or have a hospitalization. A supplemental plan can protect you financially from some of those “unknowns”.

Another big thing to consider is if you switch to an Advantage plan it can be very difficult to switch back to a supplemental plan. Insurance companies can refuse to offer you coverage if you have pre-existing conditions and they get away with this because you still have the option of coverage through an Advantage plan.
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We both chose too go to blue cross...
Old 10-28-2020, 10:28 AM
 
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We got the $110 plan. Includes vision, $2,000 in dental, low copays, and drug coverage. Not that we take any drugs! Love having blue cross rather than some health plan I’ve never heard of. My plan starts in November. DH starts in January. Free gym, sneaker allowance, and debit card for Walgreens or cvs to buy brand name items like Advil or Ebson salts.



Last edited by juliet4; 10-29-2020 at 04:06 AM..
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good advice
Old 10-28-2020, 10:33 AM
 
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You've gotten some really good advice here.Advantage plans sound great, but research the details and the differences carefully. We like the freedom of choosing our own doctor, hospital, facility, etc (as long as they accept medicare). We also like being able to see a specialist without needing a referral.

Also, advantage plans can change YEARLY, so you might have to change doctors, if your present doctor/facility, etc is moved out of network. We prefer choosing and keeping the same doctor/doctors over the years. Just the thought of changing constantly would drive us crazy-that's just us. It might not bother you.

With an advantage plan, if you travel outside "your area", you may not be covered to the same extent because your are having to go "out of network." We have relatives in another state that we visit- or will visit- once this pandemic is over.

Trying to return to regular medicare after being in an advantage plan is hard and may require you to answer a lot of health questions-sort of like trying to find out if you have a pre existing condition/are you going to be costing them a lot in terms of your use of their insurance.

I guess if you find comfort in things pretty much staying the same as far as your doctors, pharmacy, etc. and like the peace of mind of being able to travel outside your area , stick with traditional medicare. We use AARP, united healthcare, plan G as our supplemental. We also have a separate drug plan.
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Old 10-28-2020, 10:48 AM
 
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I think a lot depends on your health and your location. It is wise to go somewhere where they can lay out all the plans for you and explain all the options. DH went to a service last year (Informed Choice) and she was so helpful and it was free.
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Old 10-28-2020, 02:39 PM
 
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It can be so confusing. Well, at least it was for us. I found it helpful to attend the meetings that the insurance companies had. Unfortunately, that may not be an option this year. But, I did get a notice that one insurance company is having virtual meetings.

If you are looking for someone to talk to try your local senior center. Ours has someone on staff who will go through your choices with you. Another place to look is the state retired chapter of your union. Mine contracts with someone who will help you, in a one on one meeting, and go through your choices.

As another poster said if you choose an Advantage plan, it may be difficult to get a traditional supplement plan again. And if you do, there may be a higher transfer cost. Also you need to check the plan carefully, as many companies (Blue Cross) offer both Traditional and Advantage plans. You don’t want to sign up for Traditional and later realize it’s Advantage, or vice versa.

Good luck in your search.
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Your state
Old 10-28-2020, 02:43 PM
 
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may have a SHIIP counselors to help you examine all plans and help you decide what is best for you. It is free and funded by the state and is so helpful. We go visit a SHIIP counselor every October-November to make sure we have a plan that works for us.

SHIIP: Senior Health Insurance Information Program
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Medicare question
Old 10-28-2020, 03:05 PM
 
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Advantage plans cost less on a monthly basis if, and that’s a big IF, you are healthy. However, after a certain age you can seem quite healthy one day, and have a serious medical problem the next day. Then your Advantage plan may become very expensive with copays and hospitalization. Plus, you will only have access to doctors in your Advantage plan network, which limits your treatment options and care just when you are most vulnerable.

It will be very hard to return to a previous plan once you sign up for an Advantage plan. I have Anthem Blue Cross and pay higher monthly premiums for plan F. Zero copays for anything, including hospital stays. Worth every penny to me for the peace of mind and freedom of control it gives me.


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Old 10-28-2020, 03:32 PM
 
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We have Kaiser Advantage and are so happy with the care and what is covered. I just had hip replacement surgery and my total bill was $235 and Kaiser coordinated all the care givers and all the bills. They also keep track of any medications and treatments and every caregiver has instant access to the info.

My husband went to Kaiser Urgent Care about a month ago and he received care that was head and shoulders above what he would have received at ER and we don't have to chase bills from multiple providers. He had 15 diagnostic tests at urgent care to include EKG's, x-rays, several CAT scans, angiograms, blood draws and lab work. In 2.5 hours they diagnosed a tricky condition, formulated a treatment and scheduled a follow up appointment 2 days later.

On my Advantage plan I get Silver Sneakers, so my gym/pool fees are covered. My vision and dental are covered. Co-pays for doctors are just $10 or $35 for specialists. And now Kaiser covers chiropractic care as well as acupuncture and kicks in a bit of money for an audiologist.

Kaiser takes care of you during travel. I'm not sure how it works if you are a snowbird and spend half your year some place else.

Now, it could be that I'm happier with the Kaiser portion than I am with the advantage portion, but it's really working for us.

Of course, we could be easy to please since my last experience before Kaiser was going to an urgent care facility for heart palpitations and they couldn't find the EKG machine.
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Old 10-29-2020, 05:16 AM
 
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Quote:
I think a lot depends on your health and your location.
I wholeheartedly agree with Cat woman. I think you need to choose what suits your individual needs.

I wasn’t going to post because so many criticized Advantage, but then I read Song of Joy’s post and am grateful to her for giving me courage. I, too, have Kaiser Senior Advantage. I don’t have all the services (dental and gym) she does because I’d need Advantage Plus (but that’s okay with me because I don’t want a gym and have other dental coverage). Like Song of Joy, I have been extremely happy with my Kaiser Senior Advantage for 4.5 years. I haven’t had surgery or catastrophic illness, but I feel very well cared for and well treated. All of my problems have been addressed immediately. Preventative measures are encouraged. When I have what I consider a worrisome issue, I just want to see a doctor as soon as possible and don’t mind not seeing “my” doctor if she’s not available. Referrals to specialists are only a call or an email away—I have never been put off by Kaiser. This is the long way of saying Advantage works beautifully for me. (And I know several retired people in my area, including a doctor, who love this plan.)

ETA: I forgot to say, when DH was terminally ill, Kaiser did all the coordination with Medicare for in-home Hospice. I was never charged a penny in his 15 months of illness and I believe he was very well cared for (in-home nurse visits, paid and delivered RXs, all equipment including hospital bed, and more) and I never had to do a single piece of paperwork. Advantage was terrific for DH.
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Old 10-29-2020, 07:55 AM
 
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I was glad to see a couple of good reports about an Advantage plan . My husband was on one for 3 years. When I turned 65 this year, I also signed up for the same one. It is Aetna Advantage and it provides great coverage and lots of extra benefits (reimbursement for dental, vision and hearing) Most of our prescriptions are free and it has no premium. We are getting it again for 2021. Also, when he was hospitalized while visiting our son in California, it worked just fine.
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Old 10-29-2020, 08:32 AM
 
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DH also went with Medicare Advantage and plans to keep the same plan for the upcoming year (I am still on my work health insurance— covered until I am 65). He is with a United Health Care plan that is only offered in certain counties in our state. I believe my friend’s husband is also on the same plan.
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Old 10-29-2020, 08:50 AM
 
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I'm not old enough for Medicare, but my husband is. He's been on a United Healthcare Medicare Advantage PPO plan for the last year + and we are happy with it. He kept the same doctor and the copays are low. It is through my retirement system. I do pay a small amount for the PPO option. I would love to be on it. I pay through the nose for my plan with higher copays. He will stay on the same plan for next year.
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Old 10-29-2020, 08:12 PM
 
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I am 62 so I have my school district's insurance until 65 . I have Blue Cross. The premium for Kaiser is much less but since I paid in all of these years to Blue Cross I will continue until 65.

Not sure if I will join Kaiser or a PPO after turning 65.

Is Advantage a PPO?

My mom has been insured with Kaiser for over 40 years and has received excellent care . The only complaint I have is with their pharmacy. We contract my moms meds out to a private pharmacy and I have the pharmacist personal cell for after hours if there are issues. Assisted Living insists on this.

After my COVID adventure I'm beginning to lean towards PPO vs HMO. We shall see . I appreciate the advice here.
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Old 10-30-2020, 06:15 AM
 
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My mom has been insured with Kaiser for over 40 years and has received excellent care . The only complaint I have is with their pharmacy. We contract my moms meds out to a private pharmacy and I have the pharmacist personal cell for after hours if there are issues. Assisted Living insists on this.
I admit I don’t know what a contracted out private pharmacy is, but I’ve never had 1 single problem with Kaiser’s pharmacy. My RXs are always delivered to me promptly.

Quote:
I have Blue Cross. The premium for Kaiser is much less but since I paid in all of these years to Blue Cross I will continue until 65.
We had Blue Cross for years. I thought I had to have that to choose our own doctors. DH and I moved to Kaiser after the kids were grown and gone and it was a pleasant surprise.
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Kaiser Medicare Advantage...
Old 10-30-2020, 06:47 PM
 
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My hubby and I are both very pleased with Kaiser Medicare Advantage. We don't have Advantage "Plus" so we don't have dental and extra vision, but the plan has been so good for my dad and mom and for us that it doesn't matter. We are very, very happy with it!
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Amiga13 thank you
Old 11-05-2020, 10:00 PM
 
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I will def. come here for advice in the next couple of years

The issue with my mom was that a new CNA gave my mom by accident her roommates meds. When this happens the pharmacy needs to be immediately notified . The director of the facility remained there waiting for the pharmacy to call back. By 9:00pm the director asked me if it was ok to contact the private pharmacy that manages and organizes the meds for Kaiser. From then on I also have the private cell number. Kaiser NEVER called back.

My mom's roommate is new and does not have this service yet or it prob. would not have happened.
This service costs me about $55-$60 per month and they also take care of her vitamins, nebulizer meds, cpac stuff, and over the counter things. This pharmacy automatically renews and notify me when I have to contact Kaiser for stuff. I would have to constantly be calling Kaiser to renew. Plus they come in packets and my mom feels more in control of what she takes.

Kaiser wanted to terminate this contract which caused me much grief in July but then they decided to renew for another year.
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