Anyone on a Medicare Advantage Plan?

[Crusader]

I'll be retiring a year from now, just before turning 65. I'm a fed employee planning on continuing my FEHB (Blue Cross) med insurance, for which the gov pays about 75%. Am seriously considering doing Medicare also (free Part A and paying the monthly premium for Part B). Combining those two would result in very little, if any, out of pocket costs, ever.

Was talking with my sister-in-law over the weekend; she's 67 and is on a Medicare Advantage Plan (Part C) with United Healthcare, tied in with AARP. She pays nothing above the standard cost of Part B. My understanding of Part C is that it is combination of A&B. Also there are some nice perks like free gym memberships, a monthly OTC items stipend, and some other things. I did a little research on it, looking for negatives and trying to determine why wouldn't everyone do this, since it doesn't cost more. The one negative/con I saw was that it may have a more limited provider list than that for Part B alone.

Anyway, do any of you folks use an MA Plan? If so, what caused you to go that route and what do you think about it after having been in it? Pros and cons?

Thanks in advance.

 

[87TT]

I guess it depends on your out of pocket expense for insurance. I had a supplemental ins with part A and B but it was $200 a month. Now I have the MA for $0 a month. There are some copays for some things. But there are the perks. OTC stuff free, dental, eye exams etc.
This year so far I'm up over $1200.

 

[Crusader]

I guess it depends on your out of pocket expense for insurance. I had a supplemental ins with part A and B but it was $200 a month. Now I have the MA for $0 a month. There are some copays for some things. But there are the perks. OTC stuff free, dental, eye exams etc.
This year so far I'm up over $1200.

When you say "up over $1200" is that derived from not having to pay the $200/month for the first six months?

 

[87TT]

Yes. Dr visits with primary are free. Meds are free by mail. Get $60 worth of OTC products by mail every 90 days. Free gym. Some dental and vision. 0 premium other than Medicare. My out of pocket besides Medicare this year has been $50 for an Xray and a Ortho Dr visit.

 

[Profiler]

Don't do it. Just take regular medicare and a supplement like aarp etc. I work in the healthcare industry.

 

[AK_Skeeter]

I went with a supplemental (medigap) plan.
One advantage of a supplemental plan is it is good in all 50 states,
while most advantage plans are restricted to a provider network and restricted to a single state.

 

[wapitibob]

I have regular/basic medicare and also have a supplemental thru pacific source. Supplemental costs $40/mo; meds I take are essentially free, dental is virtually free, vision pays $200 every two years for exam and hardware, gym is free.

 

[yfarm]

Medicare pays insurance companies extra subsidies to provide advantage plans as they save medicare money. How you ask? Small provider networks with lower payments for providers. Well regarded physicians in your area are probably not in their networks. Think about why a successful busy competent doctor would agree to bargain basement rates for their work. I dont want my knee replaced by the least busy, cheapest ortho guy in my community. Reduced access to specialists. Limited ability to seek care outside your network. Have cancer, want to go to a subspecialty care center, forget about it. Remember Obamas likeyour doctor you can continue to see him, not going to happen. If you are healthy, you will save money. Want to go back to conventional medicare, difficult if not impossible.
If you travel,may have limited coverage or no coverage. As always, read the details and understand what you are buying. For me, conventional medicare with a BC/BS supplemental lets me see anyone and use any hospital in the US. No one declines BC/BS.

 

[highstepper]

There is a reason that the big insurance companies (United, Humana, etc.) push Medicare Advantage- they are one of the insurer's most profitable product lines. They are not profitable if they pay out money to doctors and hospitals for acute care for serious illness. They are generous with preventive care, gym memberships, and OTC meds, etc. That's all great, but if you are really sick and get hospitalized, they will do everything in their power to make the stay as short and cheap as possible. And god forbid that you need inpatient rehabilitation of any sort. It takes an act of congress to get such services on Medicare Advantage plans, they will stall and fight it as hard as they can, regardless if your doctor thinks its your best shot at having a better recovery. And your doctor generally has no financial incentive to recommend such a thing. And while you're languishing in the hospital waiting for authorization, the hospital is most often getting stiffed on the added days of care.
I plan on buying my own gym membership and ibuprofen and getting traditional Medicare with a supplemental policy next year. I'd rather my physicians recommend my treatment rather than for-profit insurance companies.