Medicare advantage not going away

Trade said:
I'm not your research assistant.
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Didn't say you were. Simply asked if you were old enough to be on Medicare & how advantage plans have negatively impacted you directly.
I understand by your posts that the capitalist system isn't to your liking. But until the free stuff offered by politicians actually manage to take down America I'll stay with the system that is in place that made it possible for our family to live very well.
 
Medicare and the supplemental coverage for my wife have proven to be a worthwhile investment. That is only because she has two major medical events. Open heart surgery involving multiple issues was the first event. Documents that we reviewed indicated that without the combined payments by Medicare and the supplemental coverage we would have faced a half million dollar obligation, but ultimately paid zero. The second and most recent event was to replace the aortic valve ten years after her first major event.

On the drug coverage side our out of pocket costs have been a mixed bag. Common generic drugs have been covered with little or no out of pocket. Our out of pocket cost for blood thinner necessitated by heart issues has been a big hit. Each time we refill the ninety day supply the person waiting on us comments about the more than $300 amount due. Of course the portion paid by our insurance is much more. I pay the amount without complaint realizing the benefit.

For myself the case is more favorable. Being a disabled veteran my health costs are covered by the benefits I receive. I still carry medicare and supplemental coverage for myself because the issues of coverage when you are traveling, though for the most part are covered by the VA the claims process is elaborate. All said and done we are very fortunate.
 

Knight said:
I get it you don't want to explain how you were negatively affected by a Medicare advantage plan.
Kind of funny how you chose to use a video to explain your thought process.
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Oh well, antiquated clips are sometimes more entertaining than advantage ads. :)
 
Knight said:
I get it you don't want to explain how you were negatively affected by a Medicare advantage plan.
Kind of funny how you chose to use a video to explain your thought process.
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I've never been negatively affected by a Medicare Advantage Plan because I'm smart enough to avoid them.

And I've learned a lot from youtube videos. It's a great resource.

Here's some more truth about Medicare Advantage Plans.

 
Excellent source of info on Medicare Advantage. NOT

John William Oliver (born 23 April 1977) is a British and American comedian who hosts Last Week Tonight with John Oliver on HBO. He started his career as a STAND-UP COMEDIAN in the United Kingdom and came to wider attention for his work in the United States as the senior British correspondent on The Daily Show with Jon Stewart.

Maybe a better question if you are willing to answer. What are your yearly costs for your coverage?

My truth.
I've explained mine as Zero except for a copay IF I NEED to go to the emergency room at the hospital & to refill a prescription for only one of my meds. I don't rely on COMEDIAN'S nor do I research every plan because this agent does the work for me.

***************************************************************
Alex was born with a genetic bleeding disorder called hemophilia – which means that his blood doesn’t clot properly. This condition has required him to self infuse medicine intravenously every other day since childhood.

Alex lives an active and healthy lifestyle, but his medical bills reach over $1 million each year due to the cost of his medicine. Through his personal experience, he’s learned how to navigate the confusing world of insurance and breaks it down into simple building blocks for anyone to understand.

Since 2012, Alex has helped over 1,000 clients just like you with their insurance across multiple states and numerous insurance companies. Alex’s goal is to walk you through the process, providing non-biased advice about the best plan for your needs and goals. Contact him to get started with a free consultation today and experience his award-winning service!

And yes I do believe he gives award winning service.
 
Trade said:
I expected you to reply with something like that Knight. In fact, I would have been disappointed if you hadn't.
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Same here from you. When it comes to real life experience & cost you posted a video by a British comedian. My
My posts have been about cost & actual life experiences about my advantage plan.

I think posting about real life experiences, cost & benefit received under my advantage plan might be helpful to others when looking for what might serve them better. CEO pay or complaining about the cost of advertising IMO does nothing to help understand what to look for once a person reaches the age to be on Medicare. Comparing regular Medicare to an advantage plan is needed because not all advantage plans are the same. Due diligence to decide what satisfies each persons need is always in order.

I need another good laugh do you have any more videos by comedians?
 
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Trade said:
You can have some nameless government bureaucrat manage your healthcare with Original Medicare.

Or you have have some predatory private insurance CEO like Brian Thompson of UnitedHealthcare manage it with Medicare Advantage.

It's all up to you.



Granted, it's not a very good choice, but to me it's still an obvious one.
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I don't believe Brian is managing any healthcare Advantage plans at this time. He's gone underground.
 
Claim for my 100 day supply of Eliquis not to costly. Of course I removed the claim number.

OPTUM PHARMACY 701, LLC
ELIQUIS TAB 5MG
Claim processed - 11/19/2025
Claim #:
Date of visit:
11/19/2025
Total drug cost
Total drug cost $1,846.06
Your share
Your share $6.43
 
BCBS of South Carolina allows a change from Advantage to Medicare Plan within 36 months, without underwriting.

We switch Medigap plans without underwriting as well. It just has to be done at the time of the notice of rate increase each year.

None of it is state mandated. A plan G high deductible ($2850) is about $90 a month for a 75 year old.
 
Trade said:
Doesn't bother me. I would never leave original Medicare for one of those Advantage scams.
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I disagree that the Advantage Plans are a scam. They all have an out of pocket maximum. Mine is just over $7000 this year. Basic Medicare only pays 80% with no out of pocket limit. Supplements work but cost around $1500 per year. I have been on Medicare 13 years - the supplements would have cost me at least 20,000 over 13 years. I have had no issues so far so even in a worse case scenario I would only be out $7,000 and I saved $20,000 by not paying for a supplement. Each to his own but Advantage Plans work. Apparently few understand how they work. But that is normal in this day and age.
 
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rwb said:
I disagree that the Advantage Plans are a scam. They all have an out of pocket maximum. Mine is just over $7000 this year. Basic Medicare only pays 80% with no out of pocket limit. Supplements work but cost around $1500 per year. I have been on Medicare 13 years - the supplements would have cost me at least 20,000 over 13 years. I have had no issues so far so even in a worse case scenario I would only be out $7,000 and I saved $20,000 by not paying for a supplement. Each to his own but Advantage Plans work. Apparently few understand how they work. But that is normal is this day and age.
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I totally agree with what you say in your post. Out of curiosity I accessed my wife's claims from Jan 1, 2025 to today.

This copied & pasted from her account.

Out-of-pocket costs
In-network
$175.00 spent of $900.00
$725.00 remaining
19%
Once you reach your out-of-pocket maximum, your plan will pay 100% of your covered costs
Last updated Dec 2, 2025

Total billed
Discounts and adjustments $9,625.84
Health plan pays $887.59
Your share $175.00
Total billed $10,688.43

I don't know what others pay but I do know our Advantage plan works for us.

Even that $175.00 winds up costing $0.00. Part of my retirement package pays into a HSA that reimburses me for copays.
 
Thought about look ups so thought I'd look up mine. A couple of surgeries this past year that had emergency room copays & a reduction in the cost of Eliquis.
Out-of-pocket costs

In-network
$320.00 spent of $900.00
$580.00 remaining
36%
Once you reach your out-of-pocket maximum, your plan will pay 100% of your covered costs

Last updated Dec 2, 2025

Total billed
Discounts and adjustments $95,751.38
Health plan pays $5,112.84
Your share $320.00
Total billed $101,184.22

That $320.00 winds up costing $0.00. Part of my retirement package pays into a HSA that reimburses me for copays.

Those that don't like Advantage plans probably have their reasons. But for me zero cost for excellent health care works.
 

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