Oh joy, Oh joy, Oct.15 Opening Medicare Plan Season

fuzzybuddy

fuzzybuddy

SF VIP
Location
The Sticks, Northeast PA.
OMG!!! Medicare's open enrollment period is October 15-Dec. 7, 2024. It comes every year, like the plague. I wonder what geezer athlete will be a spokesman for some insurance company, this year. I will wear out another remote muting Joe Namath.
(For Brits and Aussies, this is the time we have to select our health insurance provider. During the enrollment period, we will be subject to a minimum of 800,000 ads.)
 

It’s more tedious than the election advertising.

1728759299019.jpeg

It has become a high stakes business. The last numbers that I saw, from 2019, indicated that the government pays $12,000.00/year for each senior under contract in addition to the reimbursement for drugs, treatment, etc…
 

Murrmurr said:
It's a scam. I don't have references handy, but I've looked into it, and imo, it's a total scam.

Because that's my opinion, I'm only suggesting "Don't Enroll". (strongly suggesting)
Click to expand...
I’ve had a Medicare Advantage plan through Excellus Blue Cross Blue Shield with zero premium for five years and it has worked exactly as disclosed up front with no surprises.
 
Aunt Bea said:
I’ve had a Medicare Advantage plan through Excellus Blue Cross Blue Shield with zero premium for five years and it has worked exactly as disclosed up front with no surprises.
Click to expand...
There's big changes on the horizon. And the horizon isn't far away.

If you want, check out YT channel "Christopher Westfall | Senior Savings Network" and his most recent video.

Or channel "Medicare on Video - Healthplan65"

Or channel "Clear Value Tax"
 
Aunt Bea said:
I’ve had a Medicare Advantage plan through Excellus Blue Cross Blue Shield with zero premium for five years and it has worked exactly as disclosed up front with no surprises.
Click to expand...
JustBonee said:
I have a Blue Cross Advantage plan too, zero premium …. no issues here in Texas.
Click to expand...
I have straight medicare and I don't have a co-pay, either. I have secondary healthcare coverage and my monthly premiums are about half what you pay for Medicare Advantage.

But there's a lot more to it than copays and premiums.
 
Murrmurr said:
Do you pay zero premium, or is the premium deducted from your monthly SS?

My secondary healthcare insurance is $44/mo. It covers all my Rxs in full, eliminates copays, and pays any balances on services that straight medicare doesn't pay in full.
Click to expand...
I pay the normal Medicare premium which is deducted from my social security but the Medicare Advantage Plan has no monthly premium.

My Advantage Plan negotiates a payment with the providers so there is no overage, they agree to accept Medicare as payment in full.

I don’t pay a copay for my PCP and some generic medications but I am responsible for
copays on some services and prescriptions.

Is your secondary insurance a state sponsored plan?
 
Aunt Bea said:
My Advantage Plan negotiates a payment with the providers so there is no overage, they agree to accept Medicare as payment in full.
Click to expand...
It's my understanding (emphasis on "my understanding") that medical providers are not happy with the negotiated payments, so they are no longer taking patients with advantage plans and "Managed Care" plans. Some are no longer accepting patients with straight medicare and medicaid.

What happens, then, is patients will be referred to medical and dental clinics where they'll be seen by nurses and medical and dental students. Some people don't mind that. I do, very much so.

There's a Proposition on this year's ballot that's about funds to build a bunch of new clinics and keep existing ones open. I don't think that's a coincidence.
 
L
Murrmurr said:
It's my understanding (emphasis on "my understanding") that medical providers are not happy with the negotiated payments, so they are no longer taking patients with advantage plans and "Managed Care" plans. Some are no longer accepting patients with straight medicare and medicaid.

What happens, then, is patients will be referred to medical and dental clinics where they'll be seen by nurses and medical and dental students. Some people don't mind that. I do, very much so.

There's a Proposition on this year's ballot that's about funds to build a bunch of new clinics and keep existing ones open. I don't think that's a coincidence.
Click to expand...
We have some of that friction between the insurance companies, providers, and Medicare.

I suppose it’s necessary to help control costs.

So far it’s not a significant problem in my area but I’ve read about it being a significant issue in areas where there are limited resources.
 
Advantage plans aside, who are all these folks marketing to? Do people really shop and change plans that much every year, or is it just that many new people aging into the system? We are in a retiree medicare plan from my wife's (former) employer and we are guaranteed to be covered forever. If we ever change out of it then we can't get back in and we're at the mercy of the market (and all these commercials).
 
Aunt Bea said:
I’ve read about it being a significant issue in areas where there are limited resources.
Click to expand...
That makes sense. Sacramento doesn't have limited resources, and Sacramento County, which is huge, has countless free and low-cost clinics.

This year, I could not find a private dentist here in Sac who could see me within 6 months of the date I called with a tooth emergency...an abscess. Two of them were booked-up for 9 months. All of them had only one orthodontist, and that's what I needed. I finally relented and went to a clinic. They didn't have an orthodontist at all, so I had to settle for an extraction, because this couldn't wait. It was free, but I'd rather have had my tooth repaired and the infection treated.

The only decent doctor I could find is associated with one of our medical universities. Doctors in private practice (here in Sac) are elderly, and won't live forever. The best private practice physicians in Calif can be found in L.A.'s exclusive areas. The ones in San Fransisco are leaving and retiring.

When I was a working man, I had no trouble finding very good private practice physicians and pediatricians. And when I didn't have insurance, and paid in cash, I always got a customary 20% discount.

I agree, doctors are expensive. But by the time they earn their PhD, they have either paid hundreds of thousands of dollars for their education, or they're hundreds of thousands of dollars in debt. And, unlike, say, a nurse, their expertise is uncommon and their knowledge extensive. You pay more for an expert mechanic than you do for one with only a basic knowledge of certain parts of some engines.

A few decades ago, a specific percentage of hospital revenue (profits) went toward medical research. I believe Mercy hospitals were an exception, but I'm not sure. I've noticed that Mercy hospitals - church and religion-based hospitals - are pretty rare these days. And I've read (and seen) that some-percentage of hospital profit doesn't go toward medical research like it used to. Not since they became businesses rather than strictly places of care, and revenue and profit (gains) became separate things.
 
Last edited:
So far, the only people I have seen advising against a medicare advantage plan are people who have never had one, and have not checked it out because they never intend to have one.
People who actually have one are usually saying how happy they are with their advantage plan.

We have had an advantage plan ever since we qualified for medicare, and I have never (in almost 15 years ) had any medical problems not attended to or refused coverage for any medications. I have a-fib as well as CHF, and have had several operations for my heart, as well as a pacemaker implant.

We do check with our insurance agent most years, because companies come out with new benefits for their plans, and sometimes, it is worth changing to a different company.
Besides the regular benefits that medicare provides, we have additional ones that come only with the advantage plans, like OTC allowance, Fitness programs and allowances, eye care and dental, travel to dr appointments, and delivered meals after hospitalization, and the healthy benefits card, which helps to be able to afford healthy food, and often to help with things like rent, and even dog food or toilet paper.

We have had Devoted Health insurance for the past year, and will be staying with that in 2025 as well. We still get all of the mailer advertisements, but just throw them away.
 
You must log in or register to reply here.

Back
Top