quote:

Originally posted by 12131:
^^^^ To clarify what 6guns said, original Medicare, which is Part A and Part B, is indeed provided by the government, but Advantage and Supplement are provided by private insurance companies, as is Part D (aka Prescription Drug Plan).

Part A covers in-hospital care.

Part B covers outpatient care.

The reason for all other plans beyond original Medicare is that the original Medicare doesn’t pay for everything.

Thanks, Doc. I assumed Parts A and B were a given and that the next step only was under discussion. Sounds like SR knows what he wants.

That's just for readers who might be getting into it for the first time, which can be confusing. I know I was.

The topic is extensive and the terminology to those new to the concept is (deliberately?) confusing.

Much of what matters for this decision is both individualized (depending on your financial situation, medical conditions and risks, how much you do/don't travel internationally, the medical establishments that you use/are near, and who offers what coverage options in your particular state) and so, as much as we virtual friends want to help, our experiences may or may not apply to any other particular situation/location.

What I did when I got to that point a few years back was borrow a copy of this book from a friend who had just gone through the morass. "Get What's Yours for Medicare" I also got a referral to a company that represented a bunch of providers for the various Medicare bolt-on insurance 'parts' (as well as various 'advantage' options) and my guy there gave good, detailed answers to my questions as I considered alternatives.

For me, the 'advantages' of the 'Advantage' plans were purely financial (they're cheaper) and their many constraints made it well worth paying for the 'parts' that wrap around traditional Medicare and that's what made sense in my situation here in NC.

As to whether that would be optimal for anyone else....hard to say.

Best of luck.

Biggest reason I’m a no on this is the exit issues if/when you want back into standard Medigap plan.

Unless you’re lucky enough to die young, early into the Advantage plan, I’d expect to regret this choice.

quote:

Originally posted by 12131:

original Medicare, which is Part A and Part B, is indeed provided by the government

"Provided by the government," using money that has been taken from every one of your paychecks since 1965, so really paid for by money that you loaned to "the government" at zero interest.

quote:

Originally posted by Sigfan Roy:
I find it a bit interesting that a folks on here who would normally rather get a root canal than do business with the government are favoring government run health insurance over private health insurance simply because they turn 65.

I would rather stay on my current coverage with Christian Healthcare Ministries than go on any form of Medicare later this year! It has been better and cheaper than either my or the wife's employer's plans before we retired. This is what medical insurance should be.

My disabled sister is on Medicaid, which uses a Medicare Advantage plan for her. I despise all the phone calls (I receive as her guardian) trying to get her to agree to various home visits. No matter how many times I tell them NO, she is in a care facility with in-house continuous medical supervision, they just keep calling relentlessly.

Physical therapy approvals are slow, and on some kind of 6 week yes, 6 week no, system.

This plan has excellent drug cost coverage.

quote:

Originally posted by V-Tail:
"Provided by the government," using money that has been taken from every one of your paychecks since 1965, so really paid for by money that you loaned to "the government" at zero interest.

Yup. Everything the government “provides” us comes from our wallets.

As I understand it, Medicare pays the Medicare Advantage provider's premium. So basically the Medicare Advantage provider believes they can provide all my Medicare benefits, plus some extras, for the amount Medicare expected to pay for my benefits. They can do all this and still turn a profit. Somehow I have to think the profit comes at my expense. Not buying it.

quote:

Originally posted by Ranger41:
As I understand it, Medicare pays the Medicare Advantage provider's premium. So basically the Medicare Advantage provider believes they can provide all my Medicare benefits, plus some extras, for the amount Medicare expected to pay for my benefits. They can do all this and still turn a profit. Somehow I have to think the profit comes at my expense. Not buying it.

Bingo!

quote:

They can do all this and still turn a profit. Somehow I have to think the profit comes at my expense. Not buying it.

^^^^^^^^^^
These are private companies that are making money off of Medicare Advantage. Preauthorization is used to keep costs down. THe government has been concerned with the profits these companies are making.

Turned 65 last year and went thru the Advantage versus Supplement conundrum discussion with the wife. What drove us to the Supplemental Plan (G) is we travel a lot and the Advantage Plan limit your coverage to the area you actual live (if I remember correctly). We found a drug and dental plan for less than $100 month.