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Advice on Medicare Aetna Advantage Plan
October 16, 2018, 07:45 PM
shovelheadAdvice on Medicare Aetna Advantage Plan
At present I have a supplement through United Healthcare but am looking into this Aetna plan. Does anybody have any experience with it or similar products. I know it varies state by state but just general information as I am talking to an agent a week from now. This plan apparently includes prescription drugs which I'm paying extra for. Their policy looks on the surface a lot cheaper. And as a plus, my Cardiologist participates with them, I refuse to change that doctor.
One thing I like is that they will pay for a gym membership through Silver Sneakers. I'm in a Planet Fitness but that place is crowded for one thing and for another it's a small thing but they do not allow any street clothes like jeans while working out. A couple of other small things but the Snap Fitness, at least I can control my TV choices there and it's 24/7/365 which makes it a little more convenient.
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————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)
October 17, 2018, 08:07 AM
ohioupI've been on an Aetna Advantage Medicare plan for several years and have no complaints. My prescription drug plan is separate, however.
October 17, 2018, 11:40 AM
Steve CollinsI am not sure if it is the same thing or not but the wife and I are on the Coventry Gold Medicare Advantage Plan. Coventry is owned by Aetna.
This plan has no monthly premiums and includes prescriptions. There are more copays than we thought there would be but it is still a lot less expensive than what we had before that was costing a little north of $400 a month in premiums. Prescriptions are way less expensive than on our previous plans.
October 17, 2018, 11:59 AM
GWbikerI'm on Aetna too. Last January Aetna picked up the "Silver Sneakers" fitness plan which pays for your membership to any and all fitness centers you join.
I have memberships at LA Fitness, Chuze, Platinum and SNAP (24/7).
Another free fitness center program for us "Old Farts" is "Silver and Fit"
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"Some people are alive today because it's against the law to kill them".
October 17, 2018, 12:39 PM
ZSMICHAELNo thanks. These plans are cheaper for a reason. An attorney I know says they give it to you in the big print and in the small print they take it away.
For example, many noted cancer centers do not take Advantage plans because they require too much in the way of preauthorization and pay them less. MD Anderson will not accept these plans but will take regular Medicare. These plans are cheaper because they restrict the doctors you can see, frequently require preauthorization for care and are often only good in the state in which you reside. You can switch back to regular Medicare, BUT the supplemental plans can charge you a ton more if they choose to. They also restrict your access to certain drugs more than regular Part D plans.
October 17, 2018, 01:02 PM
NavyGuyquote:
Originally posted by ZSMICHAEL:
No thanks. These plans are cheaper for a reason. An attorney I know says they give it to you in the big print and in the small print they take it away.
For example, many noted cancer centers do not take Advantage plans because they require too much in the way of preauthorization and pay them less. MD Anderson will not accept these plans but will take regular Medicare. These plans are cheaper because they restrict the doctors you can see, frequently require preauthorization for care and are often only good in the state in which you reside. You can switch back to regular Medicare, BUT the supplemental plans can charge you a ton more if they choose to. They also restrict your access to certain drugs more than regular Part D plans.
That's a pretty broad brush commentary. Not all advantage plans are the same, and I've yet to find one that is "cheaper" than regular medicare. Mine through United Health care is exactly the same cost as medicare so once that standard fee is deducted from my SS payment I own nothing additional. comparing item by item of coverage and co-pays the Advantage plan is usually better. I do not have a supplemental plan. It's an HMO and you live by the rules of HMO's which really means most things goes through your PCP. That is referrals to specialists and staying within the network.
With my PCP, I can tell him what specialist I want to see and he sends the referral. Additionally, I've not run into a single provider that was not within United Health Care's network.
Men fight for liberty and win it with hard knocks. Their children, brought up easy, let it slip away again, poor fools. And their grandchildren are once more slaves.
-D.H. Lawrence October 17, 2018, 03:56 PM
shovelheadForgot to add this is a PPO, not an HMO.
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————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)
October 17, 2018, 04:10 PM
ZSMICHAELquote:
Forgot to add this is a PPO, not an HMO
BIG DIFFERENCE. Much more lattitude with a PPO plan.
October 17, 2018, 04:14 PM
ZSMICHAELquote:
With my PCP, I can tell him what specialist I want to see and he sends the referral. Additionally, I've not run into a single provider that was not within United Health Care's network.
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A good deal depends upon geographic location. Many specialists have plenty of business and are not interested in discounting their fees to be in their network. Subspecialists are in demand and most I know are not interested in joining a HMO.
October 17, 2018, 04:31 PM
sjtillMy wife and I belong to a Medicare capitated ("Advantage") plan. As a retired physician with Kaiser Permanente, and feeling comfortable with the choice of physicians available to us both for primary and specialty care, we are very happy with it. If we had concerns about potential quality and access to the physicians in the group, or if we lived outside of the Kaiser Permanente catchment area, we would have regular Medicare, which would indeed be more expensive.
For example, I have bladder cancer, and am followed by a specialist in urological oncology (cancer of the urological system) who was trained at Sloan-Kettering, one of the top cancer hospitals in the country. I have confidence that any treatment I needed would be available, and that it could be ordered by this urologist with no need to go to an insurance company for pre-approval.
It all depends on (1) the physicians available within the network; and (2) whether the physicians need to go to the insurance company to get approval for procedures.
In principal, I like the idea of capitated plans like this as I believe they are able to provide high quality care without excessive spending which is often the case with fee for service plans.
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“ What all the wise men promised has not happened, and what all the damned fools said would happen has come to pass.”— Lord Melbourne
October 17, 2018, 08:41 PM
shovelheadquote:
Originally posted by sjtill:
My wife and I belong to a Medicare capitated ("Advantage") plan. As a retired physician with Kaiser Permanente, and feeling comfortable with the choice of physicians available to us both for primary and specialty care, we are very happy with it. If we had concerns about potential quality and access to the physicians in the group, or if we lived outside of the Kaiser Permanente catchment area, we would have regular Medicare, which would indeed be more expensive.
For example, I have bladder cancer, and am followed by a specialist in urological oncology (cancer of the urological system) who was trained at Sloan-Kettering, one of the top cancer hospitals in the country. I have confidence that any treatment I needed would be available, and that it could be ordered by this urologist with no need to go to an insurance company for pre-approval.
It all depends on (1) the physicians available within the network; and (2) whether the physicians need to go to the insurance company to get approval for procedures.
In principal, I like the idea of capitated plans like this as I believe they are able to provide high quality care without excessive spending which is often the case with fee for service plans.
My big question each time I had to change insurance companies was if my Cardiologist is in network. He jokes "I know you inside out", that came about as he was involved with my original cath/stent procedure. He stopped during the procedure and said "Not where that one is at, he get's the big one" and then he contacted my surgeon, you guess the rest of the story.
I've been seeing him since 1998, I feel comfortable seeing him and have no desire to change.
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————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)