Medicare Advantage Explained

17 March 2023, 07:41 AM

Mikhailoh

We opted for traditional Medicare with Part D and supplemental. It costs more but is worth it I think. I don't need referrals and don't have a network, other than providers who take Medicare. Plus the international coverage is better.

My brother opted for Advantage and has had to jump through all the hoops you would expect of a PPO/HMO plan to get the care he needed.

17 March 2023, 07:42 AM

QuirtEvans

What you did is what I'm thinking, too, for exactly the reasons you've described, although I'm not at the "need to make decision" stage yet.

17 March 2023, 08:56 AM

Axtremus

quote:
Originally posted by QuirtEvans:
https://www.vox.com/policy/202...ge-enrollment-growth

Very good piece. Thanks for sharing.

17 March 2023, 09:30 AM

wtg

It is a good article. Thanks for posting it, Quirt.

We didn't even look very closely at Advantage because we had heard about the limitations imposed by the insurers and didn't want the hassle. Insurers certainly make Advantage sound attractive with the lower premiums and "free" extras like dental and vision. I'm guessing a lot of people are unaware of the tradeoffs aka there's-no-free-lunch..

Same as Mik here, traditional Medicare, Medigap, and Part D. Pay for our own dental. We see an ophthalmologist for annual vision exams, which are covered under Medicare except for the refraction. Glasses at Costco.

I've also wondered how agent commissions affect where the business goes. Some years ago when I was looking at prescription drug plans, I stumbled upon a forum for insurance agents who were talking about Part D plans. Not a small part of the discussion was about commissions, and how some agents were directing clients away from certain companies because they had dropped their commission rates.

Sidebar for those interested in how commissions for the various plans work:

https://www.commonwealthfund.o...t-beneficiary-choice

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We are all visitors to this time, this place. We are just passing through. Our purpose here is to observe, to learn, to grow, to love… and then we return home. - Australian Aboriginal proverb

Bazootiehead-in-training

17 March 2023, 11:10 AM

Mikhailoh

One thing I did not understand is how an Advantage patient could end up paying more for any given service. The coverage is supposed to be the same.

Generally the vision and dental is no better than you can do on your own, and few quality providers accept it.

17 March 2023, 12:16 PM

wtg

quote:
One thing I did not understand is how an Advantage patient could end up paying more for any given service. The coverage is supposed to be the same.

~~Out of network services?~~

Ah, now I see what you're talking about. I think the answer might be here:

https://www.kff.org/medicare/i...on-and-star-ratings/

17 March 2023, 01:32 PM

Mikhailoh

It might be, but I couldn't find it.

17 March 2023, 01:41 PM

wtg

quote:
Originally posted by wtg:
quote:
One thing I did not understand is how an Advantage patient could end up paying more for any given service. The coverage is supposed to be the same.

~~Out of network services?~~

Ah, now I see what you're talking about. I think the answer might be here:

https://www.kff.org/medicare/i...on-and-star-ratings/

quote:
Originally posted by Mikahiloh:
It might be, but I couldn't find it.

Or maybe not...back to square one....

17 March 2023, 01:42 PM

wtg

Consumer Reports did a piece on Medicare Advantage, too:

https://www.consumerreports.or...vantage-a6834167849/