# Medicare Part C



## Dennis K

Has anyone here gone the medicare part C route?


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## Buckeye

Most folks will know this as an "Advantage" plan


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## QuickSilver

I would never give up my Medicare for an Advantage plan..  Call it Medicare part C if you like... BUT it is NOT Medicare.. It's an HMO operated by a private insurance company.  Sounds good with all the bells and whistles it offers... UNTIL you have a major illness.. You are restricted to certain doctors and hospitals... with the insurance company calling the shots about treatment.  You could be subject to horrendous co-pays particularly for outpatient services and treatments.  Now I know some people are perfectly happy with their HMO... but for me.. the cost savings and extra perks  (silver sneakers)  is not worth giving up Medicare and the freedom Medicare provides.


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## Ken N Tx

QuickSilver said:


> I would never give up my Medicare for an Advantage plan..  Call it Medicare part C if you like... BUT it is NOT Medicare.. It's an HMO operated by a private insurance company.  Sounds good with all the bells and whistles it offers... UNTIL you have a major illness.. You are restricted to certain doctors and hospitals... with the insurance company calling the shots about treatment.  You could be subject to horrendous co-pays particularly for outpatient services and treatments.  Now I know some people are perfectly happy with their HMO... but for me.. the cost savings and extra perks  (silver sneakers)  is not worth giving up Medicare and the freedom Medicare provides.



.................


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## QuickSilver

Having worked in Case Management in a Hospital.. I have personally had to go to a patient's family and tell them that their 80 year old mother could not have her broken hip fixed at our hospital because her HMO wanted her transferred to another one many miles away.  They were shocked and said..  "But she has Medicare!!"   No...  not really..  She has a Medicare Advantage plan and she signed away her traditional Medicare..  So Mom had to be loaded into an ambulance with a broken hip and moved.   OR pay for her surgery herself.


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## mathjak107

Hoot N Annie said:


> Most folks will know this as an "Advantage" plan




same here . my wife went medicare and high deductible f-plan .  perhaps if we had access to the kaiser plans in our location i might have considered it but advantage plans are cheaper for a reason and the ones we have available stink ..

my buddy bragged about how little his advantage plan cost him .

when his wife got breast cancer towards the end of the year and his out of pocket for chemo was 4500.00 a year he got whacked for 9k .


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## QuickSilver

We have Medicare A.  In January when I am no longer covered by my Employer, we will have Part B... plus Blue Cross plan F    Looking for a Part D plan.   And Yes..  I have an affidavit from my Employer stating I have had insurance coverage in order to avoid a Part B penalty since I did not take Part B at age 65.


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## Dennis K

I just wonder just how many people delay retirement only because of the health care premiums they will have to pay before being eligible for medicare when they have to pay 100 percent of that premium?  I was talking to someone who's last day of work was on a Friday. I asked him when he would turn 65 and his reply was tomorrow.


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## Dennis K

QuickSilver, were you trying to make a point in one sentence of just how complicated the process can be?


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## mathjak107

i am on cobra and will go the aca route in january


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## Carla

We have to be so careful what we chose when it comes to healthcare. I have to select this month and it is making me terribly anxious, but choice is very important to me. It will cost more but I have gone to my PC doc for a number of years and the specialists I see are the ones that have helped me the most. Changing now would not be good. I don't want to see a dr I know nothing about, I already have had a recommendation for radical surgery that I questioned. Seeking another dr outside my area, that surgery was replaced with a procedure! So, there is a huge difference in Drs, especially from the smaller hospitals as opposed to the larger ones. They see more patients and have more experience. They are more current with new procedures which can be a very big deal. Saving money is great and for some, the only way they can afford it at all. I just don't want to be be tricked into purchasing healthcare that takes my choices away.


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## RustyatMMC

Turning 65 and Medicare - disclosure..this does promote my agency.  If you want our help great, if not, *please* use the information to help you understand what your options are and find someone to compare all the plans and companies for you.  I am very passionate about this subject....

I usually send this to my clients who are starting Medicare.  I have several hundred clients on Medicare and I can tell you I recommend Original Medicare (Part A and Part B) with a supplement plan (Plan G) and a Part D plan from medicines.

Here is a chart I send to clients who ask about MA plans:


"SilverSneaker is a benefit on some Medicare Advantage (MA) plans.  MA plans seem great until you use them.  They have VERY high out of pocket exposure as compared to a medicare supplement plan G.  With a medicare supplement plan G, you have a $166 deductible for medical expenses.  That’s the most you will pay for doctor visits or hospital stays.  With a MA plan, you have a max out of pocket (MOOP) from $5,000 (typical for HMO plans) to $10,000 (typical for PPO plans) per year depending on the plan type.  That’s a *LOT of risk* to take on for a free gym membership! 


 
*Medicare Supplements*
*Medicare Advantage Plans*
*A 6+ day stay at hospital*
You pay $0
You pay $1,500-2,200

*Chemotherapy*
You pay $0
You pay 20% up to max out of pocket (MOOP)

*Lab work*
You pay the first $166 (part B deductible) per year, then $0 afterwards.You pay 20%
*Doctor visits*
You pay the first $166 (part B deductible) per year, then $0 afterwards. 
You pay a copay every time you see your doctor and more for specialists.

*Networks*
You can choose your doctor or hospital anywhere in the country
You have to stay in a HMO network or pay more to be outside a PPO network.

*Max out of pocket (MOOP) for Doctors and Hospitals per year*
$166 (part B deductible)
$5,000+ with HMO networks
Up to $10,000 with PPO networks
 
 
 
*Dental/Vision*
None
You get a checkup once a year

*Gym membership*
None
You get a Free gym membership

*What clients want*
People want to be on these plans when they get sick.
People want off of these plans when they get sick.

 
MA plans are great when people don’t have claims.  When they get sick, MA plans are no fun!  Lots of bills.  I get calls all year long from people on MA plans desperate to get off them.  Every one of them are sick and the out of pocket exposure is killing them.  *Problem is once you have major claims* (like what these people who call me are having), it’s very difficult to impossible to move them to a medicare supplement.  Medicare supplement are going to ask health questions and since they are on claim, they will not get approved.

Like what was described above, get sick in November or December and have treatment roll over to the next year...guess what...new year and your out of pocket exposure resets.

I try to show all my clients that Medicare supplements are a better choice.  Most understand why, but some want the lower cost initially.  I have had several comeback desperate to get off after getting sick, but there was little we could do then.  Those conversations are never fun.  I have had enough of them and that’s why I try to convince my clients that medicare supplement plans are the best for them long term.  

On the other hand, I have had clients who get diagnosed with cancer and love how well their medicare supplement plan takes care of the doctors and hospital bills.  They can focus on getting better and not have to deal with the stress of paying these big bills that would happen if they were on a MA plan.  * I have NEVER had a phone call from a client upset with me on what their medicare supplement did not pay…never."*

I hope that helps people understand the difference.  People often forget about how much exposure they have on an MA plan until it's too late.
Thanks
Rusty


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## mathjak107

we have silver sneakers as part of our humana high deductible f-plan . they pay the gym directly . it cost me 480 a year for myself at the gym so silver sneakers is worth a lot of money and is part of some medicare supplements . .we pay 90 a month for the supplement . i pay 40 a month alone for my gym .


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## Butterfly

I'm on an advantage plan and I couldn't be happier.  My plan is tied to the largest and best hospital here, and practically all the physicians in Albuquerque accept it.  I don't pay anything in addition to my $106 (or whatever it is now) Medicare premium.  

When I had BOTH my hips replaced almost 3 years ago, I paid almost nothing -- my hospital was about $400 (that's for both surgeries, done a month apart), my orthopedic surgeon cost me $50 out of pocket (I only had to pay for the initial visit, nothing else for subsequent visits, or the surgeries themselves). Diagnostic and pre-op tests cost me nothing. Followup and home PT cost me nothing.   I got wonderful care at the hospital and had a private room.

I was able to choose my surgeon out of the large pool of physicians, and got the one I wanted, who happens to be one of the best (arguably THE best) here for hip and knee replacements. He's board certified and practices with the biggest and best orthopedic group here.

I am super satisfied with my advantage plan.

When I dislocated my shoulder a year or so ago, I paid a total of $50 to the ER, nothing for physicians, x-rays, or meds (thank God for morphine), and again got wonderful care.


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## mathjak107

the problem is with advantage plans it is hit and miss . like i said , kaiser has some excellent plans but we have none available to us . with supplements you know your exposure . with advantage plans they are a lot more complex and as many like my friend found out have exposure's you are not aware of until you hit them .

the old saying , nothing is a problem until it is a problem can be very true with many advantage plans


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## Butterfly

I'm sure that same old saying could apply to many supplements, as well.  With my plan, I know exactly what my exposure is.  If I have a question about that, I can either look it up, or, better yet, call the administrator's office and talk to a real, live, human, who also is here, not in India.  Good Rx benefits, too.

Having said that, the plan I'm on is a local one and only available in New Mexico.


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## mathjak107

that is the other draw back , we travel and most advantage plans can give you grief outside your area except for what they consider the extreme emergency's . supplements are very tightly controlled unlike advantage plans .

advantage plans are no different than regular hmo's . they can decide what they will pay for  ,what they will argue and limit .

supplements can not . as long as medicare covers the expense  they are bound by law to cover and pay what medicare does not .

don't forget with an advantage plan ,what gets counted towards an out of pocket is based on what they will pay . you can spend money for something and they can feel they won't cover it and the dollars don't count .

after our agreed deductible we have zero holes . if we took the full f-plan instead of high deductible than that is it . we know there will be not another penny for anything paid out by us .


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## QuickSilver

Part A.... Part B.... and Plan F is the way to go IMO.


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## mathjak107

if you are healthy a high deductible f-plan is well worth it . we pay 2k a year less for it than an f-plan . at best we spend about 400-500 in deductibles . remember it covers only what medicare does not . it is based on medicare prices too .

so if an mri is 2k , medicare may only allow them 500 bucks .so they pay 80% of 500 and your whole deal is 100 bucks . more often than not the deductibles are under 10 bucks so it is hard to come up with 2k in uncovered stuff . even if you do you are no worse off since you saved 2k on premium.
only humana offered it in nyc where we are


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## QuickSilver

I hate going to Vegas....  and I don't play the "boats".... gambling is just not my thing.


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## mathjak107

me too . i get sea sick and don't gamble . but we sure do take a lot of trips .  heading to nashville  next week for a few days


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## Jackie22

I love Vegas, not so much for the gambling but the shows, hotels and restaurants, its a great get-away.


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## QuickSilver

To me..  Purchasing a High Deductible plan or a Medicare HMO is akin to gambling...  You are gambling you will stay healthy and won't be hit with huge OOP expenses... or that you will not need a Specialist or hospital outside your plan.  I'm just not willing to take that chance to save a few bucks every month.   It's not worth it to me.


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## Butterfly

I"d buy a supplement, too, if this plan wasn't available to me.  The way it's set up, though, it's perfect.


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## mathjak107

QuickSilver said:


> To me..  Purchasing a High Deductible plan or a Medicare HMO is akin to gambling...  You are gambling you will stay healthy and won't be hit with huge OOP expenses... or that you will not need a Specialist or hospital outside your plan.  I'm just not willing to take that chance to save a few bucks every month.   It's not worth it to me.



a medicare hmo  is really an advantage plan , but medicare and a high deductible supplement are something else .


 the high deductible f-plan is the same 2k spread . the full f-plan costs 2k more . the high deductible f-plan is 1k and a 2k deductible .

exposure in both cases is the same only we have been saving more than 1500 a year because we don't come close to 2k in un-reimbursed medical . remember you are only dealing with what medicare does not cover fully


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## RustyatMMC

https://www.medicare.gov/sign-up-ch.../things-to-know-medicare-advantage-plans.html

In some parts of the country, Medicare Advantage (MA) plans can be a better deal than what's available MA wise in other states.  Networks have a big impact.  They can work better in urban areas, not so much in rural areas.  Also with MA plans; your benefits, deductibles, copays, premiums, max out of pocket, etc can change each year.  Your doctors can opt out of the network.  

I still stand by what I said originally.  I am a big fan of medicare supplements over medicare advantage plans.  The link above goes over some of those details.  

I feel my job as a broker is to show clients the pros and cons of each plan and let them decide.  I give them my opinion and my experience, but in the end, it's their decision.  I just hate it when I get a call a few years later when they have serious health issues and desperate to get off the MA plan.  Often, there is little I can do for them then.

In my opinion, MA plans leave too much risk on the client.  The only issue my medicare supplement clients have to worry about is the premium increase each year, which we can shop for them when they get a rate increase.


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## Butterfly

Well, I'll stick with my local advantage plan.  I don't pay a premium for it, which saves me a lot of money right there.  It  has a HUGE pool of physicians to draw from.  It does not require a referral to see most specialists (though without a referral you will wait longer for an appointment than if you have one).  When I had my hips replaced, I just decided who I wanted to see and then asked my PCP for a referral to him.  Piece of cake.   I paid out of pocket WAY less than $1000 to get BOTH hips replaced.  If I had had a supplement instead, I would have paid way more than that in a year for the premiums.

Before I signed on to this plan, I did extensive research on what was available, and this plan was and IS a much better deal than any supplement plans available here.


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## Buckeye

Different strokes for different folks.  I'm a Part A/B and zero deductible Plan F guy myself.  I had a quad bypass in 2013.  I saw the hospital bill.  $145k.  My out of pocket was zero.  8 weeks after that, my wife was diagnosed with lung cancer.  Started chemo at that time, and underwent chemo and radiation on and off (mostly on) until she passed away this past Easter.  Didn't see any of the bills until after that, and then only for the last 4 months.  $56k.  $14k per month.  If that rate was good for the two years and 9 months she was being treated then the total would be $462k.  Her out of pocket was zero. She was treated in Florida and continued treatment when we moved to Hawaii.  An advantage plan would have not travelled with us the way the Plan F did.  The flip side is that my plan F premium is a little over $220 per month plus the Part B plus my drug plan. 

When it comes to insurance, you pay for certainty and for choice.  I know exactly what my medical costs are going to be.  No variation, since all I pay is the premium.  With an Advantage plan, my costs could be much lower when I'm healthy but much higher if I have a major issue.  (The Florida Blue Advantage plan had a max out of pocket of something like $5k per year.)  I also have greater choice.  I can go to any doctor or hospital that takes medicare and my Plan F covers me.  In Advantage plans, you are required to stay within their network of Doctors and hospitals unless it meet their definition of emergency.  Limited choice.

In the interest of full disclosure, both my late wife and I were licensed to sell health and life insurance in Florida for a couple of years, including the Supplements and Advantage plans.  We had a good friend that owned the local BC/BS office and needed help during the "senior season" when we're allowed to change plans.


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## Ken N Tx

Hoot N Annie said:


> In the interest of full disclosure, both my late wife and I were licensed to sell health and life insurance in Florida for a couple of years, including the Supplements and Advantage plans.  We had a good friend that owned the local BC/BS office and needed help during the "senior season" when we're allowed to change plans.



I will be needing a new drug plan this year!!  Suggestions ???


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## QuickSilver

Ken N Tx said:


> I will be needing a new drug plan this year!!  Suggestions ???




Good question...  We will be purchasing our very first part D to begining in January...  Suggestions welcome.


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## Dudewho

mathjak107 said:


> the problem is with advantage plans it is hit and miss . like i said , kaiser has some excellent plans but we have none available to us . with supplements you know your exposure . with advantage plans they are a lot more complex and as many like my friend found out have exposure's you are not aware of until you hit them .
> 
> the old saying , nothing is a problem until it is a problem can be very true with many advantage plans



Advantage plans all by will have to have a maximum out-of-pocket by law, so you do know  exactly what your worst case scenario could be.
.


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## Dudewho

Ken N Tx said:


> I will be needing a new drug plan this year!!  Suggestions ???



At Medicare.gov you can and input your specific drugs and your ZIP Code and compare all part D plans available to you in your area. 
Referrals won't help you in this area because nobody's taking the specific drugs that you are.
.


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## Dudewho

mathjak107 said:


> that is the other draw back , we travel and most advantage plans can give you grief outside your area except for what they consider the extreme emergency's . supplements are very tightly controlled unlike advantage plans .
> 
> advantage plans are no different than regular hmo's . they can decide what they will pay for  ,what they will argue and limit .
> 
> supplements can not . as long as medicare covers the expense  they are bound by law to cover and pay what medicare does not .
> 
> don't forget with an advantage plan ,what gets counted towards an out of pocket is based on what they will pay . you can spend money for something and they can feel they won't cover it and the dollars don't count .
> 
> after our agreed deductible we have zero holes . if we took the full f-plan instead of high deductible than that is it . we know there will be not another penny for anything paid out by us .



By law Medicare advantage plans have to cover everything Medicare covers.  All medicare advantage plans have been deemed by Medicare equal to or greater than the original Medicare coverage or they cannot be sold by law.

HMO networks are a tighter network and you usually cannot go out of network unless under an emergency situations.

PPOs Will give you the flexibility of network coverage and out of network coverage. Usually have to pay more out of network with a PPO.

 With a PFFS plan you usually do not have a network and can see any doctor who will accept the plan. With a private fee-for-service plan that does not include prescription drugs in some cases you may add a part D plan with it.

 If you have a PPO without prescription drug coverage it is illegal to add prescription drug coverage with it.


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## Dudewho

QuickSilver said:


> Having worked in Case Management in a Hospital.. I have personally had to go to a patient's family and tell them that their 80 year old mother could not have her broken hip fixed at our hospital because her HMO wanted her transferred to another one many miles away.  They were shocked and said..  "But she has Medicare!!"   No...  not really..  She has a Medicare Advantage plan and she signed away her traditional Medicare..  So Mom had to be loaded into an ambulance with a broken hip and moved.   OR pay for her surgery herself.



By law, in emergency situations you will be covered for out of network care.  You just need to call the insurance company within 48 hours let them know what happened .


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## RustyatMMC

With MA plans, I have seen the benefits change every year.  In most cases, the changes do not favor the client. 

Again, my experience is people love MA plans until they get sick.  That's when they want off of them...I know is some states, the networks are better.  If you are in Florida, networks and benefits can be stronger, but over time those will erode too.

If the sickness is ongoing, you do know your limits are capped, but those limits change each year too.  I have seen caps change from $3500 a year max out of pocket to $6500+ in just a few years.  Still a lot of exposure.

MAs can be better than Original Medicare, but I still prefer clients on medicare supplement plans.


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## QuickSilver

Dudewho said:


> By law, in emergency situations you will be covered for out of network care.  You just need to call the insurance company within 48 hours let them know what happened .




Provided you are ABLE to make that call in 48 hours..


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## Dudewho

QuickSilver said:


> Provided you are ABLE to make that call in 48 hours..



In the situation you describe how did it play out?You're on the phone with them, did you and form the insurance company they came in under an emergency situation?


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## mathjak107

the big wild card is what they consider an emergency.

personally if I am traveling and don't feel well I want to be able to be seen and helped regardless of what they consider .


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## Dudewho

RustyatMMC said:


> Turning 65 and Medicare - disclosure..this does promote my agency.  If you want our help great, if not, *please* use the information to help you understand what your options are and find someone to compare all the plans and companies for you.  I am very passionate about this subject....
> 
> I usually send this to my clients who are starting Medicare.  I have several hundred clients on Medicare and I can tell you I recommend Original Medicare (Part A and Part B) with a supplement plan (Plan G) and a Part D plan from medicines.
> 
> Here is a chart I send to clients who ask about MA plans:
> 
> 
> "SilverSneaker is a benefit on some Medicare Advantage (MA) plans.  MA plans seem great until you use them.  They have VERY high out of pocket exposure as compared to a medicare supplement plan G.  With a medicare supplement plan G, you have a $166 deductible for medical expenses.  That’s the most you will pay for doctor visits or hospital stays.  With a MA plan, you have a max out of pocket (MOOP) from $5,000 (typical for HMO plans) to $10,000 (typical for PPO plans) per year depending on the plan type.  That’s a *LOT of risk* to take on for a free gym membership!
> 
> 
> *Medicare Supplements**Medicare Advantage Plans**A 6+ day stay at hospital*You pay $0You pay $1,500-2,200
> *Chemotherapy*You pay $0You pay 20% up to max out of pocket (MOOP)
> *Lab work*You pay the first $166 (part B deductible) per year, then $0 afterwards.You pay 20%*Doctor visits*You pay the first $166 (part B deductible) per year, then $0 afterwards. You pay a copay every time you see your doctor and more for specialists.
> *Networks*You can choose your doctor or hospital anywhere in the countryYou have to stay in a HMO network or pay more to be outside a PPO network.
> *Max out of pocket (MOOP) for Doctors and Hospitals per year*$166 (part B deductible)$5,000+ with HMO networks
> Up to $10,000 with PPO networks*Dental/Vision*NoneYou get a checkup once a year
> *Gym membership*NoneYou get a Free gym membership
> *What clients want*People want to be on these plans when they get sick.
> People want off of these plans when they get sick.
> 
> MA plans are great when people don’t have claims.  When they get sick, MA plans are no fun!  Lots of bills.  I get calls all year long from people on MA plans desperate to get off them.  Every one of them are sick and the out of pocket exposure is killing them.  *Problem is once you have major claims* (like what these people who call me are having), it’s very difficult to impossible to move them to a medicare supplement.  Medicare supplement are going to ask health questions and since they are on claim, they will not get approved.
> 
> Like what was described above, get sick in November or December and have treatment roll over to the next year...guess what...new year and your out of pocket exposure resets.
> 
> I try to show all my clients that Medicare supplements are a better choice.  Most understand why, but some want the lower cost initially.  I have had several comeback desperate to get off after getting sick, but there was little we could do then.  Those conversations are never fun.  I have had enough of them and that’s why I try to convince my clients that medicare supplement plans are the best for them long term.
> 
> On the other hand, I have had clients who get diagnosed with cancer and love how well their medicare supplement plan takes care of the doctors and hospital bills.  They can focus on getting better and not have to deal with the stress of paying these big bills that would happen if they were on a MA plan.  * I have NEVER had a phone call from a client upset with me on what their medicare supplement did not pay…never."*
> 
> I hope that helps people understand the difference.  People often forget about how much exposure they have on an MA plan until it's too late.
> Thanks
> Rusty




Your info on coverage on Medicare Advantage plans is very misleading. Although plans very from area to area, the plan I have has zero co-pays for labs, 250-300 a day for hospital visits, included eyeware along with check-ups and tooth cleanings. My plan has less than $5000 moop. I can go to any doctor with my HMO. It includes diabetic supplies for free. No underwriting. Not to mention it included prescription drug coverage built into it. Generic coverage mail to me for free. 
My mother had nurses checking in on her at home and had meals sent to her. All for a couple of $$ a month. 
I originally looked at Medicare supplements and even had one, but they kept raising the price. I just take the money they're was paying every month and save it in a separate account. I have my own Health $ account. Copy's are no problem.
We think we could use the premium $$ in our pockets more than the insurance company.
Different strokes for different folks I guess.


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## Dudewho

mathjak107 said:


> the big wild card is what they consider an emergency.
> 
> personally if I am traveling and don't feel well I want to be able to be seen and helped regardless of what they consider .


 
 Not really, you go to the emergency room. Plain and simple.


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## mathjak107

with an advantage plan if they are not in network look out . you could be responsible for  quite a bit in bills . what they consider an emergency and what you do can be two different things . many advantage plan networks are local only .  getting sick over seas can be a real nightmare


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## Dudewho

mathjak107 said:


> with an advantage plan if they are not in network look out . you could be responsible for  quite a bit in bills . what they consider an emergency and what you do can be two different things . many advantage plan networks are local only .  getting sick over seas can be a real nightmare



Your coverage is clearly stated in the summary of benefits and the explanation of benefits for out of in and out of network services.  No surprises if you do your homework. During annual a enrollment period we checked our coverage options. 
As I stated my HMO has out of network benefits, it is a POS or Point of service.


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## mathjak107

your hmo has out of network benefits . in our area none do . they are strictly authorized if traveling on an emergency basis and case by case


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## Dudewho

In 2015 31% of those on Medicare used Medicare advantage plans.  Since then those numbers have been growing. 
 Starting in mid October annual enrollment period is used to check the  summary of benefits for evidence of coverage for plans in your area. It clearly states what in network and out of network costs will be.  No surprises if you do your homework. 
 What they cover under  emergency situations is clearly stated in the evidence of coverage.  Remember Medicare advantage plans by cover everything Medicare covers or they cannot be sold. That's the law. As far as getting sick overseas I kind of think you're off the reservation. Original Medicare and Medicare supplements are US government insurance and cannot be used off US soil other than very specific reasons. If the closest hospital in an emergency is over the border in Canada or Mexico or something happens traveling across Canada in route to Alaska. That's about the only time you're going to get coverage with Medicare supplement on foreign soil. Medicare advantage plans do you have worldwide coverage.


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## Dudewho

mathjak107 said:


> your hmo has out of network benefits . in our area none do . they are strictly authorized if traveling on an emergency basis and case by case




Yes its a  Point of service . 

All plans are specific to areas. That's why you got to be careful as to if a MA plan is a good fit or not.


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