# Medicare Advantage Plans -- Is There A Huge Hidden Flaw?



## Ryan

This is a huge concern for me and I am trying to get some experienced and expert response to address it.

I have heard rumors about what seems to be a potentially huge flaw in Medicare Advantage plans, especially HMO type plans since they have no out of network coverage.  I would appreciate any information that will help me understand this.

Here  is one possible scenario that I am talking about.  Suppose you are in a  hospital.  While you are there, you are attended to by doctors without  your advanced knowledge and sometimes without your knowledge at all  until you get their bills later.  I know this is not an unusual scenario  because I have been assisting my father for 10 years while he has been  in and out of hospitals regularly.  There are often charges from doctors  we never even heard of... sometimes major charges depending on the  reason you are there.  Take your anesthesiologist, for example.  Does  any patient ever have a relationship with them before they go in for a  procedure?  Under many common scenarios you have no idea who they are either before or after you have a procedure.

I  have heard that such charges may not be covered by an HMO since the doctors involved may not be in network doctors.  And there may be other things not covered  as well particularly related to hospital treatment.  I've heard horror stories of five and even six figure bills due for patients  who had hospital stays even though they had a Medicare Advantage HMO  plan.

The same unexpected cost may be involved with a PPO plan as well I assume although in the scenario I described above I assume the PPO would pick up at least some of the out-of-network doctor's charges.  Still, such additional costs would probably be a surprise to most people with Advantage plans.  And the primary purpose a consumer buys insurance is to avoid such surprises.

If this is true, it is frightening and would be a major factor in making a decision about what plan to get.  Can anyone shed any expert light on this?  I am particularly interested in hearing from insurance professionals who have knowledge of how significant this problem is in practice or people who have actually had experience with this.

Thank you.


----------



## terry123

I have a PPO advantage plan and I insist on seeing only in network providers.  My pcp knows this and my family does too.  I have been known to question doctors who pop in for a consult before they see me.  If you are not an in network provider, get out..Works for me!


----------



## Chucktin

This is how we have been advised to handle these situations in a Medicare overview symposium. I suppose though it will depend on how diligent one spouse is in caring for the other.





terry123 said:


> I have a PPO advantage plan and I insist on seeing only in network providers.  My pcp knows this and my family does too.  I have been known to question doctors who pop in for a consult before they see me.  If you are not an in network provider, get out..Works for me!


----------



## Chucktin

I currently am inrolled on a HMO but am switching to PPO as of January. My health problems are, fortunately, minor thus far but the HMO Primary Care Physician and I don't communicate well.


----------



## GreenSky

The big flaw in HMO plans is a restrictive network.  The big flaw in PPO plans is a restrictive network (although if you have LOTS of money you can go out of network).

If you can afford it there is nothing better than Original Medicare with a supplement.  Go with the high F if money is tight and add a hospital indemnity plan if you must.  In fact, the best scenario is a HDF for about $35-40 per month, $10,000 of cancer coverage for another $30, and maybe a hospital plan for about the same.  It's likely cheaper than Plan F with (in my opinion) better coverage.

Some will argue how wonderful their HMO is and I won't dispute that.  My hope is that they never have an illness better treated by a non-network doctor.  My question about HMO plans is addressed to the beneficiary - "If your granddaughter has a brain tumor who do you want to do the surgery?"  Generally the answer is "The best doctor."  I then ask "What if that best doctor is at Stanford, UCLA, etc but they are not in your granddaughter's network.  How much would you then pay to save her life?"

That's my issue with HMOs.  You reliquish control of your health to others.   And that means the medical group generally controlled by an accountant.

Rick


----------



## terry123

My PPO Humana Advantage plan works for me as it has a built in drug plan that gives me my meds free.  My situation is a lot different than most as I have late effect stroke problems.  After a massive stroke from a brain aneurysm rupture, I was affected in many ways.  I was blessed to have recovered as much as I have but it takes a toll on the body organs.  When I complain that I cannot do what others my age do, my doctor reminds me that I have had 3 brain attacks and survived each one and am blessed to be alive.  I wish I would have known that I had an aneurysm before it ruptured, but it is what it is.  My plan is not offered everywhere but it works for me and I do not have to have a supplement.


----------



## mathjak107

GreenSky said:


> The big flaw in HMO plans is a restrictive network.  The big flaw in PPO plans is a restrictive network (although if you have LOTS of money you can go out of network).
> 
> If you can afford it there is nothing better than Original Medicare with a supplement.  Go with the high F if money is tight and add a hospital indemnity plan if you must.  In fact, the best scenario is a HDF for about $35-40 per month, $10,000 of cancer coverage for another $30, and maybe a hospital plan for about the same.  It's likely cheaper than Plan F with (in my opinion) better coverage.
> 
> Some will argue how wonderful their HMO is and I won't dispute that.  My hope is that they never have an illness better treated by a non-network doctor.  My question about HMO plans is addressed to the beneficiary - "If your granddaughter has a brain tumor who do you want to do the surgery?"  Generally the answer is "The best doctor."  I then ask "What if that best doctor is at Stanford, UCLA, etc but they are not in your granddaughter's network.  How much would you then pay to save her life?"
> 
> That's my issue with HMOs.  You reliquish control of your health to others.   And that means the medical group generally controlled by an accountant.
> 
> Rick


It isn’t only going out of network that can be a problem . It is the fact you have a for profit insurer as your gate keeper . They can approve or deny procedures and treatments that fall in to gray areas like those I discussed in other threads . Medicare is not for profit and is far more liberal in approving procedures .

while they both claim to cover the same things that is only in a broad sense ,like the police protect the public at large not you personally . When those advantage plans deny your procedure or modify it you have no recourse to show Medicare would have covered it since you don’t have govt Medicare


----------



## Ryan

When you have an HMO or PPO and you are making elective doctor's visits, of course you can decide not to go to an out-of-network doctor.

What my question is about though is what happens when you have an HMO or PPO and you go to a hospital.

I'll give you a specific real example.

When my father was 88 years old, he had a heart attack.  He went to the hospital emergency room.  During the time he was in the emergency room I think he was seen by maybe three doctors or more.

Then he was taken for an angiogram.  Three additional doctors were involved in that process.

Then he had a double bypass surgery.  There was a heart surgeon and yet several more doctors involved in that process.

Then he stayed in the hospital for recovery.  Various problems from digestion issues, for which he was treated by a gastroenterologist, to problems with other organs, for which he was seen and treated by several other specialists, occurred during that time.

He had no idea who any of these doctors were.  And he was of course in no condition to even think about whether they were in network doctors or not.  And even if he wasn't in a condition like that it would be impossible or foolish to insist on something like that at a time like that and possibly cause delay in your life-saving treatment or complications getting that treatment.  For the same reason I wouldn't have been able to do it for him even though I was there with him.  It just wouldn't be practical or maybe even possible to be sure that the doctors who saw him were going to be covered by the plan in that situation.  If I insisted on in network doctors chances are the hospital wouldn't or couldn't treat him at all.  You just can't arrange something like that in a situation like that.

And I think the same thing would apply to virtually all hospital stays weather emergency room or admitted to the hospital or possibly even outpatient treatment.  You simply cannot control weather in network or out-of-network doctors are going to treat you under those conditions... It's neither practical nor wise if even possible.  You often have to accept whatever doctors are available at the hospital.

Needless to say this hospital stay and the follow-up visits -- including required follow up visits with the heart surgeon who my father did not choose and may well have not been an in network doctor -- were enormously expensive.  My father had supplemental Plan G.  So in his case he had no out-of-pocket cost at all for the entire process.  But I wonder what would have happened if he had a Medicare HMO or PPO plan.

I don't think this is an unusual scenario, as a matter of fact I think this is typical of any hospital experience these days.

So my question is not about elective visits when you make an appointment with a doctor to visit his office.  My question is about whether or not, if you have an HMO or a PPO, you could find yourself in a catastrophically expensive situation when you need to use a hospital.  And if so, are you really protected?


----------



## OneEyedDiva

I think it depends on the plan. I have Aetna Open Access Medicare, which is an HMO, as part of my retiree benefits (group plan). I love Aetna! Almost 3 years ago I went to the hospital for a cardiac procedure, stayed over night and didn't pay a dime.  I didn't get any bill from the anesthesiologist nor the doctor who did the procedure, who is in network.  Members can use out of network doctors, it just costs more.  With If a plan holder is admitted to a non-network hospital, lets say in another state, there's no payment due except for the $75 E.R. co-pay (which I believe is waived if admitted).My husband has Clover. He just had hernia surgery by a doctor who does not take his plan. He was told by his PCP, who brought that doctor in on his case, that since he was admitted through the E.R., any treatment and procedure done during that admission would be covered by his plan.  We'll see!


----------



## Ryan

Thanks for that info OneEyedDiva.  Yes, no question, I think with all HMO or PPO plans, the rules for emergency room visits are different.  And there are additional things covered if you go to an emergency room and then are admitted.  I think that generally, if you are admitted that way (from an emergency room), more things are covered.  Also if you are not in your home area and have emergency care, I think it is generally covered even if it is out of network.  Trying to sort this all out is like trying to invent an atomic reconstituter.  You are a good example of an insurance customer who has a claim and still doesn't even know if you are covered.  That should never happen.  You shouldn't have to rely on your fingers being crossed to find out if you are financially wiped out or not.

But my basic question is still unaddressed.  What I am looking for is what happens if you have an HMO and you are admitted to a hospital for non-emergency reasons.  For example, what if you were admitted to a hospital for non-emergency hernia surgery.  Suppose you go to a hospital that is in your network.  Could you still be exposed to additional costs if something happens in that hospital such as your being treated by doctors who are non-network?  This is turning out to be a very difficult question to get an answer to.  I have heard rumors of horror stories, and I am sure that brokers in the Medicare insurance industry know the answer, but it's not in their interest to discuss this topic since they don't want to point out flaws in the products they make their living selling.

Very tough to find out information about this so anyone who can shed any light on this is welcome.  What I'd really like is for a broker who has experience with this explain the pitfalls related to this question, or, alternatively explain that there aren't any pitfalls and reassure that if you are admitted to an in-network hospital, then everything that happens there is covered.  I think this really takes someone in the Medicare insurance industry, who deals with many many cases, to explain.


----------



## Butterfly

Ryan said:


> Thanks for that info OneEyedDiva.  Yes, no question, I think with all HMO or PPO plans, the rules for emergency room visits are different.  And there are additional things covered if you go to an emergency room and then are admitted.  I think that generally, if you are admitted that way (from an emergency room), more things are covered.  Also if you are not in your home area and have emergency care, I think it is generally covered even if it is out of network.  Trying to sort this all out is like trying to invent an atomic reconstituter.  You are a good example of an insurance customer who has a claim and still doesn't even know if you are covered.  That should never happen.  You shouldn't have to rely on your fingers being crossed to find out if you are financially wiped out or not.
> 
> But my basic question is still unaddressed.  *What I am looking for is what happens if you have an HMO and you are admitted to a hospital for non-emergency reasons.  For example, what if you were admitted to a hospital for non-emergency hernia surgery.  Suppose you go to a hospital that is in your network.  Could you still be exposed to additional costs if something happens in that hospital such as your being treated by doctors who are non-network? * This is turning out to be a very difficult question to get an answer to.  I have heard rumors of horror stories, and I am sure that brokers in the Medicare insurance industry know the answer, but it's not in their interest to discuss this topic since they don't want to point out flaws in the products they make their living selling.
> 
> Very tough to find out information about this so anyone who can shed any light on this is welcome.  What I'd really like is for a broker who has experience with this explain the pitfalls related to this question, or, alternatively explain that there aren't any pitfalls and reassure that if you are admitted to an in-network hospital, then everything that happens there is covered.  I think this really takes someone in the Medicare insurance industry, who deals with many many cases, to explain.



My plan says that this will never happen under its Advantage coverage -- and it hasn't happened to either me or my sister or anyone else we know who is covered under our plan.  If you admitted to an in-network  hospital then everything done there falls under the plan.  (It DID, however, happen to my sister when she was covered under another plan 3 years ago and some ER doc wasn't in network.)

When I had my hips replaced, I asked this specific question of the insurance carrier and also at the hospital billing office before the surgeries.  They affirmed that indeed everything happening under their roof (and by whatever provider) was covered.  It was, and the same thing was true at my sister's hip surgery after she was under the same plan as me.  The same is true at the in-network's ERs.  My sister has had several ER visits (she has multiple health problems) and a buncha diagnostic tests.

I think your best shot is to talk directly to whatever carrier you are considering and get an answer from them, preferably in writing.  I have a deep and abiding distrust of insurance companies in general, and when I was dealing with my sister's out-of-network charge I got a lot of yeah buts and weird explanations -- i.e., this only happens if your last name begins with U and is it a Tuesday and snowing outside.  Get an answer directly from the carrier and carefully check their information booklets, etc.  Doesn't hurt to have a conversation with your hospital's billing/admitting office, too.

No disrespect to brokers, but sometimes even they are not given straight poop from the carriers, or don't have all the yeah buts.


----------



## NewRetire18

There is a lot of good info here, but a lot of misinformation here also. You have to check into the Advantage plan that you have. Not all are offered by insurance companies, and many have 4.5 to 5 star ratings. We have an advantage plan that is offered by the large hospital network in our state; not by an insurance company like Blue Cross or Humana. It offers out of network coverage, lower coverage than in-network but hey. It has proven itself to be an absolute gem; perfect healthcare for zero dollars/month. This month, we have had a first ER visit and hospitalization, and no surprises except that the care was far better, and far lower cost than we expected. Do your research on the plan you are interested in, and read the reviews from people that actually have the plan; don't rely on strangers on a forum that simply regurgitate 'experiences from someone they read about'.


----------



## Butterfly

NewRetire18 said:


> There is a lot of good info here, but a lot of misinformation here also. You have to check into the Advantage plan that you have. Not all are offered by insurance companies, and many have 4.5 to 5 star ratings. We have an advantage plan that is offered by the large hospital network in our state; not by an insurance company like Blue Cross or Humana. It offers out of network coverage, lower coverage than in-network but hey. It has proven itself to be an absolute gem; perfect healthcare for zero dollars/month. This month, we have had a first ER visit and hospitalization, and no surprises except that the care was far better, and far lower cost than we expected. Do your research on the plan you are interested in, and read the reviews from people that actually have the plan; don't rely on strangers on a forum that simply regurgitate 'experiences from someone they read about'.



ABSOLUTELY!  My plan is also offered by a large hospital network in our state, not by one of the big insurance carriers.  It works flawlessly and has great coverage as we and people we know have experienced.  I've had it for 7 years now and have had absolutely no surprises or complaints.  

You must do the research on whatever plan you are considering; they are all NOT alike.  I would not trade my plan for anything out there.


----------



## mathjak107

the problem with advantage plans is far to often they are just not a problem -until they are a problem .

like finding a good financial adviser . they are few nd hard to find and you don't really know good from bad until you have an issue .overall gov't medicare and a supplement tend to have far less issues and you don't have to 2nd guess your choice


----------



## Ryan

mathjak107 said:


> the problem with advantage plans is far to often they are just not a problem -until they are a problem .
> 
> like finding a good financial adviser . they are few nd hard to find and you don't really know good from bad until you have an issue .overall gov't medicare and a supplement tend to have far less issues and you don't have to 2nd guess your choice



No question in my mind about this.  A supplement plan is almost certain to be more comprehensive and less likely to have any leaks.  As I mentioned somewhere in this forum, both of my parents have had supplement plan G for many years and many serious medical issues with hospitalizations, and I can't ever remember them paying a dime out of pocket for anything other than the premiums.  So while over the years they have paid much more than they would have paid for an advantage plan, the cost is very predictable.  That is the whole point of insurance.  You incur a relatively small and predictable cost to protect you from an unpredictable large loss.  Unfortunately, health insurance today has become a kind of hybrid between real insurance and subsidizing a pool of certain losses (as in covering preconditions).  If you buy "insurance" that covers preconditions it's not really "insurance" since insurance is for covering unanticipated losses, not expenses that you already know are going to happen.  This complicates the economics of health care delivery a lot.  My personal view is that there is no good solution to provide quality healthcare to everyone for an affordable cost since there simply are not enough resources to go around.  No matter how much you slice and dice it, it cannot happen.  So I think healthcare will always have to be rationed as it is now for at least the foreseeable future.

But I digress. 

In any event, supplement plans are relatively expensive.  So the challenge here is to see if you can come up with an advantage plan that is sound and predictable.  Not an easy task.  As you said, your plan can be fantastic... until it gets the stress test... and then it can be a disaster.  The problem is that it is extremely difficult to know what will happen until there is a crisis.

Good point was raised that there are other groups besides insurance companies that offer advantage plans.  I am not certain if there is something like that in my area, but it's possible.  I will contact some of the hospitals and larger medical groups and see if I can get information.

Is this the way to find out about these plans, or is there some other resource where you can find out what non-insurance company advantage plans are available?  The only lists of plans I have seen are all from insurance companies.


----------



## BobF

Just heard on TV that there is some discussion in the US of going full out for medicare type medication for all, young and old alike, and no other options allowed.   If so it makes all this threads discussion a waste.   It seems that some think our European ways, and Canda's way are superior to the US and we should just go their ways and forget our individual selection ways.

If you do not mind waiting a long time for an appointment and not having choice on doctors or procedures, just do what the government says.   It sounds as if we are rapidly falling into the international poverty of all around this world.

Nothing wrong with our original ways of want more, work harder and manage your money better.    Socialism and communism are good examples of how not to go.


----------



## Olivia

My family in Austria have had no problems with medicare for all type health coverage. When my aunt (in her early eighties) had a fall at home, she had a doctor's visit to her home that very day. Another aunt who is a hypochondriac has been admitted to multiple hospital stays without a problem. A cousin is in a free program to help her lose weight and exercise after she was diagnosed with a heart problem. I have zero complaints from my family there. 

There are dentists there, but it's cheaper to get major dental work in Hungary. 

I think it's better to consider all, than to have the all or nothing approach. And, by the way, how quickly can one get an appointment with one's doctor here, other than with an emergency, and even then your doctor will tell you to visit the ER instead of going to them, even with non-life threatening problems.

Just want to add, that it all sounds really good to go the private way only in the U.S. until you have a major illness that bankrupts you. My mom's stay in the hospital with pulmonary fibrosis cost a total of $700,000! And she died anyway. If my dad didn't have three insurance company coverages, guess what would have happened?


----------



## GreenSky

Single payer all sounds so good until you can't get the services you need.

Rick


----------



## Olivia

GreenSky said:


> Single payer all sounds so good until you can't get the services you need.
> 
> Rick



I'd take that with a grain of salt considering.............that little doggie.


----------



## C'est Moi

GreenSky said:


> Single payer all sounds so good until you can't get the services you need.
> 
> Rick



Agree.


----------



## BobF

There have been times when Canada had to send folks to the US for service not offered in the Canadian health plan.   Similar from a few other countries in this world also.

For me and my wife, we have done very well with the US medical system.    We use the 911 health services efforts.   Both the wife and I have needed to use it with rapid response.   I had a problem with balance and she took me to the local hospital.   This in a small rural town in Colorado.   They ran some tests and I was released to a surgeon in New Mexico and a brain surgeon took over my situation.    He removed a tumor from the rear of my brain.

In Arizona, my wife had a heart attack and I used the 911 number to alert medical services.   In a few minutes a fire truck arrived and they started working with the wife.   Then an ambulance arrived and helped the fire dept medical folks with the wife and put her into the ambulance for a ride to the local hospital.

In Ohio I had a seizure and the bank I was in called 911.   Again it was but moments till the medical folks arrived and took me to the hospital.   This was in a smaller city of about 20,000.    I was  held for a while then sent to Toledo for closer following.

I see no reason for single payer type stuff forced on all the US population.    We don't all have the same needs nor the same abilities to pay.   Some folks live in mega size cities and others live in wide open country areas.   Needs are totally different and services must also be different.    Single payer means the richest pay for most of it through their taxes.   I am not rich but through our personal selective system my insurances have done well for us.


----------



## Olivia

> I see no reason for single payer type stuff forced on all the US population.



Far as I know we still live in a representative democracy. So who you vote for would agree with what you want. 



> We don't all have the same needs nor the same abilities to pay.



Can't argue with that.


----------



## Butterfly

Well, I, for one, think that we all have the same need for decent health care when we are ill or injured, and I strongly think our ability to pay should not determine whether or not we receive life-saving health care when the need arises.


----------



## Aunt Bea

I'm happy that Medicare was _forced_ on me and can't wait until it goes into effect for me next year.


----------



## BobF

And I am glad that we have an elective type of coverage so I am part of the decision.   Prefer this over the  'one size fits all' coverage being suggested.   That our congress has brought us the ability to set up our own medical wants and needs that we can afford makes sense.    Limiting our medical to what ever the congress feels the nation can afford so that in itself says health care itself must also include some cash from the potential patients, insurance from all, to help pay for the cost of health care.   I see no real solution for the situation but full participation from all.   And there will be limits for all.


----------



## Ryan

*Canada’s health-care wait times hit new record high, again
**Long wait times have become the defining characteristic of Canadian health care*

https://www.macleans.ca/society/health/canadas-health-care-wait-times-hit-new-record-high-again/



BobF said:


> There have been times when Canada had to send folks  to the US for service not offered in the Canadian health plan.   Similar  from a few other countries in this world also.



Tens of thousands of Canadians make the choice to pay out of their own pockets and come to the US every year for their healthcare, even though they are already paying for Canadian health care in their higher taxes.  And the number is growing every year.

Even high ranking politicians in Canada come to the US when they need treatment they cannot get in Canada including some years ago the Prime Minster of Canada himself who snuck out of the country on a plane in the middle of the night to have surgery in the US that he could have had in Canada but preferred to have it here instead.

And Canada has a tiny population compared to the US.  Imagine what would happen in a country with a population more than 6 times their size and the bureaucrat nightmare.

Think Veterans Administration.  If they can't get it right for a few million people, how can they ever get it right for 326 million?



BobF said:


> Needs are totally different and services must also be  different.    Single payer means the richest pay for most of it through  their taxes.



With a single payer system EVERYONE who pays taxes pays for it.  There is no such thing as "free" healthcare except if you don't pay taxes.  Taxpayers pay.  The problem in this country is that half the population pays NO taxes and is all for everyone else paying their healthcare bill.  This is a serious problem.  These people have no stake in the game.  And it's not just about healthcare.  They have no stake in the American game for ANYTHING.  It's very easy to vote for goodies when the other guy is paying for it all.

Yes, this country is the most compassionate and generous in the world, and that's a good thing.  But how can that continue if half the country doesn't have a stake in the fiscal game?


----------



## Ryan

Aunt Bea said:


> I'm happy that Medicare was _forced_ on me and can't wait until it goes into effect for me next year.



What do you mean it was forced on you?  Participation in Medicare is voluntary.


----------



## BobF

> Far as I know we still live in a representative democracy. So who you vote for would agree with what you want.



In the US the Constitution says our representatives are supposed to push and vote for their people wants and needs.

Also the US is supposed to be Republic, which is a bit different than a Democracy.   They two are very similar but with some small differences.

I will leave now and see if I can find those differences and post them here later.

OK, here I am now with the clarification I had promised.

Can a democracy also be a republic?


Frequently, politicians, and many ordinary Americans, refer to the United States as a *democracy*. Others find this aggravating because, unlike in a *democracy* where citizens vote directly on laws, in the United States, elected representatives do – and, therefore, the U.S. is a *republic*.
 ..................................................................

By our laws, they must be written by the Congress and not directly by vote of the people.    More expansive and lengthy definitions are also available.    Just search for democracy or republic and work with those responses.


----------



## Butterfly

Ryan said:


> What do you mean it was forced on you?  Participation in Medicare is voluntary.



Actually, no, it really isn't.  After a person reaches 65, there really is no insurance carrier that will cover you unless you have Medicare as your primary (at least here, there isn't).  So, unless you want to go without healthcare coverage altogether (which is really dumb, IMO), you've pretty much gotta go with Medicare as a basic.


----------



## mathjak107

Ryan said:


> *Canada’s health-care wait times hit new record high, again
> **Long wait times have become the defining characteristic of Canadian health care*
> 
> https://www.macleans.ca/society/health/canadas-health-care-wait-times-hit-new-record-high-again/
> 
> 
> 
> Tens of thousands of Canadians make the choice to pay out of their own pockets and come to the US every year for their healthcare, even though they are already paying for Canadian health care in their higher taxes.  And the number is growing every year.
> 
> Even high ranking politicians in Canada come to the US when they need treatment they cannot get in Canada including some years ago the Prime Minster of Canada himself who snuck out of the country on a plane in the middle of the night to have surgery in the US that he could have had in Canada but preferred to have it here instead.
> 
> And Canada has a tiny population compared to the US.  Imagine what would happen in a country with a population more than 6 times their size and the bureaucrat nightmare.
> 
> Think Veterans Administration.  If they can't get it right for a few million people, how can they ever get it right for 326 million?
> 
> 
> 
> With a single payer system EVERYONE who pays taxes pays for it.  There is no such thing as "free" healthcare except if you don't pay taxes.  Taxpayers pay.  The problem in this country is that half the population pays NO taxes and is all for everyone else paying their healthcare bill.  This is a serious problem.  These people have no stake in the game.  And it's not just about healthcare.  They have no stake in the American game for ANYTHING.  It's very easy to vote for goodies when the other guy is paying for it all.
> 
> Yes, this country is the most compassionate and generous in the world, and that's a good thing.  But how can that continue if half the country doesn't have a stake in the fiscal game?



excellent post.  


you see canada's system touted all the time . i lived in montreal decades ago  and it reminded me of the old hip clinics we had .

we were in canada last year and i asked some people we met and they seemed okay with the system but i got the feeling they were only okay with it because this is all they knew and never experienced our system . it is like we used to tell my buddy he had the easiest job in the world . he married a virgin  ha ha ha .


----------



## BobF

Just a question, not fiinger pointing.   Twenty weeks for an appointment with a specialist seems a bit long so I have a question.   I have found that for me to have a new specialist it takes about 3 or 4 week at the most.   If going from a doctors office to the hospital it can be done the same day or within a day or two.

In my case in Colorado with surgery needed, I was placed in New Mexico hospital the very same day.   With my problems with a seizure, I was taken by helicopter to a surgeon in Toledo.   This took about an hour from my passing out in a CVS while trying to pick up medications.

It seems that for us in the US there is a critical level determined immediately by the doctors and that seems to create help immediately.  All other needs are then prioritized accordingly.

So I get immediate help now and the rest may take a few days up to a few weeks.

Are your twenty weeks delays in Canada for everything or just for some very low items?    And why?    Do too many folks insist on being doctored?    Is Canada short of doctors?     Just wondering.


----------



## mathjak107

many doctors in canada  work in the US  and travel  back and forth because the pay is so much greater .


----------



## BobF

Much like that will happen in the US also.    Single payer uses a group of controllers that decide what you need in the future, who will perform care, and who will receive the care and how much it will cost.   Supply and demand are ignored and it will fail in the US as it is failing elsewhere.   The more the governments try to control things the worse it gets.


----------



## Flyagent

Ryan on an advantage plan this could happen or you can be on Medicare and have a supplement and you will be covered as long Medicare approves of it


----------



## terry123

Never had a problem seeing a specialist my pcp wants me to see.  Usually  in a week at the most.  I make it clear to him I will only see in network providers.  I have plenty to choose from.


----------



## Chucktin

Hey I want in on that half that doesn't pay taxes. Of course maybe this is some of that fake news.





Ryan said:


> *Canada’s health-care wait times hit new record high, again
> **Long wait times have become the defining characteristic of Canadian health care*
> 
> https://www.macleans.ca/society/health/canadas-health-care-wait-times-hit-new-record-high-again/
> 
> 
> 
> Tens of thousands of Canadians make the choice to pay out of their own pockets and come to the US every year for their healthcare, even though they are already paying for Canadian health care in their higher taxes.  And the number is growing every year.
> 
> Even high ranking politicians in Canada come to the US when they need treatment they cannot get in Canada including some years ago the Prime Minster of Canada himself who snuck out of the country on a plane in the middle of the night to have surgery in the US that he could have had in Canada but preferred to have it here instead.
> 
> And Canada has a tiny population compared to the US.  Imagine what would happen in a country with a population more than 6 times their size and the bureaucrat nightmare.
> 
> Think Veterans Administration.  If they can't get it right for a few million people, how can they ever get it right for 326 million?
> 
> 
> 
> With a single payer system EVERYONE who pays taxes pays for it.  There is no such thing as "free" healthcare except if you don't pay taxes.  Taxpayers pay.  The problem in this country is that half the population pays NO taxes and is all for everyone else paying their healthcare bill.  This is a serious problem.  These people have no stake in the game.  And it's not just about healthcare.  They have no stake in the American game for ANYTHING.  It's very easy to vote for goodies when the other guy is paying for it all.
> 
> Yes, this country is the most compassionate and generous in the world, and that's a good thing.  But how can that continue if half the country doesn't have a stake in the fiscal game?


----------



## Butterfly

terry123 said:


> Never had a problem seeing a specialist my pcp wants me to see.  Usually  in a week at the most.  I make it clear to him I will only see in network providers.  I have plenty to choose from.



Me, too, Terry.  And of course if the problem is urgent, you can get seen much more quickly.  My sister, who has medical problems that can become very urgent very quickly, has been able to see specialists the same day a time or two.  Our (my sister and I) experience in our Advantage plan has been that the more pressing the problem, the faster you get seen, which IMHO is the way it should be.


----------



## JimW

There certainly are a lot of myths being touted as fact in this thread about the Canadian healthcare system. 

While there may be longer wait times in Canada for certain procedures, there are also lower overall costs for the care being provided. Yes Canada does prioritize the order in which one is treated based on the severity of their needs, but the US and every other country does as well. The longer wait times for patients in Canada are for elective surgeries, not for people in need of life saving procedures.

One fact I don't see anyone post here about the US healthcare system is that the US spends more than any other country on it's healthcare system yet is consistently ranked one of the lowest in overall healthcare quality. Canada ranks higher than the US in this category. 

Sure the Canadian healthcare system has it's pitfalls just like the US system does, but the Canadian system is much easier to navigate and no one has to worry about whether or not they can afford the healthcare they need. Canada also has one of the highest life expectancies and lowest infant mortality rates in the world, they must be doing something right.

This article is a good read on some of the myths about Canadian healthcare.



> *5 Myths About Canadian Health Care*
> 
> *The truth may surprise you about international health care*
> 
> by Aaron E. Carroll, M.D., M.S., April 16, 2012                                   |                          *Comments:* 548
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> Photo by RK Studio/Kevin Lanthier/Getty Images
> 
> Health care systems differ, and there can be many myths about their pros and cons.
> 
> 
> 
> 
> En español| How does the U.S. health care system stack up against Canada’s? You’ve probably heard allegedly true horror stories about the Canadian system — like 340-day waits for knee replacement surgery, for example.
> To separate fact from fiction, Aaron E. Carroll, M.D., the director  of the Center for Health Policy and Professionalism Research in  Indianapolis, identified the top myths about the two health care  systems.
> 
> 
> 
> *Myth #1: Canadians are flocking to the United States to get medical care*.
> How many times have you heard that Canadians, frustrated by long wait  times and rationing where they live, come to the United States for  medical care?
> 
> I don’t deny that some well-off people might come to the United  States for medical care. If I needed a heart or lung transplant, there’s  no place I’d rather have it done. But for the vast, vast majority of  people, that’s not happening.
> 
> The most comprehensive study I’ve seen on this topic — it employed  three different methodologies, all with solid rationales behind them —  was published in the peer-reviewed journal Health Affairs.
> 
> 
> 
> Source: “Phantoms in the Snow: Canadians’ Use of Health Care Services in the United States,” Health Affairs, May 2002.
> 
> 
> 
> The authors of the study started by surveying 136 ambulatory care  facilities near the U.S.-Canada border in Michigan, New York and  Washington. It makes sense that Canadians crossing the border for care  would favor places close by, right? It turns out, however, that about 80  percent of such facilities saw, on average, fewer than one Canadian per  month; about 40 percent had seen none in the preceding year.
> 
> Then, the researchers looked at how many Canadians were discharged  over a five-year period from acute-care hospitals in the same three  states. They found that more than 80 percent of these hospital visits  were for emergency or urgent care (that is, tourists who had to go to  the emergency room). Only about 20 percent of the visits were for  elective procedures or care.
> 
> Next, the authors of the study surveyed America’s 20 “best” hospitals  — as identified by U.S. News & World Report — on the assumption  that if Canadians were going to travel for health care, they would be  more likely to go to the best-known and highest-quality facilities. Only  one of the 11 hospitals that responded saw more than 60 Canadians in a  year. And, again, that included both emergencies and elective care.
> *
> Finally, the study’s authors examined data from the 18,000 Canadians  who participated in the National Population Health Survey. In the  previous year, 90 of those 18,000 Canadians had received care in the  United States; only 20 of them, however, reported going to the United  States expressively for the purpose of obtaining care.*
> 
> 
> 
> *Myth #2: Doctors in Canada are flocking to the United States to practice.*
> Every time I talk about health care policy with physicians, one  inevitably tells me of the doctor he or she knows who ran away from  Canada to practice in the United States. Evidently, there’s a general  perception that practicing medicine in the United States is much more  satisfying than in Canada.
> 
> 
> 
> 
> 
> The Canadian Institute for Health Information has been tracking  doctors’ destinations since 1992. Since then, 60 percent to 70 percent  of the physicians who emigrate have headed south of the border. In the  mid-1990s, the number of Canadian doctors leaving for the United States  spiked at about 400 to 500 a year. But in recent years this number has  declined, with only 169 physicians leaving for the States in 2003, 138  in 2004 and 122 both in 2005 and 2006. These numbers represent less than  0.5 percent of all doctors working in Canada.
> 
> So when emigration “spiked,” 400 to 500 doctors were leaving Canada  for the United States. There are more than 800,000 physicians in the  United States right now, so I’m skeptical that every doctor knows one of  those émigrés.
> 
> 
> 
> *In 2004, net emigration became net immigration. Let me say that  again. More doctors were moving into Canada than were moving out.*
> 
> 
> 
> *Myth #3: Canada rations health care; that’s why hip replacements and cataract surgeries happen faster in the United States.*
> 
> When people want to demonize Canada’s health care system — and other  single-payer systems, for that matter — they always end up going after  rationing, and often hip replacements in particular.
> Take Republican Rep. Todd Akin of Missouri, for example. A couple of  years ago he took to the House floor to tell his colleagues:
> 
> “I just hit 62, and I was just reading that in Canada [if] I got a  bad hip I wouldn’t be able to get that hip replacement that [Rep. Dan  Lungren] got, because I’m too old! I’m an old geezer now and it’s not  worth a government bureaucrat to pay me to get my hip fixed.”
> 
> Sigh.
> This has been debunked so often, it’s tiring. The St. Louis  Post-Dispatch, for example, concluded: “At least 63 percent of hip  replacements performed in Canada last year [2008] ... were on patients  age 65 or older.” And more than 1,500 of those, it turned out, were on  patients over 85.
> 
> *The bottom line: Canada doesn’t deny hip replacements to older people.
> But there’s more.
> Know who gets most of the hip replacements in the United States? Older people.
> 
> Know who pays for care for older people in the United States? Medicare.
> 
> Know what Medicare is? A single-payer system.*
> 
> 
> *Myth #4: Canada has long wait times because it has a single-payer system.*
> *The wait times that Canada might experience are not caused by its being a single-payer system.*
> 
> Wait times aren’t like cancer. We know what causes wait times; we know how to fix them. Spend more money.
> 
> Our single-payer system, which is called Medicare (see above),  manages not to have the “wait times” issue that Canada’s does. There  must, therefore, be some other reason for the wait times. There is, of  course.
> 
> 
> 
> 
> 
> *In 1966, Canada implemented a single-payer health care system, which  is also known as Medicare. Since then, as a country, Canadians have  made a conscious decision to hold down costs. One of the ways they do  that is by limiting supply, mostly for elective things, which can create  wait times. Their outcomes are otherwise comparable to ours.*
> 
> Please understand, the wait times could be overcome. Canadians could  spend more. They don’t want to. We can choose to dislike wait times in  principle, but they are a byproduct of Canada’s choice to be fiscally  conservative.
> 
> Yes, they chose this. In a rational world, those who are concerned  about health care costs and what they mean to the economy might respect  that course of action. But instead, they attack the system.
> 
> 
> 
> *Myth #5: Canada rations health care; the United States doesn’t.*
> This one’s a little bit tricky. The truth is, Canada may “ration” by  making people wait for some things, but here in the United States we  also “ration” — by cost.
> 
> An 11-country survey carried out in 2010 by the Commonwealth Fund, a  Washington-based health policy foundation, found that adults in the  United States are by far the most likely to go without care because of  cost. In fact, 42 percent of the Americans surveyed did not express  confidence that they would be able to afford health care if seriously  ill.
> 
> 
> 
> Source: “How Health Insurance Design Affects Access to Care and Costs, by Income, in Eleven Countries,” Health Affairs, November 2010.
> 
> 
> 
> *Further, about a third of the Americans surveyed reported that, in  the preceding year, they didn’t go to the doctor when sick, didn’t get  recommended care when needed, didn’t fill a prescription or skipped  doses of medications because of cost.
> 
> Finally, about one in five of the Americans surveyed had struggled to  pay or were unable to pay their medical bills in the preceding year.  That was more than twice the percentage found in any of the other 10  countries.*
> 
> And remember: We’re spending way more on health care than any other country, and for all that money we’re getting at best middling results.
> So feel free to have a discussion about the relative merits of the  U.S. and Canadian health care systems. Just stick to the facts.
> _Aaron E. Carroll frequently blogs about this topic for The Incidental Economist and is the coauthor of _Don’t Swallow Your Gum: Myths, Half-Truths, and Outright Lies About Your Body and Health_.
> 
> https://www.aarp.org/politics-socie...ns/info-03-2012/myths-canada-health-care.html
> _


----------



## Butterfly

JimW, I agree with you.  I've been on a local Medicare Advantage plan for the last seven years, and I've been delighted with the care both I and my sister (on the same plan) have received.  Neither one of us has ever experienced what the nay-sayers refer to as "rationing" of health care, nor have we waited inordinate times for care. or been turned down for needed care.  My sister has had to have all kinds of specialized care (she has heart, circulatory, and pulmonary problems) and there's never been a delay or a hassle.  I think a lot of the hand wringing many people do about single payer or (shudder) socialized health care is the result of people believing all the myths and propaganda against single payer.

Under Medicare and my Advantage plan, I get a helluva lot better and faster health care than many of my friends and acquaintances who are still working and are paying a fortune for insurance with huge deductibles and co-insurance payments.


----------



## terry123

Butterfly said:


> JimW, I agree with you.  I've been on a local Medicare Advantage plan for the last seven years, and I've been delighted with the care both I and my sister (on the same plan) have received.  Neither one of us has ever experienced what the nay-sayers refer to as "rationing" of health care, nor have we waited inordinate times for care. or been turned down for needed care.  My sister has had to have all kinds of specialized care (she has heart, circulatory, and pulmonary problems) and there's never been a delay or a hassle.  I think a lot of the hand wringing many people do about single payer or (shudder) socialized health care is the result of people believing all the myths and propaganda against single payer.
> 
> Under Medicare and my Advantage plan, I get a helluva lot better and faster health care than many of my friends and acquaintances who are still working and are paying a fortune for insurance with huge deductibles and co-insurance payments.


Sounds like my experience with my Humana Medicare Advantage Plan@


----------



## NewRetire18

Same here. We just had our Advantage plan stressed with its first major health test, and it worked out _far, far better_ than we ever dreamed it would be. Experience was absolutely great with the care and low costs we experienced.


----------



## Ken N Tx

NewRetire18 said:


> Same here. We just had our Advantage plan stressed with its first major health test, and it worked out _far, far better_ than we ever dreamed it would be. Experience was absolutely great with the care and low costs we experienced.


If I may ask, what was your medical experience ??


----------



## NewRetire18

Wife suddenly starting hemorrhaging internally. Hospitalization, ambulance, CT scan, 4 specialists, 20 care givers over three days; 1 day in ICU, 2 days recovering in a private room. She is now fine after they figured out what it was; total out of pocket expense: $708.00

This is just me, but personally, I can't imagine having to pay $200-$500 per month for a medigap plan to get the same treatment- all just to save a $45 co-pay. But I'm not rich, so we do what we have to do to live on our income.


----------



## terry123

NewRetire18 said:


> Wife suddenly starting hemorrhaging internally. Hospitalization, ambulance, CT scan, 4 specialists, 20 care givers over three days; 1 day in ICU, 2 days recovering in a private room. She is now fine after they figured out what it was; total out of pocket expense: $708.00
> 
> This is just me, but personally, I can't imagine having to pay $200-$500 per month for a medigap plan to get the same treatment- all just to save a $45 co-pay. But I'm not rich, so we do what we have to do to live on our income.


I cannot afford one either so I will stick with Humana Medicare PPO Advantage plan.


----------



## JimW

Butterfly said:


> JimW, I agree with you.  I've been on a local Medicare Advantage plan for the last seven years, and I've been delighted with the care both I and my sister (on the same plan) have received.  Neither one of us has ever experienced what the nay-sayers refer to as "rationing" of health care, nor have we waited inordinate times for care. or been turned down for needed care.  My sister has had to have all kinds of specialized care (she has heart, circulatory, and pulmonary problems) and there's never been a delay or a hassle.  I think a lot of the hand wringing many people do about single payer or (shudder) socialized health care is the result of people believing all the myths and propaganda against single payer.
> 
> Under Medicare and my Advantage plan, I get a helluva lot better and faster health care than many of my friends and acquaintances who are still working and are paying a fortune for insurance with huge deductibles and co-insurance payments.



Thanks for sharing your experiences Butterfly. In my opinion there is nothing worse than being ill or injured and having to weigh your health and well being with how much getting care will cost and whether you can afford it or not. Right now I am 15 weeks post op from a major foot and lower leg operation. I am having troubles with my calf muscle which was cut as part of the operation to relieve the tension in my leg. My Dr wants me to have another MRI done on my leg but it will cost me another $250 on top of the over $6K my wife and I have paid in total out of pocket expenses this year for the both of us. The MRI is scheduled for tomorrow, but I am debating whether or not to have it done due to the extra cost. My thinking is maybe the problem will heal itself in time. But then again what if it doesn't? Then I'll be out a few more weeks of being laid up and have to have the MRI done anyway. In this case I would love to be enrolled in a universal healthcare plan that would allow me to focus on getting better, rather than worrying if I can afford to get better.

For whatever reason, anything tagged with the "socialism" label in the US gets a bad rap by a good number of people no matter what it is. When the truth is a good chunk of our society runs on "socialistic" gov't funded programs that do far more good than bad, and more often than not the same people that trash anything to do with socialism are taking advantage of these programs whether they realize it or not. The entire US public education system is a socialistic program and so is medicare. So if you went to public school, received any gov't grants for college or are on medicare you're taking advantage of a socialistic program.

My wife is Canadian, her and her family always had and still do have good experiences with the Canadian healthcare system. When my wife moved here to be with me she couldn't get over the amount of red tape involved with getting proper healthcare, having to worry how much everything will cost and how screwed up the billing system is.


----------



## GreenSky

terry123 said:


> I cannot afford one either so I will stick with Humana Medicare PPO Advantage plan.



Unless you are 90 years old and/or have a really bad agent, it's very rare that a supplement will cost $200 but let's use that as the benchmark.

The $200 monthly will pay all for major illnesses to be covered for little or no out of pocket.  So for example, cancer surgery and chemo will have virtually no out of pocket costs.  The PPO will likely cost you $6,700 and if treatment spans over a year (meaning starts in Dec and continues past Jan) you'd be out $13,400.  Can you afford that?

I'm not knocking Medicare Advantage but there are always two sides to the equation.  (Something Bernie Sanders and his supporters don't realize).

The other issue with MA, especially those who love their HMO, is access to care.  While many networks have quality doctors and hospitals, what if the best place for treatment is out of the area?  I'm thinking Cedars, the Mayo Clinic, New York, etc.?  With an HMO you are at the mercy of the medical group with whom you have contracted.

Again, Medicare Advantage has it's place and most people are indeed happy paying little or nothing for their coverage (keep in mind that Medicare pays $900/mo typically for these plans so they really aren't free).  But insurance is not for what you have now - it's for what can happen.

I've enrolled probably 500-1,000 people in Medicare Advantage plans, mainly HMO.  And rarely do I get a complaint.  Fortunately I can afford the $140 it costs for a supplement and Rx plan.  Should my wife need care I want her to get it from the best, not the doctor contracted with an HMO that we must see.

All this being said, I truly hope nobody has to receive anything but the best care regardless of plan.

Rick


----------



## Butterfly

The MA plan I have is affiliated somehow with M D Anderson; we actually have one of their satellite cancer treatment facilities here.  If need be you can actually go to the MD Anderson down in Houston(?), but much of what they do there they do here, also.  My niece was treated at the MD Anderson facility here  Even if I weren't "at the mercy" of the group  here, I would be at the mercy of my finances, which simply would not allow me to travel and have an extended stay at a hotel or apartment out of state while I was undergoing treatment.  My out of pocket limit for 2019 is about $3,000.  My MA plan also has a good drug plan.

I think it is probably a roll of the dice which plan is better for any particular person.  I'll stick with my MA plan.  The doctors in the plan are the doctors I would choose to go to anyway, and almost all the physicians in Albuquerque accept the plan (they also accept others, of course).


----------



## terry123

Butterfly said:


> The MA plan I have is affiliated somehow with M D Anderson; we actually have one of their satellite cancer treatment facilities here.  If need be you can actually go to the MD Anderson down in Houston(?), but much of what they do there they do here, also.  My niece was treated at the MD Anderson facility here  Even if I weren't "at the mercy" of the group  here, I would be at the mercy of my finances, which simply would not allow me to travel and have an extended stay at a hotel or apartment out of state while I was undergoing treatment.  My out of pocket limit for 2019 is about $3,000.  My MA plan also has a good drug plan.
> 
> I think it is probably a roll of the dice which plan is better for any particular person.  I'll stick with my MA plan.  The doctors in the plan are the doctors I would choose to go to anyway, and almost all the physicians in Albuquerque accept the plan (they also accept others, of course).


Butterfly, MD Anderson has several low cost places a patient can stay here with one connected to the hospital itself. I know because a close friend of mine's husband is under going treatment and they are staying at one of them. they are unable to afford a hotel here in Houston. They may have options there also.


----------



## Aneeda72

Hi terry123,

Knowing you have a brain aneurysm before it ruptured might not have made any difference to/for you.  Course, I don't know.  Maybe it could have been coiled or fixed.

I have known I have 2 brain aneurysms for a couple of decades now.  I have had one minor bleed because of one of then, ugh, the headache was horrific.  Or, as some doctors speculated, I had a third small brain aneurysm that burst.  Doesn't matter.

But, my aneurysms cannot be operated on or coiled.  They are small.  One is on the communication artery too deep to even consider doing anything about.  It only shows up if my blood pressure gets too high.  The other one is on the right carotid artery near the nerves that control my sight. I joke when it goes I go with it.

This aneurysm has a "neck" and is blamed for a variety of TIA's and two small strokes that I have had over the years.

My third aneurysm is on the iliac artery in my abdomen.

I frequently wish I didn't know about them.

I hope you continue to get better.


----------



## mathjak107

GreenSky said:


> Unless you are 90 years old and/or have a really bad agent, it's very rare that a supplement will cost $200 but let's use that as the benchmark.
> 
> The $200 monthly will pay all for major illnesses to be covered for little or no out of pocket.  So for example, cancer surgery and chemo will have virtually no out of pocket costs.  The PPO will likely cost you $6,700 and if treatment spans over a year (meaning starts in Dec and continues past Jan) you'd be out $13,400.  Can you afford that?
> 
> I'm not knocking Medicare Advantage but there are always two sides to the equation.  (Something Bernie Sanders and his supporters don't realize).
> 
> The other issue with MA, especially those who love their HMO, is access to care.  While many networks have quality doctors and hospitals, what if the best place for treatment is out of the area?  I'm thinking Cedars, the Mayo Clinic, New York, etc.?  With an HMO you are at the mercy of the medical group with whom you have contracted.
> 
> Again, Medicare Advantage has it's place and most people are indeed happy paying little or nothing for their coverage (keep in mind that Medicare pays $900/mo typically for these plans so they really aren't free).  But insurance is not for what you have now - it's for what can happen.
> 
> I've enrolled probably 500-1,000 people in Medicare Advantage plans, mainly HMO.  And rarely do I get a complaint.  Fortunately I can afford the $140 it costs for a supplement and Rx plan.  Should my wife need care I want her to get it from the best, not the doctor contracted with an HMO that we must see.
> 
> All this being said, I truly hope nobody has to receive anything but the best care regardless of plan.
> 
> Rick




here in new york an f-plan runs almost 300 a month .location is a big factor as well as whether an age based state or community based. we use a high deduct. f-plan for 91 a month .. but 1/2  goes for our gym which is paid for now by  silver sneakers ,so it is a great deal for us


----------



## GreenSky

mathjak107 said:


> here in new york an f-plan runs almost 300 a month .location is a big factor as well as whether an age based state or community based. we use a high deduct. f-plan for 91 a month .. but 1/2  goes for our gym which is paid for now by  silver sneakers ,so it is a great deal for us



That's true.  New York is higher than any area I've seen.  $300 for Plan F is absurd but you can blame the legislature of your state.  The same Plan F in Los Angeles for a 70 year old is about $200 (and Kalifornia is as liberal as New York).

I suspect if I sold in NY I would be suggesting the HDF as well.  It's only $36 in LA without the gym and maybe $60 with silver sneakers.

But at least NY has great pizza!

Rick


----------



## mathjak107

Ny is high because we have no premium increases as you age . We can also switch plans with no underwriting


----------



## GreenSky

mathjak107 said:


> Ny is high because we have no premium increases as you age . We can also switch plans with no underwriting



It’s the no underwriting that is the main driver of high rates. For a further explanation see Obamacare. 

Rick


----------



## Pauline1954

Im looking into a supplement. I will be turning 65 in May 4. I want to be covered by my birthday.   I am going to google and look at what you suggest. Hopefully it wont be to difficult to find info.

Thanks


----------



## Pauline1954

Im clueless on how to add a hospital idemnity plan. Can my agent write me one up?  Like I said im clueless.  I looked at the plan F and it would be a consideration for me. Thank you.


----------

