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  • Fishkiller

    TGT Addict
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    7   0   0
    Jul 22, 2019
    4,626
    96
    Frederickburg
    The whole thing is a scam sponsored by the government. Just remember no insurance company provides anything for free, they are in business to make money. Fortunately I am covered under the wife's policy. They stuck me into a Medicare supplement plan and a prescription drug plan. I have zero copays a nd no deductibles. I do pay for medications. Her former employer picks up 70% of the cost so we are fortunate. If you can afford the supplement plan do it.
     

    Tex929rr

    Active Member
    Rating - 100%
    1   0   0
    Jun 11, 2015
    469
    76
    Welfare, TX
    I have until next August to figure it out. I tried to get a quote from my current provider (on my wife’s FedEx Blue Cross plan) and was told it was too early. We agave been with USAA since 1979 so I’ll check them out as well. I’m also retired with TRS so I’ll start checking them out. All the years I was teaching it made more sense to be on her plan, but now that we are both retired all bets are off.

    This is a very timely thread for me.
     

    ronbwolf

    Active Member
    Rating - 100%
    1   0   0
    Feb 3, 2016
    475
    76
    Late to the party, but I'm just sick of the commercials, emails, texts, and phone calls for something that I am not even eligible for! I don't have enough quarters in Social Security ( spent 30 yrs in LE, and paid into a seperate system) to be eligible. I have lifetime mefical through the PERS system, so I don't need it, don't want it, and can't get it so please, make it stop!

    Sent from my SM-G986U using Tapatalk
     

    glenbo

    Well-Known
    Lifetime Member
    Rating - 100%
    3   0   0
    Sep 3, 2014
    2,231
    96
    San Leon
    To each his own. My wife and I just finished enrolling with Wellcare on a no-cost HMO that has our doctors and pharmacy in network. Doctor visits and my chiropractor have 0 copay, $3000 dental benefits yearly with 0 copay, and many other benefits that cost us nothing more than the Medicare contribution that we would have to pay anyway.

    Since we never watch TV we don't have to put up with the commercials. We're happy with this decision.
     

    rotor

    TGT Addict
    Rating - 0%
    0   0   0
    Nov 1, 2015
    4,239
    96
    Texas
    To each his own. My wife and I just finished enrolling with Wellcare on a no-cost HMO that has our doctors and pharmacy in network. Doctor visits and my chiropractor have 0 copay, $3000 dental benefits yearly with 0 copay, and many other benefits that cost us nothing more than the Medicare contribution that we would have to pay anyway.

    Since we never watch TV we don't have to put up with the commercials. We're happy with this decision.
    Good luck going elsewhere. If you need anything you will need prior approval. They make their profit saying no. Take a trip somewhere and see if you can get care.
     

    glenbo

    Well-Known
    Lifetime Member
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    3   0   0
    Sep 3, 2014
    2,231
    96
    San Leon
    Rotor, with all due respect, from what I've seen in the last few months, it seems that you believe that you and only you know anything about anything and everyone else is wrong about everything. Fine, you're as welcome to your opinions as everyone else is. But you don't know shit about me or how much research I do or what I know about the plans we've enrolled in. So your opinions mean diddly squat to me, thanks anyway.
     

    rotor

    TGT Addict
    Rating - 0%
    0   0   0
    Nov 1, 2015
    4,239
    96
    Texas
    Rotor, with all due respect, from what I've seen in the last few months, it seems that you believe that you and only you know anything about anything and everyone else is wrong about everything. Fine, you're as welcome to your opinions as everyone else is. But you don't know shit about me or how much research I do or what I know about the plans we've enrolled in. So your opinions mean diddly squat to me, thanks anyway.
    With all due respect can you get care outside the area you live in? If you develop cancer can you go to Mayo Clinic, MD Anderson, any facility you pick? Actually I know quite a lot about Medicare C. Best of luck with your choice.
     

    rotor

    TGT Addict
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    0   0   0
    Nov 1, 2015
    4,239
    96
    Texas
    Part of the plan to think about. You call the number listed and speak to an insurance agent who will get a commission steering you to a Medicare C (advantage plan). You find out your family doc and pharmacy are in the plan. So is your hospital. Sounds good.
    What happens if you have a heart attack the first night on the plan and you are not at your local hospital? Will anything be covered? If you are at your local hospital is the ER doc on the plan? You are admitted, will the invasive cardiologist be on the plan? How about the surgeon, radiologist, pathologist, anesthesiologist, pulmonologist and any other doctor that renders care? You may be responsible for a huge bill if these docs are out of network. Did you family doc get prior authorization for treatment?
    In reality it is almost impossible to find out if the doctors that will care for you are on your plan. Regular medicare, almost all of the hospitals doctors will be on regular medicare and some of them may accept some medicare advantage plans. If not you are out of network. This is one of the ways you get stuck with the bill.
    With regular medicare if a hospital takes medicare then most likely the staff does too. You can have that heart attack anywhere in the country and be covered. You are in California (god no), does the hospital take your plan?Does the staff take your advantage plan? And there are a bunch of them so some may be accepted and some not. Do you think you will be able to pick your doctor to make sure he/she is in network?
    The insurance agents can convince you that your doctor and hospital are covered but usually that is your family doctor who is also your gatekeeper and as you all know, they don't even go to the hospitals nowadays and they have to refer you for everything or you get the bill.
    I post this info to try to inform people of the tricks insurance companies play to not spend money on you. Those of you that think they are getting a good deal may find that fighting an insurance company to pay the bill is not an easy thing to do.
    I speak from experience. Have been there and done that.
    What do I suggest, regular medicare, medicare supplement, part d Rx plan. More expensive yes. Covers you virtually anywhere, yes. If you are never going to be sick or hospitalized go with an advantage plan.
    This post is not to criticize you but to help you avoid some of the traps that the advantage plans use to not pay. We all know the horrors of an HMO, my wife is in one now as it is the only one available in our area (she is not on medicare yet). She sees doctors out of network because they don't take the HMO and we pay cash full price. When you need a specialist and he is not in network you will pay the bill.

    Medicare C is the biggest moneymaker for health insurance companies. The government pays them a premium to cover you. Insurance companies are in it to make money. You do that by denying care and not paying bills.

    This simple article helps explain things
     

    Wiliamr

    Well-Known
    TGT Supporter
    Rating - 100%
    2   0   0
    Apr 15, 2011
    1,807
    96
    Austin
    What Rotor speaks of is the truth. My credential in this area is having been a health benefit representative for a group of employees covered by the Federal Employee Health Benefit Programs. There are a lot of plans available to chose from for active duty employees, and the Medicare age employees are always asking why they need the FEHBP insurance if they can get free Advantage plans. I always caution them about if it sounds to good.....

    The companies that push these "Advantage Plans" spend huge sums of money and notice they harp on the "FREE" and "Money back in your Social Security account". First, ask yourself, since when is the single most expensive part of life (Medical in elder care) FREE? Who pays for all that advertising and the "Free" calls?

    Advantage plans can sound good and if you do not travel (Most Advantage plans have a very limited area of coverage and you have to go to their plan doctors, hospital, labs, etc) they can be ok. Where they begin to fall apart is if one travels a lot, or if you are in San Antonio with a Austin Advantage plan coverage and have a heart attack and are in the hospital a week or more. You find out very quickly how little the "Advantage" plan pays. One our members last year dropped our associations FEHB plan cause he didnt like the premium in addition to his Meidcare premium. He was in another state, had a heart attack and discovered that the Advantage plan would only pay for a few things and he was saddled with a nearly 600,00 dollar bill from hospital, doctors, emergency room, ambulance etc.
    Choosing medical insurance is not a simple nor easy endeavor. It is not something to just slip into. One has to look at not just the costs of premiums, but the costs if something goes very wrong with your health. It can and does and often without warning. Choose wisely.
     

    glenbo

    Well-Known
    Lifetime Member
    Rating - 100%
    3   0   0
    Sep 3, 2014
    2,231
    96
    San Leon
    Part of the plan to think about. You call the number listed and speak to an insurance agent who will get a commission steering you to a Medicare C (advantage plan). You find out your family doc and pharmacy are in the plan. So is your hospital. Sounds good.
    What happens if you have a heart attack the first night on the plan and you are not at your local hospital? Will anything be covered? If you are at your local hospital is the ER doc on the plan? You are admitted, will the invasive cardiologist be on the plan? How about the surgeon, radiologist, pathologist, anesthesiologist, pulmonologist and any other doctor that renders care? You may be responsible for a huge bill if these docs are out of network. Did you family doc get prior authorization for treatment?
    In reality it is almost impossible to find out if the doctors that will care for you are on your plan. Regular medicare, almost all of the hospitals doctors will be on regular medicare and some of them may accept some medicare advantage plans. If not you are out of network. This is one of the ways you get stuck with the bill.
    With regular medicare if a hospital takes medicare then most likely the staff does too. You can have that heart attack anywhere in the country and be covered. You are in California (god no), does the hospital take your plan?Does the staff take your advantage plan? And there are a bunch of them so some may be accepted and some not. Do you think you will be able to pick your doctor to make sure he/she is in network?
    The insurance agents can convince you that your doctor and hospital are covered but usually that is your family doctor who is also your gatekeeper and as you all know, they don't even go to the hospitals nowadays and they have to refer you for everything or you get the bill.
    I post this info to try to inform people of the tricks insurance companies play to not spend money on you. Those of you that think they are getting a good deal may find that fighting an insurance company to pay the bill is not an easy thing to do.
    I speak from experience. Have been there and done that.
    What do I suggest, regular medicare, medicare supplement, part d Rx plan. More expensive yes. Covers you virtually anywhere, yes. If you are never going to be sick or hospitalized go with an advantage plan.
    This post is not to criticize you but to help you avoid some of the traps that the advantage plans use to not pay. We all know the horrors of an HMO, my wife is in one now as it is the only one available in our area (she is not on medicare yet). She sees doctors out of network because they don't take the HMO and we pay cash full price. When you need a specialist and he is not in network you will pay the bill.

    Medicare C is the biggest moneymaker for health insurance companies. The government pays them a premium to cover you. Insurance companies are in it to make money. You do that by denying care and not paying bills.

    This simple article helps explain things
    Now do dental for seniors.
     

    baboon

    TGT Addict
    Rating - 100%
    4   0   0
    May 6, 2008
    22,459
    96
    Out here by the lake!
    With all due respect can you get care outside the area you live in? If you develop cancer can you go to Mayo Clinic, MD Anderson, any facility you pick? Actually I know quite a lot about Medicare C. Best of luck with your choice.
    When I choose my Advantage program I was living in Houston. It started right when we moved. With the move I had to pick an all new plan based on the new region in Texas. And all that did was drag out my coverage and ability to find providers.

    We have been here 2 months shy of a year. I just seen a new eye doctor last month.
     
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