Medicare Advantage vs. Traditional Medicare

[Curt Harms]

I think this is legit, it says it's from medicare.gov. Some think that if you choose Medicare Advantage, you're stuck with it for life. I was pretty sure I was offered a choice of Traditional Medicare but am happy with my Humana plan so didn't follow up. According to this you can switch from Medicare Advantage to traditional medicare if you choose to. The only thing that seems a little odd is receiving this now instead of during or just before open enrollment.

If you or someone in your household has a Medicare Advantage Plan, you can make a coverage change during the Medicare Advantage Open Enrollment Period, which runs from January 1–March 31 each year.

You can:

Switch to a different Medicare Advantage Plan; or
Switch to Original Medicare (and join a separate Medicare drug plan).

Explore Your Options

You can switch only once during the Medicare Advantage Open Enrollment Period. Any changes you make will be effective the first of the month after you request to join the new plan.

There's no need to take any action if you're happy with the plan you have. But, if you want to find a plan that better fits your needs and budget this year, now's your chance to shop for a new plan.

Sincerely,

The Medicare Team

[Patty Hann]

Notice that it DOESN'T SAY there will be underwriting...only that you can switch.
But there will be underwriting** which can affect the price of your part B and any Supplemental (Medigap) you get.

**There are 7 states where there is no underwriting if you switch, but I can't recall which ones.

[Mike Henderson]

Patty's right. The problem with many of the Advantage plans is that they work well until you get a serious event. People might want to go back to original Medicare because they can go to just about any doctor and they don't need a referral.

The problem they encounter at that point is the supplemental plan. Medicare pays for 80% and the supplemental plan pays for the rest. But in many places, you have to go through underwriting to get the supplemental plan and since you have a serious event, the supplemental plan will be expensive. So, they're pretty much stuck with the Advantage plan.

I'm not a big fan of Advantage plans because I knew two people who had the same problem. Once they had a serious event, they couldn't get in to see a specialists for a long time. I'll stay with original Medicare and keep my freedom to choose my doctors and to be able to get the next available appointment.

Mike

[Lisa Starr]

I believe the underwriting ONLY applies to the Medigap policy. You can switch between an Advantage plan and traditional Medicare during enrollment periods without penalty. You're getting the notice now because the is a 3 month "grace period" to go back to your prior year's plan.

[Patty Hann]

I believe the underwriting ONLY applies to the Medigap policy. You can switch between an Advantage plan and traditional Medicare during enrollment periods without penalty. You're getting the notice now because the is a 3 month "grace period" to go back to your prior year's plan.

Oh... no underwriting for Part B... OK... my mistake.

[Jim Becker]

I'm using an Advantage Plan from the same BCBS provider I've had for years...and no longer need referrals like I did with Professor Dr. SWMBO's university sponsored plan from the same company. Don't assume that Advantage plans always require referrals. HMOs do, but PPOs like I have may not. One still needs to pay attention to in-network, of course, even without referrals, but the network is "yuge". I've already used my plan for surgery, as a matter of fact. I frankly can't wait to get The Professor on to the same or similar coverage mid-year when she finally turns 65. Her current insurance as a retiree is costing $711 a month. Even with my currently inflated Medicare monthly cost due to income my insurance cost for the same coverage plus things she doesn't get on the university plan is a third of that. (That's going to change real soon now when I appeal it due to status change and significant income drop)

I respect that some folks are more comfortable with traditional Medicare and some feel more comfortable with the Advantage Plans, especially when they have a good one available to them. (many of them suck "those things"...fine print matters) Franky, I sincerely hope that in my lifetime everyone gets universal health care coverage for being human, but I'm not going to hold my breath, nor am I going to say more 'cause that goes into things we can't discuss here.

Oh, and the email is legitimate. It went out to all current Medicare participants.

[Thomas McCurnin]

We concluded that the Advantage Program has a big advantage, but if one doesn't like it, it nearly impossible to switch back as pointed out above. So we declined the Advantage Program.

[Bill Dufour]

Go to your doctor(s) and ask for a printout of which plans they take. Then get a list of all medications you and spouse take from the drugstore. Contact a insurance broker who specializes in medicare and let them do the work for you at no cost.
Bill D

[Jerome Stanek]

Go to your doctor(s) and ask for a printout of which plans they take. Then get a list of all medications you and spouse take from the drugstore. Contact a insurance broker who specializes in medicare and let them do the work for you at no cost.
Bill D

And I am sure that they will recomend an advantage plan. They get no money if they don't sell a plan.

[Patty Hann]

And I am sure that they will recomend an advantage plan. They get no money if they don't sell a plan.

NOt sure, but I think a broker gets a commission no matter what plan they sell (talking of the supplements/medigap).
They just get more if they sell the Advantage Plan.

[Jerry Bruette]

Go to your doctor(s) and ask for a printout of which plans they take. Then get a list of all medications you and spouse take from the drugstore. Contact a insurance broker who specializes in medicare and let them do the work for you at no cost.
Bill D

Sounds like a plan except I don't know which oncologist, orthopedic surgeon, etc. I or my wife might need in the future.

[Bill George]

Sounds like a plan except I don't know which oncologist, orthopedic surgeon, etc. I or my wife might need in the future.

You do not want an Advantage plan, go with regular Medicare Supplemental and I have Plan F I do not pay anything out of pocket, its no longer available but I think G is very close.

[Lisa Starr]

As several have already said, do your own homework. In some areas, such as mine, there are very good Advantage plans available. I have an Aetna PPO plan with a very inclusive network, some plans do not. To me, one of the most important things to look at is the Maximum Out of Pocket (MOOP) for the plan you are considering. My particular plan has no deductible (including drugs) and a $5900 MOOP, which I consider reasonable. There is no additional premium over the Medicare amount deducted from the SS check.

[John M Wilson]

As several have already said, do your own homework.

Lisa, I couldn't agree more!

Every time this subject comes up, we get a lot of opinions from a lot of well-meaning folks, but these things vary so much depending on a myriad of factors, including health, age, location, doctors & networks, prescriptions, and so on.

We might as well be talking about each person's dental work, taxes, or the fastest route to Wal-Mart!

One person's plan & experience, even if it's perfect for them, might not work out for someone else. This is one of those topics that wide-ranging rules of thumb & advice based on generalities may be worse than no advice at all.

At least Bevel Up / Bevel Down only has two choices!

[Patty Hann]

I'm using an Advantage Plan from the same BCBS provider I've had for years...and no longer need referrals like I did with Professor Dr. SWMBO's university sponsored plan from the same company. Don't assume that Advantage plans always require referrals. HMOs do, but PPOs like I have may not........
I respect that some folks are more comfortable with traditional Medicare and some feel more comfortable with the Advantage Plans, especially when they have a good one available to them. (many of them suck "those things"...fine print matters) Franky, I sincerely hope that in my lifetime everyone gets universal health care coverage for being human, but I'm not going to hold my breath, nor am I going to say more 'cause that goes into things we can't discuss here.

You are fortunate that in your state (PA) Advantage plans have PPO options.
In my county for certain (and possibly all of AZ) all Advantage plans are HMOs that are worse than useless. (Only talking about the HMO's here in AZ)