Two Fold Medicare Question

[Bill Dufour]

Best advice I ever got was to go talk to an insurance broker. They work for you, for free. They know all the ins and outs. My wife had to switch brokers since her old one did not do medicare. He hooked her up with a different one.
They are like travel agents used to be. They fill out all the forms for you. Just make an appointment and bring in a list of all medications and your doctors.
Bill D

[Larry Frank]

Best advice given is to find an advisor. I have standard Medicare A and B with a supplement. It allows me to easily see the specialist I need.

For medication, the online program for Medicare Part D allows you to enter your prescriptions and search the options like costs and what pharmacy you can go to.

[Alan Lightstone]

Best advice given is to find an advisor. I have standard Medicare A and B with a supplement. It allows me to easily see the specialist I need.

For medication, the online program for Medicare Part D allows you to enter your prescriptions and search the options like costs and what pharmacy you can go to.

And for insulin and biologics, expect to be stunned by the cost.

[Curt Harms]

And for insulin and biologics, expect to be stunned by the cost.

There is something in the works, legislative or regulatory to cap insulin costs at $35/month. I found a neighborhood pharmacy in Trenton NJ. that has excellent prices. I was paying $23 per month with insurance for a certain medication. I lost that insurance for a while but found out about this place. I'm now paying $12/month for the same med, no insurance. Says something to me about markups on meds, even generics.

[Mike Henderson]

Best advice I ever got was to go talk to an insurance broker. They work for you, for free. They know all the ins and outs. My wife had to switch brokers since her old one did not do medicare. He hooked her up with a different one.
They are like travel agents used to be. They fill out all the forms for you. Just make an appointment and bring in a list of all medications and your doctors.
Bill D

If they don't charge you for their services, they must be getting paid another way. I highly doubt if traditional Medicare pays a broker, so that would lead me to suspect that the broker is going to push the Advantage plans at the expense of traditional Medicare.

Mike

[Larry Frank]

My Medicare advisor told me that they get a fee for helping with Medicare. He did not push the advantage plans at all.

Most important is to find out what doctors accept whatever plan you get.

[Mike Henderson]

My Medicare advisor told me that they get a fee for helping with Medicare. He did not push the advantage plans at all.

Most important is to find out what doctors accept whatever plan you get.

Here's a link to the Medicare agent/broker compensation. The way I read it, it's only compensation paid by companies who offer Advantage plans (and maybe part D plans). I can find no information about Medicare paying a broker to recommend traditional Medicare - and I can't see any reason why Medicare would pay such compensation.

It costs Medicare a bit less for someone to be enrolled in an Advantage Plan than for traditional Medicare.

So follow the money: Medicare saves money if you join an Advantage Plan, and the Advantage Plan makes a profit with you in the plan. And a broker makes a commission for selling an Advantage Plan. There's a lot of reasons for them to push you towards an Advantage Plan.

Here are some of the "problems" of an Advantage Plan.

Mike

[My experience is that Advantage Plans work well if you're healthy. But when you become ill, especially with an expensive problem, such as cancer, you have problems getting to see a specialists, you often are not permitted to receive the most modern treatments, and you have to pay quite a bit for the treatments you receive. So, in choosing an Advantage Plan, you're betting that you will remain healthy until you suddenly drop dead.]

[Alan Lightstone]

My Medicare advisor told me that they get a fee for helping with Medicare. He did not push the advantage plans at all.

Most important is to find out what doctors accept whatever plan you get.

Most physicians take Medicare. It's pretty well mandatory for hospital based physicians (anesthesia, ER, pathology, radiology). As far as Medicare Advantage plans, not necessarily true, as over the past couple of years insurance companies have been wholesale cancelling contracts with physician groups to leverage them into signing contracts with substantial fee cuts. Physician fees are fixed with Medicare (depending on your particular area), but typically the physicans then get dropped from the Medicare Advantage plans too. Aren't insurance companies wonderful. Oh, and after they cut the physician fees, they don't decrease premiums. Yup, just make larger profits.

So, always check if you are in network before seeing a physician, going to a hospital, getting an x-ray, lab tests (especially lab tests), etc...

[Dave Fritz]

Once again, FREE advice is available at your local Senior Citizen Government Office. They are not SELLING anything. Most likely they will log into this and look at all your options available and let you choose. https://www.medicare.gov/ Plans total price per year, ratings by consumers and other valuable information available FREE for you to select what works best for you. I review mine every year and have changed several times, mostly based on price. Contrary to many politicians Medicare works. I've had many more problems with insurance companies and medical providers. Don't get me started on prescription drugs. Talk about the power of a big lobby.

[John M Wilson]

My experience is that Advantage Plans work well if you're healthy. But when you become ill, especially with an expensive problem, such as cancer, you have problems getting to see a specialists, you often are not permitted to receive the most modern treatments, and you have to pay quite a bit for the treatments you receive. So, in choosing an Advantage Plan, you're betting that you will remain healthy until you suddenly drop dead.

The experience my wife had with her open heart surgery on an Advantage plan couldn't have been better. No problems with specialists, modern treatments, or any other of the things we were supposed to be scared of. So far, we are out of pocket $850 on the nearly $30,000 of bills that have arrived (many more are still in process).

I'm not trying to convince anyone of anything, and I agree that everyone should make an informed choice that works for them.

[Ronald Blue]

Every US government jurisdiction should have a senior center or resources available. Here it's the Wisconsin: Grant County Commission on Ageing. They have a specialist on board to help with those decisions. They are not SELLING anything! Their services are FREE to residents of the jurisdiction because they're paid for by your taxes. I was on the board of ours for several years and volunteered for many years after helping individuals choose the plan that best fit their needs. The medicare.gov website is excellent. What works well for one person may not work well for you. The Medicare plan finder lists all your options, rates them based on customer satisfaction, deductibles, monthly costs, prescription formularies, drug store options, doctors in system etc. It brought me great joy to see the smiles on people faces when they left and could throw away the bag of junk mail they got selling this or that product. Many seniors can't tell the difference between junk and the necessary letters. We encouraged them to put it all in a bag and have a son or daughter go through it occasionally. For many it brought great relief and piece of mind to their kids who knew what was going on with their parent.

For Ronald who started this thread, here's where I'd start: https://www2.illinois.gov/aging/Pages/default.aspx

Thanks for this link. It looks like a lot of good info there. I had not encountered it in my searches. Thanks again.

[Ronald Blue]

Ron,

As you can see from the variety of responses to this thread, there are a variety of opinions. It's important that you study the information and determine what's right for you and yours!

I expected that Ken. Varying experiences and opinions. But still something to learn from them.