Medicare supplemental insurance help?

[MW surveyor]

Ok this is not gun related unless I have an ND but need some help deciding on which way to go for Medicare supplemental insurance as I am totally confused on some things.

First off, I do not have a regular doctor and as it was explained to me but my current health insurance provider, that in this case it would be better to go with the zero dollar (not really cause I still have to pay for the medical part) HMO/PPO type plan. This is probably the cheapest out there but have to use the plan doctors and hospitals. But if I am correct, this plan also covers the majority of meds at a low copay and doctor visits and makes up the 20% of the gap in the medical/hospital?

Then there are the other plans..........that are more expensive but I'm sure works for a lot of people.

So what say you guys/gals that are on Medicare about the different plans.

[muggsy]

I'm probably the last one to ask, but my wife signed us up for Aetna for medicare and she says it's the best option. She said to avoid Humana. Everyone's situation is different, so this may not be the case for you. Sorry that I can't be of more help. You may want to talk to someone from your area who can give you better info.

[JimC]

I had Blue Cross/Blue Shield when I worked in LE.
I kept it after retirement through a retiree state plan, 80/20. PPO with $15.00 co-pay normal and $50.00 for the ER.
BC/BS is now our supplemental insurance after Medicare, still through a retiree state plan and very affordable that way.

[phil413tx]

I am not on Medicare as I am much younger but I do work with it. If you do not need a lot of healthcare, the PPO/HMO plans are what I recommend. It keeps your insurance cost down. If you have a lot of medical conditions, it is better to get the supplements and not the PPO/HMO. For current medical conditions the supplemental insurance will cost more but will keep your out of pocket expenses down. That's just my 2 cents but every person is different.

[jdlott74]

I work in the medical field in insurance following up on insurance claims for our Ambulatory Surgical Centers.

1) make sure it is a SUPPLEMENT, NOT a Medicare replacement.
2) Check to see what it covers, if it covers for Medicare coins and/or deductible. AARP does not cover for the deductible but does cover for the coinsurance (Medicare's 20%).
3) Take into consideration and double check with the supplement if you have to meet a deductible and/or Out of Pocket before they will start paying.
4) KEEP Medicare Part B coverage. Everyone gets Part A...If you don't have Part B coverage, a lot of insurances will only pay what the 20% would have been for Medicare and the patient is responsible for the remaining balance. Example...If you have Medicare Pt A, and another insurance, the services are covered under Pt B, you don't have Pt B, claim goes to the secondary insurance...If that allowable amount is $500.00 (the amount the provider is contracted for with Medicare, then whatever the 80% Medicare would have pd ($400.00) is patient responsibility.

In my over 10 years experience, getting a Medicare replacement is never a good thing. Always stick with Medicare and a supplement.

Also: FYI: If you have a Medicare replacement, and if you ever are on Medicaid, Medicaid will not pay anything.


PM me if you have other questions...

[JFootin]

Get the Part D even if you aren't currently on any meds because if you put off getting it they will take late enrollment penalties from you every month for the rest of your life! Don't ask me how I know. :mad:

I HATE HMOs! When I had my first heart attack, I was on one. I didn't know what it was and didn't call 911. But I went to see my doctor the next day. I explained my family history of heart disease, my high blood pressure, my extremely high cholesterol, that I smoked, and described symptoms that included pain in both shoulders and arms. She claimed that, because the pains were not just in the left arm that it couldn't have been a heart attack. She even got a supposed cardiologist on the phone and he said the symptoms were atypical of heart disease. She stubbornly refused to do any tests to see what happened. Had to protect her monthly bonus. When I had my second heart attack a few years later, they said they could see the damage from that first one! :mad:

IMO, any doctor who works for an HMO should have their license pulled because they obviously don't know how to honor the Hypocratic Oath! :yell:

[OldLincoln]

Some folks like HMO's some don't, but here's the deal. Your regular doctor rants about the insurance company doing this or that. The HMO doctor works for the insurance company. He has to follow what they will allow or refuse, and as a member, so do you.

[mr surveyor]

I trust my personal doctor much more than I do burocraps (never could spell that word)

[jdlott74]

Some folks like HMO's some don't, but here's the deal. Your regular doctor rants about the insurance company doing this or that. The HMO doctor works for the insurance company. He has to follow what they will allow or refuse, and as a member, so do you.

Doesn't really matter on what they allow. Medicare Replacement policies HAVE to follow Medicare allowable. They can't have their own. They also follow Medicare policies and procedures. If Medicare doesn't pay for it or have a frequency on something, the Medicare replacements have to as well.

It's not that hard for a patient to go onto the CMS (Centers for Medicare and Medicaid Services) to check the policies.

[jlottmc]

I trust my personal doctor much more than I do burocraps (never could spell that word)

You spelled it right, least as far as I'm concerned.

[MW surveyor]

Thanks for the replies.

From what I can gather so far is that it would be better to go with a supplement plan keeping both the Part A & Part B that I now have.

I know that I should have done all this in the months leading up to my birthday but at the time, my employer didn't happen to mention that the medical insurance for me was going to go up nearly 60 to 80% and so the search! Just sprang this on me about three days ago.

One plan that was also suggested was Plan F I believe through BC/BS? or AARP. With this plan it looks like you can go to just about any doctor or hospital. Need to really research this.

jdlott74, thanks for the pm offer. I'll probably take you up on it within the next few days or hours :)

[mr surveyor]

MW, you're scaring me, Dude. I'm a few months shy of 60 (yeah, I know... just another young punk), and although since I'm self employed I will never be able to actually retire, I know the whole insurance issue is really gonna start kicking me in the butttt pretty soon (as if it hasn't already in the last year). Not looking forward to dealing with the medicare and supplimental issues. The current BCBS policy is pain enough.

[Bawanna]

I just got my retirement estimates, figures and such from my union last week. Retiring is not longer an option to escape the violets at work. Around 400 a month after 20 plus years in the union. I was slightly disappointed but not terribly surprised.
The other parts, public employees account and such go strictly by age so no money there for 8 or 10 more years.

So I'll either seek something private sector or focus on being a pain in the backside to the violets at work. I'm pretty good at it so maybe I should just stick with it.

[downtownv]

Medicare with Aarp secondary is the best. I work in the Medical equipment field and know this from experience most PPO's are good. HMO's SUCK, avoid unless you are in excellent health!
United and Aentna are the low payers and many DR etc won't deal with them.....
Hope this helps but as Muggsy said everyones needs are different.

[MW surveyor]

downtownv - Warp secondary?

My eyeballs are rolling back in my head from looking at different plans/providers/etc. I'm used to reading maritime insurance policies, dry azzed engineering descriptions, soil analysis, etc.... and they are a breeze compared to this health insurance stuff.

[ltxi]

I just got my retirement estimates, figures and such from my union last week. Retiring is not longer an option to escape the violets at work. Around 400 a month after 20 plus years in the union. I was slightly disappointed but not terribly surprised.
The other parts, public employees account and such go strictly by age so no money there for 8 or 10 more years.

So I'll either seek something private sector or focus on being a pain in the backside to the violets at work. I'm pretty good at it so maybe I should just stick with it.

That would be my vote. If you can't just retire there should be some real satisfaction in working hard at properly making their life miserable.

[Bawanna]

That would be my vote. If you can't just retire there should be some real satisfaction in working hard at properly making their life miserable.

It's definitely a career goal. Lord knows they strive hard (although it comes easy for them) to make me miserable, least I can do is turn on my force field and aim it right back at them.

Maybe I'll go for my 5 verbal reprimand this week. Have an empty spot just perfect for the written notice on the wall of fame, I mean shame.

I hate myself.

[downtownv]

downtownv - Warp secondary?

My eyeballs are rolling back in my head from looking at different plans/providers/etc. I'm used to reading maritime insurance policies, dry azzed engineering descriptions, soil analysis, etc.... and they are a breeze compared to this health insurance stuff.

AARP.......... effing auto correct!

[GROTMAN]

YOU CAN ALWAYS TRY THE MEDICARE X PLAN
Medicare Part X https://webtop.east.cox.net/cloud-lzmail/viewattachment?sessionId=0oLySbbZ-54521&accountId=&folder=INBOX&uid=12718&part=1.1



You're a sick senior citizen and the government says there is no nursing home available for you. So what do you do?





Our plan gives anyone 65 years or older a gun and 4 bullets. You are allowed to shoot four Politicians!!





Of course, this means you will be sent to prison where you will get three meals a day, a roof over your head, central heating, air conditioning and all the health care you need!





Need new teeth? No problem. Need new glasses? No problem. Need a new hip, knees, kidney, lungs or heart? They're all covered.









As an added bonus, your kids can come and visit you as often as they do now.





And who will be paying for all of this? It’s the same government that just told you that you they cannot afford for you to go into a nursing home.





And you can get rid of 4 useless politicians while you are at it.





The best part of this program… now that you're a prisoner, you don't have to pay any taxes anymore.

[ltxi]

It's definitely a career goal. Lord knows they strive hard (although it comes easy for them) to make me miserable, least I can do is turn on my force field and aim it right back at them.

Maybe I'll go for my 5 verbal reprimand this week. Have an empty spot just perfect for the written notice on the wall of fame, I mean shame.

I hate myself.

Well, damn. I thought you were already working on #6. Step it up there, guy.

[MW surveyor]

GROTHMAN - I've always thought that plan X was a viable option. :)

[muggsy]

YOU CAN ALWAYS TRY THE MEDICARE X PLAN
Medicare Part X https://webtop.east.cox.net/cloud-lzmail/viewattachment?sessionId=0oLySbbZ-54521&accountId=&folder=INBOX&uid=12718&part=1.1



You're a sick senior citizen and the government says there is no nursing home available for you. So what do you do?





Our plan gives anyone 65 years or older a gun and 4 bullets. You are allowed to shoot four Politicians!!





Of course, this means you will be sent to prison where you will get three meals a day, a roof over your head, central heating, air conditioning and all the health care you need!





Need new teeth? No problem. Need new glasses? No problem. Need a new hip, knees, kidney, lungs or heart? They're all covered.









As an added bonus, your kids can come and visit you as often as they do now.





And who will be paying for all of this? It’s the same government that just told you that you they cannot afford for you to go into a nursing home.





And you can get rid of 4 useless politicians while you are at it.





The best part of this program… now that you're a prisoner, you don't have to pay any taxes anymore.

You forgot to mention that you also get all of the sex you can handle from Bubba. Every plan has its drawbacks. :)