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Post by xray on Oct 23, 2022 13:55:41 GMT
Yahoo Money Here are the biggest changes to Medicare next year Kerry Hannon·Senior Columnist Sat, October 22, 2022, 1:43 PM
Next year, seniors will see three key changes to Medicare that could save them money. Premiums and deductibles on Medicare Part B are going down, while co-sharing costs for adult vaccines are going away. Insulin copays will also be capped starting in 2023. These changes could affect if seniors choose to switch their coverage options during the annual open enrollment window that runs from October 15 to December 7.
"The most important change in 2023 will help people with diabetes," Mark Miller, author of the forthcoming book Retirement Reboot: Commonsense Financial Strategies for Getting Back on Track, told Yahoo Money. "Another important change in 2023: vaccines covered under Part D will come with no copays or deductibles. That will help with expensive vaccinations, such as the shingles vaccine."
Here’s what to know.
Medicare premiums will be cheaper. The standard monthly premium for Medicare Part B, which covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A, will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022.
The annual deductible for all Medicare Part B beneficiaries is $226 in 2023, a decrease of $7 from the annual deductible of $233 in 2022. Medicare beneficiaries can add that $5.20 monthly refund to the sizable 8.7% Social Security COLA for 2023. Part B premiums typically are deducted from monthly Social Security benefits, so that boost will be welcome as retirees still grapple with rising costs.
Adult vaccines
Starting in 2023, seniors will no longer have to pay for cost sharing for adult vaccines covered under Medicare Part D and under Medicaid that are recommended for adults by the Advisory Committee on Immunization Practices (ACIP).
Coverage of vaccines ranging from the flu to pneumonia to shingles for adults has been optional, with about half of states providing coverage and some charging cost-sharing, according to KFF data.
Inflation Reduction Act
Next year, thanks to provisions in the Inflation Reduction Act, 3.3 million Medicare Part D beneficiaries with diabetes will benefit from a guarantee that copays for insulin will be capped at $35 for a month’s supply. However, if you’re comparing Part D plans using the Medicare Plan Finder, the insulin copay cap will not show up in online descriptions of plan costs.
That’s because the law is new. The Medicare Rights Center experts advise choosing a plan by the cost of all the prescriptions you take and separately confirm that your insulin prescription is listed in the plan’s covered drugs, or the formulary. You can then add the $35 co-pay to your estimated costs.
Finally, while the Inflation Reduction Act delivered the most significant changes to Medicare in almost two decades, most of the provisions, including lower prescription drug prices and out-of-pocket costs, won’t kick in for several years. Patience.
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Live Long and Prosper....
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Post by Capital on Oct 23, 2022 14:17:18 GMT
I'm on a Advantage plan. I'm seeing both lower premiums and smaller copays and maximum out of pockets for 2023. Also seeing my maximum coverage amounts increase.
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Post by anitya on Oct 23, 2022 20:38:48 GMT
Shingles vaccine is mentioned. I took the first dose. The instructions say the second dose is 2-6 months after the first dose. It turns out the vaccine is effective for 10 yrs (I wrongly assumed it lasts the rest of my life). It would be great if members could share how many months after they took their first dose they took their second dose and what was the thought behind their choice. I could not find info on why the big 2 to 6 months range and if there is a difference in effectiveness. You can send me a PM if you prefer. win1177, Any thoughts? I asked my sibling physician and got a “take the second dose when you can” answer - seems way unscientific.
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Post by roi2020 on Oct 23, 2022 21:42:23 GMT
Shingles vaccine is mentioned. I took the first dose. The instructions say the second dose is 2-6 months after the first dose. It turns out the vaccine is effective for 10 yrs (I wrongly assumed it lasts the rest of my life). It would be great if members could share how many months after they took their first dose they took their second dose and what was the thought behind their choice. I could not find info on why the big 2 to 6 months range and if there is a difference in effectiveness. You can send me a PM if you prefer. win1177 , Any thoughts? I asked my sibling physician and got a “take the second dose when you can” answer - seems way unscientific. The Shingrix vaccine was FDA-approved for adults aged 50 or older in 2017. My physician recommended Shingrix stating that it was more effective than the "old" shingles vaccine which was still attainable in 2018. I waited only two months to receive the second dose since I wanted full shingles protection ASAP. There was limited Shingrix availability in 2018 (at least in my area). Hopefully, the vaccine is now readily available.
Edit/Add: If needed, people with weakened immune systems can get the second dose 1 to 2 months after the first.
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Post by liftlock on Oct 24, 2022 0:54:16 GMT
I got my second shingles shot 6 months after the first dose. There was a shortage of supply at that time. I suspect it doesn't matter much when one gets the second dose as long as long as it is within 6 months of the first dose. My theory is that the guidelines would be different if a tighter timeframe provided a materially greater benefit.
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Post by liftlock on Oct 24, 2022 1:26:26 GMT
I'm on a Advantage plan. I'm seeing both lower premiums and smaller copays and maximum out of pockets for 2023. Also seeing my maximum coverage amounts increase. The insurance company profits for Advantage plans must be good. The marketing efforts to sell these plans are very strong. I read somewhere that more people are choosing Advantage plans.
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Post by Capital on Oct 24, 2022 10:16:49 GMT
I'm on a Advantage plan. I'm seeing both lower premiums and smaller copays and maximum out of pockets for 2023. Also seeing my maximum coverage amounts increase. The insurance company profits for Advantage plans must be good. The marketing efforts to sell these plans are very strong. I read somewhere that more people are choosing Advantage plans. My only premiums are those charged by Medicare. I pay Part B. Due to income I also pay the additional premiums for the first level of IRMAA for Parts B and D. My coverage is very much like an employer plan. It includes Medical, Dental, Pharmacy, Eyecare and other items not covered or included in original Medicare. Mine takes care of the donut hole of Part D and requires no Medigap Plan. In 2023 there will be a new $115/quarter Over-the-Counter allowance that I will need to take some time to learn about. The Plan is a PPO not an HMO. Max out of pocket 2022 is $6,700 in network and $11,300 out of network. In 2023 these are dropping to $5,900 and $8,950 respectively.
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Post by Chahta on Oct 27, 2022 13:37:15 GMT
I'm on a Advantage plan. I'm seeing both lower premiums and smaller copays and maximum out of pockets for 2023. Also seeing my maximum coverage amounts increase. The insurance company profits for Advantage plans must be good. The marketing efforts to sell these plans are very strong. I read somewhere that more people are choosing Advantage plans. And getting stronger. Educate yourself on DCEs (Direct Contacting Entities). Insurance companies and Medicare is scheming to get rid of Part B Medicare. Advantage gives many people more bang for their buck. Part B gives you more choices at a cost. If you feel an Advantage plan meets all your needs for doctor choices and services then they work for you. liftlock, I too had the Shingrex shots. My understanding at the time was the doses came together and the second was kept for me when I got the first shot.
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Post by ECE Prof on Oct 27, 2022 15:15:00 GMT
MA plan is going stronger and better every year. My wife and I have had only MA plan ever since we got our first chance to get out of our mandatory state plan (I was automatically enrolled in the state plan, when I retired from the State U). We had to pay an additional premium, slightly more than the state's additional premium for Part-B, but it also included Part-D. However, it was very convenient. Besides, it included eyeglasses and a limited foreign care also. This was important for us. As the years went by, the additional premium went away, and so did the foreign part. However, it added hearing aids with limited amount. Besides, the hospitalization cost went up. Since you do not go to hospital many times, the cost saving was getting better, and co-payments for medicines kept going down.
Although I did not have a foreign emergency service part, I had spent about $3600 for hospitalization and installment of a stent after I had a heart attack about 7 years ago. Medicare has a foreign cell that pays some cost. Our BCBS of Tenn. asked us to submit the paper work from India, and we did. They reimbursed most of the money, except for some deductibles. It would have cost somewhere around $150000 (Cookeville) – $200000 (CA)in this country depending upon where you live. By this standard, $3600 is very cheap for medicare. In fact. India flourishes in medical tourism. There are several hospitals in Delhi doing this. It would have been a lot more expensive than what I had to spend in my town.
So, the MA plan kept growing from only 10% when I started, it was something like 33% two years ago. It is probably 50% now because of its popularity.
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Post by mnfish on Dec 12, 2022 18:49:50 GMT
The insurance company profits for Advantage plans must be good. The marketing efforts to sell these plans are very strong. I read somewhere that more people are choosing Advantage plans. My only premiums are those charged by Medicare. I pay Part B. Due to income I also pay the additional premiums for the first level of IRMAA for Parts B and D. My coverage is very much like an employer plan. It includes Medical, Dental, Pharmacy, Eyecare and other items not covered or included in original Medicare. Mine takes care of the donut hole of Part D and requires no Medigap Plan. In 2023 there will be a new $115/quarter Over-the-Counter allowance that I will need to take some time to learn about. The Plan is a PPO not an HMO. Max out of pocket 2022 is $6,700 in network and $11,300 out of network. In 2023 these are dropping to $5,900 and $8,950 respectively. Capital, I was looking at an Advantage Plan from BCBS. It states "Medical and Prescription Drug Plans bundle the benefits of a Medical Only Plan and a Prescription Drug Plan. Benefits include medical expenses and prescriptions." Blue Cross Medicare Advantage Comfort (PPO) Medical Deductible - $0 Medical out of pocket maximum - $3,700 Monthly plan premium - $67.00 So, why do you pay Part B with an Advantage Plan? (I sign up this summer. I may have a lot to learn! And I have $67k in an HSA)
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Post by habsui on Dec 12, 2022 19:56:32 GMT
My only premiums are those charged by Medicare. I pay Part B. Due to income I also pay the additional premiums for the first level of IRMAA for Parts B and D. My coverage is very much like an employer plan. It includes Medical, Dental, Pharmacy, Eyecare and other items not covered or included in original Medicare. Mine takes care of the donut hole of Part D and requires no Medigap Plan. In 2023 there will be a new $115/quarter Over-the-Counter allowance that I will need to take some time to learn about. The Plan is a PPO not an HMO. Max out of pocket 2022 is $6,700 in network and $11,300 out of network. In 2023 these are dropping to $5,900 and $8,950 respectively. Capital , I was looking at an Advantage Plan from BCBS. It states "Medical and Prescription Drug Plans bundle the benefits of a Medical Only Plan and a Prescription Drug Plan. Benefits include medical expenses and prescriptions." Blue Cross Medicare Advantage Comfort (PPO) Medical Deductible - $0 Medical out of pocket maximum - $3,700 Monthly plan premium - $67.00 So, why do you pay Part B with an Advantage Plan? (I sign up this summer. I may have a lot to learn! And I have $67k in an HSA) You still pay for Part B (typically taken out of SS). Then, you pay the additional Part C premium (which may be $0). Note that some of the deductibles may be different than with a traditional medical supplemental plan (e.g. Part G).
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Post by Capital on Dec 12, 2022 22:26:31 GMT
My only premiums are those charged by Medicare. I pay Part B. Due to income I also pay the additional premiums for the first level of IRMAA for Parts B and D. My coverage is very much like an employer plan. It includes Medical, Dental, Pharmacy, Eyecare and other items not covered or included in original Medicare. Mine takes care of the donut hole of Part D and requires no Medigap Plan. In 2023 there will be a new $115/quarter Over-the-Counter allowance that I will need to take some time to learn about. The Plan is a PPO not an HMO. Max out of pocket 2022 is $6,700 in network and $11,300 out of network. In 2023 these are dropping to $5,900 and $8,950 respectively. Capital , I was looking at an Advantage Plan from BCBS. It states "Medical and Prescription Drug Plans bundle the benefits of a Medical Only Plan and a Prescription Drug Plan. Benefits include medical expenses and prescriptions." Blue Cross Medicare Advantage Comfort (PPO) Medical Deductible - $0 Medical out of pocket maximum - $3,700 Monthly plan premium - $67.00 So, why do you pay Part B with an Advantage Plan? (I sign up this summer. I may have a lot to learn! And I have $67k in an HSA) mnfish , I pay Part B to Medicare. Medicare pays BCBS for my Part C Medicare Plan. BCBS has several different Medicare C Plans. The one I'm on does not have a premium in addition to what Medicare charges. The plan you are looking at has an additional $67 monthly premium in addition to the Part B Medicare that you will pay.
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Post by fred495 on Dec 13, 2022 2:09:45 GMT
One of the reasons I will not enroll in a Medicare Advantage plan is that you may have to get approval from the plan prior to receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service. Medicare Advantage enrollees can appeal the plan’s decision, but relatively few do so and are successfull.
Traditional Medicare, in contrast, does not require prior authorization for the vast majority of services, except under limited circumstances. Prior authorization requirements can create hurdles and hassles for beneficiaries (and their physicians) and may limit access to necessary care.
Also, having access to doctors and hospitals outside the limited pool of a Medicare Advantage plan is worth the price of higher premiums. I don't want to nickle and dime with my health at this stage of my life.
Good luck,
Fred
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Post by retiredat48 on Dec 13, 2022 2:20:14 GMT
One of the reasons I will not enroll in a Medicare Advantage plan is that you may have to get approval from the plan prior to receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service. Medicare Advantage enrollees can appeal the plan’s decision, but relatively few do so and are successfull. Traditional Medicare, in contrast, does not require prior authorization for the vast majority of services, except under limited circumstances. Prior authorization requirements can create hurdles and hassles for beneficiaries (and their physicians) and may limit access to necessary care. Also, having access to doctors and hospitals outside the limited pool of a Medicare Advantage plan is worth the price of higher premiums. I don't want to nickle and dime with my health at this stage of my life. Good luck, Fred +1...For snowbirds (FL and up north...50% of time), this is a big deal!! R$8...R48 (freudian slip!)
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Post by mnfish on Dec 13, 2022 12:44:29 GMT
Capital , "mnfish , I pay Part B to Medicare. Medicare pays BCBS for my Part C Medicare Plan. BCBS has several different Medicare C Plans. The one I'm on does not have a premium in addition to what Medicare charges. The plan you are looking at has an additional $67 monthly premium in addition to the Part B Medicare that you will pay." Thanks Capital, the wording BCBS used made it sound like Part B was included. The reason I used that example is that you get a $2,100 lower deductible for $804. In regard to my Fidelity HSA - does anyone pay their Part B premium with an HSA? Can you pay that directly to Medicare or do you just reimburse yourself?
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Post by anovice on Dec 13, 2022 13:14:07 GMT
One of the reasons I will not enroll in a Medicare Advantage plan is that you may have to get approval from the plan prior to receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service. Medicare Advantage enrollees can appeal the plan’s decision, but relatively few do so and are successfull. Traditional Medicare, in contrast, does not require prior authorization for the vast majority of services, except under limited circumstances. Prior authorization requirements can create hurdles and hassles for beneficiaries (and their physicians) and may limit access to necessary care. Also, having access to doctors and hospitals outside the limited pool of a Medicare Advantage plan is worth the price of higher premiums. I don't want to nickle and dime with my health at this stage of my life. Good luck, Fred Fred is spot on. Do you remember about 6 months before your 65th birthday, you started to get inundated with Medicare Advantage plan advertising from every insurance company that services your area? Did you ever wonder why they did not promote their Traditional Medicare plans? The insurance companies love Medicare Advantage plans because they make a ton of money on each enrollee. Many people like Medicare Advantage plans because they look like the plans they had when employed. It is familiar to you, and it is an easy transition for you. Having dental insurance nicely packaged into Medicare Advantage plans is enticing. If you go this route, make certain that your dentist accepts the insurance. But at the day, with 50% coverage and a $1,500 yearly maximum, do you really consider this good insurance? I pay my dentist $299 a year which includes 2 cleanings, 2 sets of x-rays, and a discount on any work that I need done. Having an eye exam nicely packaged into a Medicare Advantage plan is nice. But for $100 you can get one at the likes of Costco (covered with Traditional Medicare under medical if you have cataract because they need to give an eye exam). And having a pair of glasses nicely packaged into a Medicare Advantage plan is nice too. But for $150, glasses can be purchased at the likes of Costco. With Medicare Advantage, you have a network of providers that accept Medicare in the area you live. With Traditional Medicare the network is any provider in the country that accepts Medicare. If you want to go to the Mayo Clinic in Rochester, Minnesota, you go. If you want to go to the Cleveland Clinic in Cleveland, you go. If you want to go to Memorial Sloan Kettering in NYC, you go.
For me, the decision was easy. I wanted to be able to go to any doctor or hospital in the county that accepts Medicare. This is how I want my insurance plan to work. This far outweighed the + - $1,000 /year of benefits packaged nicely into a Medicare Advantage plan. If you live in a major city with access to very good doctors and hospitals or a mid-sized city with a university hospital, I can see the decision being more difficult because you may feel that you will never have the need for medical services outside of your network. But as R48 pointed out, if you are a snowbird, Traditional Medicare is the only way to go and keep in mind that if you go the Medicare Advantage route, your decision may be final. If you start out with a Medicare Advantage plan when you turn 65, with "Trial Rights" you have 1-year to switch to Traditional Medicare with no questions asked. After that 1-year period, if you want to switch to Traditional Medicare, the insurance company can require you to go through underwriting. And we all know what that is about.
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Post by liftlock on Dec 13, 2022 15:04:09 GMT
One of the reasons I will not enroll in a Medicare Advantage plan is that you may have to get approval from the plan prior to receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service. Medicare Advantage enrollees can appeal the plan’s decision, but relatively few do so and are successfull. Traditional Medicare, in contrast, does not require prior authorization for the vast majority of services, except under limited circumstances. Prior authorization requirements can create hurdles and hassles for beneficiaries (and their physicians) and may limit access to necessary care. Also, having access to doctors and hospitals outside the limited pool of a Medicare Advantage plan is worth the price of higher premiums. I don't want to nickle and dime with my health at this stage of my life. Good luck, Fred Fred is spot on. Do you remember about 6 months before your 65th birthday, you started to get inundated with Medicare Advantage plan advertising from every insurance company that services your area? Did you ever wonder why they did not promote their Traditional Medicare plans? The insurance companies love Medicare Advantage plans because they make a ton of money on each enrollee. Many people like Medicare Advantage plans because they look like the plans they had when employed. It is familiar to you, and it is an easy transition for you. Having dental insurance nicely packaged into Medicare Advantage plans is enticing. If you go this route, make certain that your dentist accepts the insurance. But at the day, with 50% coverage and a $1,500 yearly maximum, do you really consider this good insurance? I pay my dentist $299 a year which includes 2 cleanings, 2 sets of x-rays, and a discount on any work that I need done. Having an eye exam nicely packaged into a Medicare Advantage plan is nice. But for $100 you can get one at the likes of Costco (covered with Traditional Medicare under medical if you have cataract because they need to give an eye exam). And having a pair of glasses nicely packaged into a Medicare Advantage plan is nice too. But for $150, glasses can be purchased at the likes of Costco. With Medicare Advantage, you have a network of providers that accept Medicare in the area you live. With Traditional Medicare the network is any provider in the country that accepts Medicare. If you want to go to the Mayo Clinic in Rochester, Minnesota, you go. If you want to go to the Cleveland Clinic in Cleveland, you go. If you want to go to Memorial Sloan Kettering in NYC, you go.
For me, the decision was easy. I wanted to be able to go to any doctor or hospital in the county that accepts Medicare. This is how I want my insurance plan to work. This far outweighed the + - $1,000 /year of benefits packaged nicely into a Medicare Advantage plan. If you live in a major city with access to very good doctors and hospitals or a mid-sized city with a university hospital, I can see the decision being more difficult because you may feel that you will never have the need for medical services outside of your network. But as R48 pointed out, if you are a snowbird, Traditional Medicare is the only way to go and keep in mind that if you go the Medicare Advantage route, your decision may be final. If you start out with a Medicare Advantage plan when you turn 65, with "Trial Rights" you have 1-year to switch to Traditional Medicare with no questions asked. After that 1-year period, if you want to switch to Traditional Medicare, the insurance company can require you to go through underwriting. And we all know what that is about.I agree with the observations made by fred495, anovice and R48 about the potential disadvantages of Medicare Advantage plans.. I have Medicare Plan G for the reasons they have listed. However, it's worth noting that it is the HMO variety of Medicare Advantage plans that restrict access to health care providers located in the providers HMO network. There are PPO style Medicare Advantage plans that allow one to see any in or out of network nationwide provider who accepts Medicare. I do not know whether PPO Medicare Advantage Plans require advance approval to utilize providers outside of the HMO network for costly medical procedures. Medicare Advantage plans often have low or zero cost monthly premiums. Many of these plans will have co-pays with relatively higher out of pocket maximums. Traditional Medicare plans will have higher monthly premiums and lower out of pocket maximums. My Medicare Plan G runs about $200 per month and its out of pocket maximum is the annual Medicare deductible which is a little over $230 a year. So the total cost of my Medicare Plan Plan G has a known maximum cost of about $2630 per year. A healthy person on an Advantage plan may save quite a bit of money on premiums and out of pocket cost for co-pays and co-insurance. However, they are taking on the risk of incurring higher maximum out pockets costs as defined by their plan if they get ever need extensive medical care. This trade off strikes me as being to difficult to judge. Will a person save enough in some years to offset potentially higher costs in other years. My brother is quite happy with his PPO Medicare Advantage plan. He was pleasantly surprised that his hospital bills were substantially covered by his PPO plan. Medicare Advantage Plans strike me as being more difficult to understand and judge. I read somewhere that Advantage plans are required by law to cover the same procedures that are covered under traditional Medicare. I also read that some Advantage plans have been known to deny coverage for such procedures. The last thing ones needs to worry about when they need Medical Care is whether their costs will be covered.
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Post by fred495 on Dec 13, 2022 15:46:32 GMT
liftlock said:"The last thing ones needs to worry about when they need Medical Care is whether their costs will be covered."
Fully agree. That's why I supplemented my Traditional Medicare coverage with a Medigap Plan F. Everything is covered, don't recall ever receiving a bill from a doctor or hospital for services that weren't covered by these two plans.
Sleeping well at night is worth the price of the additional premium.
Fred
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Post by anovice on Dec 13, 2022 16:03:48 GMT
"There are PPO style Medicare Advantage plans that allow one to see any in or out of network nationwide provider who accepts Medicare. I do not know whether PPO Medicare Advantage Plans require advance approval to utilize providers outside of the HMO network for costly medical procedures."
This is a tricky area. Medicare Advantage PPO plans, like employer PPO plans, do have some out of network coverage. Some require preauthorization, some are only for emergencies, and to my knowledge all are costly for utilization out of network. Medicare Advantage plans are not designed for out of network.
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Post by racqueteer on Dec 13, 2022 16:28:02 GMT
I have the AETNA Medicare PPO plan from my work, and have had little difficulty with benefits, etc. Among other things, I have had six ablations at about $250,000 a pop. I suppose some things could be better, but I can't say I've had any issues. Although physicians tend to want to check, my plan requires no pre-approval, and any out-of-network services simply cost a little more.
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Post by anovice on Dec 13, 2022 17:36:19 GMT
I have the AETNA Medicare PPO plan from my work, and have had little difficulty with benefits, etc. Among other things, I have had six ablations at about $250,000 a pop. I suppose some things could be better, but I can't say I've had any issues. Although physicians tend to want to check, my plan requires no pre-approval, and any out-of-network services simply cost a little more. I just checked the summary of benefits for the Independence Personal Choice 65 Prime RX PPO in my area. The covered medical and hospital benefits have an out-of-network coinsurance of 40% for most services. That is significant.
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Post by Deleted on Dec 13, 2022 17:46:43 GMT
liftlock said:"The last thing ones needs to worry about when they need Medical Care is whether their costs will be covered." Fully agree. That's why I supplemented my Traditional Medicare coverage with a Medigap Plan F. Everything is covered, don't recall ever receiving a bill from a doctor or hospital for services that weren't covered by these two plans. Sleeping well at night is worth the price of the additional premium. Fred Maybe MA plans are minimizing this: jamanetwork.com/journals/jama/fullarticle/2662877
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Post by anovice on Dec 13, 2022 20:18:15 GMT
liftlock said:"The last thing ones needs to worry about when they need Medical Care is whether their costs will be covered." Fully agree. That's why I supplemented my Traditional Medicare coverage with a Medigap Plan F. Everything is covered, don't recall ever receiving a bill from a doctor or hospital for services that weren't covered by these two plans. Sleeping well at night is worth the price of the additional premium. Fred Maybe MA plans are minimizing this: jamanetwork.com/journals/jama/fullarticle/2662877"The office conducted this review out of concern that Medicare Advantage’s payment model incentivized denying payments and services." "Our case file reviews determined that MAOs sometimes delayed or denied Medicare Advantage beneficiaries’ access to services, even though the requests met Medicare coverage rules,” the OIG said. “MAOs also denied payments to providers for some services that met both Medicare coverage rules and MAO billing rules." thehill.com/policy/healthcare/3470005-probe-finds-medicare-advantage-plans-deny-needed-care-to-tens-of-thousands/
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Post by FD1000 on Dec 13, 2022 20:42:07 GMT
liftlock said:"The last thing ones needs to worry about when they need Medical Care is whether their costs will be covered." Fully agree. That's why I supplemented my Traditional Medicare coverage with a Medigap Plan F. Everything is covered, don't recall ever receiving a bill from a doctor or hospital for services that weren't covered by these two plans. Sleeping well at night is worth the price of the additional premium. Fred Pretty easy choice when you look at all the options and you enough. I started Medicare in 2022. It's also important to select first time well looking years ahead. The 2 original Medicare companies, Aetna+Mutual of Omaha should be as your top choices.
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Post by habsui on Dec 13, 2022 21:07:28 GMT
liftlock said:"The last thing ones needs to worry about when they need Medical Care is whether their costs will be covered." Fully agree. That's why I supplemented my Traditional Medicare coverage with a Medigap Plan F. Everything is covered, don't recall ever receiving a bill from a doctor or hospital for services that weren't covered by these two plans. Sleeping well at night is worth the price of the additional premium. Fred Pretty easy choice when you look at all the options and you enough. I started Medicare in 2022. It's also important to select first time well looking years ahead. The 2 original Medicare companies, Aetna+Mutual of Omaha should be as your top choices. Well, here in Washington State, one can switch medigap plans anytime without medical underwriting. And it uses community rating.
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Post by FD1000 on Dec 14, 2022 3:41:52 GMT
Pretty easy choice when you look at all the options and you enough. I started Medicare in 2022. It's also important to select first time well looking years ahead. The 2 original Medicare companies, Aetna+Mutual of Omaha should be as your top choices. Well, here in Washington State, one can switch medigap plans anytime without medical underwriting. And it uses community rating. This is correct but with exception, see ( link). rules can vary and insurers may require you pass a written health screening. 1) If you have a Medigap plan A, you can switch to any other Medigap plan A...but not to G for example without screening 2) If you’re switching from some other type of health insurance plan to a Medigap plan, rules can vary and insurers may require you pass a written health screening. Here in GA, when I checked advantage plans, out of 50+ plans, only one had all my doctors. While Medigap G include them all.
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Post by retiredat48 on Dec 14, 2022 6:32:58 GMT
I'm afraid to make any change to my current plan (AARP/Unitedhealthcare), as I get a spousal monthly medical bill of $99,999.99, for which I pay zero!
R48
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Post by anovice on Dec 14, 2022 10:29:34 GMT
liftlock said:"The last thing ones needs to worry about when they need Medical Care is whether their costs will be covered." Fully agree. That's why I supplemented my Traditional Medicare coverage with a Medigap Plan F. Everything is covered, don't recall ever receiving a bill from a doctor or hospital for services that weren't covered by these two plans. Sleeping well at night is worth the price of the additional premium. Fred Pretty easy choice when you look at all the options and you enough. I started Medicare in 2022. It's also important to select first time well looking years ahead. The 2 original Medicare companies, Aetna+Mutual of Omaha should be as your top choices. FD1000: I am not understanding your post. What makes Aetna and Mutual of Omaha "top choices"? Certainly, UnitedHealthcare (AARP), Cigna, Humana, and a few others are equally good (or bad) companies. After looking at the financial strength of the insurer, I would submit that the top choices depend on where you reside. While all these companies are national, their presence is stronger/weaker in different places. For example, where I live, Mutual of Omaha does not have a strong presence. If I lived in Georgia, I would inquire with the likes of Emory University Hospital as to which companies they have the best experience with. If the provider has an easy time processing a claim, that would be a top choice for me.
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Post by mnfish on Dec 14, 2022 11:23:23 GMT
I'm currently with BCBS and tried to get Medicare supplement pricing on-line yesterday but it stated I was too far out from my birthday. BCBS swings a pretty big stick in MN as far as what they allow providers to charge.
In regard to an earlier question, no one has an HSA that they use to pay Medicare premiums?
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Post by FD1000 on Dec 14, 2022 12:12:43 GMT
Pretty easy choice when you look at all the options and you enough. I started Medicare in 2022. It's also important to select first time well looking years ahead. The 2 original Medicare companies, Aetna+Mutual of Omaha should be as your top choices. FD1000: I am not understanding your post. What makes Aetna and Mutual of Omaha "top choices"? Certainly, UnitedHealthcare (AARP), Cigna, Humana, and a few others are equally good (or bad) companies. After looking at the financial strength of the insurer, I would submit that the top choices depend on where you reside. While all these companies are national, their presence is stronger/weaker in different places. For example, where I live, Mutual of Omaha does not have a strong presence. If I lived in Georgia, I would inquire with the likes of Emory University Hospital as to which companies they have the best experience with. If the provider has an easy time processing a claim, that would be a top choice for me. I'm talking about Medigap which is supplement to original Medicare. You want a strong company with lower prices, a large number of patients, and long reliable history. For example, BCBS got out for several years, and came back. Emory offers advantage not Medigap. The fact that most advantage companies don't have all my doctors is a red flag. Medigap or advantage is an old debate.
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