Advantage plans that give you money back?

[wijames]

I just signed up for Medicare and I keep hearing about Advantage plans that will pay you back for part of what Medicare charges you. How can they afford do that? is this common?

 

[Mack]

I just signed up for Medicare and I keep hearing about Advantage plans that will pay you back for part of what Medicare charges you. How can they afford do that? is this common?

Hi, and welcome to MyMedicareforum.com!

Medicare pays the insurer a set rate for each person they insure under Medicare Advantage. The insurer then restricts what doctors and hospitals you can use under their Medicare Advantage plans. The insurer has contracts with doctors and hospitals at a reduced rate. So it costs the insurer less because you MUST use their network of doctors and hospitals. They can give you money back because of the payment they receive for you from Medicare, and due to the contracts with doctors and hospitals at reduced rates.

With a Medicare Supplement plan you can use any doctor and hospital that accepts medicare, while Medicare Advantage restricts who you can use.

So your questions before enrolling in Medicare Advantage should be:

1. Are you willing to be restricted to the Medicare Advantage plans doctors and hospitals in order to save money?

2. Do you say in the same location year round, as opposed to spending some time in other states (which would be out of the Network of your Medicare Advantage plans) thus they would not pay for doctor visits in the other states.

Medicare Advantage makes sense only if one is on a very tight budget. Otherwise original Medicare and a Medicare Supplement plan makes more sense due to the freedom it offers to see any doctor or use any hospital or other provider that accepts medicare.

 

[wijames]

I just signed up for Medicare and I keep hearing about Advantage plans that will pay you back for part of what Medicare charges you. How can they afford do that? is this common?

Hi, and welcome to MyMedicareforum.com!

Medicare pays the insurer a set rate for each person they insure under Medicare Advantage. The insurer then restricts what doctors and hospitals you can use under their Medicare Advantage plans. The insurer has contracts with doctors and hospitals at a reduced rate. So it costs the insurer less because you MUST use their network of doctors and hospitals. They can give you money back because of the payment they receive for you from Medicare, and due to the contracts with doctors and hospitals at reduced rates.

With a Medicare Supplement plan you can use any doctor and hospital that accepts medicare, while Medicare Advantage restricts who you can use.

So your questions before enrolling in Medicare Advantage should be:

1. Are you willing to be restricted to the Medicare Advantage plans doctors and hospitals in order to save money?

2. Do you say in the same location year round, as opposed to spending some time in other states (which would be out of the Network of your Medicare Advantage plans) thus they would not pay for doctor visits in the other states.

Medicare Advantage makes sense only if one is on a very tight budget. Otherwise original Medicare and a Medicare Supplement plan makes more sense due to the freedom it offers to see any doctor or use any hospital or other provider that accepts medicare.

That's what I was told and since I am on a tight budget and live in Florida year round, it sounds like an advantage plan is the way to go. I have to change doctors when I retire anyway because I live 30 miles from my present doctors who I choose because they were close to my work.

 

[mattspits]

Keep in mind that many people choose Medicare Advantage because they want to. If you are fairly healthy and only seeing the doctor for your annual visit, you will save a lot of money by being on a Medicare Advantage plan. The key is to be aware of the network that the plan uses so you can access the providers that you want. If you'd like more info on Medicare Advantage plans than check out 10 Things You Must Know Before Enrolling in Medicare Advantage

I just signed up for Medicare and I keep hearing about Advantage plans that will pay you back for part of what Medicare charges you. How can they afford do that? is this common?

Hi, and welcome to MyMedicareforum.com!

Medicare pays the insurer a set rate for each person they insure under Medicare Advantage. The insurer then restricts what doctors and hospitals you can use under their Medicare Advantage plans. The insurer has contracts with doctors and hospitals at a reduced rate. So it costs the insurer less because you MUST use their network of doctors and hospitals. They can give you money back because of the payment they receive for you from Medicare, and due to the contracts with doctors and hospitals at reduced rates.

With a Medicare Supplement plan you can use any doctor and hospital that accepts medicare, while Medicare Advantage restricts who you can use.

So your questions before enrolling in Medicare Advantage should be:

1. Are you willing to be restricted to the Medicare Advantage plans doctors and hospitals in order to save money?

2. Do you say in the same location year round, as opposed to spending some time in other states (which would be out of the Network of your Medicare Advantage plans) thus they would not pay for doctor visits in the other states.

Medicare Advantage makes sense only if one is on a very tight budget. Otherwise original Medicare and a Medicare Supplement plan makes more sense due to the freedom it offers to see any doctor or use any hospital or other provider that accepts medicare.

That's what I was told and since I am on a tight budget and live in Florida year round, it sounds like an advantage plan is the way to go. I have to change doctors when I retire anyway because I live 30 miles from my present doctors who I choose because they were close to my work.

 

[Norma]

Thank you Matt for this timely information.

I have been on Medicare since 2009 (early retirement) and feel I've run the red line on tach far enough.

Except for trauma injuries I've brought upon myself, I am very healthy but, Nobody Owns Tomorrow and I don't like the HMO PPO concept of health care.

Your simple explanation has just help me decide which plan I need to invest in.

My questions:

1. Do all Supplemental providers charge the same for identical coverage?

2. Customer service is critical. I've heard some nightmare stories from the insurance writers and the folks at doctors' offices. Is there a list of top rated Providers I might study?

Thanks for your help

 

[Mack]

Hi Norma,

I can answer the first question. NO, all supplemental providers do not charge the same for identical coverage. I noticed a big difference in premiums when I was shopping. Also it depends on where you live as premiums vary.

As far as question #2 the only one I have personally been a member of is AARP's United Healthcare Medicare Supplement Plan. I have been well pleased with the customer service. Also they were among the lower priced plans. Certainly it is among the largest (if not the largest) and not likely to go out of business, which could happen to some of the smaller providers.

I have never had a problem with any provider taking AARP United Healthcare, and I have used it in locations other than my home state. They have a great website which allows you to login and check your claims, just like the mymedicare.gov website. They have other benefits as well, such as a nurse hotline.

Since I am pretty healthy I choose Plan N and it has proven to be the right one for me. I don't mind paying the low medicare deductible plus a $20 copay to go to the doctor once or twice a year. Saves a lot more in premiums than other plans. If someone goes to the doctor monthly they might want to look at Plan A or one of the others.

Thank you Matt for this timely information.

I have been on Medicare since 2009 (early retirement) and feel I've run the red line on tach far enough.

Except for trauma injuries I've brought upon myself, I am very healthy but, Nobody Owns Tomorrow and I don't like the HMO PPO concept of health care.

Your simple explanation has just help me decide which plan I need to invest in.

My questions:

1. Do all Supplemental providers charge the same for identical coverage?

2. Customer service is critical. I've heard some nightmare stories from the insurance writers and the folks at doctors' offices. Is there a list of top rated Providers I might study?

Thanks for your help

 

[Norma]

Hi Norma,

I can answer the first question. NO, all supplemental providers do not charge the same for identical coverage. I noticed a big difference in premiums when I was shopping. Also it depends on where you live as premiums vary.

As far as question #2 the only one I have personally been a member of is AARP's United Healthcare Medicare Supplement Plan. I have been well pleased with the customer service. Also they were among the lower priced plans. Certainly it is among the largest (if not the largest) and not likely to go out of business, which could happen to some of the smaller providers.

I have never had a problem with any provider taking AARP United Healthcare, and I have used it in locations other than my home state. They have a great website which allows you to login and check your claims, just like the mymedicare.gov website. They have other benefits as well, such as a nurse hotline.

Since I am pretty healthy I choose Plan N and it has proven to be the right one for me. I don't mind paying the low medicare deductible plus a $20 copay to go to the doctor once or twice a year. Saves a lot more in premiums than other plans. If someone goes to the doctor monthly they might want to look at Plan A or one of the others.

Thank you for your quick reply; it is a huge help

I had not considered an AARP plan; I will now check for it's availability in my state.

Unless I were to have a catastrophic health event, I only see the doctor twice annually to renew my BP meds. I have always been an outdoor person and strongly feel that has helped to keep me free of colds and flu.

I just received the 2015 Medicare booklet, your input has been very helpful to steer me thru a few things.

Thanks again
Norma

 

[wijames]

After a lot of checking I signed up with a Humana bronze plan that gives me everything I was looking for and also gives me back $92.00 a month of what Medicare charges me. I even got to keep my present doctor, a real plus! I'll let you know how it works out.

Hi Norma,

I can answer the first question. NO, all supplemental providers do not charge the same for identical coverage. I noticed a big difference in premiums when I was shopping. Also it depends on where you live as premiums vary.

As far as question #2 the only one I have personally been a member of is AARP's United Healthcare Medicare Supplement Plan. I have been well pleased with the customer service. Also they were among the lower priced plans. Certainly it is among the largest (if not the largest) and not likely to go out of business, which could happen to some of the smaller providers.

I have never had a problem with any provider taking AARP United Healthcare, and I have used it in locations other than my home state. They have a great website which allows you to login and check your claims, just like the mymedicare.gov website. They have other benefits as well, such as a nurse hotline.

Since I am pretty healthy I choose Plan N and it has proven to be the right one for me. I don't mind paying the low medicare deductible plus a $20 copay to go to the doctor once or twice a year. Saves a lot more in premiums than other plans. If someone goes to the doctor monthly they might want to look at Plan A or one of the others.

Thank you for your quick reply; it is a huge help

I had not considered an AARP plan; I will now check for it's availability in my state.

Unless I were to have a catastrophic health event, I only see the doctor twice annually to renew my BP meds. I have always been an outdoor person and strongly feel that has helped to keep me free of colds and flu.

I just received the 2015 Medicare booklet, your input has been very helpful to steer me thru a few things.

Thanks again
Norma