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A
anereus Asked October 2015

Are there any pitfalls that I should be aware of with Medicare Advantage?

I am considering changing my 86 year old Mom to a Medicare Advantage program. It seems cheaper that what she is paying now. She is currently on Part A, B and gap coverage. Are there any pitfalls that I should be aware of?

EXPERT Carol Bradley Bursack, CDSGF Oct 2015
Medicare Advantage can be okay for younger people who have few health problems, however for someone who is 86 I would recommend traditional Medicare Parts A and B plus a supplemental policy Plan F. Then there are no co-pays. The co-pays can add up very quickly if there's a hospitalization or if there are a lot of doctor visits. There are other traditional plans (supplemental) that are cheaper than Plan F but there are co-pays. In my opinion, Plan F is worth every cent.
Carol

JB0928 Oct 2015
My mom had the advantage program, but went back to regular medicare (with part A and B) and added United Health Care Supplement F that I pay on her behalf monthly. The pitfall I see is spending more money in the long run or in a shorter time if a health crisis arises. If your mom is in good health, maybe you can keep the costs down, but that's risky I think. My mom has a slew of health problems and visits many doctors regularly. She's also had a number of procedures that have been very costly. So far the supplement pays for whatever Medicare doesn't and she hasn't gotten in a bill in over two years. Medicare advantage seemed cheaper at the time, but it cost her a whole lot more given her health issues and that's why she changed.

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arianne777 Oct 2015
I am 84, and have had a Medicare Advantage plan since age 65. I would not recommend enrolling an 86 year old person in it. As the person who posted the first comment said, the savings are greatest in the earlier years when a person is less likely to incur larger chargers per doctor visit or hospitalization.

grandmazimb24 Oct 2015
There are pros and cons to medicare advantage plans. Most have an out of pocket maximum so that you know in the worst case what the maximum amount you have to pay will be. The premium is often cheaper than a supplemental plan. However, the network of providers is more restrictive than regular medicare & it seems like the insurance co is more closely monitoring the patients use of resources. I think the biggest plus to a medicare advantange plan is that many of them don't have the 3 day hospital admission before going to a rehab facility requirement. There is a growing problem with people being held in the hospital for "observation", instead of actually being admitted. Some time the observation lasts for days. The patient is then transferred to a nursing home for rehab but hasn't met the hospital stay requirement & medicare won't pay for the cost of the nursing home stay.

SunshinerRain2 Oct 2015
On a very tight budget (below $1000/mo. income), I was delighted to plug into a low or no-pay Medicare Advantage plan! However, when adjusting an upper shelf in one of my kitchen cabinets, I was exerting such pressure on the shelf clips - my feet slipped backwards, I fell off the counter and seriously broke my ankle. The deductibles and co-pays for surgeries and hospitalizations soon exceeded the $$$ I thought I had "saved"! I was 72. I've been back on a Medicare Supplement/Gap policy ever since - even though the Select Plan F is now near $200./month.
We need to work on reducing the COST of health care in America - via pressure on legislators and any other means at our disposal. The more our Insurers pay out, the higher our premiums will become! Check medical bills and report questionable charges being made to Medicare and Insurers.

Nansacola Oct 2015
Medicare Advantage is like an HMO. You can only user their doctors and hospitals.

debrakgray Oct 2015
I put my mom on an advantage plan when we moved her here. (The same one I am on.) Quite a few doctors/specialists in our area stopped taking Medicare patients when Obamacare kicked in. We don't have to have referrals, we just go to any doctor we want. Most are in the plan's network. My 92 yr old mom is in pretty good health, but I wasn't, and I still got excellent care. Sure, we have co pays and premiums, but I think it is well worth it. This coming from a person who did insurance billing for a living.

Llamalover47 Oct 2015
I have Medicare Supplemental through AARP United Health Care Plan F and I pay a monthly premium. EVERYTHING IS TAKEN CARE OF, EVEN WHEN I HAD TO USE IT OUT OF STATE. NO BILLS!

JoAnn29 Oct 2015
Yes, Mom has AARP United health and haven't had any problems. Last hospital stay cost Mom $500. Then 20 here 20 there. She has the Medigap because shehas state prescription plan.

JoAnn29 Oct 2015
Just got info on Blue Shield Medicare Advantage and its says its an HMO. You have to pick a primary.

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