Sister in AZ is on an Advantage plan with the free gym membership and all. Got cancer and had a $2500 out of pocket expense for chemo. Then she wanted to switch to a Supplemental plan (with regular medicare) and couldn't because cancer was a disqualifier. If you talk to a broker, be sure to ask about these things. The costs and rules are different for every state, I'm told.
JoAnn is correct. You would be limited as to doctors to choose, and would have to stay inside a network. I love Kaiser, which is a plan somewhat like this, but I know people who have problems with others, unable to find providers for specialty care in their area, unable to get "permission" for procedures, having to go to another doctor in an emergency or another hospital, and having problems with coverage. Advantage costs less. My advice, if the insurance is good and the elder has been happy with the supplemental and can AFFORD it, don't change. Sometimes, upon entry into elder care at ALF the facility has "groups" they work with and they encourage the change. This can be good because often the groups have a visiting nurse or nurse practioner who checks on people at the facility, blood pressure and so on. If one moves, however, then there is still that plan. So what to do. Hard choices. The care in advantage plans can sometimes be a bit more limited, as well. For instance "You don't need that skin tag removed; it is harmless". That sort of thing.
One difference is Medicare allows you to go to any doctor. Medicare Advantages have a network meaning you use their doctors. Yes, there are savings. The doctors u have maybe in their Network, they may not be.
I suggest you call ur Office of Aging and ask if they can help u choose the right plan for you. You can always make a change at open enrollment if u find u don't like an Advantage plan.
From what I understand, mostly your deductibles. Someone on here told me that the Advantage plans are great until you use them. For instance, if you’re hospitalized, you could wind up paying thousands out-of-pocket to meet your deductible before the insurance starts paying. That’s why I’ve stayed away from those policies even though the advertisements make them sound wonderful.
4 Answers
Helpful Newest
First Oldest
First
ADVERTISEMENT
I suggest you call ur Office of Aging and ask if they can help u choose the right plan for you. You can always make a change at open enrollment if u find u don't like an Advantage plan.