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In reply to the discussion: Medicare Advantage Plans Often Deny Needed Care, Federal Report Finds [View all]progree
(10,904 posts)Two ways to go:
(1). The original Medicare route:
-Start out with Medicare Parts A and B. Part B covers 80% of qualified claims, the insured person has to cover the other 20%. Also, Part A (Hospital coverage) has limitations.
-Optionally, add a Medicare Supplement Plan (aka Medigap) to improve coverage, e.g. take care of the 20% that Part B doesn't cover and better hospital coverage. Optionally, but extremely very strongly recommended. Without one, just that 20% that Part B doesn't cover can (and does) sink many elderly persons financially.
-One must still pay the Part B premium on top of the Supplement premium.
-The government insures the part A and B, while Supplement plans are always sold by private health insurance companies. So this route is partially privatized, unless one is a riverboat gambler and tries to get by with just Part A and B alone.
(2). The Medicare Advantage (M.A.) route:
- Roughly equivalent to original Medicare with a Supplement plan. Is essentially handing over original Medicare to a private insurance company which insures it all. Aka fully privatized Medicare
- But one must adhere to provider networks or pay much more for out-of-network care.
- One must still pay the Part B premium along with the M.A. premium
- Often, has some extras like some dental and vision coverage (unlike Supplement plans that rarely do)
- Is more heavily subsidized by the government than (1) above, that's why its usually cheaper. When they suck enough people into M.A., then the subsidies will almost certainly be less generous.
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I decided on the original plus Supplement route (1) above, because I hate networks with a passion. Plus I read about how people like M.A. because it all costs less than (1), until one gets seriously and/or chronically ill, then many try to switch to (1), but Supplement plans can charge sick people more or deny them coverage completely (they can't if someone starts out with Supplement and signs up within a few months window of when they are first eligible for Medicare, like I did). Some switch anyway.
Complicated.