Just signed up for Medicare Advantage

Just signed up for Medicare Advantage and they billed me for late enrollment in the drug plan even though having it through the VA is supposed to cover that. After mailing in the form twice and talking to someone on the phone twice over the last 2 months I spent several hours on the phone last evening trying to straighten that out. They want a starting date and ending date for the coverage. VA covers me until die but they still want a date. I kept telling them God hasn't told me that yet. Now they want me to get a "top to bottom" wellness check. I wonder if that means naked? I guess I'll find out.

I wonder if that means naked? I guess I'll find out.

Yes, you will find out. But don't get your hopes up. More than likely their version of "top to bottom" means going over your medical history and current meds, checking your vitals, and sending you on your way without undressing at all. But you can hope for something that's more thorough than that. Good luck!

Sorry for bumping into an old conversation. The "top to bottom" wellness check typically means a comprehensive physical exam that includes various screenings and tests to assess your overall health. It doesn't necessarily mean you must be naked, but it's always good to ask your healthcare provider what to expect during the exam. If you want to learn more about medical plans, check this https://www.remedigap.com/medicare-supplements/medicare-plan-n-vs-plan-g/. I hope that helps you!

I am several years out from Medicare eligibility. I really have no interest in getting a Part C plan when the time comes. They advertise them night and day on TV which means there is a ton of profit in these plans for the insurance companies because, if there wasn't, they would not be trying to get all this business. Basically free money as they get a fixed amount each month from the government for each member and at the same time work extra hard to limit payouts and delay treatments (hoping you will die and save them even more money). Frankly, when I see the various restrictions and hoops you have to go through with these plans, it reminds me of when I was in an HMO back in the 1990's and that was not pleasant at all. Restricted network, limited doctor choices, difficulty scheduling, oddball fees for things that should have been covered 100%, etc. Most telling to me is recently New York City wanted to move all city government retirees to a Part C plan to save the city money (I believe the city pays the Medicare fees for their retirees). The retirees and unions hit the root and the city backed down. If these plans are so great, one would have thought they would have embraced them. But they listed all the problems with these plans and the reason they wanted to stick with traditional Parts A, B and D Medicare.

It is up to each person to make up their mind and sort it all out but I have already made up my mind. I just have to wait for my birth certificate to age out to become eligible LOL.

If an employer offers a subsidized secondary insurance ( such as AARP or BCBS) to Medicare retirees they are offering Advantage Plans now to replace that expense. I will have to transition to such a plan in 2024. I ran the numbers and I would come out even under this new plan if I had no more than ten or so medical encounters per year. (Labs, office visits, procedures, specialists)

I have many friends that use Advantage Plans as they do not have retirement benefits to help offset the monthly cost of a supplemental plan. These plans vary widely by zip code and seeing specialists can be daunting as there may be few to chose from and be some distance from one’s home. Rx coverage sucks no matter which plan you have.

While you can switch plans every enrollment period, the carrier does not have to take you if they do not like your existing conditions. You only get a no restriction enrollment opportunity once, at initial (age 65) sign up.

My experience, based on two annual Medicare wellness exams, is that they involved filling out a pre-appointment questionnaire that was discussed at the office visit. I did have some bloodwork done, but do not remember that there was anything beyond the regular stuff that had been being done.

Medicare allows one "physical exam" when you initially enroll. Subsequent annuals are Wellness exams which features a questionnaire and interview where you may not even see a physician.

Traditional Medicare is fee for service , if you don’t use a service you don’t pay for a service , Medicare advantage is a scam on tax payers because tax payers will now be charged $10,000 a month by big insurance even if your in peak physical health . They will provide you a never ending journey of paper work snags, denied care & substandard care when your health changes or you developed something chronic , and here’s the catch advantage plans want you when your healthy because your a cash cow if you get sick and expensive they will frequently abandon you . When that happens your screwed because your no longer eligible for traditional fee for service Medicare in some places they will allow you for 2-3,000,000 to buy back into traditional Medicare , advantage plans aren’t really Medicare they are private medical plans that work great when you don’t need them because your making them $10,000 a month should you actually need something you will be caught in coverage denials and medical necessity reviews that take years . Bush in an attrmpt to privatize and weaken Medicare created private Medicare plans , take any big health insurance company and look at the break down of profits , fully more than 1/3 of that profit is tax payer subsidies payed out in the form of advantage plans( also in many cases you will lose your doctor in the switch from actual Medicare to advantage plan , so be prepared for that ) . You’ve signed up for something that hurts us all . It is currently up in debate by the AMA on wether it’s ethical for a doctor to not tell you what your signing up for by going to an advantage plan .please don’t be angry I’m just the truth , I am not the one who is tricking you and stealing what you worked for ,the insurance company is , if you’ve run across me you know I am retired and have one of the rarest diseases in the world , so I have to be alert and aware of every scam and swindle to ensure I or my friends don’t fall victim , I may not know you personally but I love you and respect you , because we are all just humans trying to survive as best we can .

@SAP We’ve had a Medicare advantage plan with no issues. Even after some very unusual, expensive and involved surgeries, no out of pocket expense. They covered for Medicare. I wasn’t aware if these advantage plans were somehow subsidized by taxpayers. But for us, it’s been a blindfold and hasn’t cost us. Maybe I’m missing something.

Medicare advantage is a scam on tax payers because tax payers will now be charged $10,000 a month by big insurance even if your in peak physical health .

As I noted in an earlier post, I am four years out from eligibility and in exactly four years will be going through all the paperwork and other BS to make sure I am covered in June 2027 (or get a lifelong penalty from Medicare).

When all these Medicare Advantage ads started appearing on TV a few years ago, I did an online search to find out exactly what was going on. There are a multitude of articles on it and, yes, it is free money for the insurance companies. So much in fact that they buy up thousands of hours of ad time to get people to sign up because, again, free money. But then, digging into the nitty gritty, one finds that like every other business, they are "for profit" organizations and want to get as much money as they can from the government while, simultaneously, paying out as little as possible. They are all basically HMO's with an incentive to keep from paying you claims.

Back in the early 1990's, when the medical insurance system had its first major implosion, HMO's suddenly became all the rage. My employer switched us all from a PPO system that had been in place for decades to an HMO plan. We had that about two years before it became apparent that people were not getting the coverage they expected and many people had difficulty getting appointments, procedures approved, etc. Eventually we went to a more liberal managed plan that had more options and better coverage.

There have some rumblings from time to time of scaling back or eliminating the Medicare Advantage plans because of all the financial nonsense going on with them. But who is complaining the loudest? The INSURANCE COMPANIES! They will not give up that free money without a major fight and my biggest fear is they may actually get it expanded even more in order take even more money from the system. With it looking like Medicare will be in the red before the end of the decade, that provides ample opportunity for our politicians to play shenanigan's with the system in order to send even more money to these companies in exchange for nothing.

Lots crosstalk and details The most basic difference between the traditional Medicare and the Medicare Advantage regards your available choices. With the traditional Medicare you can go to any doctor who takes Medicare; with The Advantage plans you must use their doctors or hospitals - unless they give you a waiver/ RX to some alternative but you do get some extras like eyeglasses and/or DDS. I had two surgeries in the past 3 years including robotic heart surgery Under traditional Medical Care with followup physical! therapy and wound care. Never saw a bill! Yes Medicare Supplement Insurance is costly but if you have medical issues it is really worth it

Michjay said….

I had two surgeries in the past 3 years including robotic heart surgery Under traditional Medical Care with followup physical! therapy and wound care. Never saw a bill! Yes Medicare Supplement Insurance is costly but if you have medical issues it is really worth it

I couldn’t agree with you more. In the last few years I’ve had multiple major heart surgeries and treatment for prostate cancer with robotic radiation therapy and much more! I haven’t had to pay a cent with my (pretty pricey) Blue cross Blue Shield supplemental insurance. It was well worth it though!

Yes Medicare Supplement Insurance is costly but if you have medical issues it is really worth it

Given the cost of premiums for my advantage plan compared to cost of premiums and co-pays I had under private insurance when I was working - my combined Medicare/Advantage plan is a bargain!! No restrictions on doctors either. The only out of pocket costs I've had since retiring are for prescriptions.

Pretty sure Medicare entry exam includes coverage for a “barium enema,” - it was specifically listed at their site - so indulge if you get the offer!