Medicare Advice for Parent

Sell your heart.

How old is your mother? If 65, she would be eligible and should have received paperwork on enrolling. I'm thinking you would be able to get her on outside of open enrollment since this would be a qualifying event.

I would suggest using CHATGPT and pose the question to it. If you haven't used, it is very user friendly. When posing the question, put your mothers age and what state. It will guide you and tell you what and how you need to enroll (if applicable).

You are a good son - bless you both!

Forget about COBRA. Look into a managed Medicare plan like Humana or CIGNA. More benefits that traditional government Medicare, better reimbursement and less out of pocket for your mom.

OP, I remember someone on here talking about Medicare once, and suggesting that everyone see a "Medicare Broker" who can help explain the whole system to you, and also complete the necessary forms for you.

I'm assuming there's a fee, though.

Not sure where to find a "broker," but it might be a place for you to start.

Thank you. I think I’ll have to see a broker or at least have someone more knowledgeable than me try to help me figure it out.

I also was incorrect. She actually has Medicare Part A. That’s how lost and overwhelmed I am.

Medicare Part A is "free" to all Medicare eligible people so most elect it as soon as they can. There is no reason not to.

Medicare Part B costs money (currently around $140 a month). Most people have it taken from their social security check, though you can pay it directly if you want to.

Since Part B costs money, it isn't unusual (like your Mom) to forgo Part B if you have access to commercial insurance. Why pay for it if you have primary insurance?

Once that commercial insurance ends though, your Mom should sign up for Part B ASAP, or as R3 mentioned, sign up for a MAPD plan (which includes medical & prescription usually). MAPD plans have hoops to jump through (networks, prior auths, etc.) that normal Medicare doesn't, but the benefits are generally much better.

There are also Medigap policies, that cover 100% of whatever Medicare doesn't and have no prior auths, no networks, etc. They are the easiest and most comprehensive (for medical - not prescription), but ... $$$.

Do not elect COBRA. It is expensive, and there are better options for Medicare eligible people.

A Medicare broker is the best route. They can explain everything for you, and usually there is no direct cost to you (or your mother). They get paid commissions by the insurance company.

First, OP, make an appointment at your local Social Security office. They can enroll her in Medicare Part B, the sooner the better, because the cost goes up with each successive year you wait.

After that, you can wade through the advantages of the various supplementals and choose one if you think it's necessary. Different plans cover different things, so you'll want to comb through them carefully to see which one/s might be best for your mother.

These things truly are a nightmare to decipher, and no salesperson is going to tell you the truth. I would imagine the poster who suggested having AI do it is giving you great advice.

But get Medicare B first!!!

Thank you for your replies with actual advice. Part of my confused stemmed from someone telling me that one can only have Part A or Part B but not both.

She could become a prostitute and pay that way

She can only get Medicare if she’s 65 or older ( and either she and/or husband worked and paid into Medicare for 10 years.

Interestingly, social security offices have the best info about Medicare because people deal with the two about the same time. You can also call 1-800-Medicare

[quote]Part of my confused stemmed from someone telling me that one can only have Part A or Part B but not both.

This is clearly wrong. As others have said, she can absolutely have one or both. Part A is free; Part B has a cost as noted above and can be declined (she may or may not be automatically enrolled).

I had a somewhat complicated request to refuse Part B. While it required waiting a couple hours for callbacks from Social Security, the staff were well informed and most helpful in finding a solution for me.

OP check to see if any libraries near you offer free seminars on understanding Medicare. They explained all the differences between regular Medicare and Advantage plans and what covers what. Also AARP as medical insurance is very good.

Talk to a BROKER

If your Ma is Medicare eligible, get her on one of the Medicare Advantage plans. My mother has it and breezed through her cancer diagnosis and treatment with very little financial pain. Her breast surgery was $950 out of pocket. Every test and surgery was covered. I'd look at Blue Cross Medicare Avantage.

He doesn't need a broker. The Enrollment period is in the late Fall So just get her enrolled in a plan early in November.

If she is over 65- enroll in ORIGINAL Medicare (my CPA and Retirement analyst both advised against Medicare advantage plans). If she is not yet 65, contact his HR dept to find about about extending 18 months of cobra

If R3 is talking about a Medicare Advantage plan, PAY NO ATTENTION TO THAT POST. Advantage plans are neither Medicare nor an advantage. Anyone who tells you anything different is lying and woefully stupid.

Just call Medicare at (800) 633-4227 and they can guide you through the process.

Part A covers hospitalizations, and there is no premium.

Part B cover doctors, clinics, lab tests, out-patient procedures. The premium is $185 a month (not $140 as some stated above). Part B only covers 80% of what Medicare is charged. The remaining 20% is your responsibility. You can either pay that yourself, or you can buy supplemental, or medigap insurance, which will pay that remaining 20%. My premium for the supplemental insurance is $140. There are different supplemental plans - I have a Plan G. No matter who I buy the Plan G supplemental policy from, the coverage is exactly the same - the only difference is the monthly premium.

Then there is Plan D for your prescriptions. My premium for that is $0. And it covers most generic drugs for free or very little cost. But if the drug is not generic, then my coverage is not good.

Medicare Advantage does away with Part B, and supplemental insurance. It is private - you are basically in an HMO. You have to have pre approvals for many things and you pay an out of pocket co-pay for each doctor’s visit. The out of pocket cost goes higher if you see a specialist. - maybe $75 per visit. You can only go to certain approved hospitals and doctors - if you see a doctor out of plan, then you pay much more for the visit. Medicare Advantage is not Medicare - you are dealing with a for-profit insurance company. Medicare doesn’t even get the bill - it goes to the private insurance company.

If you travel, Medicare advantage is not for you.

Many hospitals and doctors won’t see patients who are in Medicare Advantage. I go to the Mayo Clinic - they will not see you under any circumstances if you have Medicare Advantage.

Hope this helps.

[quote]Thank you. I think I’ll have to see a broker or at least have someone more knowledgeable than me try to help me figure it out.

When I was doing all this for my dad around ten years ago, I found out through my library (which had posters and pamphlets) that our local United Way Office had a team of Medicare brokers in their office starting in October and running through January. I believe the program at the time was called "The Point at United Way " (or something like that - 'The Pont' was in the name). Anyhow, United Way had donated the office space to them for that fourth quarter.

I went to the same woman each year and she was a HUGE help, and FREE. She took all the time we needed, explained everything, and made sure we were satisfied with our choices. He saved a ton of money with her between monthly fees and prescriptions. I don't know if this still exists or if it's offered, but call your local UW office and find out. If they're not offering it - ask who does. Or, contact your library and ask them if they know of any place offering free Medicare brokerage for seniors (sometimes the libraries will have these on certain days in the fall). I should point out that this service I found 10 years ago was not available online, nor did the UW advertise it online on their site - so call if you don't see it !

Hope this helps!

If there is a council on aging in your area, something like that, they will explain it. They have seminars to go over the basic stuff and then you can see an advisor to go over what is best for your mother. Medigap is the term for stuff not covered by Part A and Part B.

Also depending on what prescriptions she takes, it might be cheaper not to get Part D and instead order them from CostPlus, Mark Cuban’s mail order service and pay.

Forgot to say it’s not necessary to wait until that “enrollment period” in November for medigap. You can sign up anytime.

I have original Medicare and buy a part B and part D. That’s because I do not want to deal with NETWORKS. I got into it through a broker friend of mine who recommends plans, even those she doesn’t get commission for. You can all of the info on Medicare’s website too. The problem is the Rx drugs. You only have to pay $2000 out of pocket now (until Trump fucks it up), but different plans only cover some prescriptions. Same issue with Advantage.

Trump and Kennedy Jr have been talking about throwing all Medicare into insurance companies Medicare Advantage, so regular old “traditional Medicare” may be over soon.

I’m sorry about your dad, OP. Good luck helping mom out, I hope she knows how fortunate she is having you worry for her.

Since your mom id 65+, she doesn't qualify for COBRA or ACA/Obamacare. Those would pay, at most, as secondary coverage (20%). Once you reach 65, your options are Medicare or "creditable" insurance through an employer that either you or a spouse is working for. "Creditable" is usually defined as a company of 20+ employees. This is how your mom was insured until your father's passing. She has 2 options for Medicare. She either chooses traditional government Medicare along with a supplement (aka MediGap) or she opts for a Medicare Advantage plan. There are advantages and disadvantages to both. Original Medicare with a supplement is far, far less restrictive. There are no networks or prior authorizations required. You simply go to any provider anywhere in the US that accepts Medicare. The negative is that it is more expensive. Medicare Advantage is a privatized version of Medicare (Republicans dream come true) in which you sign up for a specific plan with network restrictions and required prior authorizations. It's similar to what most people have while working. There are a very few PPO Medicare Advantage plans still available but they are being phased out. Nearly all are the more restrictive HMOs. I STRONGLY advise that you get in contact with an independent agent. I used Giardini Medicare and highly recommend them.

Talk to a broker many states have "Navigators" to help people find and understand coverage. COBRA is not considered creditable coverage for Part B. Neither is a plan from the Marketplace. She has a limited time (generally 7 months) to enroll before she will pay lifetime penalties for Part B and D. I would be careful about Medicare Advantage plans. They promise a lot, but there are many who report problems with pre-authorizations and such.

Continuing from R25. You can always start out with original Medicare and a supplement then switch during annual open enrollment to a Medicare Advantage plan if the premiums get too great. It can be VERY difficult or impossible to do the reverse in most states as they usually require medical underwriting. Otherwise, everyone would switch back to the more comprehensive original government Medicare/supplement when they got sick. I personally am taking original Medicare with a supplement because I can afford the better and less restricted coverage. If it's just not in the budget, an Advantage plan is a lot better than nothing. Please get in contact with an agent soon and help your mom understand it if you can.

R18's reply was a good one. Be very careful with Medicare Advantage, as many specialists don't take it at all, though they take original Medicare. I remember taking my mother to the best cancer practice for infusions and they had a big sign up that they accepted regular Medicare but not Medicare Advantage.

Then get a medigap policy for the other 20%. Plans F and G are the most comprehensive (and most expensive). My recent prostate cancer radiation treatment was fully covered at the best teaching hospital cancer center. I paid not a dime (aside from the Medicare deduction from social security and the monthly premium for the medigap policy. If you can afford that, that's the way to do it. No preauthorizations, no networks, no hassle. Second opinion? Just get the outfit you want to do it and do it. Be somewhat careful in shopping for a provider for Part D (drug plan). Each has its own formulary (list of approved drugs, usually divided up into generics and other types, with associated co-pays). My husband and I are paying $22 each a month for Part D. Our co-pay,ments are very modest, though Trelegy (3 drug inhaler) is only partially paid for, and it's an expensive drug.

While you definitely want an agent/broker to guide you with a Medicare B supplement/Advantage plan option, you generally have to pick a part D supplement on your own. They don't give agent commissions so most will guide you, but you need to do some of the work yourself. If you opt for an Advantage plan (not my recommendation), it already includes drug coverage so part D isn't needed. You want to select the cheapest part D available that has your medications on formulary. You have the ability to change this every year during open enrollment should your needs change. Below is a link that allows you to compare plans. You enter the medications you are taking.

What do you pay for your Medigap policy R28?

There is a reason Advantage plans are so popular (over 50% last I looked). It isn't because people love them. It is because the alternative (Medicare plus Medigap PLUS part D policy) can run $300-$400 a month (an this is on top of the $185 for Part B - thanks R18).

I work in insurance, and steered my parents to an Advantage PPO plan (I would NOT do an HMO). I didn't love it, but they also did not want to pay almost $1200 a month for just insurance. They just can't afford it.

Add into this, even with a Medigap+Part D polices, you will still have to pay drug co-pays.

Those against Advantage plans have good points (R17 and R22 - well mostly just R22), but a person really needs to evaluate their own health before making this decision.

I'm R25,R27, R29. Trying to get a a PPO Medicare Advantage plan now is nearly impossible in much of the country. There has been a recent and drastic change to the much more restricted HMO network plans. MediGap/supplement plan costs vary greatly by region. New York and Florida are particularly high. A 65 year old non-smoking male can expect to pay $140/month in a large city in California for a plan G. Costs do go up as you age so ultimately some people have no option but to switch to an Advantage plan down the road. You must pay the part B premium regardless of the option you go with. My parents ended up having to switch to an Advantage plan in their 80s due to the cost. My recommendation is to go with original Medicare with a supplement if you can afford it and for as long as you can afford it. You can always switch down to Advantage but not the reverse.

[quote]You can always switch down to Advantage but not the reverse.

You can, but they underwrite you - meaning they ask health questions and price your premium accordingly.

Because I retired before the age of 65 and started receiving Social Security benefits, I was automatically signed up for Medicare.

R32 ...or in many cases, simply deny you. There are a few states (very few) that make it easier, but you'll likely be stuck with Advantage if that's what you went with initially (outside of the trial rights period). You CAN ALWAYS change to an Advantage plan should the costs of a supplement become too much to afford. Basically, each person has to decide for themselves how comfortable they are with the restrictions of an Advantage plan vs the cost of a supplement. There really is no right or wrong answer.

Another Medicare treat is that when you go to your doctor for your physical, you're handed an ipad with lots of questions that they have prepared for you to answer.

BTW, the doctors don't like it, they prefer to be the ones who ask the questions.

Medicare isn't that complicated. Set up an account for your mother (and you while you're at it) on saa.gov to start. There's good info there, especially info specific to your mother. Also, there are alot of good videos on YouTube about it all.

R37 It is a bit more complicated in this particular situation. She and her late husband declined Medicare part B at 65 because her husband had credible coverage through work. That was a perfectly fine and reasonable thing to do, but now she does need to submit a CMS-L564 form (Employer Coverage Verification) signed by her late husband's employer. I'm not sure she'll be able to apply for part B online (ssa.gov site) in her case either. She may need a CMS-40B form (Application for Enrollment in Medicare Part B) to use with the Employer Coverage Verification. Otherwise, she can be permanently (for life) given a penalty for not taking part B at age 65.

I definitely wouldn't just sign up for any old plan (supplement or Advantage) without the assistance of an independent agent. It costs you nothing extra (insurance supplement/Advantage company pays the commission). If you have any issues with your policy, your agent will assist you. Agents also know which plans are most likely to hold their value over time.

Another consideration that you really must look into is the possibility that your late father's company offers supplements and/or Advantage plans as a retirement benefit. If they do, it will almost always be much better value than anything else you can get as a private person. Some companies, including where I worked, actually reimburse for the part B premium. Please check this out before you sign up for anything else.

OP, go to the link below. Hook up with an insurance agent through Health Markets. They can guide you and your mother through the system. I used an agent through Health Markets years ago when I was self-employed. The agent visited me in my home and he signed me up with affordable insurance through Obama’s exchange. It was a godsend to have this guidance as I didn’t know my ass from my elbow when it came to this. Good luck, OP.

I have been on Medicare Advantage for nearly ten years. It's fine. I have had no problems with it. When you buy "supplemental insurance" to combine with your Medicare plan you're doing the same fucking thing. I mean it's the same result. And not necessarily the most cost effective.

Use a broker, they make a commission, you don’t pay them. If she’s over 65 sign her up for Medicare parts A & B. It’s she takes a lot of medications sign up for part D. Cigna has the most comprehensive coverage currently. Sign up for Part G, the premiums for part B, D and G will still be lower than the premium through a workplace or an individual plan. Interestingly enough, right now United Healthcare has the best Part G. It will pay for a gym membership, a good discount on hearing aids, vision exams and prescriptions, and dental work. I suspect this is temporary because they’re under a dark cloud because the Luigi incident highlighted how heartless they can be. But during every open enrollment period you can change carriers as needed. Meet with the broker every year, they’ve studied up and can show you comparisons. Open enrollment is between 10/15 and 1/15 each year…I think.

R40 "When you buy "supplemental insurance" to combine with your Medicare plan you're doing the same fucking thing."

I'm glad you like your Advantage plan. A lot of people do. The idea that it is "the same" as original Medicare with a supplement is, however, very misleading and just not true. With original Medicare/supplement, you have no networks, no prior authorizations, no need for referrals. You simply make an appointment with any provider anywhere in the USA that accepts Medicare and you are in. If you want to see a cancer specialist at MD Anderson, you are in. If you feel that you would benefit from a specialized world-class facility like the Mayo Clinic, make an appointment. None of this is possible with a Medicare Advantage plan. You must see providers in your network in order to be covered. If your doctor thinks you need an MRI to get an accurate diagnosis, it might be covered IF your doctor can make a case and get it authorized. If you would like to get the opinion of an orthopedic specialist, well...if you can get your primary to agree to a referral, you can see one that's in network.

DO NOT GET A MEDICARE ADVANTAGE PLAN.

It’s like private insurance you had when working—they will deny potentially lifesaving treatment to save money. What worse is, while you can change to regular Medicare, MediGap plans (which help pay co-pays and limits the yearly amount you’d have to pay for an illness) CAN refused to take you if you have a preexisting conditions after age 65.

The nicest thing about having standard Medicare is that it’s good everywhere in the US, unlike Medicare Advantage plan. MA plans are only good in network, which is near you only.

One other wrinkle is that if you father worked at a very lucrative job even after starting to receive Medicare, Medicare will charge more for part A insurance initially than the average cost of $180 something a month, if your dad earned over a certain amount. Medicare and SS will continue to change that extra fee until the next time your mom files taxes to prove that her income is low enough (as the vast majority of seniors do) to qualify for the lower Part A fee.

Usually a widowed spouse receives the larger of the two SS amounts (in other words, if your dad's monthly SS was greater than your mom's, she will receive his amount). All of this is unnecessarily complicated, but it's the system we have.

If there is any chance that your father is/was eligible for a pension, it's quite common that the pension will cover the cost of supplemental insurance with whatever company it uses, for the widow, by deducting that amount from the money she would otherwise receive. That is a good deal if your dad had such a thing. Nothing out of pocket, no decisions to be made, and usually very good insurance - no fly-by-night outfits.

Here's a source you can talk to for free before or instead of getting a broker: https: // www.shiphelp.org / . Once in, look for your local SHIP (State Health Insurance Assistance Program).

R44 I believe you are talking about IRMAA (Income-Related Monthly Adjustment Amount). That has nothing to do with Medicare part A which is completely premium free for everyone that worked at least 40 quarters (10 years) during their working life (or had a spouse that did). IRRMA is the additional premium amount for Medicare part B that the wealthy have to pay. It's based on your income from the prior 2 years. For the vast majority of Americans, the part B premium is $185/month (2025 rate for incomes of up to $106,000 single filer or $212,000 married filing jointly). It can go up substantially if you are a high earner. The maximum is $628.90/month (2025) for single filers with incomes >$500,000/year. Part D (drug coverage) is also subject to IRMAA, but it's not that much even at the highest end.

The employer doesn't necessarily have to provide a pension to provide Medicare benefits in retirement. Those are 2 different types of benefits of which some employers give both, either or neither. My employer provides a reimbursement for the part B premium as well as a portion of my Medicare supplement. I mentioned in an earlier post that the OP really needs to check and find out what his father's retirement benefits are as that may make all the difference it what his mother does for Medicare. If there is a supplement offered as a retirement benefit, the benefits manager at his father's job may be able to help set up everything including signing up for part B.

More on IRMAA and tables for 2025. It goes up every year like anything else. If you are subject to IRMAA on retirement, it isn't necessarily permanent. If/when your income drops, so does your IRMAA obligation. It's generally based on your income from the prior 2 years. Things like taking a substantial distribution from a 401K or IRA can trigger IRMAA. It's something to watch out for.

[quote] I have been on Medicare Advantage for nearly ten years. It's fine. I have had no problems with it.

That's because you've been lucky and not suffered anything really serious (aka expensive). If that time comes you'll find that your coverage is woefully poor, and you'll wish you had switched back to traditional Medicare.

There is a reason more and more health care providers have stopped taking Medicare Advantage patients.

R42, and R43, With my Blue Cross Medicare Advantage I have done self referrals, and had no problem, and I have never been turned down for a procedure or a test. I am a cancer survivor. I get MRI's and colonoscopies regularly. The Preferred Provider Network version has never been an obstacle and you can absolutely go to a specialist outside the network if you need to. Yes. You will pay more. My co pay for a doctor's visit is $25 and if it is an out of network provider it is $40. I take 8 different prescription medications every day and my costs for those is low too. I am a Costco member so I use their pharmacy along with my insurance and I am doing really good with it. When I got COVID while visiting California three years ago, I needed two different prescriptions and was able to get them (at CVS) with no problem.

I am telling you from my personal experience that my Medicare Advantage plan is not some terrible, dangerous, costly, inefficient insurance. And if you believe a supplemental insurance hitched to the Medicare plan cannot turn you down for a procedure or a test you are wrong. All insurers can and do deny claims or withhold approvals every day. Look. You can always change. Basically, you're enrolled in Medicare. If you want to switch from a supplemental to Advantage to try it out, you can do it during the enrollment period. Try it for a year. If you don't like it you can always switch to supplemental. It's not forever.

She can apply for survivors benefits through SS and if she doesnt have a lot of money she can get Medicaid and snap (which is shit but its something)

R40, R49 I an glad that your Advantage plan has worked for you. Based on your option to see specialist out of network with ease tells me you have a PPO plan. That stands for Preferred Provider Network. It's a tired system where one can leave the network, or use an extended network for a increased copay. Unfortunately, this option is closing. Most areas no longer are offering it as of this year to new members. Odds are, you are going to have to change to an HMO soon.

There is one time you have an option to try an Advantage plan for one year and switch back, it is what I referred to in R34 as "Trial Right". Other than that one time, it's very difficult to switch back to original Medicare and get a supplement. You have to be able to pass medical underwriting in most states (not just most states, but nearly all of them). You can ALWAYS switch from original Medicare to Advantage during open enrollment. There is no medical underwriting for that.

The "supplemental insurance", assuming you mean the Medicare supplement can NOT turn you down for the procedure or test. You are wrong on that. They are legally bound to pay the 20% Medicare didn't cover without question. They do not have any ability to enter into decision making, period.

I've said over an over again that there is no right or wrong with whichever you choose. If you are OK with the restrictions of the privatized Advantage system and want to (or need to) save the money, that the option you should take. If you can afford the flexibility of original Medicare with a supplement, take that for as long as it is in your budget then switch to Advantage once it's not.

If I'm honest, I picture a future where the Republicans privatize Medicare completely and original Medicare is no longer a thing. At that point, the costs of Advantage will soar and benefits diminish, but that's another topic for another day.

R51 Your vision of the future is not a fantasy. Benefits will diminish and costs will soar across the board both for a hollowed out version of Medicare and for health insurance in general within the next 3-5 years if we continue along the current path.

OP here back with an update. It’s been a long tedious day.

I do have an appointment with the insurance broker soon, but in the meantime I’ve been trying to enroll my mother into Medicare Part B through the Social Security website. I can’t even create an account for her as the image verification process is not matching her photo to her ID photo when they’re virtually identical.

I called the social security 1-800 number for help and to make an appointment at my local office. The local office has no appointments available and what they’re going to do is send me a letter in the mail with a possible way to make an appointment in the future.

DOGE created a mess.

I just went ahead and printed out the documents that I would most likely find on the social security account website, am going to fill them out, and hope for the best.

R28 asked what my Medigap policy cost. It's a little over $300 a month for Plan F, which was the best and most expensive available. (Plan G is almost the same.) Having said that, I've never had to pay anything for some major medical stuff -- including prostate cancer radiation that was billed at over $150,000 (though of course the provider, a major medical center and teaching hospital accepts the negotiated rate) and many associated tests before and after. My Plan D is about $42 a month, and since I'm only on generics for blood pressure and a statin, I pay very, very small amounts when I get 3 month refills in the mail from CVS Caremark.

I'd just add that I'm fortunate that cost isn't a factor. My husband and I are in the middle tier of IRMAA so we do pay more for Part B. And likely to stay there now that we're taking 401K RMDs of almost $100K a year.

In general, get the best medical insurance you can afford. If that puts you in an Advantage plan, get a PPO if possible. Understand what limitations there are if you travel a lot, within the US or internationally.

Europe treats its elderly population so much better. There are no extra medical costs at all

[Quote] If I'm honest, I picture a future where the Republicans privatize Medicare completely and original Medicare is no longer a thing.

That is the goal of the GOP no matter what they say out loud. Just like with SS, they want to take public funds and push them to the private sector to make huge profits and offer you far less than you get now

Medicare Advantage plans act like private plans, particularly if you have some expensive procedure or testing. They can deny you that care, just like private insurance does.

Standard Medicare rarely denies.

R55 I'm not sure what this post is referring to. If you are on Medicare, in most cases, there is NO coverage outside of the US. Some plans offer brief periods of reimbursement of up to 80% of emergency care only. If you travel or live abroad, you had better look into other health insurance options. Europe doesn't subsidize healthcare for Americans on holiday.

I assumed R55 was commenting broadly on the healthcare available to Europeans, not to American Medicare recipients in or visiting Europe.

[quote]Europe doesn't subsidize healthcare for Americans on holiday.

No, but they do expect to offer medical services on an emergency basis to non-Europeans at a price, but a fair price. If an non-European breaks a leg or requires an ambulance and an overnight stay at hospital for an apparent heart attack, he will be presented with a bill -- for a couple of hundred Euros. And if he's unable to pay it, he will not be hounded for the rest of his life, and probably not asked more than once or twice. The system doesn't tilt on making maximum € from every misfortune.

The EU countries, and the countries of most other industrialized nations, have universal healthcare. The way that is managed depends on the country. I understand that the NHS in the UK is completely covered by tax dollars. Germany, however is more like American Medicare. Retirees in Germany do have to pay monthly unless they are indigent. In that case it would be covered in much the same way as Medicaid is in the US. Medicare is actually comparable (as it is currently) to a universal healthcare system although only for the elderly and a select few others. If the US had Medicare for all, it would be an excellent system.

When you travel abroad you can get traveler's insurance and I highly recommend it. You can get coverage for as long as 18 months. My sister works in London. She has been a resident so she gets basic health care from the NHS, but her company pays for supplemental private insurance.

Have you sold your heart yet!?

US is crazy - $1400/month at 64 for basic coverage. Then you turn 65 and for $185/month you have stellar SOCIALIZED coverage as good as the best in the world. Now just need to live to 65 to get it.

Our CPA and financial planner both told us the same thing, "stick with original Medicare only!" Companies offering advantage plans are reimbursed by the Govt for a specific fixed amount -set by law. When your claims are low, no problem for you. But wait until they have a lousy financial Qtr. or you have super expensive treatments .deny-deny-deny.

It's important to remember what I said before. Medicare Advantage Plans are neither Medicare nor an advantage.

I’ve been asking a few senior friends about their Medicare. Most have no fucking idea what they’re on. After seeing their cards, ALL are on Medicare Advantage. Reasons? AARP recommends it, my husband has it, blah blah blah. Nobody knows shit about Medicare.

AARP does not recommend advantage plans over traditional Medicare. They simply provide as much information about the plans as possible so people have the info they need to make an informed decision.

More and more healthcare providers have stopped accepting Advantage Plans.

R64 The US government spends more taxpayer money per patient on Medicare Advantage (MA) patients than it does on patients with original Medicare. YET, MA patients’ claims are rejected far more often those of Original Medicare patients.

In addition, some MA companies have been found to be “up-coding” patients’ conditions to get even greater Federal reimbursements, all the while denying treatment of the patients.

That means that the for-profit private companies that run MA plans are raking in taxpayers’ money via the Federal government, in some cases fraudulently.

Gee, I don’t think we’ve heard anything from the Trumpites about cutting the waste and fraud of the MA insurance companies that consume taxpayers’ money.

Perhaps not surprisingly, the most likely replacement if the Trumpites terminate Original Medicare is MA plans.

I have Humana MA and I just got a bill for my MRI for $6, 600 and change. It was entirely covered by my Medicare Advantage. I had cancer surgery two years ago. My share, was $900.00 If I reach a point where I start having difficulties with my plan I will switch. Once a year, every Fall there's an enrollment period. You can switch. You have choices. Nothing is etched in stone.

OK. Say you have Medicare and you buy supplemental insurance. Not Medicare Advantage. You do realize they can deny claims too? They can have a lousy financial quarter too. Every single thing you complain about with MA is also true of other insurance carriers. And anytime you are dealing with any government program they have what is called the "capitation rate." They all cap the amount the government is willing to reimburse the Plan.

r70, Unlike Medicare Advantage plans, Medigap policies do not routinely deny claims. As a supplemental insurance, a Medigap plan's function is to cover costs left over after Original Medicare (Parts A and B) has already paid its share. Because of this, Medigap claims denials are rare, and usually the result of an administrative error. The initial claim is first approved or denied by Medicare, not your Medigap insurer. re. If you opt to switch from Medicare Advantage to original Medicare.. Once you switch, you may need to undergo medical underwriting for a Medigap (supplemental) policy, which could result in denial or higher premiums if you switch after your first year with Medicare.

also, You will not find a "capitation rate" for Medigap plans

R70 You are simply misinformed in your understanding of how MediGap (supplements) work. When something is covered by Medicare, a supplement (regardless of issuing insurance company) has no choice but to cover it. They can’t deny the claim. Original government Medicare, unlike the private Medicare Advantage plans VERY rarely requires prior authorization. One of the few instances is with blepharoplasty (they want to make certain it isn’t primarily for cosmetic reasons). Medicare Advantage is well known for making patients and doctors jump through hoops. Medicare Advantage is private insurance plain and simple and is very similar to insurance through employment or ACA/Obamacare. They are more commonly an HMO (they are rapidly phasing out PPO options for Advantage plans) and have network restrictions, claims denials and prior authorization requirements that simply are not seen with original Medicare/supplement coverage. They are much cheaper, though. Certainly they are much better than nothing. I tell friends and family to get original Medicare with a supplement…if they can afford it. If they can’t, get an Advantage plan.

R73, then why is R70 coming up with all this bullshit?

R74 Why does Donald Trump come up with his bullshit? Who knows.