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  • Medicare supplemental insurance???

    does anyone have info on what insurance is best for Medicare supplement ????

    i was just told i MUST get Aetna Advantage or be dropped from
    Aetna by November 1st....after they told me for two years that
    i cannot have that plan til i turn 65...i will not turn 65...but now
    they are insisting i get their Medicare Advantage Plan....
    right now i have regular Aetna, and i pay $445 for each person
    getting it....but my deductible is very low...i also have Medicare
    as primary insurance....i had Aetna thru employer before i retired...

    however...Aetna deductible for Medicare Advantage Plan is
    $6700....and i think that is way too high....
    i do not know what their policy is concerning scoli surgery....
    i do want to find a plan with a lower deductible....

    any info much appreciated....
    jess

  • #2
    Medicare supplement.

    Jess, Go to the Medicare web site for your state. They have satisfaction ratings. In every state "A" plan offers the same benefits. The same for B, C, D, E, F, etc.The only difference is price.
    The higher the deductible the lower the monthly premium.
    Medicare benefits to physicians is the same regardless of the plan you have. In other words even if you get an expensive plan the doctor gets paid the same amount. You are responsible for any Medicare deductibles.

    My husband's company offered a terrible plan,after retirement, which required driving some 40 miles to certain doctors. We switched over to our own Medicare supplement. If the deductible in your plan is so high you cannot afford it what good is that? Keep in mind there is no penalty/pre-existing condition situation if you switch over to your chosen plan within a certain time and not cancel before switching over. Some Medicare plans will have a waiting period for pre-existing if you let you present policy lapse first.

    Be aware that not every physician/scoliosis surgeon will take Medicare.

    Go to medicare.gov and read up on your rights.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

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    • #3
      hi Karen
      thanks so much for the reply....

      i spoke to Aetna...it is the City of New York that changed their
      policy for all NYC employees who get Medicare....that is who is responsible
      for the changes now...
      the woman at Aetna is only in charge of "enrolling people"
      and gave me the number of someone at Aetna who knows the plan
      they are offering me.....
      BUT... she said Aetna does not have a Medigap plan...

      i spoke to my NYC union pension people...they said i can switch
      to another insurance company if i want to....and the newsletter
      explaining what they all offer comes out September....

      do you know anything about differences between Medicare
      Advantage plans and Medigap plans...??????
      i heard that Medigap is better, but has higher premiums....
      of courese, Aetna said that is not true....

      i do plan to call CT state insurance people next week....i am having
      trouble with their website....

      jess...& Sparky

      Comment


      • #4
        Medicare Advantage restricts, like an HMO which doctor you can see. Regular Medicare gives you a choice of ANY doc in the USA who takes MEDICARE.
        Be careful. Low premiums can mean higher out of pocket costs which can blindside. You know you will need care down the pike. Try to budget what you can afford as far as premiums for the plan that offers you the most. You can read a lot on-line about tips re: Medigap.
        Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
        Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

        Comment


        • #5
          Originally posted by Karen Ocker View Post
          Medicare Advantage restricts, like an HMO which doctor you can see. Regular Medicare gives you a choice of ANY doc in the USA who takes MEDICARE.
          Be careful. Low premiums can mean higher out of pocket costs which can blindside. You know you will need care down the pike. Try to budget what you can afford as far as premiums for the plan that offers you the most. You can read a lot on-line about tips re: Medigap.
          Karen, That may be true about which doctor you can see if you get an HMO plan. Jess, make sure you get a PPO plan if you get for a Medicare Advantage plan because it will not limit you to certain Doctors. We had Tufts Medicare Advantage PPO in Massachusetts and were very pleased with it. I paid very little out of pocket costs when I had my surgery. When we moved to NC, we signed up for BC/BS supplemental plan and the premiums were very expensive, so this year we switched back to a Humana Medicare Advantage PPO plan with low premiums, but higher deductables. It also covers me when I go back to see Dr. Rand in Boston. We are setting aside what we are saving on the premiums just in case we have to spend time in a hospital. Our plan also pays for most of our generic prescriptions. With BC/BS, we had to get a separate prescription plan. If you think you will be having surgery next year, it would probably be better if you got a PPO plan with higher premiums and a lower deductable. Every year, these plans change or are eliminated or whatever. I am not sure, but Medicare Advantage plans might be eliminated with Obama care. It is all a crap shoot and is very difficult to wade through all of the different plans available to your state, and each state is different. If you have a council on aging in your town, they will help you to make a decision as well as the Medicare web site that Karen mentioned.
          Good luck! it is a tough decision to know what is best.
          Sally
          Diagnosed with severe lumbar scoliosis at age 65.
          Posterior Fusion L2-S1 on 12/4/2007. age 67
          Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
          Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
          New England Baptist Hospital, Boston, MA
          Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

          "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

          Comment


          • #6
            turns out i don't have the insurance options i thought i did...
            i have to go with a NYC plan...since i am a NYC employee, retired...
            that leaves me Aetna or GHI....with Medicare my primary...
            i can cover husband as well, til he qualifies for Medicare, and
            then he could be covered with same plan as me...

            i do not iike either option....
            coverage of either of them is not great...

            jess

            Comment


            • #7
              i have Aetna Medicare Advantage PPO

              but i do not think very many scoli surgeons take it...

              i had to take the plan i have to stick with help from
              having a plan thru NYC DOE....

              looked it up online...it is a different time period to change out of an
              advantage plan and back into regular Medicare.....then after
              that you can pick a supplemental plan...
              looks like it is beginning of year, every year....

              jess...and Sparky
              Last edited by jrnyc; 06-09-2014, 01:33 AM.

              Comment


              • #8
                Can you switch under the Affordable Care Act? I don't know enough about it.
                Sharon, mother of identical twin girls with scoliosis

                No island of sanity.

                Question: What do you call alternative medicine that works?
                Answer: Medicine


                "We are all African."

                Comment


                • #9
                  Insurance

                  Originally posted by jrnyc View Post
                  i have Aetna Medicare Advantage PPO

                  but i do not think very many scoli surgeons take it...

                  i had to take the plan i have to stick with help from
                  having a plan thru NYC DOE....

                  looked it up online...it is a different time period to change out of an
                  advantage plan and back into regular Medicare.....then after
                  that you can pick a supplemental plan...
                  looks like it is beginning of year, every year....

                  jess...and Sparky
                  Did you check to see whether your favorite surgeons are in it? Call their offices.
                  Changing plans are allowed under the ACA in Nov unless there is a "life changing event". This includes change of job, loss of coverage and others. Low incomes sometimes allow for a subsidy. Check with an ACA navigator or on-line.
                  Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
                  Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

                  Comment


                  • #10
                    all the info in looked up says Medicare Advantage plans
                    cannot switch til January...
                    i do not know if the info people are looking at involvees
                    Medicare...

                    jess

                    Comment


                    • #11
                      Lonner takes my insurance...
                      i am totally shocked...

                      jess

                      Comment


                      • #12
                        Jackpot! I'm so glad you have him as an option, Jess.
                        Sharon, mother of identical twin girls with scoliosis

                        No island of sanity.

                        Question: What do you call alternative medicine that works?
                        Answer: Medicine


                        "We are all African."

                        Comment


                        • #13
                          thanks Sharon...
                          my jaw literally dropped when the woman on phone
                          told me they take it...

                          i do not know what i will be doing...but it is so good
                          that he takes it

                          jess...and Sparky

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