Beware of medical provider changes in Medicare PPO plans

[WinniWoman]

@WinniWoman What a mess!

Yup. And my problem is I worked in healthcare all these years and plus I was an account executive for a not for profit HMO. I know too much.

 

[bogey21]

And pity the poor people on "socialized" medical care ... aka Medicare

Medicare is great if you have the money to pay for Traditional Medicare with a Supplement and a Prescription Plan. You can use any Doctor or Hospital in the US that take Medicare patients. I did have a problem finding a PCP who took Medicare patients but other than that have had zero problems getting treated competently and promptly. The problems (to the extent there are any) seem to be with the zero or low premium Advantage Plans. Basically like everything in life money talks...

George

 

[WinniWoman]

Medicare is great if you have the money to pay for Traditional Medicare with a Supplement and a Prescription Plan. You can use any Doctor or Hospital in the US that take Medicare patients. I did have a problem finding a PCP who took Medicare patients but other than that have had zero problems getting treated competently and promptly. The problems (to the extent there are any) seem to be with the zero or low premium Advantage Plans....

George

Yes- but I am not on Medicare until 6/2021

 

[VacationForever]

Yes, thank you VacationForever and others for the information. Have you had this happen to you since you seem very knowledgeable on this topic? It’s just a surprise to us that our Medicare
premium would be raise. Here I thought once we sold the rental properties most of the unforeseen expenses would be gone and we would be “headache free” without all those extra problems. Live and Learn as they used to say. I love reading all these topics and feel tuggers are a great asset.

Yes. First hand experience hence I have posted the process.

 

[bogey21]

Yes- but I am not on Medicare until 6/2021

If you have no pre-existing conditions, you might look at United Healthcare's Short Term Policies. You could buy one for 6 months and after it matures buy another for one year. That would cover you until June 2021. I believe that you get access to the same network as other United Healthcare policies. Short Term Policies are a heck of a lot cheaper. The downside is that you can't renew a policy at maturity (you have to write a new one) which means that anything that happens to you during the life of the expired Policy is considered a pre-existing condition and they won't write the successor policy. This is why I recommend the 6 month policy first followed by a one year policy. You can find them at www.uhone.com These are the same policies issued for years by Golden Rule Insurance which was acquired by United Healthcare...

George

 

[WinniWoman]

If you have no pre-existing conditions, you might look at United Healthcare's Short Term Policies. You could buy one for 6 months and after it matures buy another for one year. That would cover you until June 2021. I believe that you get access to the same network as other United Healthcare policies. Short Term Policies are a heck of a lot cheaper. The downside is that you can't renew a policy at maturity (you have to write a new one) which means that anything that happens to you during the life of the expired Policy is considered a pre-existing condition and they won't write the successor policy. This is why I recommend the 6 month policy first followed by a one year policy. You can find them at www.uhone.com These are the same policies issued for years by Golden Rule Insurance which was acquired by United Healthcare...

George

Thanks, George. I remember you mentioning them before. I will check those out also.

I went on the website but only dental and vision plans come up for some reason. I see it says New Jersey on that website. LOL! More craziness! OMG!

 

[Talent312]

Today, I talked to my doc about going on Medicare.
Should be seamless, he says. Should be, but...
They got my DOB wrong in their records and so, had trouble finding lab reports.
They got my email address wrong, so their nice "reminders" were being returned.
Then, they dunned me for the co-pay they forgot to collect before.... We shall see.

 

[bogey21]

Mary Ann - Go to www.uhone.com ; put in your Zip Code and birthday. When plans come up scroll down past the Bundled Plan which mentions Dental and you will see a whole list of plans to choose from. I used these for years for the healthy 41 year old Son of my ex-wife (not my natural Son) for 5 or 6 years. Premium was $200+ per month vs something like $500+ per month for regular insurance. His problem was he was not eligible for ObamaCare as he had no income and ex-wife didn't want him on Illinois Medicaid. Now he has income and regular insurance. $300 per month times 5 or 6 years was a heck of a lot of savings...

George

 

[WinniWoman]

Mary Ann - Go to www.uhone.com ; put in your Zip Code and birthday. When plans come up scroll down past the Bundled Plan which mentions Dental and you will see a whole list of plans to choose from. I used these for years for the healthy 41 year old Son of my ex-wife (not my natural Son) for 5 or 6 years. Premium was $200+ per month vs something like $500+ per month for regular insurance. His problem was he was not eligible for ObamaCare as he had no income and ex-wife didn't want him on Illinois Medicaid. Now he has income and regular insurance. $300 per month times 5 or 6 years was a heck of a lot of savings...

George

George I am telling you- I did- nothing comes up but dental and vision. No bundled plans- nothing else.

 

[geekette]

Is anyone wishing for the Canadian healthcare system now? Just listen to these conversations. I don't know about you, but I don't want to spend the rest of my life obsessing about how to deal with all of this all this nonsense.

BTW- I pretty much decided to stay on the retiree medical instead of COBRA and when I move just go on Obamacare EPO and call it a day no matter what. Take my chances. Then we will call that stupid VIA Benefits and change hubby's Part D and also call Empire and change to Anthem in NH.

ENOUGH ALREADY! This is ridiculous with this health insurance stuff! Where is geekette? She is right- maybe just forget having insurance altogether. It is a big scam!

Sitting right here, watching the misery, keeping my $875/month in my pocket! But, boy, are they after me by phone, mail and email. Nope, not buying.

Uninsured, my meds are $4 each, less than I used to pay, and much MUCH better than what it used to say my insurance saved me (over 150/month for just one med - musta been a fear note from CVS but why do they care if I'm insured? They sure don't print a line that says "this could cost you only 4 bucks if you decide to dump your crappy insurance..." but it never said that).

Tomorrow I go to my newest PCP and either pay at the gate with HSA funds or maybe I get a bill. We'll see... Part of my preferred hospital network but at a very convenient med building 5 minutes from home (vs 20 to hospital campus with traffic that is moving).

Even with insurance, I went to the docs I wanted to see, so that part isn't a big change. everybody is in-network for me, if they're a good doctor.

 

[WinniWoman]

Sitting right here, watching the misery, keeping my $875/month in my pocket! But, boy, are they after me by phone, mail and email. Nope, not buying.

Uninsured, my meds are $4 each, less than I used to pay, and much MUCH better than what it used to say my insurance saved me (over 150/month for just one med - musta been a fear note from CVS but why do they care if I'm insured? They sure don't print a line that says "this could cost you only 4 bucks if you decide to dump your crappy insurance..." but it never said that).

Tomorrow I go to my newest PCP and either pay at the gate with HSA funds or maybe I get a bill. We'll see... Part of my preferred hospital network but at a very convenient med building 5 minutes from home (vs 20 to hospital campus with traffic that is moving).

Even with insurance, I went to the docs I wanted to see, so that part isn't a big change. everybody is in-network for me, if they're a good doctor.

You are a brave one! I am with you! Where do you get your meds? Walmart? Really- this is how I feel now. I will pay the $545 premium for the month or so I am still living in NY, but as soon as I move I will apply for Obamacare, a Silver Plan. I will also have to pay for the retiree medical for one more month to allow for the Obamacare plan to take effect- which will probably be 3/1. The cheapest one with low copays. I don't care anymore. I can keep $400 per month in my HSA instead of giving it to these despicable health insurance companies.

I was hoping once we moved I could put this cr0()^0p behind me but I will still have to deal with it once there to get it taken care of finally. Hubby's Medicare also. I am literally burnt out from all this. I want to concentrate in moving and be happy. Instead- I am getting more and more depressed.

 

[WinniWoman]

Anyone have experience with these?

5 Best Christian Healthcare Ministries (Medical Sharing Reviews)

Here are the 5 Best Christian Healthcare Ministries! What is a Christian healthcare ministry and how does it differ from traditional health insurance?

biblereasons.com

 

[VacationForever]

Anyone have experience with these?

5 Best Christian Healthcare Ministries (Medical Sharing Reviews)

Here are the 5 Best Christian Healthcare Ministries! What is a Christian healthcare ministry and how does it differ from traditional health insurance?

biblereasons.com

@Steve Fatula has it.

 

[DancingWaters]

MaryAnn,
Could you move in with your son and begin signing up for new drivers license, health care and etc using your new house address? Then go back and get your stuff when your house is ready.

 

[WinniWoman]

MaryAnn,
Could you move in with your son and begin signing up for new drivers license, health care and etc using your new house address? Then go back and get your stuff when your house is ready.

Unfortunately not. He lives in a dingy studio apartment. But no reason to anyway. We own the new house now. We have an air mattress in there- but that is about it. We just got back from being up there actually.

Now we have to tend to all things for the move in February.

 

[Brett]

Anyone have experience with these?

5 Best Christian Healthcare Ministries (Medical Sharing Reviews)

Here are the 5 Best Christian Healthcare Ministries! What is a Christian healthcare ministry and how does it differ from traditional health insurance?

biblereasons.com

I have no personal experience but some recent articles about Christian cost-sharing medical health ministries
https://www.nytimes.com/2020/01/02/...tion=click&module=Top Stories&pgtype=Homepage
https://www.wsj.com/articles/groups...-drawing-more-membersand-scrutiny-11560177134

 

[WinniWoman]

I have no personal experience but some recent articles about Christian cost-sharing medical health ministries
https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html?action=click&module=Top Stories&pgtype=Homepage
https://www.wsj.com/articles/groups...-drawing-more-membersand-scrutiny-11560177134

Doesn’t sound too good.

 

[ilene13]

I am a retired high school assistant principal. I retired with a Cadillac Traditional BC/BS plan. It is my supplement. It is $1600 a year for my husband and me. Our primary is Medicare. Because my husband is a practicing physician and I have a wonderful retirement our MONTHLY Medicare premium is $498 each! This is because of the IRMAA. From my school district’s plan my prescription plan which is excellent should be free. Unfortunately they put all the retirees on a Medicare Part D plan— they did not know about IRMAA’s. So we are paying $150 a month for that. My union grieved it and we won. Now they give me back the $1800 a year in a health debit card. I resent that because we do not have many medical expenses and we have nothing to spend the money on. It’s my money and they should just give it back. I am aware that we are very lucky to have great insurance. My insurance is from Buffalo, NY and we live in Florida. It also covers us anywhere we travel. My husband is a physician and he does not like Medicare Advantage plans, that’s why much to my school district’s dismay I will not change to the Advantage plan that they offer!

 

[bogey21]

George I am telling you- I did- nothing comes up but dental and vision. No bundled plans- nothing else.

I just tried it, entered my Zip Code and DOB and it worked for me. All I can figure is that they aren't licensed to write Health Insurance in your Zip Code...

George

 

[Sugarcubesea]

When you retire in 2026, they will use that income plus household income to calculate 2028 rates. Upon receiving the rates letter in 2027, you need to send in an appeal form, letter and proof of your retirement. They will send you a letter with the approval and eliminate that earned income amount and recalculate to come up with a new Medicare cost amount. If they have already started deducting premiums using the old higher amount they will either send you a refund check if the amount was taken out of your social security check or stop pulling money from your account if you have not started taking social security. You have to stay on top of the adjustment and call them if you don't see a refund check or that deduction is still going on at the higher amount etc.

Link to the life changing event appeal form. https://www.ssa.gov/forms/ssa-44-ext.pdf

You can find full list of change of life events accepted reasons in the pdf file.

Thanks for the great explanation... This is so helpful

 

[bogey21]

Mary Ann - if the Zip Code you used at www.uhone.com was your NY Zip, maybe Short Term Plans are not legal in NY State. Try your NH Zip Code. Maybe it will work.
I just tried it with Illinois and Texas Zip Codes and got a long list of plans...

George

 

[MULTIZ321]

I just tried it, entered my Zip Code and DOB and it worked for me. All I can figure is that they aren't licensed to write Health Insurance in your Zip Code...

George

I too entered my Zip Code and DOB and it worked for me,

Mary Ann did you enter your NH zjp code?

Richard

 

[geekette]

I just tried it, entered my Zip Code and DOB and it worked for me. All I can figure is that they aren't licensed to write Health Insurance in your Zip Code...

George

exactly what I'm thinking. Came up for me. I get that it's short term, but 12k deductible (one person) is nuts.

 

[geekette]

You are a brave one! I am with you! Where do you get your meds? Walmart? Really- this is how I feel now. I will pay the $545 premium for the month or so I am still living in NY, but as soon as I move I will apply for Obamacare, a Silver Plan. I will also have to pay for the retiree medical for one more month to allow for the Obamacare plan to take effect- which will probably be 3/1. The cheapest one with low copays. I don't care anymore. I can keep $400 per month in my HSA instead of giving it to these despicable health insurance companies.

I was hoping once we moved I could put this cr0()^0p behind me but I will still have to deal with it once there to get it taken care of finally. Hubby's Medicare also. I am literally burnt out from all this. I want to concentrate in moving and be happy. Instead- I am getting more and more depressed.

I had looked up my key meds and found I could get 90 day supply from Costco for 20 each, so figured I'd head over to CVS and find out what they were charging me for scrips they already have for me. I was shocked to find it was $4, so, I'm going where I was going, when I had insurance that allowed 0 cost meds, and the last, more expensive/less good exchange plan, when they generally cost me 18.

It seems to me that Walmart was indeed the one leading the charge for $4 meds (how many years ago? I don't hear about it anymore ) and apparently, others have followed suit. Anyone with pricey meds might wanna do a simple internet search, see if they can cut their costs. I would have paid the 150/month cuz I MUST have this one, and rationed if I had to but checking into it, 20 was going to be fine with me. 4 blew my mind.

One of my doctors thinks I'm diabetic (I do not think so, kinda-fasting level was 105 and not showing other symptoms). Hard to say what that would cost me but Type 2 mostly shows up from bad lifestyle so less eggs, more oatmeal, less sugar snacks, more fruit snacks. Not a chip or cola person, so no hard deprivations to get onboard with. I've always been active, there is not lack of exercise here. I'm not overweight, 130 at 5'4", same I've been most of my adult life, but apparently the BMI is not ideal to them and they think I should weigh 115, which I haven't seen since age 14. They apparently don't account for boob weight. Perhaps if I'd had a double mastectomy I would finally meet their level. sheesh.

 

[geekette]

Random thought - what about insuring through a trade group? AARP is the only thing that comes to mind, not sure you will find a radiology group out there, or similar, but worth a look in the back of a trade mag.

Next random thought -- check into a hospital system that would be convenient, they may make arrangements for you. I am actually shocked at how much they have worked with me to keep things affordable (they wrote off A LOT of pricey PT). They have their own Medicare Advantage plan but unfortunately nothing for pre-Medicare age except significant financial help including no charge visits, massive write offs and 0% financing for the costs they can't write off but I can't pay. I'm down to about 1500 with them, may add a grand to that if the crappy insurance did indeed deny the MRI I needed.