Hospitals, doctors drop private Medicare plans over payment disputes

[pittle]

We originally had retiree insurance from the company we both worked for as the supplement for Medicare, but about 2 years later, they stopped it and we went with Plan F which was significantly less than what we had been paying and provided better services. We were "grandfathered" in to Plan F when it was no longer an option for new retirees and we were happy to keep it.

My husband had cancer back in 2008 when we were on the other plan we we paid 20% out of pocket until we had paid $10,000 each year. When his cancer returned in 2020, we had Plan F and did not have to pay the 20%, nor any deductibles whatsoever. In the past 3 years he has had over $700,000 in treatments at Mayo and we have only had the monthly premium payments of $295 per month to pay. FYI - Mayo sends out notices each fall that they do not take Advantage plans. So, had we had one of those, he would not have been able to have the best doctors available to him.

 

[dago]

We originally had retiree insurance from the company we both worked for as the supplement for Medicare, but about 2 years later, they stopped it and we went with Plan F which was significantly less than what we had been paying and provided better services. We were "grandfathered" in to Plan F when it was no longer an option for new retirees and we were happy to keep it.

My husband had cancer back in 2008 when we were on the other plan we we paid 20% out of pocket until we had paid $10,000 each year. When his cancer returned in 2020, we had Plan F and did not have to pay the 20%, nor any deductibles whatsoever. In the past 3 years he has had over $700,000 in treatments at Mayo and we have only had the monthly premium payments of $295 per month to pay. FYI - Mayo sends out notices each fall that they do not take Advantage plans. So, had we had one of those, he would not have been able to have the best doctors available to him.

 

[Tia]

Here is more information about the several states allowing residents to change Medigap policies *without medical underwriting*:
https://www.senior65.com/medicare/article/switching-medigap-plans-here-are-your-options

States with a Medigap Birthday Rule are California, Idaho, Illinois, Louisiana, Maryland, Nevada, Oklahoma, and Oregon.
Connecticut and New York have guaranteed issuance for all at any time.
Maine allows Medigap enrollees to switch at any time of the year.
Missouri has a Medigap Anniversary Rule.
Washington State allows a switch to anything except Plan A at any time of the year.

Wonder why all states don't have the birthday Rule....

 

[Brett]

Wonder why all states don't have the birthday Rule....

That seems like a good idea. And why not make "open enrollment' actually open all year?
https://livelyme.com/blog/why-do-open-enrollment-periods-exist-for-health-insurance/

 

[lotus921v]

I don't think I had previously see Medicare Advantage referred to as a "Private Medicare plan," which suggests that it is not Public, and therefore subject to restricted access.

It’s a replacement plan for Medicare that gives you a bit broader option however it functions like an HMO. Mayo Clinic just dropped taking them. I don’t take them at my clinic either. They’re incredibly difficult to work with.

 

[DrQ]

 

[Carolinian]

There was a major hickup in northeastern North Carolina with one of the big medical insurers dropping the hospital and doctor network of ECU Medical School from their insurance network. That included the Medicare Advantage plan I currently have and my doctor, but I have switched to a different plan with a different carrier for next year to avoid it. I expect this one will have more fireworks than most because the insurance company that dropped them also manages the State Health Plan for state workers and retirees, and so the State Treasurer has gone ballistic with them.

One thing that many people do not know is that even though Open Enrollment ends in early December, it is still possible to change Medicare plans as late as the end of March.

 

[dago]

If you DH is working for a company larger than a certain size (Insurance covers more than X employees) you can delay enrolling in Medicare A & B. If you are covered by a high deductible plan and are socking $ in an HSA, you can continue to do so after you turn 65. That is what I did.

You can then use the HSA to pay the Plan G premium with tax free money.

Unless the rules have changed, as far as I know you cannot use HSA funds to pay for Medigap (Supplement) premiums. You can pay for Part B, C or D and just about any other medical expense.

 

[dago]

What a relief. Now that the AEP is over, I am no longer getting inundated with the incessant commercials for Medicare Advantage.

 

[4TimeAway]

Medical tourism based on timeshare locations?

US costs have spiraled out of control, while some countries have cash prices that less than US copays without the paperwork and wait.