These Medicare plan ads!!!!

[LAS14]

How can they possibly be worth the money they're spending. They seem to take up half the broadcast time on CNN and have been going on for at least a month. Are there still people seeing them for the first time? People who haven't made up their mind.

I don't really understand them. "Medicare open enrollment is about to end." That doesn't sound like a supplemental plan. But it's got to be, right? I'm on Medicare, but with really good insurance. Everything is almost always covered in full. So I've never investigated what's going on. I wouldn't mind hearing some comments from DUers.

tia
las

[msongs]

1. all over msnbc as well as ads for meds with a side effect called death nt

[Boogiemack]

38. you had better check it out closely. It is not what you think it is...and it is NOT Medicare. nt

[samnsara]

2. ..and they are always calling me up....

...I have private insurance so I always tell them that and it ends the call.


I am not rude to them.. I used to have a job similar to this and you get paid by the minute. These days, jobs where you work at home are are a godsend for parents. Its a bad enough job without me yelling and hanging up on them.

[in2herbs]

3. My H has been keeping track of the phone numbers on these advertisements. Thus far he has

337 different phone numbers to call for Medicare info. I suspect that any licensed insurance agent with enough money can purchase a bank of toll free numbers and create and run different ads off of these numbers. I suspect that the agents get a percentage of the plan's price, cuz the plans are all for the same companies. We too are tired of these ads.

[LAS14]

25. Interesting! nt

[stopbush]

4. The rules and benefits change a bit every year.

This year it’s the cash back benefit, where some plans will reimburse your monthly premium directly to you.

The Medicare Advantage plans compete like crazy to get subscribers/patients. There is $ to be made. In my case, I’m with Kaiser Permanente Medicare Advantage. I had one surgery in January that KP billed at $15,000. Medicare paid them $9,000. They’re happy that $ went to them and not Aetna or Blue Cross. The part that didn’t get reimbursed is a tax write off.

If the cost of getting me signed up with them is cheap prescriptions or whatever, the odds are that they are still going to make out in the end if and when I need a procedure that costs significantly. If I was getting refunded my $144 a month by KPA (I’m not), it would still pay off for KPA on that one procedure that paid them $9,000.

[Sherman A1]

5. Easy fix

Turn off cable and infotainment noise and they go away.

[lilymidnite]

6. Medicare Advantage plans

There's a lot of money to be made by the insurers in Medicare Advantage plans. They are advertising heavily to get people to switch from one to another. Odd thing about them is that there is little difference among them, except for max out-of-pocket and in-network doctors and hospitals. Ninety % of what is covered by Medicare Advantage plans is required by law. People in general don't understand them and the potential big downsides to them. This is not disclosed at all.

What you don't see is ads for Medicare supplement plans, which are much more expensive than advantage plans. A friend, who just passed from cancer earlier this year, didn't have to pay a dime for his treatment.

Don't get me wrong, I have a Medicare Advantage plan. But I live in a mid/larger city where there are many doctor choices. Plus it covers during overseas travel (in the event Americans are ever able to travel again), which original Medicare doesn't. So, I weighed the disadvantages when I enrolled earlier this year. At some point it becomes clear that there is little difference between them. So, we get flashy ads with carrots being waved (transportation, gym memberships drug plans, etc.)

[octoberlib]

9. My mom keeps wondering about Advantage. She has an excellent plan with United that

pays everything. She has surgery and owes nothing but it doesn't provide dental. What are the downsides to Advantage plans?

[TexasBushwhacker]

16. The down side of advantage plans is that they generally have a smaller network

of providers. With traditional Medicare, you can go to any doctor that accepts Medicare, which is basically everyone. Advantage plans usually work fine in medium to large cities, but it can be a problem in a small town, especially with specialists. What if you need to see a urologist and the only urologist in town doesn't accept your Medicare Advantage plan.

The dental coverage with Medicare Advantage plans is pretty minimal. You're better off paying for a dental plan through AARP.

[octoberlib]

23. Thanks for the answer!

[yellowdogintexas]

18. if the plan with United is her Medicare, it is an Advantage plan. If it ia a benefit from

her employer (lifetime coverage) that is different.

Advantage plans were a gift to the Big Insurance industry. They make money on them and if you have to go out of network you are SOL

Traditional, original Medicare is not designed to make a profit. The deductible and co pay are very reasonable, and there are no networks. No matter where you are, there is a doctor who will take your insurance. If you combine it with a Med-Sup plan there is very little out of pocket.

There are very few facilities which do not take Medicare Part A

[octoberlib]

24. Thanks for the info!

[SharonAnn]

36. Another downside is that if you leave the Advantage plan, options are usually more $$$

You would then be elible for insurance “underwriting” analysis. With a pre-existing condition you might not be able to qualify for another plan or it may be much more expensive.

There’s no “underwriting” analysis like that when you sign up at age 65, they have to take you. But if you want to change later the rules and costs can be different.

[in2herbs]

41. In my area my MA plan provides basic dental at no cost. It's just the basics i.e., cleaning,

x-rays, etc. To get help with fillings, dentures, implants, etc., they offer an additional plan for $38/month. But these plans have a cap of about $1,500.

[CTyankee]

10. My husband took this on and the Advantage plan is better for us.

Physical therapy and dentistry are my two big areas. I like a fitness plan that puts me in the gym twice a week and I know for sure I'll have more dentistry needs as I go into my 80s. I'm in remarkably good shape, don't smoke or drink, now in PT for arthritis in my back (I have daily exercises at home too), and I need an upgrade on my eyeglasses.

Hubby should go to P.T. as he has had two surgeries on his back. He doesn't want to go so I finally gave up. Ditto the dentist. He's afraid of what the dentist will tell him!

So I just take care of my health and hope for the best for him!

[yellowdogintexas]

21. Some of the Advantage plans have dental and vision plans but they cost more

I would consider one if it were not for the network and the for profit aspect.

[JustGene]

7. Profiteering at it's finest n/t

[spinbaby]

8. It at least cuts down on the emotional blackmail commercials

Send us money or this cute kitten or puppy dies!

[Hoyt]

11. The main advantage for many with Advantage Plans is the beneficiary usually doesn't have to pay

an extra $200 - $300 a month for a supplement and drug plan. The government pays the plans a little extra and the plan hopes they can keep cost down by controlling utilization and negotiating with providers, drug companies (unlike traditional Medicare, Advantage plans can negotiate with drug companies), etc.

If one is relatively healthy and lives in an area where there are lots of docs in the plan's network, it's not a bad deal. If you live in an area without lots of in network docs -- and you like to pick your own doc -- Advantage plans probably aren't the best choice if you can afford the extra $200 - $300 a month. They can eat you up with copays if you get sick, but there is also a limit on how much you have to pay out-ot-pocket each year.

I had Kaiser at one time and I was fine with basically being told what doc I had to go to (they give you limited choice sometimes).

[octoberlib]

26. Is there still a donut hole with their prescription drug plans?

[Hoyt]

30. I think it does, but I'm not positive. I think a Plan could offer to cover some or all of

donut hole as an enhanced benefit, but I bet none do.

[rsdsharp]

12. The vast majority of these ads are called PI.

Unlike most commercials where the station or network charges a specific fee every time it airs, a PI ad has the advertiser pay a negotiated amount Per Inquiry. In other words, they only pay based on the number of calls they receive to the toll free numbers. No calls, no (or very minimal) fee.

[spanone]

13. insurance is big money.

[Vinca]

14. If I see Joe Namath one more time . . .

[Arthur_Frain]

15. Broadway Joe works pretty cheaply these days

nt

[TexasBushwhacker]

19. My old pal Ovaltine!

[Hoyt]

20. I agree. It's kind of sad to see him doing that junk. And he looks terrible.

[shanti]

40. Pat Boone

Why do they keep showing him?? Gah!

[Grasswire2]

17. It's a scam, IMO.

Should not be allowed on television. It's misleading. And Joe Namath looks like a perv or something there.

[KWR65]

22. The companies get paid $11k per year to have Medicare Part C Plans

If you are on Medicare you better be careful which plan you sign up for. Getting out-of-network care can cost you a bundle. They promise free eyeglasses, but if you get out-of-network hospital care you will be in debt.

[Lady Freedom Returns]

27. They bought the ad time.

So the networks are obligated to run them.

[ProfessorGAC]

28. And They're NOT 15 Second Spots

I timed a Humana spot at a minute 45 seconds.
It just went on & on.

[DeminPennswoods]

29. Medicare sends out a book every year detailing everything

as well as the types of plans and what they cover. It's in plain English and easy to read and understand.

Essentially the difference is:
For medicare advantage, the insurer pays first and then bills medicare for reimbursement, but the premium could be as low as 0 extra;
For medicare supplement (or medi-gap), it's more expensive upfront, but virtually everything is covered. My mom was in hospice for many months and we did not pay a dime for anything under her supplement plan.

[doc03]

31. I don't understand. I get a Medicare Advantage Plan through my union. I pay $125 a month

it has maximum out of pocket for in network of $1000 and $3400 out of network. It also includes a drug plan but none of my drugs are over the deductible and it pays some for glasses. I hear all these ads so last year I talked to a salesperson from Humana she looked at my plan and she told me she couldn't match it. Their plan was like $50 more. But these ads from Humana for one say you can get all that for Zero payments plus dental. The supplements are better but much more expensive and you have to buy a separate drug plan. Then they have plan A B C F G whatever to complicate it more. That is supposed to make it easier but it just confuses me. There in one just came on TV for Humana, pay nothing get everything, the salesperson said nothing about anything being free. If I leave my union plan I can't get back in the group so I just end up staying with it. Nobody I know understands them.




I also have tried to get on the VA but have applied twice and they say I have too much income. That is Ok but just this week I was
talking to another guy that gets VA benefits and find out he gets almost exactly what I do on his pension and SS. Neither one of us is a combat veteran so we should be the same. Is it who you know or what?

[Wounded Bear]

32. Happens every year at this time...

[airplaneman]

33. Its just Medicare Advantage which is private for profit insurance.

They never talk about the down side.
You must get pre-approval to see a specialist.
Doctors and specialists must be In Network.
Your local Hospital may not be in their network.
They can ultimately deny anything.

Some (healthy) people like Advantage.

Agents get $600 for each Advantage signup but $0 for traditional Medicare signup.

For me I have been soo screwed by private insurance in the past and now I have No Cost at the point of service traditional Medicare - yes it's about $3500 a year - two surgeries over $100K in paid bills and I paid $0

Private insurance was $1600 per month with 16K out of pocket before they cover it all and not including pharmacy with had its own $300 deductible and forever co-pays.

-Airplane

[0rganism]

34. i never got those ads until i had to sit in a hospital waiting for a transfusion

if we're talking about the same ones, they're like the most annoying, ugliest shitpiles i've ever laid eyes on. and after being in that room for 4 hours, i understand how they're devastatingly effective.

i didn't get it at all until i had to sit in a hospital in-patient room for a couple hours watching TV while waiting on a cortical steroid transfusion to counteract MS symptoms. then i got to see them hunting in their native environment.

first, the primary text is huge, presented in bold primary colors, and allocated to the center of the screen. this is essential, as the TV in a hospital room may be standard definition & format (thus cutting off the HD sidebars, leaving only the center) and seen from a distance by a patient on medication. conversely, the fine print is small enough that none of it will be legible at standard-definition resolutions from any distance. the ads play to patient billing insecurities; if your insurance benefits -- from whatever source -- are limited and/or about to expire, that hospital room is going to cost you. a lot. every day. and you might be stuck there on meds for weeks.

while you're partially or completely incapacitated during your stay, you'll be wanting to keep up with current events. so you watch the news channels hospitals make available to in-patients with private rooms. that's where the ads run mostly.

and they promise to inform you about benefits you might not have known about. if you're in any way insecure about your means of payment, you'll take this crap more seriously every day you're in there. the simple, stupid graphics and repetitions they apply are ideal for understanding by weakened elderly people and those who've been heavily medicated.

do not underestimate those ads. if you're annoyed and unmoved by them, it's probably because you're not the target audience, something for which you can be thankful.

[marlakay]

35. Try being 64 1/2 I get stuff in mail daily

Offering me advice, info, plans etc.

I already know what I am doing same plan as hubby who is older. Not looking forward to the paperwork or being treated differently by doctors now that insurance will pay them less. I had a friend who said her doctor always encouraged her to come in every 3-4 months and switched to once a year once she was on medicare.

And my naturalpath doctor takes regular insurance but not medicare so I signed up few years ago with regular doctor.

[LAS14]

37. I sure never experienced a change in behavior after we went on Medicare. nt

[marlakay]

39. Thanks I hope that is the case here

I was living in small rural area in WA when friend said that. I am in city of 85,000 now with lots of retired folks here.