It is the that time of year for most who are reviewing their Health Insurance options available, especially if you are a New Medicare recipient. Congratulations. Everyone has worked most of their lives to look forward to finally having retirement and then you hit Medicare age to be receiving the "benefits" you "earned" for all the years of your hard work!
If you are currently reviewing the option of going with a Medicare Advantage Health Plan right now, STOP! Stop right now and save your future and retirement money you need to hold on to! Why? Because it's not all what it's presented to be. It's a numbers game and they do not share what you could be impacted with IF you do end up with a health crisis.
Medicare is your right to have and keep as is! You already will pay via your social security income the Medicare portion of est. $183.00 a month, unfortunately it is not free anymore. That was changed a few years ago with our government's choice to change. Medicare Advantage Insurance carriers have been advertising and selling how great their plans are with their respective companies. They share it's a plan that covers everything 100% and you don't need a secondary insurance plan. You can save your money, no extra cost per month. That is not true.
This is all part of their way to manage your care and the monies expended tightly and to benefit savings. That is not always a bad thing, but if/when you do have a health crisis, you will be on the hook for HIGH DEDUCTIBLES, minimum 5,000.00 deductible out of your pocket for each year. WARNING: when you choose an Advantage plan, you are giving up your Medicare original plan and its benefits to you, it is auto administrated by the carrier you chose your benefits now go through them NOT directly to you.
Here is a true example of what happened to a recent Medicare Advantage patient : This person wanted to save money each month on paying for secondary coverage which amounted to a very small amount considering big scheme. He chose a Medicare Advantage plan. In the year he had this plan he broke his hip, had to be in the hospital and then have surgery and rehab to follow. The plan insurance card was given to the hospital with assumption since they were on the "preferred list by the carrier" all would be covered. NOT the case! Look out. Problem #1: the hospital was covered BUT the Hospitalist physicians were not on the plan list or credentialed with them. Guess what? Bills appeared later in amount up to $2,000.00 not covered by the insurance. (read the fine print).
#2: this person then had to go to rehab, he required a lot of rehab BUT because of this insurance they only allowed the Medicare allowable number of days at 20 days and nothing more! Actually insurance wanted to kick him out on day 18, but the family fought. The Rehab facility was beginning to charge the patient for every day thereafter directly. This was a shock to the patient and the family!
#3: a few months later bills start piling in, and insurance identified -"oh this is your deductible portion to cover". The bills totaled up to $7,000K! and many drugs were also not covered! Add the medications in and you're looking at $8,000k for the year OUT OF POCKET expenses CASH! This is a true story shared. It almost broke the person who lived on a very tight budget.
What do we recommend you do? KEEP your regular Medicare benefits! It will cover 80% of your Medical/Health bills. Research to find best price on a Secondary Insurance to cover your 20% of health /medical costs. This is important. You need secondary coverage and Part D (Rx). Most have gone thru senior membership companies like AARP or AMAC to purchase a reasonable rate of secondary insurance through other carriers. There are arrays of plans to choose from. Most are affordable monthly and will cost less of an investment than when you are surprised with an $5-10K bill during the year if you have a crisis event. Always prepare and plan for what could happen and be thankful when it doesn't happen.
The unfortunate circumstance that impacted the American people is the un-affordable care act. 15 years ago affordable insurance health plans were in abundance we could choose from based on our budgets - private to public companies. Now it has become a serious task to find better health insurance options that we can afford through other sources.
It is recommended to contact a local insurance agent you know or a Health Advocate who can guide you to the right resources to help you.