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ellenrr

(3,864 posts)
Tue May 27, 2014, 04:58 PM May 2014

Hey! I finally understand the difference between medicare "advantage" and medicare "supplement"

Maybe everybody already knew this, ..but
to me it was confusing.
so a Medicare Advantage replaces Medicare as primary and has network.
A medicare supplement is secondary to Medicare, and there is no network.

now this is what I understand after one and half hour on the phone with my insurance - so if anyone thinks this is wrong pls tell me.

for me, I've had the Medicare Adv. and it was awful. For ex, this month I already paid over $100/month in co-pays.
The medicare supplement Plan F costs me less than $200/month, and the biggest thing is I can go anywhere that accepts Medicare.

I finally made the change, bec my dr. sent me for Physical Therapy and I couldn't go to the place I wanted to go.
Plus with med adv., it was going to cost me a co-pay of $50/ per visit, or $150/week. for 4-6 weeks.

4 replies = new reply since forum marked as read
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Hey! I finally understand the difference between medicare "advantage" and medicare "supplement" (Original Post) ellenrr May 2014 OP
I believe I am remembering this correctly.... DebJ May 2014 #1
For me, my Advantage plan SheilaT May 2014 #2
Yes it is very complicated, why we need single-payer! ellenrr May 2014 #3
Probably depends on what is available in your area question everything Jun 2014 #4

DebJ

(7,699 posts)
1. I believe I am remembering this correctly....
Wed May 28, 2014, 08:34 AM
May 2014

Obama shifted funds out of Medicare Advantage because the basic program was cost-inefficient; government support
was simply putting money into insurers' pockets with no 'Advantage' to the public. It looked to me like an attempt to
privatize Medicare, actually. It was this fund cutting that had Republicans trying to say Obama cut Medicare, when he
didn't.... he shifted funds out of a profit hungry system and INTO direct Medicare. I think I got that right.

Glad you got your therapy issue handled.

 

SheilaT

(23,156 posts)
2. For me, my Advantage plan
Wed May 28, 2014, 02:45 PM
May 2014

costs me nothing above my Medicare premium, includes drug coverage, although I only take one prescription medication, a diuretic. My copay on that has dropped from $10 with my old employer-based plan, to $4 now. And I'll have no copay if I'm willing to get a three month supply by mail instead.

But everyone does need to read all the different plans available to them very carefully. What is right for each person can vary enormously.

Oh. And my Advantage plan I have no copay for regular office visit, and only $30 for a specialist. The doctor I already had was in their plan. I would have to once again read all the fine print in my plan to see if physical therapy would be covered, but I suspect it probably does, with some sort of limits.

My plan does have a network, and since my needs are so very low, it's more than adequate for me. For everyone, no matter what kind of supplement or Advantage play they get, it's important to know that if you're away from home and some emergency comes up, any place that accepts Medicare will treat you.

I did spend time on the phone with the company I chose to go with for my Advantage plan

I can tell you that when I was most recently getting my prescription filled, another woman at the same pharmacy clearly had no clue about Medicare Part A and Part B and her need to get prescription coverage in some form. She seemed to think that Medicare was going to automatically cover everything. As you know it doesn't, and how you get additional stuff, like prescriptions, covered, can be complicated to figure out.

question everything

(48,797 posts)
4. Probably depends on what is available in your area
Tue Jun 17, 2014, 10:21 AM
Jun 2014

I think that my is advantage since it has been paying part of my gym membership...

I changed a few years ago and I first called Medicare and the person there was really helpful. With my zip code the agent ran through several plans and their costs and what they offer.

Mine is about $120 a month - yes, has been going up by 5-10 a month since I joined. But my costs, including phy. therapy last year, are $15 an office visit. Otherwise between it and Medicare I really don't have to pay... keep my fingers crossed.

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