| To: Kirk © who wrote (115179) | 8/19/2021 2:04:07 PM | | From: John Koligman | | | | Just another comment on Medicare - what Rarebird says makes sense, but my wife and I have a Humana Advantage plan. We live right outside Chicago and the plan we have includes the largest medical group in the state, which we used and liked prior to Medicare. It has a zero dollar monthly cost, and the kicker is that the plan's out of pocket max is $2650, so even if you were really sick and hit the max you still would be saving money over the $200/month for a supplemental. They also throw in 2k of yearly dental benefits, $300 for glasses, and a membership at a very nice local gym (which we enjoyed and have not used lately, for obvious reasons). So, I think it boils down to access and how many docs are in your area and are 'in network'. There are copays, you can see your primary at no cost, but a specialist visit is $25. I recently had a stress test and echocardiogram, both were $25 each out of pocket (you don't want to know what the provider billed though <ng>).
If the Biden plan passes they are talking about adding the dental/vision/hearing benefits to regular medicare, so that would be a plus, but my assumption is that perhaps the Advantage plans would then increase them.
Also, there are a whole range of Advantage plans out there, the HMO types generally are low/no cost with lower out of pocket max amounts, and the PPO types are more expensive with higher out of pocket max amounts.
John
Edit - One VERY important thing I forgot to mention is you need to carefully research the ability to switch from regular Medicare to an Advantage plan and vice versa in your state. The general rule is you have a year to pick a type of plan and then switch from one type of Medicare to another. After that, you might be subject to 'pre-existing' condition checks by an issuer of a Medicare supplemental plan if you decide to switch from an Advantage plan back to regular Medicare. |
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| To: John Koligman who wrote (115180) | 8/19/2021 2:33:31 PM | | From: Kirk © | | | | | Thanks for the info. I like having the added funds for health clubs, dentist and vision. I think it is because those "all in one" plans save a lot of costs to overhead so they entice us with extras that help keep us even more healthy. My list of questions for my decision include can I get the insurance for my current dentist who won't take my $100 per year Costco plan any more as they lose too much money on me... and can I get $ for swimming at the Elks Club and yoga classes at my local 24hr fitness when I'm up for returning to indoor workouts without masks. |
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| To: Kirk © who wrote (115181) | 8/19/2021 2:55:35 PM | | From: John Koligman | | | | The other thing I noticed is that some groups are 'transitioning' their primary care physicians to patients with Advantage plans only. They claim the care will take more time and be more 'comprehensive', hence the change. My cynical side says maybe it is also due to money/reimbursement advantages, but thought I'd mention it. Here is part of a letter our group sent my wife, as her primary care physician is included in the move.
"Our New, Comprehensive Primary Care Initiative for Medicare Advantage PatientsAt DuPage Medical Group our physicians and associates are committed to providing our patients with the highest quality health care. We continuously seek new ways in which we can enhance patient care and their overall patient experience. DuPage Medical Group is excited to announce our new – Comprehensive Primary Care Initiative for Medicare Advantage patients.
This Initiative will allow a select number of DMG Primary Care Physicians (listed below) to transition their Medicare (Age 65+) practices to the more comprehensive patient and wellness focused care models promoted by certain Medicare Advantage plans. Effective January 1, 2021, and due to the additional demands on their time that this Initiative will require, those select Physicians will only continue to serve as a primary care physician to those Medicare-eligible patients which are enrolled in the Medicare Advantage plans they participate in. They will no longer continue seeing primary care patients with traditional Medicare insurance.
Medicare Advantage plans typically provide additional benefits not available under traditional Medicare. These plans may also provide benefits that address patients’ social and environmental needs as well. Patients impacted by this change should have received a letter from their primary care physician advising of this change and specifying the Medicare Advantage plans they participate in. More information as to particular plan benefits may be obtained by contacting a licensed and independent insurance agent, if you do not have an agent we have partnered with agents who can help. They can be reached at 855-429-1086 for a no obligation Medicare benefit plan review. Their goal is to help our patients find the best plan that fits their individual healthcare needs.
All physicians will continue to accept patients with Commercial insurance plans that are currently accepted by DMG. Please refer to the Insurance information page in the Resources section of our site for a list of DMG accepted Insurance Plans." |
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| To: John Koligman who wrote (115182) | 8/19/2021 3:28:08 PM | | From: Kirk © | | | | I think your cynical side is correct but if you have the MA plans, then it is good news since they won't have to spend as much time on insurance issues.
I long thought Medicare should change to a "whole health per person" deal where the government pays a certain amount per subscriber (Medicare adult) then it is up to the hospital to figure out how to care for the person then prevent them from all merging so you have choices to keep them competing for RESULTS.
But it really needs this as a single payer system that starts when you turn 18 and spends the money up front to keep people healthy so they are not already basket cases by the time they reach 65. |
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| To: John Koligman who wrote (115180) | 8/20/2021 4:21:30 PM | | From: Rarebird | | | | My supplemental Plan G plan with Aetna costs me $143 a month. The problem with these plans are that there are 8-10% rate increases per year. I was with Cigna Plan G for 3 years and switched out to Aetna Plan to save $50 per month. Same benefits for both. So, in a way, it is like trading.
What I don't like about the Medicare advantage plans is that G-d forbid you get unexpectedly sick and are out of your home area, you better be careful what hospital or doctor you see because if it is not in network, you will get charged a fortune.
If you plan on staying put in your home area, then medicare advantage is worth it if your network is composed of top doctors and hospitals.
I understand in cases of emergency the extra fees are waived. But that can be a debatable point outside of sudden heart attacks and epileptic seizures. |
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| To: Kirk © who wrote (115181) | 8/20/2021 4:31:16 PM | | From: Rarebird | | | | The Dental insurance I have in my Plan G supplemental Plan is basic and does not include periodontal cleanings, which I need and have seperate insurance for.
As for gym memberships, that is a bit overrated as it only costs $10 a month for a good gym membership in Las Vegas. I had that gym membership with Cigna Plan G for $25 a year. But Aetna and the other providers dropped that this year ( and some the year before).
You make a good case for being on a Medicare Advantage plan. But just make sure you stay put in your local network and don't get sick if you are travelling outside your local network. If you do, you will be charged a small fortune, outside of what is considered an emergency. |
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| From: Rarebird | 8/20/2021 4:40:54 PM | | | | | | GDXJ with a close below $40 for the week. I expect more follow through to the downside next week, with an initial strong bounce at the 200-SMA.
Gold miners are good for a huge 7 month rally every 4 years. Otherwise, they are a short sellers dream, as close to a sell and hold as you get.
Interesting that the Gold bugs still dream about the Miners rallying while the broad market tanks. That happens after the Fed stops tightening and the first of a long series of rate cuts is anticipated.
MSFT and AAPL are the real safe havens today, not the Gold Miners
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| To: Rarebird who wrote (115184) | 8/20/2021 6:05:10 PM | | From: John Koligman | | | | As with most of American healthcare, Medicare is probably more complex than it needs to be, and I often wonder how many folks really know their exposure and the potential 'gotchas' in the system. That said, the monthly cost for a supplemental around here would have been close to $400/month for my wife and I, so I figure we are saving around $4500 on those, throw in $600 a year for glasses that we both need, a grand or so for dental, and $600 for a nice gym membership and I figure we are ahead almost 7k a year. Last year due to Covid we really didn't go to the doctor much at all, this year the savings will be a bit less as we have been going, although the costs are really low. I had a bunch of expensive tests and co pays were $25 each. I don't think emergency care is a problem, the plans will cover it outside your area if needed. If you live in multiple places regular medicare would generally be the ticket, I have not looked into the possibility that some Advantage plans may cover more one locale. The one biggie people need to be aware of is that it is easy to switch from regular medicare to an Advantage plan, but after the first year it may not be so easy to switch back depending on where you live, as you may be subject to medical underwriting when buying a supplemental.
One thing that was 'music to my ears' is that my plan does not allow 'balance billing', that may also be the case for all medicare, I am not sure. I see that Congress has finally gotten around to fixing that glaring hole in our medical system. It's disheartening that one could do as much homework as possible, go in for a procedure, and face large surprise bill anyway because the hospital uses an out of network doctor on the team performing the operation. Anesthesiology is the specialty that seems to pop up most often in these cases. |
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| From: The Barracuda™ | 9/10/2021 11:23:37 PM | | | | | | Biden's recent executive order regarding vaccines is, IMO, a reason why the TX gold depository is where one should store their gold/silver/other PM.
Why?
Because, if in the future, another govt bureaucrat decides that your gold is not really your gold, the private vaults will say "yes sir". However, a state government vault, holding your property, will have the protection of being a sovereign states facility .
That means that the states police power and its access to the federal courts will most likely be defending your property from theft by the bureaucrat. |
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