Health Insurance



Jim Simmers

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Now, now, db. You may speak for most, but I’m pretty sure I don’t piss everyone off. You need to learn to control your statements better.
I am pretty sure you do. I have read your posts on other threads and you’re probably one of the best at it. Just saying!
 

eyexer

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This is mind boggling to me. My gut tells me if this is truly the case med sups would no longer exist. Congress and state legislatures would have stopped insurance companies from selling them at the very least to protect our most vulnerable citizens, seniors.
 

Jim Simmers

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This is mind boggling to me. My gut tells me if this is truly the case med sups would no longer exist. Congress and state legislatures would have stopped insurance companies from selling them at the very least to protect our most vulnerable citizens, seniors.
Well, at some point it may happen. Mind boggling because few can get the whole just of the information through text. I left my number you can call me. But the longer we’re just go back and forth the more confused you may get. I have nothing to gain by giving you information that isn’t true. I told you about the program and all the wonderful benefits you get. Other members who are on advantage plans have chimed in. So if you want real information then give me a call.
 

Jim Simmers

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Any idea why Medica has changed? There are 4 counties in ND that we are forced to take an Advantage plan now if wanting to stay with Medica , i am Stutsman and we are one of them.
Any truth that some of the advantage plans don't cover some of the more expensive drugs?
My cousin works in this field and she suggested stay clear of Advantage Plans. I am not on a bunch of drugs other than blood pressure and cholesterol so not a big thing for me.
Sorry I missed your question on drugs. Medicare decides what drugs are covered and which aren’t. That does not mean all drugs are on all plan formularies. What it does mean that every drug plan must have 2 equivalents available. The drug plan may ask you to try a cheaper alternative and they call that step therapy. If your drug that works for you and is not covered you can ask to appeal. While the appeal is going through, the plan will cover it for 30 days. Maybe 60 if they haven’t ruled. I hope this helps.
 


Pheasant 54

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My agent I deal with has also told me to stay away from advantage plans. Both my parents are in a nursing home , my parents received a letter that is over a page long in small type laying out why they want to avoid these at all costs and the reasons why.

Those of you that have them good luck , but my family will be staying far away
 

Freedom

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This is mind boggling to me. My gut tells me if this is truly the case med sups would no longer exist. Congress and state legislatures would have stopped insurance companies from selling them at the very least to protect our most vulnerable citizens, seniors.

"I’m from the government and I’m here to help."
 

eyexer

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Well, at some point it may happen. Mind boggling because few can get the whole just of the information through text. I left my number you can call me. But the longer we’re just go back and forth the more confused you may get. I have nothing to gain by giving you information that isn’t true. I told you about the program and all the wonderful benefits you get. Other members who are on advantage plans have chimed in. So if you want real information then give me a call.
I’m simply picking your brain because I know zero about advantage plans. There obviously has to be advantages and disadvantages to both or med sups would have ceased to exist by now. That’s just common sense. If you sell something, I don’t care what it is, that is so inferior to another product it simply goes away. Especially if the much better provide is cheaper,and on some cases like you claim, even free. Like I said before I have no need for either since I’ll be on fed blue cross until I die.
 


Motor Mouse

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Well everyone I do feel bad and sorry for this post as it’s turned out. Someone earlier in this post said let’s relax and get back to what this site is intended for. I agree and feel responsible for where this post has went. I’m sorry.

Jim is not a bad person or wrong on many accounts. Advantage plans may be right for many people. They are not right for 99.5% of most seniors. I will use Humana as an example . Look up what there CEO earned with stock options and sales people earned in wage and commission 2022. It is staggering. Look at Humana’s profits for 2022. Humana is one of many. Where does all that money come from? Government payments and seniors. Watch tv for an hour tonight, you will be bombarded with commercials for Medicare advantage plans, it’s that time of year and happens every year. Take my bet you won’t hear Humana, United Health Care or any other trying to sell you a N, G, F (if you Qualify) or other gap plan. Why? I wonder? Again Advantage plans are a good option for many people but not all depending on your situation. My original post was about how complex Medicare is and that most seniors just put their trust in an insurance salesman.

I also intended to point out that advantage plans are not free! They are costing the tax payer billions!

I’m done with this now! Should not even post this! Back to fishing!
 

eyexer

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Well everyone I do feel bad and sorry for this post as it’s turned out. Someone earlier in this post said let’s relax and get back to what this site is intended for. I agree and feel responsible for where this post has went. I’m sorry.

Jim is not a bad person or wrong on many accounts. Advantage plans may be right for many people. They are not right for 99.5% of most seniors. I will use Humana as an example . Look up what there CEO earned with stock options and sales people earned in wage and commission 2022. It is staggering. Look at Humana’s profits for 2022. Humana is one of many. Where does all that money come from? Government payments and seniors. Watch tv for an hour tonight, you will be bombarded with commercials for Medicare advantage plans, it’s that time of year and happens every year. Take my bet you won’t hear Humana, United Health Care or any other trying to sell you a N, G, F (if you Qualify) or other gap plan. Why? I wonder? Again Advantage plans are a good option for many people but not all depending on your situation. My original post was about how complex Medicare is and that most seniors just put their trust in an insurance salesman.

I also intended to point out that advantage plans are not free! They are costing the tax payer billions!

I’m done with this now! Should not even post this! Back to fishing!
You bring some very good points. Since I know nothing about advantage plans and their funding I’ll just you. How are they actually funded. The actual process and where the money comes from
 

Jim Simmers

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I’m simply picking your brain because I know zero about advantage plans. There obviously has to be advantages and disadvantages to both or med sups would have ceased to exist by now. That’s just common sense. If you sell something, I don’t care what it is, that is so inferior to another product it simply goes away. Especially if the much better provide is cheaper,and on some cases like you claim, even free. Like I said before I have no need for either since I’ll be on fed blue cross until I die.
Medicare has been around since 1965, advantage and Prescription Drug plans since 2006. Being their newer perhaps and people can choose which way they want to get their Medicare. Speculation on my part except having more options. When you think of the insurance you had during your working years typically through your employer. Premium, deductible, copays and max out of pockets. Those are what advantage has. Not every plan but some do. Routine Dental hearing and vision, you could get those in your plan but once you got on Medicare you would have to purchase those separately. Now you can get those in every advantage plan. Just some offer more than others. I thinks it’s only a matter of time before supplements as we know them are gone. Don’t know if it will be in our lifetime. Just like Medica cost plans. They were started to replace some of the advantage plans because the money for advantage plans was taken and given to fund Obama care with the idea that once advantage plans gained market share over cost plans the cost plans would go away. So in Morton, burliegh, stutsman and grand forks counties that’s why medica can not offer their cost plan. They also added a couple advantage plans to replace them. So you you’re reading this, you are against advantage plans but are on a medica cost plan, you need to look at what your complaining about cause they are from the members view, the same. Only different on how they are funded or their relationship with the federal government.
 

Jim Simmers

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Well everyone I do feel bad and sorry for this post as it’s turned out. Someone earlier in this post said let’s relax and get back to what this site is intended for. I agree and feel responsible for where this post has went. I’m sorry.

Jim is not a bad person or wrong on many accounts. Advantage plans may be right for many people. They are not right for 99.5% of most seniors. I will use Humana as an example . Look up what there CEO earned with stock options and sales people earned in wage and commission 2022. It is staggering. Look at Humana’s profits for 2022. Humana is one of many. Where does all that money come from? Government payments and seniors. Watch tv for an hour tonight, you will be bombarded with commercials for Medicare advantage plans, it’s that time of year and happens every year. Take my bet you won’t hear Humana, United Health Care or any other trying to sell you a N, G, F (if you Qualify) or other gap plan. Why? I wonder? Again Advantage plans are a good option for many people but not all depending on your situation. My original post was about how complex Medicare is and that most seniors just put their trust in an insurance salesman.

I also intended to point out that advantage plans are not free! They are costing the tax payer billions!

I’m done with this now! Should not even post this! Back to fishing!
Looking through this site this is the place for this. We all have a common bond and that’s the outdoors. Thats why there are so many threads. If you don’t want to participate in this, don’t click it.
Advantage plans are not for everyone. I think they are based on what I see on a daily basis for 18 years. But I also know if you’re not comfortable with something and like what you have you should just stay there. It doesn’t happen often, but it does where I turn down an enrollment if the beneficiary is uneasy and all their going to be is miserable. I have been at this too long to be miserable with you. lol. But I am always here for my people when issues come up and they can. I know there are many here that are glad you started this post. Like I said earlier, you just don’t and be happy where you are. Someday when you want more information, I will be here. Tight lines.
 


3Roosters

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Looking through this site this is the place for this. We all have a common bond and that’s the outdoors. Thats why there are so many threads. If you don’t want to participate in this, don’t click it.
Advantage plans are not for everyone. I think they are based on what I see on a daily basis for 18 years. But I also know if you’re not comfortable with something and like what you have you should just stay there. It doesn’t happen often, but it does where I turn down an enrollment if the beneficiary is uneasy and all their going to be is miserable. I have been at this too long to be miserable with you. lol. But I am always here for my people when issues come up and they can. I know there are many here that are glad you started this post. Like I said earlier, you just don’t and be happy where you are. Someday when you want more information, I will be here. Tight lines.
Hey J. Simms. Thanks for the info. I am sure @Vollmer will accept your money for your sponsoring your business.
 

camper

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I have not made a penny off this thread. Fact! But a lot are getting valuable information. Oh and for the record I could fish through the ice today!
Geneva? I’ve caught a lot of perch out of that lake.
 

AaronJ

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$0 premium plans are not free and surely are not a scam. 51% of the Medicare population is on an advantage plan. I would be glad to give you some insight how advantage plans really work. On original Medicare a senior basically will pay $174.50 for part B which with part A covers 80% of your doctoring bills. Then that 20% you are expected to pay average $200 per month for 20% plus have no drug coverage, no routine services like dental, hearing and vision. Whats really the scam here? These plans have been around for 18 years now and are not going anywhere. Perfect? Nothing is perfect but for most people they are a better option. I have been offering them since 2006. I have never had anyone whos been on them say, "What a farce!" 701-220-3251 if you want to visit.
Advantage plans are pure garbage when you actually need coverage. They are bilking millions from seniors across this country. If you are a healthy senior are they a decent option??? Maybe. If you are ill in any way they are pure garbage and should be illegal. You are clearly in sales and NOT in healthcare.

Once you take an advantage plan in lieu of regular Medicare you may not be allowed to get on Medicare.
 


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