Thank you for your response. I do not want to have an advantage plan now that I know these companies have been scamming the government AND do everything they can to avoid paying large bills.
I also do not wish to have Kaiser. Longer story, but with Kaiser, I have had some great doctors and unwarranted denials, while watching some people die through Kaiser mismanagement. A person cannot sue Kaiser while insured. A family friend did successfully sue once her husband was dead. I personally had to pay a hospital bill because I didn’t get a referral and went to the wrong hospital from an urgent care.
I’m looking for the type of coverage your wife has opted for.
At my age, I’ve witnessed the de-evolution of insurance companies throughout my life. I don’t trust them at all. But I need coverage as I age and am more likely to need coverage for hospitalization or larger cost things.
at the medicare.gov site where they will provide what kind og gap and drug plans are available. We reviewed those - called some of the providers, decided how much risk we were willing to buy down and then arranged for a gap and drug plan. There is also a network of people who are not out to sell you anything you may wish to call SHIP for advice - it is the state health insurance assistance program. https://www.shiphelp.org/ link is a locator for each state. Good luck.
I was referred to you by a woman in my Women’s Group. I have a question. Since Im quickly becoming disillusioned by my Providence Medicare Advantage Plan, do you know of a way to compare other Medicare Insurance Plans without being hounded by phone calls and agencies I do not wish to deal with?
By the way, I am a healthy senior who when faced with one ambulance, clinic/ER visit and one prescription while on vacation in Hawaii, saw all three charges denied by my insurance. I was suspicious about all the little carrots these plans offer, likely to distract from atrocious service and denials when a patient really needs them.
Hi Cathy, There are a number of things to consider.
1. Does it need to be Medicare Advantage? - If not then you might consider regular medicare with a gap plan and a drug plan. It will likely increase the monthly cost but Medicare has a fairly low claims denial rate. The gap plan should be able to help with the Medicare 20% copay. My wife has a low cost drug plan in case of something really serious but we also buy meds with Good RX or some other pharmacy discount card because overall we find that can sometimes be cheaper.
You probably want more. I'ts a good idea to know the claims denial rate just in case. If you are in Oregon or Utah I think the Insurance commissioner has that data. I am including a link
Thank you for your response. I do not want to have an advantage plan now that I know these companies have been scamming the government AND do everything they can to avoid paying large bills.
I also do not wish to have Kaiser. Longer story, but with Kaiser, I have had some great doctors and unwarranted denials, while watching some people die through Kaiser mismanagement. A person cannot sue Kaiser while insured. A family friend did successfully sue once her husband was dead. I personally had to pay a hospital bill because I didn’t get a referral and went to the wrong hospital from an urgent care.
I’m looking for the type of coverage your wife has opted for.
At my age, I’ve witnessed the de-evolution of insurance companies throughout my life. I don’t trust them at all. But I need coverage as I age and am more likely to need coverage for hospitalization or larger cost things.
Thank you for your help.
Here is a link https://www.medicare.gov/plan-compare/#/?year=2024&lang=en
at the medicare.gov site where they will provide what kind og gap and drug plans are available. We reviewed those - called some of the providers, decided how much risk we were willing to buy down and then arranged for a gap and drug plan. There is also a network of people who are not out to sell you anything you may wish to call SHIP for advice - it is the state health insurance assistance program. https://www.shiphelp.org/ link is a locator for each state. Good luck.
I was referred to you by a woman in my Women’s Group. I have a question. Since Im quickly becoming disillusioned by my Providence Medicare Advantage Plan, do you know of a way to compare other Medicare Insurance Plans without being hounded by phone calls and agencies I do not wish to deal with?
By the way, I am a healthy senior who when faced with one ambulance, clinic/ER visit and one prescription while on vacation in Hawaii, saw all three charges denied by my insurance. I was suspicious about all the little carrots these plans offer, likely to distract from atrocious service and denials when a patient really needs them.
Thank you.
Cathy
Hi Cathy, There are a number of things to consider.
1. Does it need to be Medicare Advantage? - If not then you might consider regular medicare with a gap plan and a drug plan. It will likely increase the monthly cost but Medicare has a fairly low claims denial rate. The gap plan should be able to help with the Medicare 20% copay. My wife has a low cost drug plan in case of something really serious but we also buy meds with Good RX or some other pharmacy discount card because overall we find that can sometimes be cheaper.
2. Here is a Medicare.gov link comparing different types of Medicare Advantage Plans (PPO, HMO, etc) https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/compare
You probably want more. I'ts a good idea to know the claims denial rate just in case. If you are in Oregon or Utah I think the Insurance commissioner has that data. I am including a link
https://www.kff.org/medicare/issue-brief/over-35-million-prior-authorization-requests-were-submitted-to-medicare-advantage-plans-in-2021/ of a Kaiser report that lists some company denial rates. I hope this helps. let me know and I can find more. As an aside - I have a call in to the HHS OIG because I know they have the Medicare Advantage Denial rates broken out by company. If I get it I will let you know...Alan
Alan - another resource on burnout for you - https://www.themuse.com/advice/you-didnt-cause-your-own-burnout?utm_source=facebook&utm_medium=social&utm_campaign=editorial_april2023&utm_content=advice&utm_term=owned&fbclid=IwAR0kZ-QV8fMn7-EMTNMH-46CU4jCEB2ULAldBhup-mk4Z_O-QU867LBGO2E_aem_AYnrWZnYRqfCkrlsMXaoW_k_E0COGZ7N-DnjIMMue5c0IXP3pMIzWsM4MoB_BCigKZo