Good morning! It’s another perfect day in our neighborhood. Art took me to Kosher Kroger. I had a full cart and it was all covered by our Medicare Advantage spending card, $76.00 worth of groceries, and his bag of six medications were all covered by insurance. So of course, it’s a good day in the neighborhood😅
“He has told you, O man, what is good; and what does the Lord require of you but to do justice, and to love kindness, and to walk humbly with your God?” Micah 6:8
Jo – In our area, we have a couple businesses that specialize in helping seniors pick the best Medicare plan for their situation. I’m not sure how much they cost, but I think they are affordable.
One of the businesses is owned by a man who used to attend my church. He had helped my mom a great deal, and she was very grateful.
Do you have anything like that in your area that could help you out?
I’ve used a Medicare agent (free and I’ve found mine to be pretty fair and willing to compare and contrast benefits specifically for you regarding your doctors, etc.).
Medicare, generally, is impossible for average folks to navigate unless it can be a full-time job. And even then …
I am thinking also that most provider pharmacists would be a good source of specific info regarding mediation costs and possible breaks.
I have heard a downside of the Advantage plans is you can’t later go back to ‘regular’ or traditional Medicare, but I’m not really sure why. Advantage plans are private (and they are less costly) but are mostly HMOs, I believe. Because I’m still working full time I am on a PPO plan through traditional Medicare which has been very convenient in being able to skip referrals and a lot of the cumbersome processes for making appointments without long waits; if I ever have to retire that will probably have to change.
Jo I’ve not heard positive things about the Advantage plans. I do believe there are better supplement plans considering what one’s needs are for them but they do tend to have higher premiums.
We chose to go only with A and B Medicare and it works for us. We are in total control of our providers (which thankfully we have had no trouble in finding) and we pay our yearly deductible along with 20% of our medical costs. This most recent hospital stay will be most likely our more significant cost to pay. But, the surgeon’s office and the hospital told me they would much rather work with just Medicare than the other insurance providers due to paperwork and hoops they must jump through. Medicare will require some adjustments to charges for the hospitals and doctors. Nj
I’ve been happy with the traditional Medicare — paid virtually nothing for the knee surgery, the insurance also covered nearly all of the PT appointments. I have A and B and a ‘gap’ coverage plan.
My friends on the HMOs seem to get stuck waiting for long periods to get appointments on a referral — as in many weeks sometimes so they’re always having to call both parties (referring dr and referral place) to see what the status is.
The traditional PPO allows you to go to any doctor who takes Medicare (without a referral). (And I think there still is a preferred ‘network’ but it seems pretty wide and generous.)
My neighbors (on an HMO) are going through an issue now where their insurance is not (but this isn’t even clear to them yet) covering the hospital they’ve used, which is also where she goes for PT. So they’ve been stuck in limbo for a few weeks not knowing where they can go.
We have Aetna Medicare Advantage. Art researched all options and it was best for him. When it was my turn to choose, I went to a program with an independent agent. He explained how the government has mismanaged Medicare and how private can get a whole lot of extras packed in for what you get on regular Medicare. He pulled out his wallet and said, “This is my personal card.” It was Aetna Advantage. It’s probably not the same in all parts of the nation. It is not HMO. We have the top doctors and #1 healthcare system in Georgia. We have choices. We have vision and dental through the plan. We get the spending card with $90 per quarter for OTC supplies like canes, bandaids, meds, things sold at a pharmacy, and $75 per quarter for fresh healthy foods for each of us. After a hodpital stay you can get frozen meals delvered for recovery perood. You also can get some hours with a personal care assistant to help around the house and to run errands. And there is free membership at a gym or the Silver Sneakers program. Like I said, it may not work like that elsewhere, but that is our plan.
Ha! She called and I did not get to edit before posting😄 My “dog-walking friend.” She has told numerous others about our “Signature” Aetna Advantage plan. I remember the agent said it is not available everywhere. My only problem with it is that you can only use the sprnding card at certain stores. I can’t use it at my Publx, a mile from here. I have to go to Kroger, 2-3 miles from here. It is good at Walmart, Walgreens, and, of courde, CVS, which owns Aetna.
I might like a dig to walk. Do they require leashes? Are they polite and do they obey? Will they get into a car?
btw, Abby’s coming along both on the walks and her better leash behavior – but also in her sit-stays we’re practicing in the backyard.
Next will be longer sit stays and then I will begin to back — then walk — away, still requiring her to sit in place. We’ll see, that may be a new hurdle. And I still need to get her to get onto the training platforms which she’s resisting.
The insurances are certainly different in different states. Ours is determined by my husband’s former work. It is a supplemental and has been good for us. I am grateful we have it. We do not get extra, though, like Janice.
Wandering Views 
Good morning! It’s another perfect day in our neighborhood. Art took me to Kosher Kroger. I had a full cart and it was all covered by our Medicare Advantage spending card, $76.00 worth of groceries, and his bag of six medications were all covered by insurance. So of course, it’s a good day in the neighborhood😅
LikeLiked by 1 person
Good morning from beautiful with a heavy frost Idaho.
mumsee
LikeLiked by 1 person
morning! Cold frosty morning in my neck of the woods. Snow heading in tomorrow and Saturday! ⛄️❄️
Nj
LikeLiked by 1 person
what is a Medicare advantage card?
I keep reading about benefits we can get but wondered if they were just a scam
jo
LikeLiked by 1 person
Cloudy, 60s, and no rain in the forecast for a change.
Long day, long night covering a 3-hour landslide meeting. Now to write the story.
LikeLiked by 1 person
“He has told you, O man, what is good; and what does the Lord require of you but to do justice, and to love kindness, and to walk humbly with your God?” Micah 6:8
LikeLiked by 2 people
Jo – In our area, we have a couple businesses that specialize in helping seniors pick the best Medicare plan for their situation. I’m not sure how much they cost, but I think they are affordable.
One of the businesses is owned by a man who used to attend my church. He had helped my mom a great deal, and she was very grateful.
Do you have anything like that in your area that could help you out?
LikeLiked by 1 person
I’ve used a Medicare agent (free and I’ve found mine to be pretty fair and willing to compare and contrast benefits specifically for you regarding your doctors, etc.).
Medicare, generally, is impossible for average folks to navigate unless it can be a full-time job. And even then …
I am thinking also that most provider pharmacists would be a good source of specific info regarding mediation costs and possible breaks.
LikeLiked by 2 people
I have heard a downside of the Advantage plans is you can’t later go back to ‘regular’ or traditional Medicare, but I’m not really sure why. Advantage plans are private (and they are less costly) but are mostly HMOs, I believe. Because I’m still working full time I am on a PPO plan through traditional Medicare which has been very convenient in being able to skip referrals and a lot of the cumbersome processes for making appointments without long waits; if I ever have to retire that will probably have to change.
LikeLiked by 1 person
Jo I’ve not heard positive things about the Advantage plans. I do believe there are better supplement plans considering what one’s needs are for them but they do tend to have higher premiums.
We chose to go only with A and B Medicare and it works for us. We are in total control of our providers (which thankfully we have had no trouble in finding) and we pay our yearly deductible along with 20% of our medical costs. This most recent hospital stay will be most likely our more significant cost to pay. But, the surgeon’s office and the hospital told me they would much rather work with just Medicare than the other insurance providers due to paperwork and hoops they must jump through. Medicare will require some adjustments to charges for the hospitals and doctors. Nj
LikeLiked by 1 person
I’ve been happy with the traditional Medicare — paid virtually nothing for the knee surgery, the insurance also covered nearly all of the PT appointments. I have A and B and a ‘gap’ coverage plan.
My friends on the HMOs seem to get stuck waiting for long periods to get appointments on a referral — as in many weeks sometimes so they’re always having to call both parties (referring dr and referral place) to see what the status is.
The traditional PPO allows you to go to any doctor who takes Medicare (without a referral). (And I think there still is a preferred ‘network’ but it seems pretty wide and generous.)
My neighbors (on an HMO) are going through an issue now where their insurance is not (but this isn’t even clear to them yet) covering the hospital they’ve used, which is also where she goes for PT. So they’ve been stuck in limbo for a few weeks not knowing where they can go.
LikeLike
We have Aetna Medicare Advantage. Art researched all options and it was best for him. When it was my turn to choose, I went to a program with an independent agent. He explained how the government has mismanaged Medicare and how private can get a whole lot of extras packed in for what you get on regular Medicare. He pulled out his wallet and said, “This is my personal card.” It was Aetna Advantage. It’s probably not the same in all parts of the nation. It is not HMO. We have the top doctors and #1 healthcare system in Georgia. We have choices. We have vision and dental through the plan. We get the spending card with $90 per quarter for OTC supplies like canes, bandaids, meds, things sold at a pharmacy, and $75 per quarter for fresh healthy foods for each of us. After a hodpital stay you can get frozen meals delvered for recovery perood. You also can get some hours with a personal care assistant to help around the house and to run errands. And there is free membership at a gym or the Silver Sneakers program. Like I said, it may not work like that elsewhere, but that is our plan.
LikeLiked by 1 person
I did have to pay $30 as my part for each PT visit but other co-pays are a lot less. I don’t think upfront cost is any more than regular Medicare.
LikeLike
My dig-walking friend was thrilled to swttch to our plan when I set her up with the agdnt.
LikeLike
Ha! She called and I did not get to edit before posting😄 My “dog-walking friend.” She has told numerous others about our “Signature” Aetna Advantage plan. I remember the agent said it is not available everywhere. My only problem with it is that you can only use the sprnding card at certain stores. I can’t use it at my Publx, a mile from here. I have to go to Kroger, 2-3 miles from here. It is good at Walmart, Walgreens, and, of courde, CVS, which owns Aetna.
LikeLike
I might like a dig to walk. Do they require leashes? Are they polite and do they obey? Will they get into a car?
btw, Abby’s coming along both on the walks and her better leash behavior – but also in her sit-stays we’re practicing in the backyard.
Next will be longer sit stays and then I will begin to back — then walk — away, still requiring her to sit in place. We’ll see, that may be a new hurdle. And I still need to get her to get onto the training platforms which she’s resisting.
It all takes time, patience — and lots of cheese.
LikeLiked by 2 people
Just hope you don’t end up with a constipated dog. 🙂
LikeLiked by 1 person
It’s Friday! And here’re you weekly political funnies.
Oh, and, First!
LikeLike
The insurances are certainly different in different states. Ours is determined by my husband’s former work. It is a supplemental and has been good for us. I am grateful we have it. We do not get extra, though, like Janice.
LikeLiked by 1 person