Medicare Question

NadiaSookar

Hi everyone,

My mom was just diagnosed with Alzheimer's (mild) state. She currently has Medicare under an Advantage Plan - United Healthcare. Because of her new diagnosis, we are considering moving her back to Original Medicare in order to have more options for care. Does anyone have advice about this (i.e. having Original Medicare vs. an advantage plan) with a dementia diagnosis. Is there a preferred option?

Any insight would be greatly appreciated!

btrackwell

I was recently diagnosed with ALZ and have a Medicare advantage plan with United Healthcare. When I called my insurance guy to switch to supplemental he did some research on supplemental plans. Unfortunately having the diagnosis of ALZ disqualifies me from affordable plans as I am now in a different category. He found supplemental plans that would take me with a cost of 400-500 dollars a month. My united healthcare plan has an out of pocket limit of $3800 with is less than 400-500 a month. So he advised me not to switch. But run it by your insurance agent.

Victoriaredux

My opinion; Medicare Advantage plans are fabulous - for insurance companies. They throw in a few goodies and get real power over what they will cover.

With , hopefully,new treatments coming in the future - and they won't be cheap- keeping choice would matter to me more than a free pair of eyeglass frames or a gym discount. Again, my opinion.

Next open enrollment period look for unbiased [not by a salesperson] talks in your area about the differences and how changing plans work in your state.

Here is a source : https://www.shiphelp.org/

I've attended a few on line talks through the years - some on line & some in person at local health libraries. Speaker quality varies - some have been fantastic , some just read [it seems] cards — I always learn something new . The one I heard this year was the best ever . I wanted to hear about the annual changes.

harshedbuzz

Not all MAPs are created equal.

That said, MAPs do not offer any benefits associated with the GUIDE program which could be useful depending on the family and state in which they live.

https://www.cms.gov/priorities/innovation/innovation-models/guide

HB

April23

I would contact an elder law attorney before switching. Make sure you understand the rules and what is required.

JulietteBee

My DM has an Advantage plan from years before her diagnosis. If you have certain conditions, or under 65, the required supplement proves to be cost prohibitive. You can get many advantage plans with little or no plan premium, depending on whether it is a PPO or HMO.

Personally, I had BCBS for many years until a few of my prized providers were no longer in-network. I've since then switched to Humana PPO with absolutely no regrets.