Re: Turning 65 in 2012. Need advice on medical.

cdrcos wrote:
How much does the Medicare Advantage Plan cost you per month - if you save the $2400 of Part B?

I'm going to tell you, but you won't believe me until you check it out.

It costs nothing for the advantage plan.

As I understand advantage plans, they set up a network of providers, then tell the government they will provide your health care for a set fee, regardless of how much you use the plan.
The government then sends them X dollars per month for your care.

Yes, it sounds too good to be true, and if you have any chronic ailments such as heart conditions, you may have to pay more.

I'm not an expert, but I am a customer.
If it doesn't work, I can stop the advantage plan and go back to paying for the Part B.

Dennis

If it sounds too good to be true, it probably isn't. :lol:

Here's a down and dirty extract I copied about MSA costs"

How Much Does a Medicare Advantage Plan Cost?

In addition to your Part B premium, you usually pay one monthly premium for the services included. Each Medicare Advantage Plan can charge different out of-pocket costs. Your out-of-pocket costs in a Medicare Advantage Plan depend on:

Whether the plan charges a monthly premium.
Whether the plan pays any of your monthly Part B premium.
Whether the plan has a yearly deductible or any additional deductibles.
How much you pay for each visit or service (copayments or coinsurance).
The type of health care services you need and how often you get them.
Whether you follow the plan’s rules, like using network providers.
Whether you need extra benefits and if the plan charges for them.
The plan’s yearly limit on your out-of-pocket costs for all medical services.
 

It looks to me like they're saying you would be paying BOTH Part B and a monthly fee for the MSA, but that the MSA might pay part of the Part B premium.

I'm getting ready to go on TFL soon myself and I still haven't seen anything that is a better deal than TFL (of course, that could change depending on what the idiots on the Potomac decide to do.) In addition, I'm signing up for Tricare Plus which allows you to stay with the doctors and clinics you have if you're treated at a Military Treatment Facility. Tricare Plus is a program that may or may not be offered at the MTF, depending on local policy. It's a simple application process that can only be done within 30 days of your 65th birthday here at Fort Gordon.

You might want to check into the MSA a little further before you jump. JMHO.

Sarge3398 wrote: If it sounds too good to be true, it probably isn't. :lol:

Here's a down and dirty extract I copied about MSA costs"

How Much Does a Medicare Advantage Plan Cost?

In addition to your Part B premium, you usually pay one monthly premium for the services included. Each Medicare Advantage Plan can charge different out of-pocket costs. Your out-of-pocket costs in a Medicare Advantage Plan depend on:

Whether the plan charges a monthly premium.
Whether the plan pays any of your monthly Part B premium.
Whether the plan has a yearly deductible or any additional deductibles.
How much you pay for each visit or service (copayments or coinsurance).
The type of health care services you need and how often you get them.
Whether you follow the plan’s rules, like using network providers.
Whether you need extra benefits and if the plan charges for them.
The plan’s yearly limit on your out-of-pocket costs for all medical services.
 

It looks to me like they're saying you would be paying BOTH Part B and a monthly fee for the MSA, but that the MSA might pay part of the Part B premium.

I'm getting ready to go on TFL soon myself and I still haven't seen anything that is a better deal than TFL (of course, that could change depending on what the idiots on the Potomac decide to do.) In addition, I'm signing up for Tricare Plus which allows you to stay with the doctors and clinics you have if you're treated at a Military Treatment Facility. Tricare Plus is a program that may or may not be offered at the MTF, depending on local policy. It's a simple application process that can only be done within 30 days of your 65th birthday here at Fort Gordon.

You might want to check into the MSA a little further before you jump. JMHO.

Whether the plan charges a monthly premium.
My Plan charges no monthly premium.
Whether the plan pays any of your monthly Part B premium.
My plan pays all of my monthly Part B premium.
Whether the plan has a yearly deductible or any additional deductibles.
There are deductibles, but TRI Care covers all of them.
How much you pay for each visit or service (copayments or coinsurance).
My plan does charge co pay, but TRI Care covers all of them.
The type of health care services you need and how often you get them.
That's the big variable.
Whether you follow the plan’s rules, like using network providers.
Whether you need extra benefits and if the plan charges for them.
The plan’s yearly limit on your out-of-pocket costs for all medical services.

Regardless of what plan you use, you are still covered by TRIcare.

Again, I am not an expert, but I will continue to post as I learn more.

We went to a Health Fair while at Pelican Roost and a TriCare Representative was there. I just went on TFL and wondered if I had to continue going to TFL approved doctors as I did when on TriCare Prime. Answer was it is in my best interest as all bills will be paid directly by Medicare and Tricare to the doctors. If I go to a non approved Tricare doctor TriCare will pay me and maybe not all of the bill and I will have to pay the doctor. Are your doctors on your Medicare Advantage plan also TriCare doctors or will you have to make payment to the doctor as was explained to me?

I doubt the doctors in the advantage plan I joined will be in the tricare book.

I called the TFL 1-800 number and asked how the system would work.
They said most advantage plans will submit your claim for the co-pay to TFL for payment, but if they don't, there is a form I can submit with the doctors paperwork and they will reimburse me.

I start using advantage/tfl in May. I'll let you know what I find out then.

Dennis

been on medicare and TFL for a couple of years now. You do not need a referral for a specialist since medicare will be your primary. My wife is still on TRIICARE Prime. She will switch to TFL next year. She had to spend several days in the hospital last fall. The hospital bill was over $30,000. Did not have to pay a dime. ( did my time in the SSBN Navy....saturdays, sundays and a bunch of nights LOL )

PS..keep on top of the news, sign up at congress.org to get updates to see how your state reps are voting on issues concerning us military retirees. They keep trying to cut the benefits we all did our time to earn.