Looking for advice about medicare advantage

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peaches1
peaches1 Member Posts: 137
edited December 2020 in Employment, Insurance, and Other Financial Issues

Hi- I have not posted on here in ages. I was diagnosed with stage 2 BC 4 1/2 years ago, and I found a new lump last year, and it showed up on an ultrasound, but a breast biopsy found out it was benign, and they are following it.

I know this is last minute, but I have a Blue Cross medicare plan F plan, and I was going to switch to a cheaper plan last year, but an insurance agent in Chicago who only deals with health insurance who I have dealt with before, said that because of my history of breast cancer, I would have to go through underwriting, and they would either deny me or jack up my rates, and he told me to keep the plan I have. I love the plan F, because once I pay the $200 in premiums, it pays for anything else except for eye exams. I could switch to a medicare advantage plan though, and I would not have to go through underwriting, and the lower premiums temps me, but I have been told that I would still have the $144 for part B taken out of my social security every month, and I would have to pay copays which I do not have to right now. Right now I go to see the oncologist twice a year, and my PCP twice a year, and I am supposed to go to my ophthalmologist once a year, but I haven't yet this year because of COVID.

I am also being followed by a urologist for blood in my urine. They found a complex kidney cyst last year, and it has grown a little bit, and I am going for another CT urogram for it. I am just worried that if it is something, which hopefully it is not cancer, that if I switch to an Advantage plan, that It will end up costing me way more than $200 a month extra I currently pay. On my last kidney ultrasound the radiologist just recommended that I have another kidney ultrasound in six months to a year. One of my sisters is an endocrinologist, and she showed my test results to two different kidney specialists in New Orleans, and they both say that this needs further testing. My urologist is only willing to order another CT urogram. Does anybody here have an Advantage plan, and also have lots of medical problems? Should I just keep the BCBS plan F I currently have?

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited December 2020

    peaches - if it were me I would NEVER give up my traditional medicare. I can go to any doc or hospital or rehab or.... I went through two breast cancer surgeries, not to mention a broken shoulder & several MOHS skin cancer surgeries and never paid one penny over the once a year deductible. ($180 then I think). If you can afford it, get a medigap policy that pays the other 20% and you're in like gold.

    Yes - I pay for eyeglasses, but that's a small price to pay.

    I'm sure there are people who will argue the other side of the coin, but I absolutely want the freedom to pick my own docs anywhere in the country. And go to the top hospitals for consults or second opinions whenever I want.

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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited December 2020

    I have a Medicare Advantage plan and I'm very happy with it. I live in a pretty large city, so I get a lot of choices in the network for doctors and facilities. In a small town, that would be a problem. All I pay is the Part B amount with no additional charge for the premium. My co-pay cap for the year is $2500 (I think that's the current amount). There's no deductible. My regular prescriptions are free because it includes the drug plan. I've had to pay a small token amount for a few one-time specialty drugs. There's no charge for primary care visits, and $35 for specialists. Most costs have gone DOWN in the five years I've been on the plan, and coverage has improved.

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  • Spookiesmom
    Spookiesmom Member Posts: 9,568
    edited December 2020

    I’ve had an advantage plan for years. I love it. I live in the 3rd most populated county and have a large number of drs in network. If I want to see a certain dr, my pcp agrees. Next year specialist copay will be $5. Generic meds ,90 days $3.60. I am on Ibrance. They pay over $13 000 A MONTH for it. No hassles.

    I do have the $114 taken out every month, that’s it. Besides my meds and a few copays. Next year they will allow $400 towards glasses. X-rays, no charge. MRI was $25 this year.

    Open enrollment ends December 7, so you are running out of time.

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  • flashlight
    flashlight Member Posts: 698
    edited December 2020

    Hi peaches1, I agree I wouldn't change this year. Next year you should have more information on your health issues. I have a medigap policy. I got it to keep my doctors across state lines and it was the best decision. My husband has a less expensive plan and this year he has had to have a few test. He even had to pay a $300.00 deductible for cataract surgery, CT scan, biopsy, and not to mention a $45-50.00 copay to see the doctor. I have been trying to get him to change to a more expensive plan that covers more.

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