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MIButterfly

(1,791 posts)
Thu Dec 11, 2025, 11:23 AM 23 hrs ago

Medicare Advantage

My best friend retired this year and asked me about Medicare options. Twice I tried to talk her out of getting a Medicare Advantage plan. So what does she do? Lets some smooth-talker convince her to sign up a for a Medicare Advantage plan.

Some people have MA and it works out well for them. God bless them. But I was not willing to take that chance. I told her it wasn't Medicare; it's private health insurance and they can deny your claim any time they want to. And then what are you going to do? She said that if your doctor says you have to have to have a procedure, they have to pay for it, right? That's one of the dumbest things I ever heard anyone say. An insurance company is not in the business of making sure you get the health care you need; it's in the business of making money for its CEOs and shareholders and they do that by denying claims. It's a BUSINESS and the purpose of a business is to make money. All these things they give you for nothing or next-to-nothing to get you to sign up - haven't you ever heard you don't get something for nothing? And the way they try to shove Medicare Advantage down your throat every year from October to December makes me think it's something more to their benefit than mine.

I hope it works out for my friend, but like I said, I'm just not willing to take that chance. Am I wrong?

19 replies = new reply since forum marked as read
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Medicare Advantage (Original Post) MIButterfly 23 hrs ago OP
Medicare advantage plans are scams LetMyPeopleVote 23 hrs ago #1
Absolutely! SheltieLover 22 hrs ago #14
You said and did the right thing. OLDMDDEM 23 hrs ago #2
Whatever plan she has it will probably change next year, not cover as much and cost more more Walleye 23 hrs ago #3
Both of us have had MA two different non profit companies and never had any problems question everything 23 hrs ago #4
Heck no, you are 100% correct vapor2 23 hrs ago #5
I'm with you My Friend BOSSHOG 23 hrs ago #6
She can change back in first year. However, she like 51% of Medicare eligibles may find it works best for her. Silent Type 22 hrs ago #7
She may find its the only thing she can afford at that time. slightlv 21 hrs ago #18
Our local Council on Aging will sit down with you multigraincracker 22 hrs ago #8
Anything that advertises as aggressively as it does can't be good NewHendoLib 22 hrs ago #9
someone must pay for the ads. rampartd 22 hrs ago #10
Right. Wednesdays 22 hrs ago #11
Even if it does work, it's bad for everyone else Bobstandard 22 hrs ago #12
My daughter is an RN Case Manager Freddie 22 hrs ago #13
Tell your friend to call her local Council on Aging and perhaps her local Senior Center SheltieLover 21 hrs ago #15
We've had MC Advantage for 13 years cyclonefence 21 hrs ago #16
Advantage has paid out over a million dollars to keep my wife alive. YMMV. Ferrets are Cool 21 hrs ago #17
My union UAW/BC/BS is great for us retirees multigraincracker 19 hrs ago #19

Walleye

(43,584 posts)
3. Whatever plan she has it will probably change next year, not cover as much and cost more more
Thu Dec 11, 2025, 11:27 AM
23 hrs ago

I had Aetna for about a year and I really didn’t like it. I switched back to regular Medicare. It wasn’t easy, they don’t encourage it. But I’m very happy with it. They can’t just change things up on you. It takes an act of Congress, so at least it used to. I really don’t need to go through all that paperwork every year and “choices“

question everything

(51,564 posts)
4. Both of us have had MA two different non profit companies and never had any problems
Thu Dec 11, 2025, 11:27 AM
23 hrs ago

Paid for major and minor surgeries including three weeks post surgery rehabilitation.

vapor2

(3,573 posts)
5. Heck no, you are 100% correct
Thu Dec 11, 2025, 11:29 AM
23 hrs ago

Thom Hartmann does a spiel on Advantage programs and difficult to switch to traditional Medicare if you sign up for Advantage.

Many doctors won't take Advantage

Advantage is PRIVATIZED Medicare

Denials are more than common with Advantage

Some do say it works for them but one day they will be denied necessary care

BOSSHOG

(44,410 posts)
6. I'm with you My Friend
Thu Dec 11, 2025, 11:32 AM
23 hrs ago

Medicare Advantage is designed to give an advantage to people who support republicans. They got some slick, sympathetic, effective commercials. It is not designed to keep us well in our olden years. But let’s spend time and effort demonizing socialism while hawking snake oil.

Silent Type

(12,297 posts)
7. She can change back in first year. However, she like 51% of Medicare eligibles may find it works best for her.
Thu Dec 11, 2025, 11:43 AM
22 hrs ago

slightlv

(7,253 posts)
18. She may find its the only thing she can afford at that time.
Thu Dec 11, 2025, 01:38 PM
21 hrs ago

I tried to change back the day after I had a "visit" by someone who was suppose to talk to me about the differences between Medicare and MA, and among the different MA plans. Talk about slick? Got my signature on something I didn't even know I was signing... and I just don't fall for that. I mean, this guy was so slick, I reported him. I was signed up on MA without my knowledge and without my consent, since I'd said several times that I was NOT interested in signing up that day. I needed time to think and compare. No... I do not want to sign up for anything today. And STILL he found a sneaky way to get my signature!

When I went to pick up scripts the next day, THAT'S when I discovered what he'd done. Getting back home, I immediately called Medicare to tell them what had happened and that it was NOT what I wanted and I wanted to change back.

Sure... I could change back, it would just cost me a bunch more money to do it. And THEN I'd have to find a supplemental (that would take me... they don't have if you've been on MA at any time) that I could afford. They penalize you dearly if you're a former MA, even a one-day-old like me at the time.

The "extras" are carrots they dangle. They don't include enough to actually make it functional if you need it, but they're there for common ailments. New glasses script is okay... just bring your own frames, for example.

And I'm thinking I STILL could use a supplement program to pay for what the MA now *won't* pay for! Co-pays and deductibles are higher then ever, thanks to the R's and what they're doing to the ACA. Companies see a way to profit more without bearing the stigma, so they jack things up.

We don't have healthcare in this country. We have insurance-care, to ensure the insurance companies keep raising their shareholder profits.

multigraincracker

(36,816 posts)
8. Our local Council on Aging will sit down with you
Thu Dec 11, 2025, 11:45 AM
22 hrs ago

and pick the best plan for you.
They give great advise and do not make any money off of you.
You can check at your local Senior Center.

Wednesdays

(21,505 posts)
11. Right.
Thu Dec 11, 2025, 11:58 AM
22 hrs ago

When I was about to turn 65, I got countless postcards inviting me to a "free meal" at a pricey restaurant where they would discuss Medicare Advantage plans.

I told my family, "They wouldn't go through the expense of paying for a free meal if they didn't think they'd recoup that money."

Bobstandard

(2,143 posts)
12. Even if it does work, it's bad for everyone else
Thu Dec 11, 2025, 12:06 PM
22 hrs ago

Insurance companies who offer Medicare Advantage plans get paid by the government for each person they enroll. They work hard to deliver fewer services than they get paid for. MA plans are the most profitable part of the medical insurance industry thanks to taxpayers. Folks who are happy with their MA plans are just lucky. Horror stories are everywhere.

Freddie

(10,030 posts)
13. My daughter is an RN Case Manager
Thu Dec 11, 2025, 12:27 PM
22 hrs ago

She very strongly suggested we stay away from Advantage plans. From her point of view, they are constantly second-guessing medical professionals and trying to deny care or shorten rehab stays, etc. We have traditional with an AARP supplement and are very happy with it.

SheltieLover

(75,625 posts)
15. Tell your friend to call her local Council on Aging and perhaps her local Senior Center
Thu Dec 11, 2025, 12:41 PM
21 hrs ago

They will set her straight!

You did good by your friend. Too bad they didn't have the cognitive capacity to comprehend your advice and act on it.

cyclonefence

(5,137 posts)
16. We've had MC Advantage for 13 years
Thu Dec 11, 2025, 12:50 PM
21 hrs ago

and have been very happy with it. But after watching John Oliver eviscerate Advantage plans, we switched last week to traditional MC. As a poster above points out, your friend can always switch back next year if it doesn't work out for her, which is what we will do, too. The premium is lower, and the only difference I can see is that traditional MC pays less per day for hospital stays. I was in the hospital this last year for several short stays, so I'm not sure this is going to work for us, but we'll see.

multigraincracker

(36,816 posts)
19. My union UAW/BC/BS is great for us retirees
Thu Dec 11, 2025, 02:47 PM
19 hrs ago

Free drugs and only a few dollars on most office visits plus dental.

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