For us the only possible downside of an Advantage plan is that should we decide to change to supplements rather than Advantage we would be 'rated' to determine what our premium for supplements would be. (If you go onto supplements when you are age eligible you pay the same as your age peers regardless of your health every year. If you go into supplements later they look at your health to determine your premium.)
We are pleased with $0 copay for our primary care, $0 for most of our meds, $0 for routine tests and X-rays (CT Scans, MRIs etc have copays that are reasonable), free OTC by mail monthly benefit, vision/dental/hearing benefit, gym choice membership, low co-pays for specialists, a flat daily copay for hospitalization regardless of cause for the first week with no copay thereafter and a maximum out of pocket (MOOP) for the year for all medical except prescriptions of under $4000. My Part B Medicare cost covers the premium for my Advantage plan.
My sisters pay more for their supplements than my annual MOOP yet it does not make sense for them to change to an Advantage plan because their former employers cover about half of the cost of their supplements and provide them with more flexibility both in their home area and outside of it. They have generous PPO plans while Advantage plans are generally HMO plans. In my Advantage HMO I have found excellent doctors and idiots. PPO plans also have excellent doctors and idiots.
MOOP is the maximum I might pay in a year. In reality, my medical expense for 2020 thus far is a $30 copay to a dermatologist who took a skin cancer off my face. Three visits to my primary care doc during the year, mammogram, blood work, chest x-ray were all for $0 copays. My flu shot and prescriptions all came to $0. And, of course, the monthly amount Social Security pulls from my check for Part B, which is not included in the Advantage Plan MOOP.
Edited 3 time(s). Last edit at 12/04/2020 08:15PM by Flash.
