Pharmacy tech here. Advantage coverage is crap—and can prevent you from switching back to regular Medicare...

the problems come when trying to get "Medigap" coverage - they can ding you big time for that

and that can price you out of coverage. Doesn't necessarily prevent you, unless you're healthy--or rich.

If you skip it (1) no insurance company is required to issue you a Medigap/Supplement plan and (2) if they choose to issue the plan they can set the fee based on your health/age/etc. at the time you try to switch. (There are a few states which offer a bit more protection - but not many)

So you can drop Medicare Advantage, and rely on basic Medicare plan (which covers 80% of your expenses). You will be on the hook for the other 20% - or - if a company chooses to offer you a Medigap/Supplement plan your costs will almost certainly be significantly higher than if you had made the choice when you started Medicare.

It is not well known, and the government is misleading. You have to dig pretty deeply to find the information I've summarized above - because they imply that you can always switch back to Medicare without expressly stating that you are only legally entitled to the version of Medicare which covers 80% of the costs - not the combination most people think of as traditional Medicare (Medicare + Medigap/Supplement)

I’ve had many patients report that their part D plan told them they were stuck with them for good. Even if you ignore their bad advice, Medicare holds you to waiting until open enrollment windows. I’ve had too many patients stuck with a part D plan only to find out that the coverage is garbage and they would’ve saved more if they’d just stuck with regular Medicare.

Medicare might not be perfect, but outsourcing it to private insurance companies is NEVER in our best interest. Big Pharma is geared toward profit, not actually helping anyone in a meaningful way.

Plan D is drug coverage. A Plan D policy is needed if a person stays with traditional Medicare. Still a better deal than Advantage.

...some even offering a free dinner at a local restaurant, in exchange for a "seminar" about a Medicare Advantage plan.

Needless to say, I ignored them all.

Especially at open enrollment time, but at other odd times every so often. It's hella annoying.

some really don't have much of a choice - that's part of the plan too

At the beginning of every year, I can’t keep count of the number of patients who just deflate when they realize they have to meet the Medicare deductible before they start to pay for anything—sometimes to the tune of thousands of dollars—and they’ve been put on some crap specialty medication that they’ll have to pay out of pocket for over several months before they actually see any benefit.

I can't understand why I can see the doc twice a year for some kind of "checkup" but it doesn't include taking my blood, checking blood pressure, etc...... what the heck is that all about - seems like for the amount I'm paying, that should be included as part of preventative measures

When an MD prescribes something and the insurance company—which involves NO ONE with a medical degree—refuses to pay for it.

I’ve had a shit ton of stress from a job I hated, no raise in three years, and an ever-increasing list of crap things we had to do because Walgreens was bought out by a hedge fund, is closing stores, and trying to “eliminate waste,” doing shit like forcing us to call at least 10 patient a day—from any other store—and try to convince them to come in for a vaccine or let us fill their scripts for them. I was in their latest round of layoffs April 16, and it’s obviously not going to get better there. Sycamore (the hedge fund) is going to strip Wags down to the bone and bail when they’ve sucked it dry. I was in the latest round of layoffs on 4/16 and freaking.

Between the stress and poverty, I managed to lose a lot of weight—like 80 lb in three months, and still losing. I went to my PCP and thought at least I’d be able to proudly say I was ready for skin surgery, and my doc immediately laughed at me. “Good luck getting your insurance to okay that. I mean, I could put it through but they’ll never approve it. Ha!”

Goodbye and FU, Dr. Shah. Makes me wonder how there are so many people on so many sketchy drugs for weight loss (how is it Ozempic, Mounjaro, etc. have so many dangerous side effects like thyroid cancer, yet are approved immediately?) and how do THEY manage to qualify to fix the aftermath? Is everyone truly paying cash or going into debt to fix what should be considered not only a physical but more importantly, a mental health repair as well?

Whilst everything else around me goes to shit, I thought I’d at least get a long-overdue do-over after 23 years of PSTD from a shitty marriage I should’ve bailed on the second year… (my ex is the reason I recognized the orange bawbag as a malignant narcissist before almost anyone else figured him out). Instead, the insurance I’ve been paying my whole working life is as worthless as everything else in this world.

Nothing about healthcare in this country even makes sense anymore.

doesn't seem like anyone gets raises anymore unless they change jobs.....so much for any "loyalty"

also, Walgreens seems to have gone very downhill, the workers seem very stressed

I worked under layoff culture for decades in IT - went through it three times so I know how much it sucks

not good losing that much weight! I too lose weight rapidly when stressed so I would drink protein drinks, that seemed to work for me

I have a feeling the weight-loss drug fix for all won't end well, who knows about the long-term side effects?

something has to give, America is spiraling in so many ways

All adds up about $700 a month (at present) to maintain my SS deductions, G plan supplement premiums and part D prescription plan. It ain’t cheap.

whenever I hear people casually tossing around "Medicare for all" I wonder if they have any idea how pricey it can be

Under a true "Medicare for All" single-payer system, traditional insurance premiums are completely eliminated.

You would no longer pay a monthly premium to an insurance company, and there would be no deductibles, copays, or out-of-pocket costs at the doctor's office. SAVING PEOPLE THOUSANDS OF DOLLARS.

Coverage is no longer tied to employment, marital status, or age.

Progressive taxes (Greater wealth pay more)

Avg family earning $50k -60k avg tax cost $840....much lower cost for much better coverage.

The wealth hoarders don't want you to have this.

they've wrecked Medicare by introducing the "Advantage" scam - time to start from scratch

It's like you're damned if you do and damned if you don't.

Mr. B and I have managed to ignore the siren call of Medicare Advantage so far. It's hard to ignore when we're being pinched by the cost of our Medicare supplements, but I am determined not to give in.

and she was trying to switch back, but said it was extremely difficult and she really regretted doing it in the first place.

I'll always remember that and tell others not to do it.

and renewals happen, starting in November each year.

I agree completely about Medicare Advantage. Any Medigap insurance is not cheap but can cover what isn't covered under Part A and B. It's private supplemental insurance, but it doesn't drain the Medicare trust fund. Part D policies can help cover the cost of prescription drugs. Some supplemental policies are enough that you don't need a Part D policy.

I see you haven't changed

But if people read before they sign Advantage users were not to be permitted back into regular Medicare programs later. Don’t let the bobbles and trinkets distract you! But of course if they do get bailed out they will have been given a windfall the that the rest of us pay for. Free things up front but eventually if a person gets sick the costs will be higher for them. Talk to a reputable insurance agent before deciding.

Clinton and the republicon controlled Congress approved this market-based alternative to achieve three primary goals:

"Expand Options": To give beneficiaries more choices, allowing them to receive their benefits through private managed care plans (like HMOs) rather than relying solely on the traditional government fee-for-service model. Buyer beware comes roaring back.

"Reduce Costs": To ease the growing financial strain on the Medicare system by leveraging the cost-controls and preventive care strategies commonly used in private-sector insurance. Corporate profit maximization the only metric that matters. Privatize everything in the public sector, keep the republicon agenda going even when the official party is out of power.

"Offer Lower Premiums": To provide seniors with less expensive, bundled alternatives (we don't cover things junk policies) to traditional supplemental "Medigap" policies.

Clinton was a so-called "New Democrat"- a political "moderate" (republicon lite) that sought to combine progressive social values with widespread "deregulatory" / laissez-faire economics.

Just wait for all these "Dems" to come out in full force in 2028...

Looking at you Republicon lites: Mark Kelly, Pete Buttigieg, Gavin Newsome, Andy Beshear and so mamy more...

After turning 65 I called twice to get on Medicare, but they told me I do not qualify. I currently have no health coverage at all. How long can a diabetic live without medication?

surely they had to tell you WHY you're "not qualified" - WTF?

They just told me that I do not qualify and hung up on me.

seriously, that sounds ridiculous

Make Medicare supplementals remotely close in terms of affordability ...
Then we have something to talk about.