Here's How Much We Paid With Medicare | Medicare Supplement vs Advantage

[Michael]

DeusxMac wrote:
Michael, what company has an Advantage plan that covers services from “anybody who takes Medicare anywhere in the country”?

Does it also include rehabilitation, nursing homes and other ancillary facilities and services?

Here's a copy/paste from my account:

United Healthcare Medicare Advantage GA-0002 (PPO)
Medicare National Network Access
Monthly Premium $0

This is a Georgia PPO plan that looks like it's in all of the 159 counties (I didn't count all of them in the list but the list is 15 lines long and the first line has 12 counties).

Here's a copy/paste from their Summary of Benefits: UHC Medicare Advantage GA-0002 (PPO) has a network of doctors, hospitals, pharmacies and other providers. With this plan, you have the freedom to enjoy nationwide access to care at in-network costs when you visit any provider participating in the UnitedHealthcare® Medicare National Network (exclusions may apply). Plus, you have the flexibility to visit any provider nationwide who accepts Medicare. You may pay a higher copay or coinsurance when you see an out-of-network provider.

There's a $6200 max out-of-pocket for in network care and $9500 max out-of-pocket for combined in and out of network care. I just looked it up and my current out of pocket for the year (including my surgery) is $959.87. That's from billing of $121,956 (overwhelmingly that's from my urologist and associated providers but also includes my annual physical and dental cleaning) and a reduced payment from United Healthcare to the providers of $9,660.42. So, I'm a long way from meeting my max out-of-pocket.

They cover rehab services: Physical, Occupational, and Speech and Language at $25 for an in-network provider and $60 for out of network.

They cover skilled nursing care. For in network, it's $0 copay for days 1-20 and then $203 copay per day for days 21-100. For out of network, it's $225 for days 1-43 and then $0 for days 44-100.

It covers all the other stuff I was familiar with from our old work insurance: durable medical equipment, ambulance, substance abuse and so on.

Here's something I didn't know about until I was just looking this up: they'll provide 28 free meals over 14 days, delivered to your door in a cooled container if you've been admitted to the hospital or skilled nursing unit. They don't say who they contract with. I could have done that for a couple of weeks after my one-day hospital stay a couple of months ago!

I know that United Healthcare (and others) have HMO options in Georgia. I see those every year when we review and renew our coverage. I wouldn't do an HMO option because literally none of our doctors are in network for United Healthcare.