Medicare Advantage - Don't do it

[Cbdb2]

I just have part B.

The hospital billed Medicare $50,000 for a surgery, and my part was $500. I don’t know how this works, but this kind of ratio has happened several times.

I paid about $250 for cataract surgery, plus $600 for eye drops. I don’t have prescription coverage.

Was that $50k for cataracts? If so something is wrong.
"While providing precise figures is challenging due to the numerous variables involved, the following estimates offer a general overview of cataract surgery costs in 2025:
Without Insurance (Self-Pay): For individuals paying out-of-pocket for standard cataract surgery with a monofocal lens, the total cost per eye can range broadly from approximately $3,000 to $6,000. Should you opt for premium IOLs, this estimated cost can escalate significantly, potentially ranging from $5,000 to $9,000 or even higher per eye, depending on the specific lens chosen and the provider's pricing."

 

[amper42]

According to the FBI’s Internet Crime Complaint Center, people ages 60+ submitted more than 140,000 complaints and reported nearly $5 billion in direct losses in 2024.
Data theft is accelerating. It's no longer safe to answer the phone without knowing who it is and don't click on emails from unknown senders. More data here:

Preventing Cyber Scams that Target Seniors

crr.bc.edu

 

[jimmyjames8]

Everyone considering a Medicare Advantage Plan should watch this video.
While it's designed to be comedy, it's a realistic warning of what to expect.

Medicare Advantage costs US taxpayers way too much and tries to implement road blocks to coverage so corporations get rich. The incentive for profit and quality healthcare delivery at a reasonable price can't coexist. Once you get into an Advantage Plan and realize how bad the networks are along with pre-authorization requirements, it's hard to get out without paying penalties. Stay with regular Medicare if you want good coverage and wallet protection.

The Medicare Advantage commercials and sales people are not your friends.

Exactly opposite of my experience and even if you get into an Advantage plan and for some reason dont like it or it doesnt work out for you, guess what, you can get out and change plans in a year. I have a couple friends who I have tried to explain this (medicare advantange) to and they continue to keep their more expensive plans that provide less coverage as is their right.

 

[Esprit]

I know of UK for when my brother and family lived there. I was shocked how much begging/complaining they had to do to get an appointment for minor illnesses. Appointments were weeks and months in the future for what would be a few days for us.

I'm always shocked when I read information about American healthcare. In Italy, I book my family doctor's appointments with an app choosing the day and time from those available, I book medical appointments and tests with an app, I pay the co-pay for the services (a few euros...) with an app, and if I need hospital treatment, I don't have to pay for anything: ambulance transport, treatments, surgeries, medications, or lunches, regardless of income.

P.S. More examples: if you're diabetic, Abbott sensors (over €130 per month) are provided free by the public health system, if you suffer from OSAS, masks and CPAP are free, Ozempic or Mounjaro are free for diabetics and will soon be free for obese people…

P.P.S. A survey conducted by a consumer association reports "increases" in the tickets that most citizens are required to pay (exemptions are provided for certain medical conditions, age, income, etc.):

Costi ticket sanitari: salvo (per adesso) il nuovo tariffario del 2025. Ecco cosa prevede

Resta in vigore (per il momento) il nuovo tariffario delle cure e prestazioni garantite ai cittadini operativo dal 2025. Il Tar ha accolto alcuni ricorsi da parte di strutture sanitarie private contrarie alle tariffe entrate in vigore col 2025; le tariffe, considerate dal Tar illegittime...

www.altroconsumo.it

​

 

[amper42]

Exactly opposite of my experience and even if you get into an Advantage plan and for some reason dont like it or it doesnt work out for you, guess what, you can get out and change plans in a year. I have a couple friends who I have tried to explain this (medicare advantange) to and they continue to keep their more expensive plans that provide less coverage as is their right.

Actually, this is incorrect. If your advantage plan is no longer desirable due to price or coverage and you want to go back to Medicare there may be lots of obstacles depending on the timing. From much higher Medigap premiums to having to qualify with an exam for obtaining coverage and other issues. Selecting a Medicare Advantage plan is a gamble.

 

[Canuck57]

I suddenly wasn't feeling well Dec 6, went to Emergency and released Dec 11. Excellent care during stay, numerous tests during stay with rapid results. Follow up appointments with specialists already setup and will be seen within the coming few weeks. No personal cost, of course paid through taxation.

 

[amper42]

Advantage offers NO Advantage
15 health systems dropping Medicare Advantage plans

15 health systems dropping Medicare Advantage plans | 2026 - Becker's Hospital Review | Healthcare News & Analysis

Hospitals and health systems continue to sever ties with Medicare Advantage plans heading into 2026, citing persistent frustrations with prior authorization denials and slow reimbursement from insurers. MA now covers more than half of the nation’s older adults, making these contract terminations...

www.beckershospitalreview.com

 

[RigorDude]

Below is a graphic showing how medical insurance company stock valuations increased from 2010 to some date in early (the seventh?) Nov. 2025 week since the "Affordable Care Act" (ACA) was signed into law (March 2010) by the President at that time. It seems that the ACA has been very relevant to their value. This despite how in this time period of 2025 to market close 07 Nov. 2025 (year to date data) the United Health Group company's stock price is down almost 36%, Cigna stock is down almost 4%, Molina stock is down almost 47%, Centene stock is down almost 38%, Elevance (Anthem) stock is down about 13% and then Humana stock price is only down about 1/4%; Aetna is now a part of CVS' holdings so my free stock app has no entries for Aetna.

View attachment 489241

I’m curious: what is the source of the graphic? Also, let’s bear in mind that Nov 2025 was fairly close to the all-time high for the major indices, while back in early 2010 U.S. equities were still in recovery from the 2008-2009 financial crisis. For example, in Mar 2010 the S&P 500 had only recently cleared 1,000. Last November it was 6,700. Remember that surge of investor confidence after the Orange Helmsman won the election? How quickly things can change.

“Figures don’t lie, but liars figure.” Samuel Langhorne Clemens

 

[Soandso]

I’m curious: what is the source of the graphic? Also, let’s bear in mind that Nov 2025 was fairly close to the all-time high for the major indices, while back in early 2010 U.S. equities were still in recovery from the 2008-2009 financial crisis. For example, in Mar 2010 the S&P 500 had only recently cleared 1,000. Last November it was 6,700. Remember that surge of investor confidence after the Orange Helmsman won the election? How quickly things can change.

“Figures don’t lie, but liars figure.” Samuel Langhorne Clemens

As much as I'd like to cite that dated graphic I do not recall the source. Those with internet skills seem to be able to reverse find images but I'm not that savvy.

Other than that I am uncertain of your interest today (late March 2026) by mentioning 2010/2025 data points. I think you are intending to discuss some Medicare and/or Medicare Advantage financial aspects since there's been a change of the USA administration. Although I've noticed news worthy aspects of the entire subject of USA "health care" it hasn't been something I've continued any deep dives into so would welcome your current views.

As a satisfied Medicare Advantage enrolle I can provide some financial orientation. In Oct. 2025 I had some outpatient surgery which 3 months later in 2026 was billed to Medicare Advantage in the amount of US$2,049.00 and Medicare Advantage only paid US$689.30 with US$0.00 being my share. Farther back in May 2025 I was in the hospital for specialized tests which 5 months later was billed to Medicare Advantage in the amount of US$3,673.49 and Medicare Advantage only paid US$31.00 with US$50.00 being my potential share (although the hospital never asked me for that, yet). I've received additional medical specialists' care in 2026 without any problems obtaining appointments or denials of coverage for procedures (elsewhere above I described the benefit perks trimmed from my 2026 Medicare Advantage plan).

 

[RDoc]

Actually, this is incorrect. If your advantage plan is no longer desirable due to price or coverage and you want to go back to Medicare there may be lots of obstacles depending on the timing. From much higher Medigap premiums to having to qualify with an exam for obtaining coverage and other issues. Selecting a Medicare Advantage plan is a gamble.

Depends on the state. Here in MA you are guaranteed to be admitted to medigap if you leave medicare advantage.

 

[amper42]

Don't breathe easy yet.

Only four USA states (CT, NY, Mass and MA) have medical ins. protection to be admitted to medigap without penalty if you leave medicare advantage. In the other 46 states and Washington, D.C., once you have been in a Medicare Advantage (MA) plan for more than 12 months, you generally lose your federal "guaranteed-issue" rights to buy a Medigap (Medicare Supplement) policy). This means insurers can use medical underwriting to deny you coverage or charge much higher premiums based on your health history.

No one ever moves in retirement, right?
You don't see the US States known for large retiree populations in the group of four states with medigap protection. Move to AZ, Florida, South Carolina, Wyoming, Georgia, TN or Idaho but sign up for medigap first if coming from CT, NY, Mass and MA.

They make it complicated on purpose?