It's time to stop the Medicare 'Advantage' scam before Medicare is dead

1
This is an opinion piece But it is worth the read especially for us that are over 65 or going to be over 65 soon.
Unless you’ve been out of the country for the past few years, you’ve seen the ads on TV featuring Joe Namath, Jimmy Walker, or William Shatner hawking so-called “Medicare Advantage” plans.
Medicare Advantage is not Medicare.
It’s private health insurance being offered to people over 65, with the bill paid for by Medicare. Once you get on an Advantage plan it’s very difficult to get off, and if you’ve been on for more than a year you may not be able to go back to regular Medicare with a Medigap plan at all.

It’s also one of the most effective ways that insurance companies are using to kill Medicare for All before it's even birthed, since almost half of all people who think they’re on Medicare are actually on these privatized plans instead.

Nearly from its beginning, Medicare has allowed private companies to offer plans to seniors that essentially compete with it, but they were an obscure corner of the market and didn’t really take off until the Bush administration and Republicans in Congress rolled out the Medicare Modernization Act of 2003.
The must read article is here. https://www.rawstory.com/medicare-advantage/

I am a retired RN in 40+ years of practice in healthcare, with the last few years I work in Home Health, I am very familiar with Medicare and these Advantage plans. I was a manager in the agency having also been a field nurse. We did not take any of the advantage plan patients. At that time I didn't know of any reputable Home Health Agency in the DFW area that would take those patients. We took all Medicare patients. I could go on about the other pitfalls like you can only see Doctors on their "accredited" list. So when you call you find out the doctor is not accepting new Advantage Plan patients at this time. The salespeople for these Advantage plans make TOS look like the honest man that Diogenes of Sinope was looking for.

While I'm on my soap box. Here is another thing to remember. When you sign up for Medicare make sure you sign up for Part A, that's the hospital part and is mandatory. Also sign up for Part B. That is outpatient services. It is not mandatory BUT if you don't sign up to start with and later need to sign up, you have to play catch up and pay for all the time you didn't have it in a lump sum. You also have Part D drug plan. and the last is the supplemental plans that cover further cost. I was lucky I have a Plan F that cover all out patient and hospital cost not covered by the other plans. It is no longer available for enrollment. I see my family doctor or have some out patient procedure I don't pay any deductible they have to accept what Medicare on the Plan F pays.

Even if you are still young enough not to worry about signing up in the near future, please read the link because you might need to help an older relative, neighbor or friend.

I would still love to see universal health care for everybody.
Facts do not cease to exist because they are ignored.-Huxley
"We can have democracy in this country, or we can have great wealth concentrated in the hands of a few, but we can't have both." ~ Louis Brandeis,

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

3
Good info. I laugh they call it 'Plan C' (C for crap). Medicare A&B; Plan F (grandfathered in) and D from gitgo (15 yrs) SS for 17 yrs taking retirement at 63. Plan G some what replaces F (no longer avail), but you're now out about $3K in co-pays with G, albeit less expensive than F. F costing me $951 per quarter currently, but no co-pays and no deductible, which is why it's no longer available.
Advantage plans should be illegal. Medicare for all is ideal.
"Being Republican is more than a difference of opinion - it's a character flaw." "COVID can fix STUPID!"
The greatest, most aggrieved mistake EVER made in USA was electing DJT as POTUS.

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

4
Sounds like a hit piece...
Fact is Medicare sucks. It's expensive and then the insurance companies pile on. Whether a Supplement plan like the piece of shit vultures at United or Humana or Mutual Upyourbutt sell, or the Advantage Plans that the accounting garbage at hospitals like to sell...

The differences are substantial. Do Your Homework. An advantage plan generally costs much less than a supplement...by an order of magnitude. Do Your Homework - Do Your Homework - Do Your Homework.

The reality is glaringly obvious to anyone with a brain:
No Member Of Congress Has Ever Had To Sign Up For Medicare to begin with.

They will never have to sweat over a choice between buying food or medicine or paying rent. Because they are covered by their own plan for life, and their kid's lives...
They will never have to worry over dental plans or donut holes or trying to get their chemotherapy covered under part B instead of part D....

So They Have No Incentive To Change It.

And those fucking pieces of filth that are the insurance industry continue to throw boatloads of money at each and every one of them to make certain that it stays that way.

ETA: This is why we have shiny objects like GUNS and ELON MUSK and RUDY...they keep us distracted from focusing on stuff that might actually benefit us.
Subliterate Buffooery of the right...
Literate Ignorance of the left...
We Are So Screwed

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

5
rolandson wrote: Tue Aug 16, 2022 4:56 pm Sounds like a hit piece...
Fact is Medicare sucks. It's expensive and then the insurance companies pile on. Whether a Supplement plan like the piece of shit vultures at United or Humana or Mutual Upyourbutt sell, or the Advantage Plans that the accounting garbage at hospitals like to sell...

The differences are substantial. Do Your Homework. An advantage plan generally costs much less than a supplement...by an order of magnitude. Do Your Homework - Do Your Homework - Do Your Homework.

The reality is glaringly obvious to anyone with a brain:
No Member Of Congress Has Ever Had To Sign Up For Medicare to begin with.

They will never have to sweat over a choice between buying food or medicine or paying rent. Because they are covered by their own plan for life, and their kid's lives...
They will never have to worry over dental plans or donut holes or trying to get their chemotherapy covered under part B instead of part D....

So They Have No Incentive To Change It.

And those fucking pieces of filth that are the insurance industry continue to throw boatloads of money at each and every one of them to make certain that it stays that way.

ETA: This is why we have shiny objects like GUNS and ELON MUSK and RUDY...they keep us distracted from focusing on stuff that might actually benefit us.
What he said!
"it's a goddamn impossible way of life"
"And so it goes"

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

7
Wino wrote: Tue Aug 16, 2022 4:45 pm Medicare for all is ideal.
How about Healthcare for all?
Medicare still leaves the patient with 20%. And no dental. And the most confusing convoluted gibberish ever devised for pharmaceutical coverage.

Where as in every other "developed" country and in many of what we, arrogant shits that we are, call the third world, health care is a human right, not a profit making scheme. France, Germany...shit all of the EU, Japan, The UK, all of Scandinavia, even fucking Albania...
See a doctor, no charge. Need surgery, no charge, and...

contrary to what the miserable fucks who are the insurance industry will tell us, the only place that wait list needed care is the US.

Now of course we'd be foolish to simply say okay healthcare is available. We don't have the people or facilities to care for everyone. First we need hospitals and doctors and nurses and technologists and technicians. We need to train more people and build more everything first.

Instead we scream at each other and start each news cycle with the latest about orange Jabba and the little Jabba wannabes...

We are so totally fucked up.
Subliterate Buffooery of the right...
Literate Ignorance of the left...
We Are So Screwed

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

8
rolandson wrote: Wed Aug 17, 2022 3:21 am Now of course we'd be foolish to simply say okay healthcare is available. We don't have the people or facilities to care for everyone. First we need hospitals and doctors and nurses and technologists and technicians. We need to train more people and build more everything first.

Instead we scream at each other and start each news cycle with the latest about orange Jabba and the little Jabba wannabes...

We are so totally fucked up.

The two parties would rather keep people distracted and fighting each other than actually resolve problems like health care. They want to do the least amount of work to get reelected.

TT brings up the same topic a few times a year and it's the same old discussion.

Biden just signed a $740 billion dollar bill that includes health care like an extension of the ACAS, but nothing in there regarding abolishing Medicare Advantage. Western democracies from Canada to the Netherlands, Germany, France...base their national health programs on insurance companies, but their insurance companies operate very differently than ours.
"Everyone is entitled to their own opinion, but not their own facts." - Daniel Patrick Moynihan

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

9
rolandson wrote: Wed Aug 17, 2022 3:21 am
Wino wrote: Tue Aug 16, 2022 4:45 pm Medicare for all is ideal.
How about Healthcare for all?
Medicare still leaves the patient with 20%. And no dental. And the most confusing convoluted gibberish ever devised for pharmaceutical coverage.

Where as in every other "developed" country and in many of what we, arrogant shits that we are, call the third world, health care is a human right, not a profit making scheme. France, Germany...shit all of the EU, Japan, The UK, all of Scandinavia, even fucking Albania...
See a doctor, no charge. Need surgery, no charge, and...

contrary to what the miserable fucks who are the insurance industry will tell us, the only place that wait list needed care is the US.

Now of course we'd be foolish to simply say okay healthcare is available. We don't have the people or facilities to care for everyone. First we need hospitals and doctors and nurses and technologists and technicians. We need to train more people and build more everything first.

Instead we scream at each other and start each news cycle with the latest about orange Jabba and the little Jabba wannabes...

We are so totally fucked up.
Have to start somewhere and Medicare for all would be (IMO) an easier lift than universal health care.

I have no idea your experience with Medicare with Medi-Gap & Part D - my experience has been par excellence when compared to my past health insurance. As I have posted several times before, even when I had employer supplied insurance I maintained my own personal BCBS catastrophic policy. This gave me much freedom as I was never held captive in fear of having no health insurance if leaving an employer. This policy had no drug plan. Medicare has by far been the best health insurance at a reasonable cost I've ever had and cost controls.
When I retired at 63 and self-employed, I continued to pay my BCBS until I qualified for Medicare - those two years cost me $24+K in total premiums - I would expect some 17 years later that same policy would cost $24-$30K annually. Currently I'm paying sub $5K annually for Part B, Part F and Part D (do have a $480 deductible and small co-pays for some drugs). I'm not going to detail my past health under Medicare, but I've not once been denied any service, procedure nor placed on a wait list - from ablations to multiple surgeries, radiation treatment, ILR heart monitors, MRI/X-Rays, ER visits (numerous), needle biopsies, lab work - NOR have I paid one cent for any of these procedures outside of my premiums. I had one denial from Humana over a drug in Part D, which was resolved in my favor.
Medicare may not be perfect, but it sure as hell beats the crap out of the alternates, short of universal health care - where you will get put on wait list, have to get pre-approved procedures and possibly approval as to doctor used.
I just lost my GP - early 50's - thought he'd be my last. He quit end of March 2022 after his group practice joined WellMed. WellMed is a taste of advantage plans (they have their own and owned by United Health) - seeing a doctor now is like pulling hens teeth - can see PA's all day - I've never met my "new" primary assigned. I'm also finding not many doctors or practices want 80+ YO as a new patient.

I do agree we are so totally fucked up.
"Being Republican is more than a difference of opinion - it's a character flaw." "COVID can fix STUPID!"
The greatest, most aggrieved mistake EVER made in USA was electing DJT as POTUS.

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

10
Yes, private health insurance companies are so powerful and pour so much money into politics in order to gum up the works for publicly funded health insurance. That is the crux right there. All the inefficiencies and difficulties of Medicare is a result of intentional fukery, of private health insurance dollars at work in our government.

Improved Medicare for All is supported by the big automotive manufacturers fer chrissakes: No “out-group” provider considerations, no deductibles, no pre-existing condition. Everyone covered in one plan, with a low-low monthly premium that most working Americans can afford. Lower than what we are all paying now anyway.

It’s been proven to work, not reinventing the wheel nor a moon-shot. It’s Just private insurance money protecting their cash cows, gumming things up politics for all Americans.
"It is better to be violent, if there is violence in our hearts, than to put on the cloak of non-violence to cover impotence. There is hope for a violent man to become non-violent. There is no such hope for the impotent." -Gandhi

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

11
Wino wrote: Wed Aug 17, 2022 9:15 am Have to start somewhere and Medicare for all would be (IMO) an easier lift than universal health care.
Who is going to treat 40-100 million new patients...and where? We haven't the personnel or facilities to manage what we have now. Dump millions more into the system and it will collapse.
We start with education, at the kindergarten level, while undertaking a gargantuan building program to create the teaching, training and care facilities needed.

In the meantime we nationalize healthcare and send the bill to Wall Street. Dr.'s want a six figure salary, fine...let Musk pay for it.

Make no mistake, physicians and nurses and technologists and technicians deserve a sizeable reward, and...that. has. to. stop. They're heros for the most part. And... They spend no more energy learning their trade than a machinist does learning their's. They, the AMA and the AOA just control membership in their rather exclusive clubs.

Getting into medical school is an extremely limited possibility that a very few ever achieve. And that is not based on merit. Thousands of qualified potentials are turned away every year because... if there are too many in the club, the price for their service goes down.

We start by making all higher education, whether academic or vocational, free. We stop allowing our teaching institutions to be training camps for professional sport. We demand that education focus on education.
Wino wrote: Wed Aug 17, 2022 9:15 am I have no idea your experience with Medicare with Medi-Gap & Part D.
It's called end of life. And not receiving the medications that have a greater potential at delaying or reversing the process, because they are prohibitively expensive.
It's called being paralyzed by a course of chemotherapy selected by some middle management fuck in accounting over the objections of treating physicians, and the two heart attacks that followed.
It's in the fine print. All six thousand pages.

Do not lecture me about this insanity we call Medicare. I can recite it inside and out. Spouse can recite it inside and out.

And Medi-gap, holy fucking shit, think about what you wrote and what it represents! MEDI-GAP? Are you fucking serious? In the allegedly "Greatest Country EVER" we have a thing called Medi-Gap?
And Medicade?
These are systems designed to exclude, not provide care. Care is provided at the source, what we have created is a system to justify the existence of 'management'.

None of this is worth defending.

How about just providing care?
I mean, it's right there in the constitution. The same part of the constitution that justifies every department and agency (except the post office) that the federal government has in place...
The Preamble. That part about "the general welfare"...just what about that does not include our health?
Subliterate Buffooery of the right...
Literate Ignorance of the left...
We Are So Screwed

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

12
Bisbee wrote: Wed Aug 17, 2022 2:08 pm Yes, private health insurance companies are so powerful and pour so much money into politics in order to gum up the works for publicly funded health insurance. That is the crux right there. All the inefficiencies and difficulties of Medicare is a result of intentional fukery, of private health insurance dollars at work in our government.

Improved Medicare for All is supported by the big automotive manufacturers fer chrissakes: No “out-group” provider considerations, no deductibles, no pre-existing condition. Everyone covered in one plan, with a low-low monthly premium that most working Americans can afford. Lower than what we are all paying now anyway.

It’s been proven to work, not reinventing the wheel nor a moon-shot. It’s Just private insurance money protecting their cash cows, gumming things up politics for all Americans.
Why is the big automotive manufacturers supporting the Medicare For All? It is because the current system is costing them big big bucks. Big Health Insurance is worse than Big Pharma in screwing the system to make money. I had to deal with them for years in my professional life and a RN. Everything from denying treatments and drugs, that were prescribed by a doctor, only allowing so many home health visits or so many days in a hospital. I saw a surgeon so mad because he had a patient who's blood pressure had dropped during a procedure and they gave the patient an extra bag of IV fluids to increase the pressure, but the Insurance company refused to pay for it because it wasn't in their protocols. I saw this'd other things like it for many years.

One even affected me. I was working for a Home Health company, and had abdominal surgery that required a temporary colostomy and home health to help with it til I was able to go back to work. I was back to work all healed and the boss came by and told me that my insurance had not paid the bill for the home care. Well my insurance was through my wife and was BCBS with the State of Texas. I said you're kidding since we have a contract with them provide home healthcare. Not kidding and we may need to write it off as charity. He came back two days later and said they pad on the 119th day. It had gotten so bad in Texas with the various Medical insurance companies not paying the State legislature passed a law they had to pay the bill with in 120 days, because they had been delaying payment up to six months some even one year.

Now with medicare Working in Home Heath we admit a patient fill out the 485 form on the computer state how many days we need to treat the patient and the diagnoses. that would be sent to our home office in Georgia reviewed and sent tp the regional Medicare office. With in three days we had initial payment in the bank for the standard initial five visits. If we needed more visits we did an update and got approval and money.

I have seen and know of cases where Medicare fraud has taken place. But I can say when these people are caught, and they do get caught, they get free healthcare. Courtesy of the Federal Prison System. That is excepting those that steal billions and they get elected to be a senator, such as Rick Scott.
Facts do not cease to exist because they are ignored.-Huxley
"We can have democracy in this country, or we can have great wealth concentrated in the hands of a few, but we can't have both." ~ Louis Brandeis,

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

13
rolandson - wasn't lecturing or proselytizing, simply stating my interface/experience with Medicare. It, along with SS, meager savings and working until 80 kept me off welfare, out of poverty, independent and alive. Without SS/Medicare/Medi-Gap, I wouldn't be here for the conversation. It damn sure isn't perfect or ideal, but I've not seen anything in my entire life that ever was 100%.
"Being Republican is more than a difference of opinion - it's a character flaw." "COVID can fix STUPID!"
The greatest, most aggrieved mistake EVER made in USA was electing DJT as POTUS.

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

15
Physician spouse worked with...
Patient presents with abdominal pain... ct confirms appendicitis. Healthnet insurance demands 24 hours observation. Physician says "fine, tell me your name so I can give it to the family for the wrongful death lawsuit they'll bring...because the patient will be dead in 24 hours."

In my case, last summer...
Physician ordered a specific chemo cocktail.
Insurance said no, first use "this".
Physician says that "this" is contraindicated due to patient history.
Insurance said "so what."
I got it.
A week later I'm in an ambulance, paralyzed (don't let anyone tell you that paralysis isn't painful...it's excruciating)...
hospitalized for a week.
Go home.
Attending calls that evening telling me my blood work indicates I'd had a heart attack while there, best go see a cardiologist when you're up and about.
Next day I turn gray and can't stand up.
Same ambulance crew showed up.
Another week in hospital.

The heart attacks were the result of a serum allergy reaction to the chemo cocktail. So was the paralysis that I still haven't recovered from.

Medicare at its finest.
Subliterate Buffooery of the right...
Literate Ignorance of the left...
We Are So Screwed

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

16
rolandson wrote: Wed Aug 17, 2022 2:30 pm
Wino wrote: Wed Aug 17, 2022 9:15 am Have to start somewhere and Medicare for all would be (IMO) an easier lift than universal health care.
Who is going to treat 40-100 million new patients...and where? We haven't the personnel or facilities to manage what we have now. Dump millions more into the system and it will collapse.

Who's treating them now?We do need to expand the healthcare system It almost totally collapsed during COVID.

We start with education, at the kindergarten level, while undertaking a gargantuan building program to create the teaching, training and care facilities needed.
Who's treating them now? We do need to expand the healthcare system It almost totally collapsed during COVID.
In the meantime we nationalize healthcare and send the bill to Wall Street. Dr.'s want a six figure salary, fine...let Musk pay for it.
Good luck on that.
Make no mistake, physicians and nurses and technologists and technicians deserve a sizeable reward, and...that. has. to. stop. They're heros for the most part. And... They spend no more energy learning their trade than a machinist does learning their's. They, the AMA and the AOA just control membership in their rather exclusive clubs.
I say B.S on the energy learn their trade. Let's se Im sent four years part-time studying for my ADN to get my RN this included hours in the hospital training. I later went back to school for another two years to get my BSN that not only required more nursing courses and science courses but actual time in hospital and community nursing to get the Bachelors degree. Nursing RN 2 to 4 years school and and there is a difference between an ADN and a BSN education wise I have both and the BSN has more nursing theory in their classes than the ADN. Also need one plus year experience to settle in to really becoming a nurse.
Getting into medical school is an extremely limited possibility that a very few ever achieve. And that is not based on merit. Thousands of qualified potentials are turned away every year because... if there are too many in the club, the price for their service goes down.
Now let's talk about the Doctors. First they must have a four year degree in a science major that is normally called a pre med major the consist of major's biology and chemistry courses, not the easy ones the non-science majors take. After the four year degree there is four years of medical school with long hours of study and labs and work. My wife taught in the Gross anatomy lab at UNT Health Science Center while doing a post PhD study. When they finish the medical school they have the equivalent of a Phd in biology/chemistry. They then go to an internship where they will spend up to sometimes 80 hours a week in the hospital this is for one year. Then they go for a residency program in a specialty area for two to 5 years depending of their choice and vacancy. So they have spent minimum 4 years undergrad, 4 years medical school, one year internship, and 2 to 5 years residency for a grand total of 11 to 14 years to learn their trade. I think that is more than a machinist learning their trade. Just looked and it is four to five years.

To even be considered for a medical school you must almost have to have at least a near 4.0 GPA along with other recommendations from professors and community leaders etc. It is based on merit. there are so few schools for the amount of applicants to medical school. there are more schools opening. We have there medical schools in the DFW area when I started nursing we had one. Now we have UT Southwestern in Dallas, UNT Health Science and TCU Medical school Fort Worth. All get hundreds of applications each year but the are just so many positions open.

As for the price for service.Consider a Doctor in a private practice. The Doctor has over head of a speciality office that requires certain features that jus any office space can't provide.Need to equip all theExam rooms and have needed medical and lab equipment on hand along with things like and Xray machine if they do many X-Rays such as an orthopedic practice. The lease cost more. Then he needs trained office staff to take calls, handle insurance, billing, greet patients, and know which ones needs to be seen on a n urgent basis. He need Medical Assistants or Nurses depending on the practice. Disposable medical supplies and various other medical and non-medical equipment.Then the Doctor needs malpractice and liability insurance for his practice and office. The list and cost go on. Outside of the cost of doing business there is the school loans that piled up going to Med school. Medical schools are more expensive than most graduate programs. Law school and business schools have books and papers. Medical schools have labs and Cadavers. Getting a cadaver for the gross lab is very expensive and you can only use one of a short period with dissection before it is all used up.

So you can see why Doctors charge so much and yes they make a good income. Would you like to go to a doctor that was trained like a machinist? Yes machinist are needed. I lived across the street from a man that was a Master Machinist. He learned the trade back in the days before computers. Part of his required education was at the University of Oklahoma. Unfortunately, Machinist are needed less and less due to CNC and other computer controlled devices. I don't see that as ig a deal in healthcare. Although we re seeing robotics filling some ares.
We start by making all higher education, whether academic or vocational, free. We stop allowing our teaching institutions to be training camps for professional sport. We demand that education focus on education.
I agree on making it free using tax dollars to support the public schools of higher education free and on the last part or make the sports just a minor part of the education process and start that in the public schools. My wife taught science in a rural district here in Texas where the had to raise the superintendent salary because the Texas law states he is the highest paid person in the district and they had hired the ex-coach from UTA to be the new football coach at the high school.
Facts do not cease to exist because they are ignored.-Huxley
"We can have democracy in this country, or we can have great wealth concentrated in the hands of a few, but we can't have both." ~ Louis Brandeis,

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

17
TrueTexan wrote: Now let's talk about the Doctors. First they must have a four year degree in a science major .
Okay.
I've a BS in Chemistry. I didn't get into medical school. Got a B in first term Organic. After 2 years as an industrial chemist I returned to school and took an MS in Physics. Taught Physics at the university level for 2 years before being laid off by St. Ronnie in 82. Went to work for a hospital driving an electron microscope until I wised up.

I know all about what is involved to acquire an MD. If I had any doubts I could have asked my father. Or spouse who spent her carrier in ophthalmology as a retinal angiographer..

A machinist may not spend their training in a university, but their training is as demanding, as intricate and as detailed as that of any physician or nurse or technologist. Rather than a university they do apprenticeships. Their certification is as difficult to acquire as a four year degree.

Spend an afternoon in an aerospace lab and any demeaning stereotypes that one may hold should, if they've a brain, evaporate. These technicians are as educated as any in any other profession. Just because they don't have initials after their names doesn't disqualify them as intricately trained professionals.
Subliterate Buffooery of the right...
Literate Ignorance of the left...
We Are So Screwed

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

18
TrueTexan wrote: Wed Aug 17, 2022 4:42 pm SNIP
Although we re seeing robotics filling some ares.
Yes!!

Sixteen months ago when diagnosed with lung cancer in left upper lobe, I was given three options by oncologist, referred doctors to see regarding surgery for removal of upper lobe, radiation or chemo. The surgeon I visited was old school with surgery thru large incision thru my back to remove upper lung with long time recovery plus almost 80 yo and no local family structure capable to assist (not to mention I sleep with a dog). His younger doctors in group did the robotics thingy thru three (as I recall) relative small incisions - very expensive, but less recovery time and higher age survival percentage. Either way, this was the "gold standard" for squamous small cell carcinoma. Even though PET scan had not seen any other active cancer cells elsewhere, there were still no guarantees they weren't lingering. Losing half of a lung on top of COPD was not enticing to me any more than long term recovery. So my decision, at almost 80 and approaching end of life, was to go radiation which was a walk in the park. If cancer returns, it will be more radiation, if isolated, plus chemo if spread. So far my two six month follow up CT's have shown no live cancer cells at node and it has reduced in size and eventually will just be scar tissue. Had I been 15-20 years younger, I'd have gone for the robotics surgery.

Back on subject - go back 14 years - I had suffered from Afib for years before finally diagnosed. Was then on various meds to restrain events and blood thinners. My then cardiologist suggested I get a heart ablation and that he would set it up with Seton Heart Center in Austin, TX. I hesitated getting the procedure as it was quite expensive, but decided to go to Austin for consultation with physician. When I told him why I was hesitant (expense) he laughed and said, "With Medicare and your Plan F, it won't cost you a cent!" In December 2012 I checked into Seton at 5 AM and was on the way home to SATX late that afternoon - I've had not one recurrence of Afib - nor did the procedure and follow ups cost me one cent, other than gas and overnite at Seton Homes AND my bored daughter who spent a small fortune on dining and drinking on my credit card whilst I was in recovery. LOL That hospital and doctor bill at list price was approx. $160K.

When prior to and starting Medicare I did my due diligence making my choices. Having never been state or government employed or military service nor work for a corporation with options to keep healthcare after retirement, I had little choice, but from my studies, Advantage Plans were, then and now, total bullshit. Best decision I ever made was taking Plan F Medi-Gap and keeping it when I was offered Plan G at a cheaper cost. At this date and time, I have only praise for my Medicare experience and it's a damned shame not everyone has access. I'm not truly convinced that universal health care for all will be an improvement, and at my age, not something I'm going to lose sleep over.

ADDENDUM: I will have six month CT's for the rest of my life, same as I do annually for cystoscopy due to bladder cancer in 2012 and again 2017 (latter nonmalignant). 2012 was not a good year. LOL
"Being Republican is more than a difference of opinion - it's a character flaw." "COVID can fix STUPID!"
The greatest, most aggrieved mistake EVER made in USA was electing DJT as POTUS.

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

19
Wino, you have been through the medical wringer. like you just before turning 65bI did the due diligence and looked at all options. I also settled on the Plan F and haven’t wanted to change. I love it when I check out of the doctor’s office I just wave and keep on going.
Facts do not cease to exist because they are ignored.-Huxley
"We can have democracy in this country, or we can have great wealth concentrated in the hands of a few, but we can't have both." ~ Louis Brandeis,

Re: It's time to stop the Medicare 'Advantage' scam before Medicare is dead

21
TrueTexan wrote: Wed Aug 17, 2022 9:25 pm Wino, you have been through the medical wringer. like you just before turning 65bI did the due diligence and looked at all options. I also settled on the Plan F and haven’t wanted to change. I love it when I check out of the doctor’s office I just wave and keep on going.
TT, it's seemed like a wringer at times, that's for sure!! I'm thankful for modern medicine and procedures keeping me this side of dirt, knowing it's a losing battle kinda sucks tho none of us are gonna make it out alive. Some days are diamonds; some days are rust. LOL

Re Part F - upon my second visit with oncologist with the decision to go radiation, I was sitting at the checkout lobby waiting to be called to set up body mold and radiation series frequency. The door to the finance office was open (it's next to this station) and I heard some mention Mr. Wino and asked if she needed to see me to make payment arrangements - she said, "You mean Mr So&So Wino?" they responded yes and she responded "No! He's good to go!!" I smiled.
"Being Republican is more than a difference of opinion - it's a character flaw." "COVID can fix STUPID!"
The greatest, most aggrieved mistake EVER made in USA was electing DJT as POTUS.

Who is online

Users browsing this forum: Semrush [Bot] and 1 guest

cron