USA : Original Medicare or Medicare Advantage ???

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I just signed up for Medicare for the first time, wondering whether or not I should choose Original Medicare or Medicare Advantage. My first issue is to find out more about my BPH problem, prostate size, lobes, obstructions, by an MRI. My second issue is catheters cost since I am doing CIC. Any shared personal experiences will be appreciated. Hank

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  • Posted

    You should definitely go with a Medicare Advantage Plan and not just straight Medicare. I would also advise you to get a PPO plan and not a HMO. It cost me an extra $77 a month but well worth it. I can't comment on catheter cost, but I can tell you that cost for your medications will go way up no matter what you do. I just paid $443 for a 90 day supply of Vesicare.

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  • Posted

    Hank,

         I went on Medicare a little over a year ago. I decided against a Medicare Advantage plan for one reason: to be able to choose my care team. With a Medicare Advantage plan, you are required to use their physicians. If their physicians happen to be the ones that you would use anyway, then it's probably just fine. 

         We each have a different situation though. In my case, I did receive an annual benefit from my former employer that cut the cost of the supplemental insurance by more than half. For my particular situation, this worked out well for me. 

         I'm quite sure that a Medicare Advantage plan will cost less for almost everyone compared to Original Medicare with or without a supplemental plan.

    Ken

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  • Posted

    I can't help you on the two Medicare plans, as I am under the military's TriCare for Life.  I have the original Medicare with Part B.  Between Medicare and TFL, the cost of my catheters and lube is fully covered.  Medicare will pay for hydrophilic catheters, but there has to be additional justification.  Your doctor or supplier should be knowledgeable of the reimbursement requirements and limits.

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  • Posted

    I think where you live is the determining factor. If you are out in the sticks like me then a supplement may make more sense because all of the medicare advantage plans limit the doctors you can see to their own network. However if you live in a highly populated area and you get all your care locally and all the docs you ever plan to see are local and in the network than a medicare advantage plan may work.

    I get almost all my care through the VA but I have to drive 400 miles to be seen at a VA medical center and not just a clinic so I have original medicare and a high deductible plan F that costs about 35 bucks a month. 

    It depends on your personal situation, one size definitely doesn't fit all,  I spent a couple of months  looking at various plans and asking for advice before I made what I think the the best course for me.

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