2019.12.03 23:21
2019.12.03 23:34
2019.12.04 05:06
Dr. Lee,
It would be very nice of you to explain more on Medicare Advantage. Is it different from a supplemental insurance like AARP?
BTW, does the visit to the specialty require the referral from primary physician? Someone told me that such independent visit to the specialty like nephrologist without proper referral will no be covered by Medicare and will be charged 100% to the patient. Is that correct?
Regards
BB Lee
2019.12.04 06:04
Medicare Advantage is a HMO, 선배님.
You have to have a primary care physician, a gate keeper,
who decides whether or not you need to see a specialist.
You cannot see the specialist you want and cannot go to the hospital
you want to go to unless your gate keeper agrees and refers you to the specialist
assuming the specialist and the hospital you want happen to be on the roster
of the HMO network, which more than often is not the case.
Traditional Medicare with AARP supplement insurance is an excellent choice with free access
to any specialists and any hospitals in USA, which I used to recommend to my patients.
My wife and I have traditional Medicare with AMA supplement insurance underwritten by
Transamerica Insurance Co. Any retired MD can buy the AMA supplement insurance,
and you do not need to be AMA member.
2019.12.04 06:35
Thanks, Dr. Lee.
So, "Medicare + AARP Supplement" allows free choice of specialists - does it still need the referral by the primary physician?- but "Medicare only" would not? I heard there are quite a few other options for this supplemental insurance and this 'Medicare Advantage' might be the one you do not recommend! Indeed I didn't join an additional Medicare D? for the drug coverage - my wife claims it is not worthy of paying extra- but instead I buy the medicines through the mail order to Canadian pharmacy though it is a right decision or not.
Thanks for such free consultation!
Warm regards,
BB Lee
P.S. Any advantage of AAA over AARP Supplement?
2019.12.04 07:57
In your case and in the case of Medicare only you decide which specialist.
Of course your family doc is free to recommend any or you are free to ask him
to recommend one.
I agree with your wife and cancelled Medicare Part D and used to get all meds
from Canada and now from healthwarehouse. com(USA) at comparable prices faster.
I still purchase med from Canada once in a while when I find a relative bargain.
By not having drug coverage, my monthly SS benefit rose more than what I expected.
You are doing everything correctly, I believe.
I did not compare AAA to AARP so I can't answer your question.
I went for AMA insurance when AMA offered it 15 yrs ago over AARP
because both were comparable except AMA supplement premium was a little cheaper.
2019.12.04 10:21
Thanks a bunch, Dr. Lee, to clear my confusion. Now I don't have to bug my wife on her decision on this medical insurance stuffs.
Warm regards,
BB Lee
2019.12.04 11:09
You are welcome, 선배님.
hope I helped you clear some confusion on your part.
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So many seniors take the bait of relentless TV commercials advocating
Medicare Advantage and regret when they get seriously sick with cancer,
heart attack, stroke or accident.
This article describes the truth behind all those commercials.
Raph Nader called "Medicare Advantage" "Medicare Disadvantage,"
which I wholeheartedly agree with.
Throughout my medical practice, I lectured my patients not to join Medicare Advantage,
and 9 out of 10 would listen to me.