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No. This is not well known, but what I stated was absolutely true. There are endless unbelievably insidious tricks and rules like these: If I were to switch fr

No. This is not well known, but what I stated was absolutely true. There are endless unbelievably insidious tricks and rules like these: If I were to switch from a Medicare Advantage Plan back to Traditional Medicare, I could never get a Medigap (or supplemental plan) which covers the 20% that Medicare Part B does not cover. This is due to the fact that I have a pre-existing condition. Actually, I probably have 50+ pre-existing conditions from a medical insurance underwriter standpoint, but that is beside the point. See: https://www.kff.org/medicare/press-release/in-all-but-four-states-seniors-on-medicare-can-be-denied-a-medigap-policy-due-to-pre-existing-conditions-except-during-specified-windows-of-opportunity/ https://www.kff.org/medicare/press-release/in-all-but-four-s... > Depending on their state, Medicare beneficiaries who miss these windows of opportunity may unwittingly forgo the chance to purchase a Medigap policy later in life if their needs or priorities change, OR IF THEY CHOOSE TO SWITCH TO TRADITIONAL MEDICARE AFTER SEVERAL YEARS OF BEING IN A MEDICARE ADVANTAGE PLAN. This is a huge deal. I have type 1 diabetes plus 2 rare immune-mediated diseases that affect my peripheral nervous system. My insulin pump supplies are covered under Part B. A couple of my hospitalizations were covered under Part B under an "observational status". I used to receive infusions of a blood product in the hospital every 2 weeks that cost my insurance about $10,000 each time, under contract. I also need a couple of different infusions, although far less frequently, to stay alive. So for me, unless I totally uproot my life and move to one of those 4 states that does not allow the pre-existing condition clause to preclude me from Medigap coverage, I am stuck on a Medicare Advantage plan. I am screwed. These plans only become more hardcore and strict. I cannot be on an HMO, which many Medicare Advantage plans are. I have a very rare disease that maybe a few doctors can treat, even though I live in a huge, very populous city. I also need the doctors I currently have, which work like a team. I cannot afford the several prior authorizations and the delays that will happen from switching insurance. I cannot afford to make a mistake. Switching to a Medicare Advantage Plan can be extremely problematic for somebody like me, due to logistical issues. They could cost me my life too, and that is no exaggeration. I may have to switch to a Medicare Advantage Plan, as costs are capped and I have an exorbitantly expensive medication that I must take to survive. Under Traditional Medicare, under Medicare Part D, I am subjected to catastrophic coverage levels. I can expect to pay $50,000/year for my healthcare, if I lose employer based coverage through a family member via Affordable Care Act partial or full overturn. In the case that I am forced to switch to a Medicare Advantage Plan, there is no going back to Traditional Medicare, due to pre-exisiting condition clauses in Medigap plans. That is extremely problemsome as it limits my access to doctors and other care, as I have a very rare disease. Fortunately, I am a European Union citizen, so I can just leave. But, it makes me profoundly sad. What I mean is that I no longer feel welcome in my own country, my homeland. I have been in remission for a year now and I am close to completing my degree so I can work. I really want to work! But the United States makes it extremely hard for me. There are just way too many things tied to working, especially health insurance. It is really sad. My family is here, but I know I would be better off in Europe. Right now, I have been focused on language learning non-stop. Obviously you learn one language at a time. I am currently working on Croatian. All I can do is try to move on.

omgwtfbyobbq 7y ago
After you graduate, looking into employment in government might be a good idea. My grandmother is a survivor annuitant (grandfather worked for the federal government) and she has Aetna PPO through the OPM in addition to plain Medicare A/B. It acts as a medi-gap policy when a provider accepts Medicare, and acts as a normal PPO when they don't. I'm not sure if you would be eligible for something similar, but I think it's worth looking into. The only thing that's a pain about it is Aetna conforms to Medicare's policies on covered care, so if you want something and Medicare won't authorize it, you have to go to a provider who does not accept Medicare to get it. You can also get coverage from a provider who accepts Medicare when the treatment isn't covered by Medicare by switching from Medicare to a 5-star advantage plan, since Aetna would not longer be able to fall back on Medicare not authorizing it, but then you lose the medi-gap aspect, although that's not too bad because Aetna has OK out of pocket maximums.

omgwtfbyobbq 7y ago

After you graduate, looking into employment in government might be a good idea. My grandmother is a survivor annuitant (grandfather worked for the federal government) and she has Aetna PPO through the OPM in addition to plain Medicare A/B. It acts as a medi-gap policy when a provider accepts Medicare, and acts as a normal PPO when they don't. I'm not sure if you would be eligible for something similar, but I think it's worth looking into. The only thing that's a pain about it is Aetna conforms to Medicare's policies on covered care, so if you want something and Medicare won't authorize it, you have to go to a provider who does not accept Medicare to get it. You can also get coverage from a provider who accepts Medicare when the treatment isn't covered by Medicare by switching from Medicare to a 5-star advantage plan, since Aetna would not longer be able to fall back on Medicare not authorizing it, but then you lose the medi-gap aspect, although that's not too bad because Aetna has OK out of pocket maximums.