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Re: Medicare Experience So Far [Re: Ramsey] #8576925 04/12/22 06:28 PM
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Mom is part of Teacher Retirement (TRS) she is on Medicare Advantage that is managed by United Healthcare.


Big Beckett!!
Re: Medicare Experience So Far [Re: Texas buckeye] #8577145 04/12/22 11:03 PM
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Originally Posted by Texas buckeye
This is most likely a medicare advantage plan through united healthcare. Those are really decent plans up front but they suck for some things, and rehab must be one of those things that they suck at.

Regular medicare does have a limit to rehab as well, but with regular medicare if the dr requests it, it is done. There will be co-pays and 20% that isn't covered (possibly secondary insurance will, many times it doesn't), but medicare is actually pretty decent with end of life type care. The medicare advantage plans are not typically good for end of life care, and I have said for along time they are generally good as long as you are healthy but if you are a sick person (Interstitial lung disease is not a healthy person) then a advantage plan is not for you.

I am sorry for the problems your mom is having ramsey. One option, not a poopular option, but if she doesn't have much money or assets, is to let her get medicaid as well and then she can use that coverage or it can at least help. Some hoops to go through to get that, but it may help. Of course then you are dealing with medicaid facilities and those aren't always the nicest, let alone the best...


Like a Ladybird deed?

Re: Medicare Experience So Far [Re: Lakhota] #8577151 04/12/22 11:17 PM
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Originally Posted by Lakhota
More than likely it is a Medicare Advantage plan and not a Medicare Supplement plan. Different rules for the two different plans.


Most likely this is the case - I have posted here many times about Advantage plans - premiums are either very little or nothing and the plan is great until you file a claim - sorry to hear you are going through this

Last edited by tlk; 04/12/22 11:17 PM.

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Re: Medicare Experience So Far [Re: Ramsey] #8577186 04/13/22 12:02 AM
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Originally Posted by Ramsey
Mom is part of Teacher Retirement (TRS) she is on Medicare Advantage that is managed by United Healthcare.

Sorry to hear this issue. My wife is also retired from TRS and in the same plan. And I will be also in 3 years.

Re: Medicare Experience So Far [Re: tenyearsgone] #8577277 04/13/22 01:26 AM
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Originally Posted by tenyearsgone
Originally Posted by Texas buckeye
This is most likely a medicare advantage plan through united healthcare. Those are really decent plans up front but they suck for some things, and rehab must be one of those things that they suck at.

Regular medicare does have a limit to rehab as well, but with regular medicare if the dr requests it, it is done. There will be co-pays and 20% that isn't covered (possibly secondary insurance will, many times it doesn't), but medicare is actually pretty decent with end of life type care. The medicare advantage plans are not typically good for end of life care, and I have said for along time they are generally good as long as you are healthy but if you are a sick person (Interstitial lung disease is not a healthy person) then a advantage plan is not for you.

I am sorry for the problems your mom is having ramsey. One option, not a poopular option, but if she doesn't have much money or assets, is to let her get medicaid as well and then she can use that coverage or it can at least help. Some hoops to go through to get that, but it may help. Of course then you are dealing with medicaid facilities and those aren't always the nicest, let alone the best...


Like a Ladybird deed?


I don’t know what that is… confused2

Re: Medicare Experience So Far [Re: Ramsey] #8577285 04/13/22 01:30 AM
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A "Lady Bird" deed is a nickname for an enhanced life state deed. It is named after Lady Bird Johnson, because allegedly President Johnson once used this type of deed to convey some land to Lady Bird.


(R-TX) .-- " TCNN CURL CRLB VFF OGI SNDL CGC TLRY "

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Re: Medicare Experience So Far [Re: Lakhota] #8577334 04/13/22 02:12 AM
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Originally Posted by Lakhota
More than likely it is a Medicare Advantage plan and not a Medicare Supplement plan. Different rules for the two different plans.


The MEDICARE ADVANTAGE PLAN is a supplement plan. If possible get out of it at the first possible second.





Re: Medicare Experience So Far [Re: Texas buckeye] #8577359 04/13/22 02:40 AM
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Originally Posted by Texas buckeye
Originally Posted by tenyearsgone
Originally Posted by Texas buckeye
This is most likely a medicare advantage plan through united healthcare. Those are really decent plans up front but they suck for some things, and rehab must be one of those things that they suck at.

Regular medicare does have a limit to rehab as well, but with regular medicare if the dr requests it, it is done. There will be co-pays and 20% that isn't covered (possibly secondary insurance will, many times it doesn't), but medicare is actually pretty decent with end of life type care. The medicare advantage plans are not typically good for end of life care, and I have said for along time they are generally good as long as you are healthy but if you are a sick person (Interstitial lung disease is not a healthy person) then a advantage plan is not for you.

I am sorry for the problems your mom is having ramsey. One option, not a poopular option, but if she doesn't have much money or assets, is to let her get medicaid as well and then she can use that coverage or it can at least help. Some hoops to go through to get that, but it may help. Of course then you are dealing with medicaid facilities and those aren't always the nicest, let alone the best...


Like a Ladybird deed?


I don’t know what that is… confused2


Look up Enhanced Life Estate Deed. And whatever you do don't trust websites with free or $19.95 deeds. If you want to go this route call up a title company that you may use because they are the one that has to issue a title policy. Ask them for the attorney that they recommend to write this deed that they will underwrite.

This works in Texas now, but the future isn't guaranteed. It is a Medicaid planning tool to keep a home, and possibly other property, immune from MERP, Medicaid Estate Recovery Program.

Almost amateur info here, but from what I've learned is that the vast majority of nursing home residents are on Medicaid. To get there they have to "spend down" their assets to a low minimum. Their homestead, minimal funds, maybe a car, is exempt.

I know of families that received a letter from Medicaid VERY SOON after the passing of a Medicaid recipient. It went something like, "Sell this home now and send us the proceeds."

If that home had been put into this Enhanced Life Estate Deed beforehand it bypasses probate. I think at 12 midnight of the passing the heir of that home is the owner, zip and done.

Don't let Google send you down some rabbit hole of BS ads for cheap useless docs. Just call a title company, tell them what you are interested in doing, and what attorney do they recommend. And whatever you do, don't even call a so-called "Medicaid Planner." I sat through a session of a BS presentation. They basically played a shell game that ended with them selling me an annuity.

Luckily, we never even got to to the point of needing Medicaid in the first place.


Re: Medicare Experience So Far [Re: DLALLDER] #8577396 04/13/22 03:48 AM
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Originally Posted by DLALLDER
Originally Posted by Lakhota
More than likely it is a Medicare Advantage plan and not a Medicare Supplement plan. Different rules for the two different plans.


The MEDICARE ADVANTAGE PLAN is a supplement plan. If possible get out of it at the first possible second.


Not true at all. A medicare advantage plan is a medicare replacement with very defined enrollment and dis-enrollment times. It is also not what is known as a medicare supplement, or secondary insurance to medicare. When you sign up for a medicare advantage plan you do not get to use regular medicare for that enrollment period (usually one year) and you have to comply with the policy terms of the advantage plan.

Many times there are very easy to find disadvantages for medical advantage plans (yes, it is kind of funny considering the name) and most of those will come in the very expensive things that cost medicare a lot of money where the advantage plan limits coverage of those things. These plans originated as a way to save money for the govt by getting people off regular medicare and these plans heavily market with lots of gimmicky things to attract people to enroll, but they feel the pain when they get really sick. The worst of it is when the people don’t have a choice because something like the teachers union tries to save money on healthcare costs by giving crappy plans. Sorry ramsey and ramsey’s mom

Re: Medicare Experience So Far [Re: DLALLDER] #8577406 04/13/22 04:04 AM
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Originally Posted by DLALLDER
Originally Posted by Lakhota
More than likely it is a Medicare Advantage plan and not a Medicare Supplement plan. Different rules for the two different plans.


The MEDICARE ADVANTAGE PLAN is a supplement plan. If possible get out of it at the first possible second.


No, it is not a standardized Medicare Supplement plan. The standardized plans are plans A through J and if it is a standardized plan no manner who the company is that sold it or what state it is in the coverage is the same only the premiums will vary. With a Medicare Advantage plan what the plans offer can vary between the companies.

The difference with a Standardized Medicare plan is that when a claim is submitted it is submitted to Medicare first and then it is submitted to the Supplement company and you will receive a “EOMB” explanation of Medicare Benefits With a Medicare Advantage the clams is submitted to the MedicRe Advantage company and not to Medicare and you will receive a letter from the Advantage company showing how much went towards your deductible and how much they paid.

Advantage plans will have stuff like Silver Sneakers which is discounted gym membership and other gimmicks. A true Medicare Supplement plan doesn’t have any of that crap and is pretty simple if Medicare pays the plan pays.

I may be wrong on this but it is my understanding that what the insurance companies did was they went to Medicare and said hey we have this Advantage plan that we want to sell and it will cost you Medicare less. So no claims are submitted to Medicare and in return Medicare pays to the Insurance companies the Medicare premiums for the Medicare beneficiaries. This way the cost to Medicare is lessened and therefore the insurance companies say what benefits are payable.

Re: Medicare Experience So Far [Re: Texas buckeye] #8577412 04/13/22 04:20 AM
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Originally Posted by Texas buckeye
Originally Posted by tenyearsgone
Originally Posted by Texas buckeye
This is most likely a medicare advantage plan through united healthcare. Those are really decent plans up front but they suck for some things, and rehab must be one of those things that they suck at.

Regular medicare does have a limit to rehab as well, but with regular medicare if the dr requests it, it is done. There will be co-pays and 20% that isn't covered (possibly secondary insurance will, many times it doesn't), but medicare is actually pretty decent with end of life type care. The medicare advantage plans are not typically good for end of life care, and I have said for along time they are generally good as long as you are healthy but if you are a sick person (Interstitial lung disease is not a healthy person) then a advantage plan is not for you.

I am sorry for the problems your mom is having ramsey. One option, not a poopular option, but if she doesn't have much money or assets, is to let her get medicaid as well and then she can use that coverage or it can at least help. Some hoops to go through to get that, but it may help. Of course then you are dealing with medicaid facilities and those aren't always the nicest, let alone the best...


Like a Ladybird deed?


I don’t know what that is… confused2


I don't deal with much Medicaid as a health administrator, but from my understanding, it's where the person needing coverage deeds their assets to a family member to hide it from Medicare. It makes it look like they don't own as much.

Re: Medicare Experience So Far [Re: tenyearsgone] #8577415 04/13/22 04:35 AM
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Originally Posted by tenyearsgone
Originally Posted by Texas buckeye
Originally Posted by tenyearsgone
Originally Posted by Texas buckeye
This is most likely a medicare advantage plan through united healthcare. Those are really decent plans up front but they suck for some things, and rehab must be one of those things that they suck at.

Regular medicare does have a limit to rehab as well, but with regular medicare if the dr requests it, it is done. There will be co-pays and 20% that isn't covered (possibly secondary insurance will, many times it doesn't), but medicare is actually pretty decent with end of life type care. The medicare advantage plans are not typically good for end of life care, and I have said for along time they are generally good as long as you are healthy but if you are a sick person (Interstitial lung disease is not a healthy person) then a advantage plan is not for you.

I am sorry for the problems your mom is having ramsey. One option, not a poopular option, but if she doesn't have much money or assets, is to let her get medicaid as well and then she can use that coverage or it can at least help. Some hoops to go through to get that, but it may help. Of course then you are dealing with medicaid facilities and those aren't always the nicest, let alone the best...


Like a Ladybird deed?


I don’t know what that is… confused2


I don't deal with much Medicaid as a health administrator, but from my understanding, it's where the person needing coverage deeds their assets to a family member to hide it from Medicare. It makes it look like they don't own as much.

Called him out on grammar and now this lol.


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Re: Medicare Experience So Far [Re: Ramsey] #8577418 04/13/22 04:48 AM
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If you are ever in need of Medicaid the first thing you need to is get in touch with a Elder Care Lawyer they know all the ins and out of Medicaid. There is a five year look back period that Medicaid will do to see if monies have been given away or property has been transferred and this can keep a person from qualifying for Medicaid.

A spouse is allowed to keep a residence, a vehicle, their retirement plans, Social Security, and so much savings. However, the splice can not keep their spouses retirement plans, Social Security, and transfer monies that was in their spouses name into their name to qualify their spouse for Medicaid. Yes you have to spend down to a certain level and if a person is single Medicaid may come after property to pay for their care after the person has died.

It’s my opinion that that is fair. Why should the Federal Government ie the taxpayers be on the hook for the care of a individual if there is property that can be sold to pay for their care? I don’t understanding the thinking that mom or dad’s house or land should be passed down to their kids of other family members instead of being sold to pay for their care and putting the taxpayers on the hook for it. Yes it would suck to have to sell property that had been in the family for generations but on the other hand why should the taxpayers be responsible!

I do fully understand the cost of taking care of a person in a nursing home and in my wife’s situation it would be anywhere from $5000 to $6000 a month and that does not include her meds, insurance, or clothing care. Also we would be responsible for providing the furniture for her room.

Re: Medicare Experience So Far [Re: Ramsey] #8577465 04/13/22 11:23 AM
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my MIL is in assisted living now and it runs around 7K a month for everything - thankfully we got a LTCare policy on her years ago and it is now paying out like a slot maching


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Re: Medicare Experience So Far [Re: Ramsey] #8577476 04/13/22 11:55 AM
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Originally Posted by 2Beez

Called him out on grammar and now this lol.


There's nothing wrong with my grammar. Even ran it through a checker to be sure..... angel

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