Example of a Medicare Advantage EOC

southernlady

Administrator
Staff member
Because we moved (going full timing), we had the opportunity to choose a new Medicare Advantage plan outside of normal enrollment.

Got a copy of the 2017 Plan Details. They are required by law to send them out as printed copies to Medicare members. Typically called "Get to know your benefits". It has the EOC (Evidence of Coverage) inside. Many EOC's are 80-100 pages long. The Medicare one is well over 250 pages.
 

Spiky Bugger

Well-Known Member
We just got our 2024 offerings from his retirement plan. We have a Medicare Advantage PPO plan. At first I was irritated that they no longer offered their Medicare Supplement plan to go with traditional Medicare. But it looks like the only changes are good ones. (But I haven’t looked at the Rx formulary.). ( Or FOUND the EOC.)

BUT…not only is using this MUCH easier than dealing with two policies, but it covers MOST things. His expensive meds are covered FAIRLY well. But for those, we go to the VA where the most expensive medication is $22. OTOH, I won’t go full-VA because the drive is a nightmare and they probably won’t give me my opioids and my outside PCP will.

MrSue will, sooner or later, need hip replacement surgery. Both venues will do it/cover it, at little or no cost to us. But now I’m wondering if we should push for sooner because of his cognitive issues and the effects of general anesthesia on the elderly and those with dementia, which he technically ALMOST has. (I don’t like calling him elderly because I’m older than he is!)

Insurance. I really hate insurance. And what’s REALLY sad is that (I think) that like any company, their primary obligation is to their shareholders, NOT to the people who buy their products/services. So as long as they are making money, they’re ”doing the right thing.” UGH.
 

k9ophile

Well-Known Member
I'm sure that insurers care more for the shareholders than the people who have the insurance. But then, I worked for a for-profit health-care company. I am, admittedly, prejudiced.
 

JackieOnLine

Moderator
Staff member
MrSue will, sooner or later, need hip replacement surgery. Both venues will do it/cover it, at little or no cost to us. But now I’m wondering if we should push for sooner because of his cognitive issues and the effects of general anesthesia on the elderly and those with dementia
yes, this is a real and big issue, I feel for you and him dealing with it.

Insurance. I really hate insurance
YES!!!!!
 
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