Skip to content
HearingTracker
Log in

Medicare Advantage and HAs (it's "open enrollment" time

39 replies323 viewsLast reply

Jump
Link to this topic
Reply

I'm exploring new to address my problems understanding "speech in noise," and specifically considering Phonak Eon Spheres. I have "traditional" Medicare, which does not offer any HA benefits. This is the 10/15 to 12/7 "open enrollment" interval during which Medicare beneficiaries can elect to change plans and providers. It's totally unclear to me how much the "Hearing Care" benefit offered by many "Medicare Advantage" (Medicare Part C) plans is actually worth. I'd be grateful for any experience-based reports. For example:

  1. Is the cost benefit substantial, or merely a $200-%500 discount on the cost of the HAs?
  2. Do most plans offer access to audiologists, or only to online services or HA dispensers.
  3. Compared to Costco pricing for the HAs the warehouses sell and service, are the Medicare Advantage plans worth the restrictions on provider access that come with Medicare Advantage plans?

There are several threads on the forum that discuss this, but they're all a few years old.

Thanks so much.

19 people in this conversation16 min readJump to latest

To me, the issue would be giving up Medicare, and moving to Medicare Advantage. There are so many issues with MA. The question I tell people to ask themselves: Can you afford std Med, or do you need to be on MA for the price? Only if one can't afford std Med should you be on MA.

IMHO.

Do you currently have a Medicare Supplement (AKA Medigap) plan to cover the Original Medicare copayments? If yes, you should be aware that you may have trouble re-enrolling in a Medigap plan if you decide to switch back to Original Medicare after trying Medicare Advantage.

https://www.goodrx.com/insurance/medicare/medical-underwriting-eligibility-medicare-supplement7

@x475aws said:

you should be aware that you may have trouble re-enrolling in a Medigap plan if you decide to switch back to Original Medicare after trying Medicare Advantage.

SO MANY thanks for the GoodRx link. Traditional Medicare Supplement "Plan F" policies are expensive but not limiting. Even if a Medicare Advantage plan PAID THE ENTIRE ONE TIME COST of hearing aids, I don't think I'd "jump ship" to a Medicare Advantage plan.

Understand that brokers get paid far more to enroll someone in MA than in Medicare B+D, so you're paying a salesman a lot for an MA plan, even if you do the research and buy an MA plan on your own. That payment has to come from somewhere, and IMO you've got to assume it comes from actual coverage.

This year, lots of insurance companies have dropped the MA plans in counties all across the US because they don't make money. The MA companies are loyal to themselves, not to their subscribers.

Your best bet is to call the insurer you're considering to get details on their coverage and call their approved service providers ... and maybe ask here to find out if any participant has experience with those providers.

And don't forget providers like Zip Hearing for low prices - not as low as Costco, but a lot lower than 'retail', albeit with some limitations.

In reply to @philbob57

@philbob57 said:

Understand that brokers get paid far more to enroll someone in MA than in Medicare B+D, so you're paying a salesman a lot for an MA plan, even if you do the research and buy an MA plan on your own.

I did NOT know that. And it's only a day or two that I learned that signing up for a MA plan would mean I'd no longer be guaranteed eligibility to return to traditional Medicare if I was dissatisfied with the MA plan.

And, it seems, the "hearing coverage" is often a trivial discount anyway.

I cannot believe all the MA bashing. I have had MA for many years, and most or all my friends and neighbors do as well.

Obviously the merits of every type of coverage depend on the individual needs, but many millions use MA plans.

Next year's MA plans won't be as good as this year's according to this Wall St. Journal article (no-paywall link). Premiums might still be low or zero, but costs for using the plans may rise, networks may shrink, and extra benefits may be discontinued. Part D drug plans for Original Medicare are also getting worse, though with less impact than the MA changes.

In reply to @x475aws

x475, Thanks for posting that informative article from the WSJ about health insurance. It seems every year it becomes more important to research health insurance options. One of our daughters works for a state agency which handles health insurance for state employees. She has told us that the health insurance industry is changing at an ever rapid pace. Even she who keeps track of this industry is challenged by the rate of change.

In reply to @jeffrey

@jeffrey said:

I have MA along with Kaiser and it's great

Of course, Kaiser is the cream of managed health care. That's not always been the case, but in many metropolitan and small city markets in states where Kaiser is available, extraordinarily well trained physicians are leaving "private" practice and joining TPMG (Kaiser's medical providers' group practice). However, Kaiser is not available everywhere, and the financing of medical care in general becomes ever-more complex. Another poster on this forum has intimated that although Kaiser Health Plan offers a pretty generous "number" for hearing aid discounts, it's with a specific third party that apparently quotes pretty high "retail" prices for hearing aids.

And (I didn't know this previously) apparently the switch from traditional Medicare to Managed Medicare (also known as Medicare Part C or Medicare Advantage) may be an enforced one-way trip, because apparently insurance providers offering Medicare Supplements are under no obligation to offer traditional supplement policies to people who've switched to MA and decided they didn't like the restricted provider profile.

Edited
@jimrobertson said:

extraordinarily well trained physicians are leaving "private" practice and joining TPMG (Kaiser's medical providers' group practice).

Doctors and surgeons at Kaiser don't have to manage business taxes and regulations and support staff issues and all the rest. They're free to be doctors. that's a good part of the appeal for doctors. That said, kaiser also sets rules in terms of how many patients doctors see per hour, etc. In my 30 years experience with kaiser, doctors and surgeons take the time needed with patients or surgeries coming in that require more extensive treatment. The system allows them to be doctors and not accountants, and they take time needed for a successful outcome for the patient before them, rules be damned. when my issues are minor, I finish my appt. get out of there and allow my doctors to treat the more serious cases following after.

In reply to @x475aws

@x475aws said:

Next year's MA plans won't be as good as this year's according to this Wall St. Journal article

I haven't read the article yet, but I HAVE investigated MA plans offered by the same company that currently covers me through a "traditional medicare supplement" (plan F level, which is supposed to be the most comprehensive level) through Anthem Blue Cross. I'm paying a premium of about $500 per month for that, and separately I pay about $80/month to Healthspring (used to be Cigna) for a Part D PDP (prescription drug plan). Anthem Blue Cross's "best" MA plans seem to cover all the providers I use AND offer optical, dental, and hearing benefits, and INCLUDE the PDP, but they have zero dollar premiums. Elsewhere in this thread other posters have claimed that sales agents are desperate to get people into the MA (Medicare Part C) plans. There must be SOMETHING that drives that desire. I haven't asked the sales rep for Anthem, but perhaps that's where I should start.

I HAVE been told that I can do MA on a "trial" basis with a guarantee that I can return to my previous "traditional" Medicare plan so long as I do so within the trial period, which is 1 calendar year. and that Medicare rules prevent the insurance company from restricting my right to re-enter because of my age or any pre-existing medical condition. What am I not understanding?!

@jimrobertson said:

I HAVE been told that I can do MA on a "trial" basis with a guarantee that I can return to my previous "traditional" Medicare plan so long as I do so within the trial period, which is 1 calendar year.

Hmm, some states have additional rules, so apparently GoodRx doesn't give the whole story. This is Nevada from 2025:

This video is something everyone considering Medicare Advantage, or already using a Medicare Advantage policy should watch. I’ll just add that the Medicare Advantage policies are dropping extra benefits this year, so be careful that the policy you have or consider will have hearing aid coverage in 2027.

lawyer,I wish that you and others would mention the provenance--sponsors--of videos that they tell us to watch. "somebody" on facebook has posted a video on Medicare!!! everyone should watch, you say. Who the hell are they? Easy enough to mention that. There's a million hack videos on facebook. I don't use it much anyway.

That is a good idea. This video is by a presenter who gives his background at Johns Hopkins , one of the top research hospitals.

I have Medicare Advantage, and my plan gives a 50% discount on from hearing centers within their network. However, their hearing aids are still pricier than Costco.

In reply to @LawyerFL

@LawyerFL said:

This video is something everyone considering Medicare Advantage, or already using a Medicare Advantage policy should watch. I’ll just add that the Medicare Advantage policies are dropping extra benefits this year, so be careful that the policy you have or consider will have hearing aid coverage in 2027.

Thanks for that, although I'll second the notion that in general I avoid faceBook for fear of tickling some bot with questionable motives.

However, the thread topic here still puzzles me. As a "Traditional Medicare" subscriber for almost 15 years now I wonder a bit about how and WHY the vendor of my "Plan F" Medicare supplement would be trying to "sell" me something (a MA plan) for which I'd pay NOTHING (at least in premiums) and which supposedly would offer me MORE than for which I'm now paying about $500 per month. I've done SOME of my "due diligence." The hospitals, physicians, and "advanced practice" non-doctoral level providers my wife and I see are all listed as participating in the MA plan, so why on EARTH would the vendor (Blue Cross) be trying to get me to switch to a plan for which I provide them NO revenue? Does HHS, via Medicare & Medicaid Services, ITSELF provide them financial support for people to whom it sells MA plans?

Related discussions