@dabomb79 DON'T DO MEDICARE ADVANTAGE - THEY TAKE ADVANTAGE OF YOU!
I'll tell you what I tell all my patients at the PT clinic I manage and all my friends - GET MEDICARE! They'll cover practically everything (at 80% without a medigap plan) and you don't have to jump through hoops to get things approved.
For example, a post op patient with Medicare does not have a visit limit so long as it's deemed "medically necessary" which means the patient either needs an Rx for PT or their doctor needs to sign our Initial Exam/Progress Notes to continue treatment. Simple! Now let's say that same post op patient has a Med Advantage (MA) plan through Anthem BC - I submit for prior auth through another third party (Carelon), and they might get maybe 9 or 10 visits to use for 3 months. If the doctor/PT is advising 2x a week for let's say 4 months, they'll run out of those visits shortly after 1 month!! We submit again, now maybe they get 4 or 5 visits. And they typically whittle down from there. If the patient isn't post op, I'll get 4 or 5 visits tops to use for 2 months. The Medicare patient won't have this problem.
I would highly suggest to everyone to get Medicare and a secondary or better yet supplemental. Depending on the medigap plan, some still may have a doctor's visit copay, but several plans will pay the remaining 20% that Medicare doesn't cover (at the cost of a higher premium, of course).
And the best part - Medicare's annual deductible is extremely low. This year it's $226. For everything! Even better with the Medi-Medi plan your relative already has, they don't even owe the deductible! They should owe nothing!
I'll give the example of my parents. 2020 was an intense year for us - between the two them I had to coordinate 5 surgeries, 2 under emergency and 2 others I classify as urgent (including removing a very aggressive tumor). Their total billed out for surgeries came to around at least 750k. What did they owe? Just $223 each for the annual Medicare deductible! (They had a supplemental, but it was the lowest tier so they did owe $20 office visit copays but it wasn't much).
I say Medicare Advantage - they take advantage of you. Instead of you getting your earned MC benefits, the claims now go to a third party payer like Anthem BC/UHC/Aetna and THEY will determine if your procedures are a covered benefit, many times requesting pre approval even for outpatient physical therapy post op as I highlighted in the above scenario. My dad's retired and gets his insurance through work still - they are forcing all employees to an MA plan. We're calling them and he's paying to keep his Medicare. Why would they force everyone on an MA when the previous year employees could choose? Makes you think...(not really)
If they already have Medicare and Medicaid secondary, why change?? That's a Medi-Medi plan. Even providers not in network with medicaid (like us) can take it, we just agree to accept Medicare payment in full and not bill the patient the remaining 20%. You do NOT want to deal with the prior approvals. Your relative will be denied necessary care. I see it all too often!!
TL;DR Medicare all the way 1000%%%