Medicare Advantage Plans

[Big Turk]

On 10/6/2025 at 8:09 PM, Mike in Horseheads said:

Hey Peeps on Medicare...  Anyone else get their Medicare Advantage Plan cancelled and you have to find a new one?  I've had a great one since April when I first got on and now the choices are slimmer and more expensive in co pays etc.  Current plan is Excellus Blue/Active (PPO).  Be interested in if others are getting the same notice.

 

Mike

 

PLEASE don't make this politics!

 

 

 

My Dad got a notice that Kaleida would no longer accept his UHC plan in 2026 for Medicare Advantage so I spent the weekend delving into things and got him set up on Univera today...only for him to receive a letter in the mail from Kaleida this morning that it reached an agreement with UHC and would continue accepting it next year. 

 

Went to medicare.gov and basically sorted thru all the options there.

 

This sh!t should be illegal.

Edited November 10 by Big Turk

[nosejob]

On 10/6/2025 at 8:09 PM, Mike in Horseheads said:

Hey Peeps on Medicare...  Anyone else get their Medicare Advantage Plan cancelled and you have to find a new one?  I've had a great one since April when I first got on and now the choices are slimmer and more expensive in co pays etc.  Current plan is Excellus Blue/Active (PPO).  Be interested in if others are getting the same notice.

 

Mike

 

PLEASE don't make this politics!

 

 

I recently found out that my UHC advantage plan is going away. It's seems that now medicare C plans are the new advantage plan? I've been researching medicare.gov trying to compare plans. Most have all but stripped dental and even the riders barely cover what a year's worth of rider premiums add up to.

I think the Gov't. should require x amount of dental coverage. I believe dental/periodontal issues lead to more major health complications and expenses.

I'm trying to navigate dentures now.

 

It looks like UHC is only gonna do dual eligible meaning one has to qualify/have Medicaid and Medicare. It sounds ass backward policy wise to me.

I guess the best I can see so far is Excellus also. Any opines on this would be great.

[Mike in Horseheads]

9 minutes ago, nosejob said:

I recently found out that my UHC advantage plan is going away. It's seems that now medicare C plans are the new advantage plan? I've been researching medicare.gov trying to compare plans. Most have all but stripped dental and even the riders barely cover what a year's worth of rider premiums add up to.

I think the Gov't. should require x amount of dental coverage. I believe dental/periodontal issues lead to more major health complications and expenses.

I'm trying to navigate dentures now.

 

It looks like UHC is only gonna do dual eligible meaning one has to qualify/have Medicaid and Medicare. It sounds ass backward policy wise to me.

I guess the best I can see so far is Excellus also. Any opines on this would be great.

I'm down to Excellus and Humana as my two finalists. I'll pry stay with excellus.

[nosejob]

2 minutes ago, Mike in Horseheads said:

I'm down to Excellus and Humana as my two finalists. I'll pry stay with excellus.

That' what I was thinking, Between Bluechoice and Humana choice. Thanks for the reply!

[Mr Info]

On 10/6/2025 at 8:25 PM, Another Fan said:

IMO having Medicare as primary and then picking up a secondary insurance is the way to go.

This is not necessary if you have good Medicare Advantage insurance. 

If you have a Medicare Advantage plan you're at the mercy for things like authorizations.

 

But it depends on one's age as well.  If you're not like that sick I can see the appeal.  
 

Would you clarify this reply? Medicare is only available when you reach 65 years old. 

 

[BillsFan4]

5 hours ago, nosejob said:

That' what I was thinking, Between Bluechoice and Humana choice. Thanks for the reply!

Just make sure that they are widely accepted locally. My mom had fidelis for a while and we kept having trouble finding doctors in the area. Especially in certain fields, where it was almost impossible. 

 

She switched to Independent health and we really haven’t had any problems since. Now her plan is going away so she has to switch again.

 

I was hoping to find her something else from Independent but that doesn’t look likely at the moment. I know Highmark blue cross/blue shield is pretty widely accepted in WNY.

 

We have a few calls into different places that are supposed to help you sort through plans but none have even called back yet. I’m guessing these places are just overwhelmed. It seems like medicare made some pretty widespread changes for this coming year. Everyone we talk to is looking for a new plan.

[nosejob]

1 hour ago, BillsFan4 said:

Just make sure that they are widely accepted locally. My mom had fidelis for a while and we kept having trouble finding doctors in the area. Especially in certain fields, where it was almost impossible. 

 

She switched to Independent health and we really haven’t had any problems since. Now her plan is going away so she has to switch again.

 

I was hoping to find her something else from Independent but that doesn’t look likely at the moment. I know Highmark blue cross/blue shield is pretty widely accepted in WNY.

 

We have a few calls into different places that are supposed to help you sort through plans but none have even called back yet. I’m guessing these places are just overwhelmed. It seems like medicare made some pretty widespread changes for this coming year. Everyone we talk to is looking for a new plan.

I'm gonna stick to a PPO. I like to be able to make appointments with my ortho specialists...and cardiologist etc. on my own. primaries don't do much of anything.

[Another Fan]

4 hours ago, Mr Info said:

 

Well first, some people younger than 65 qualify for Medicare benefits if they have a disability.  

 

If your health is more compromised and you have a Medicare Advantage plan....  you are largely at their mercy for medical authorizations for something like say skilled nursing vs traditional Medicare.  If per se the nursing home would even be in network with the Medicare Advantage plan.  

 

It's insurance.....they are in it to make money before anything else including patient care.   

[Wacka]

I see my broker Tuesday. She is leaning towards  Aetna. I have to have ECMC covered because of my transplant.  I have 6 doctors (including dentist) and she said they are all in plan. She also said Roswell is covered although I don't need them (at least for now).

Edited Sunday at 11:15 PM by Wacka

[MarkyMannn]

On 10/6/2025 at 8:09 PM, Mike in Horseheads said:

Hey Peeps on Medicare...  Anyone else get their Medicare Advantage Plan cancelled and you have to find a new one?  I've had a great one since April when I first got on and now the choices are slimmer and more expensive in co pays etc.  Current plan is Excellus Blue/Active (PPO).  Be interested in if others are getting the same notice.

 

Mike

 

PLEASE don't make this politics!

 

 

I had a Blue Cross Blue Shield Advantage free pay plan.  Surprisingly coverage was quite good.  Now gone.

Edited Monday at 01:56 AM by MarkyMannn

[Mike in Horseheads]

3 minutes ago, MarkyMannn said:

I had a Blue Cross Blue Shield Advantage zero pay plan.  Surprisingly coverage was quite good.  Now gone

I had the Blue Active PPO, yup gone

[BillsFan4]

I found a couple free HMO plans thru blue cross/blue shield that look pretty darn good. I can get the exact name of the plans if anyone wants them.

 

The coverage appears better than my mom’s old independent health plan (which she liked). We were able to compare it to the new plan independent health is offering to replace hers for $40/month and it has better coverage than that plan too. 
 

We are leaning toward one of those 2. The one plan has slightly lower out of pocket costs in some stuff like x-rays ($25 vs. $50) and out patient hospital ($375 vs $475). But the other plan provides an $81/month credit toward the Medicare part B premiums that are deducted out of social security payments every month. So I think we are leaning toward that one.

 

Ive had blue cross/blue shield for many years now and love them. It’s not Medicare though.

 

Next step is to call blue cross/blue shield directly. That’s been helpful for us in eliminating some plans we were considering.

Personally, i’d recommend everyone do that before choosing your plan. Once you have it narrowed down to a couple, call those specific insurance companies and talk to them to make sure you are reading/understanding everything correctly. Double check that your doctors and medications are covered, etc.

Edited Tuesday at 04:33 PM by BillsFan4

[Wacka]

Just came back from my broker. Was there for 90 minutes. Problem wasn't her it was the insurance  (Aetna) people. Got a dual medicare plan. First the dentist was in the plan, then it disappeared from their site. Thought I would have to change dentists, but stopped at the dentist on the way home and they said they are in all the Aetna plans.  Gave the agent a list of my meds and all my  Drs. and she checked which plans they were in ahead of time.. 

[T&C]

4 hours ago, BillsFan4 said:

I found a couple free HMO plans thru blue cross/blue shield that look pretty darn good. I can get the exact name of the plans if anyone wants them.

 

The coverage appears better than my mom’s old independent health plan (which she liked). We were able to compare it to the new plan independent health is offering to replace hers for $40/month and it has better coverage than that plan too. 
 

We are leaning toward one of those 2. The one plan has slightly lower out of pocket costs in some stuff like x-rays ($25 vs. $50) and out patient hospital ($375 vs $475). But the other plan provides an $81/month credit toward the Medicare part B premiums that are deducted out of social security payments every month. So I think we are leaning toward that one.

 

Ive had blue cross/blue shield for many years now and love them. It’s not Medicare though.

 

Next step is to call blue cross/blue shield directly. That’s been helpful for us in eliminating some plans we were considering.

Personally, i’d recommend everyone do that before choosing your plan. Once you have it narrowed down to a couple, call those specific insurance companies and talk to them to make sure you are reading/understanding everything correctly. Double check that your doctors and medications are covered, etc.

Its a real shame that they made all of this like it's some sort of a game... nothing seems to be straightforward with anything anymore. Can't imagine an older person with no computer prowess at all navigating the labyrinth of Medicare...

[Augie]

1 hour ago, T&C said:

Its a real shame that they made all of this like it's some sort of a game... nothing seems to be straightforward with anything anymore. Can't imagine an older person with no computer prowess at all navigating the labyrinth of Medicare...

 

Thank you!

 

We are fairly savvy people (OK, my wife is) with banking backgrounds, and this was a nightmare for us. It was concerning enough that she went to a local college and took a Medicare class. Fortunately, we were blessed with a financial planner as a perk from her employer. This guy is super smart (he works for a division of Goldman) and saved us a bunch in potential tax penalties. We asked about Medicare and he said he couldn’t help us, it is it’s own animal. 

 

He hooked us up with an advisor who guided us thru everything. He presented options, but he also kept us from doing anything that would bite us later. The best deal is often the deal that is going to go away first, for example. So my wife mentions that her “professor” at the college class was pushing Advantage plans as the best option. Our guide again reminded us he is an hourly worker for a company that helps people like us, with zero commission. He asked my wife if the “professor” mentioned that they get paid at a higher rate when they sell Advantage. He didn’t say it was better or worse (it depends I guess), but that might explain why he’s pushing it. For everyone. That would be nice to know. 

 

Back to your point….this stuff is WAY too complicated for most people in this country. You’re at their mercy unless you’ve done your homework, and even if you have you are still at their mercy. The BOMBARDMENT of solicitations alone can make you dizzy! It’s a mess. 

 

Rant over. 

 

 

.

Edited Tuesday at 10:41 PM by Augie

[Mike in Horseheads]

7 hours ago, BillsFan4 said:

I found a couple free HMO plans thru blue cross/blue shield that look pretty darn good. I can get the exact name of the plans if anyone wants them.

 

The coverage appears better than my mom’s old independent health plan (which she liked). We were able to compare it to the new plan independent health is offering to replace hers for $40/month and it has better coverage than that plan too. 
 

We are leaning toward one of those 2. The one plan has slightly lower out of pocket costs in some stuff like x-rays ($25 vs. $50) and out patient hospital ($375 vs $475). But the other plan provides an $81/month credit toward the Medicare part B premiums that are deducted out of social security payments every month. So I think we are leaning toward that one.

 

Ive had blue cross/blue shield for many years now and love them. It’s not Medicare though.

 

Next step is to call blue cross/blue shield directly. That’s been helpful for us in eliminating some plans we were considering.

Personally, i’d recommend everyone do that before choosing your plan. Once you have it narrowed down to a couple, call those specific insurance companies and talk to them to make sure you are reading/understanding everything correctly. Double check that your doctors and medications are covered, etc.

Excellus bues seems to be different than your Blues 

https://www.excellusformedicare.com/Vital?utm_source=sfmc&utm_medium=email&utm_campaign=aep_2025_reacquisition_cny_r2_a_t2&utm_content=explore_our_plans_button&utm_term=exc_medicare#Drug-Plan-Table-Anchor

[BillsFan4]

1 hour ago, Mike in Horseheads said:

Excellus bues seems to be different than your Blues 

https://www.excellusformedicare.com/Vital?utm_source=sfmc&utm_medium=email&utm_campaign=aep_2025_reacquisition_cny_r2_a_t2&utm_content=explore_our_plans_button&utm_term=exc_medicare#Drug-Plan-Table-Anchor

The plans were not through excellus. I’ll look them up again tomorrow and let you know the plan name.

 

edit -

 

The two plan names are “Community Blue Medicare HMO Signature” and “Community Blue Medicare HMO Merit”

 

 

Edited yesterday at 01:09 AM by BillsFan4

[BillsFan4]

So I talked with a Medicare agent from community blue (blue cross/blue shield).

 

He said the Signature plan is much better than the merit plan. He said unless you only care about that $81/month credit (of the merit plan) the signature plan is better in every other way. He said you will pay a lot more out of pocket expenses with the merit plan.

 

He was also saying that Medicare offices around the country are completely swamped this year. He said they made some really major changes and cuts to Medicare. He said people don’t yet realize how much stuff has been cut. He said it’s been an absolute mess. Said they only have 26 agents to handle this stuff and have thousands of people calling just their office alone. He said the rollout for these changes has been very chaotic and the Medicare system was not prepared to handle this.

 

If anyone wants it, the number I called is 1-844-614-0343. They give you the option of a call-back so you don’t have to wait on hold. They called me back within about 15 minutes.

 

 

We picked the signature plan for now. But we finally got a call back from this local place called “the clarity group” who help you sort through and pick plans. They are supposed to be calling later today to schedule an in-person appointment for my mom. So I think we are still going to go to that.

Apparently they are super swamped as well but the lady was going to try to squeeze us in before the 12/7 deadline.

 

I guess if your current Medicare plan is being ended you actually have until 12/31 to pick a new plan via the SEP (special enrollment period).