Mary Lou Retton Fighting for Her Life in ICU

[Disneychick75]

i can't speak for anyone else but the medicare advantage plan dh and i are both on costs us more than traditional medicare-we still pay the traditional medicare monthly premium but are also charged an additional monthly premium each.

Just asked my husband this is what we have.

 

[luvthatduke]

Colonial Penn recently had Mary Lou Retton on one of their commercials. Seems like, if someone is pushing life insurance, they probably have it. But quite possibly not.

She may have life insurance, maybe through Colonial Penn.

The problem her children are stating is that she doesn't have medical insurance.

 

[DCLMP]

I don't give two fricks about her financial situation, but I will say my neighbor who is 78 just spent 11 days on a ventilator in ICU and is home now doing as well as any 78-year-old that just recovered could do.

 

[Beezle2]

I didn't know about any of it until the last few days. I still don't wish death or extreme hardship on her, but I don't think super highly of her after learning more.

She definitely gives Ayn Rand vibes.

 

[kymom99]

Actually, those Medicare advantage plans are LESS generous than regular Medicare. They may waive the premium and offer free prescriptions, but they have have much high deductibles if you actually need medical care. The ablation I had in June was "free" under Medicare and my Medicare coverage. It would have had a $6,000 (20%) out of pocket deductible with a Medicare Advantage plan.
Medicare Advantage plans are a good deal, for those who never need medical care, otherwise, traditional Medicare is likely a better option.

I believe from listening to my sisters in law that my MIL had the advantage and it wasn’t as good. I don’t understand fully, but I’ll need to soon when my husband joins the Medicare ranks.

 

[Christine]

With regard to the Medicare Advantage plans and the comment @georgina made regarding those plans costing the taxpayers more, she's correct. There's been several analyses done on those plans (easily searched) and it appears that the private insurers are doing very well with these plans and that Medicare is overpaying the private insurers.

Here's an older link that summarizes the issue if you want to read up on it: https://www.npr.org/sections/health...1885/medicare-advantage-overcharges-exploding

Of course, it's a "management" problem by Medicare/government and no fault of a person on the plan. Not sure if anything has been done to curb expenses since the 2021 when this was published but it was being looked at and was known problem.

 

[tony67]

it appears that the private insurers are doing very well with these plans and that Medicare is overpaying the private insurers.

This is the problem - the insurance companies make way too much profit from these plans and from all the plans.

Ive said it before but if we are required to buy the insurance then there needs to be a cap on the profit of the plan or more regulation from the government

I'd prefer not to have the government involved but the insurance companies are evil from my experience. The whole goal is to either not pay the claim or drag it out as long as possible. In my experience they have software thats whole purpose is to look for reason not to pay a claim even if its just to delay it.

 

[Christine]

This is the problem - the insurance companies make way too much profit from these plans and from all the plans.

Ive said it before but if we are required to buy the insurance then there needs to be a cap on the profit of the plan or more regulation from the government

I'd prefer not to have the government involved but the insurance companies are evil from my experience. The whole goal is to either not pay the claim or drag it out as long as possible. In my experience they have software thats whole purpose is to look for reason not to pay a claim even if its just to delay it.

I wholeheartedly agree with you.

 

[Disneychick75]

Maybe traditional Medicare should cover dental, vision and hearing care and prescriptions. If it did, there would not be as great a need for the advantage plans. Most older people will need these types of care and it's why they get advantage plans. The system probably needs a restart.

 

[dvcgirl67]

She definitely gives Ayn Rand vibes.

But without the personal responsibility? I don't think that's how it's supposed to work. .

 

[tink2424]

This is the problem - the insurance companies make way too much profit from these plans and from all the plans.

Ive said it before but if we are required to buy the insurance then there needs to be a cap on the profit of the plan or more regulation from the government

I'd prefer not to have the government involved but the insurance companies are evil from my experience. The whole goal is to either not pay the claim or drag it out as long as possible. In my experience they have software thats whole purpose is to look for reason not to pay a claim even if its just to delay it.

Yeah, this is definitely one of the issues. Unfortunately the issue is multi-factorial and we really want to be serious about solving the issue we have to look at the whole process. That is why I am not for universal healthcare as it would just make the whole thing worse. I would be for it if we were able to eliminate a lot of the waste in the system but I fear that will never happen.

 

[Meriweather]

We have an advisor that figures everything out for us.
We have A, B and D.
Eye is covered through an ophthalmologist under medical.
We don't have dental, but our dentist has one that helps a little.
I think I paid about $100 to various people for my hip surgery in Jan. It was over $100,000

 

[barkley]

Maybe traditional Medicare should cover dental, vision and hearing care and prescriptions. If it did, there would not be as great a need for the advantage plans. Most older people will need these types of care and it's why they get advantage plans. The system probably needs a restart.

what i've personally experienced/witnessed regarding retirees opting into the advantage plans is in large part b/c they either don't have retiree health benefits from a private employer OR (VERY COMMON in recent years)-they retired from public service jobs that 'guaranteed' retiree health benefits but those employers no longer offer them to new hires and are doing their best to get those still eligible to opt out by choosing the most obscenely expensive plans that often have retiree premiums at obscene costs (4 figures a month for a single retiree w/no spouse or dependant covered) AND (based on evidence uncovered in a healthcare benefit lawsuit between retirees and my former government employer) are chosen by the employers to further alienate usage by limiting or entirely eliminating reasonable usage/coverage (in my case the only option was a single ppo but they had no preferred providers w/the insurance company pointing out that they are not obligated to recruit/seek them out but simply offer the opportunity for providers to sign on).

i know it's not common anymore for employers (private) to offer retiree health insurance but there was a time when straight vanilla medicare could cover a person fairly well. with the advent of costco, walmart and other lower cost resources for glasses it was'nt a huge burden to be without coverage, dental? honestly i've never had a plan private or public sector that paid a great deal so the average checkups/cleanings/xrays were/are not a big financial burden. where i see the big uptick in cost (average person/average senior meds) is perscriptions. i look at what meds cost today vs. when my mom passed in 2011 and it's insane. vs. what it was costing her with just vanilla medicare in the early 2000's it's out of control.

i opted into the advantage plan b/c i needed to drop my retiree coverage. my biggest consideration was perscriptions. the advantage plan i have offers very good coverage and still allow brick and mortar pharmacy usage-which i found that other perscription coverage plans did not (only mail order unless documented, by their criteria-urgent/emergency). if i was given the option of simply having 'vanilla medicare' and it offered just the perscription coverage i receive now-i would gladly continue to pay the additional premium i'm paying now for my advantage plan and forego all the extras they offer but largly go unused on my part.

 

[tvguy]

With regard to the Medicare Advantage plans and the comment @georgina made regarding those plans costing the taxpayers more, she's correct. There's been several analyses done on those plans (easily searched) and it appears that the private insurers are doing very well with these plans and that Medicare is overpaying the private insurers.

Here's an older link that summarizes the issue if you want to read up on it: https://www.npr.org/sections/health...1885/medicare-advantage-overcharges-exploding

Of course, it's a "management" problem by Medicare/government and no fault of a person on the plan. Not sure if anything has been done to curb expenses since the 2021 when this was published but it was being looked at and was known problem.

The elephant in the room is that Medicare Advantage Plans have done a better job negotiating lower prices for services from Doctors and Hospitals than Medicare has. Although in my recent experience, Hospitals WAY overbill for procedures. As I have posted before, I had a cardiac albation in June. The hospital bill came to $198,000. Medicare only pays $30,000 for that procedure, and my Medigap private insurance paid $1,600. The hospital considers a $198,000 bill fully paid for $31,600.

 

[gmi3804]

I had a cardiac albation in June. The hospital bill came to $198,000. Medicare only pays $30,000 for that procedure, and my Medigap private insurance paid $1,600. The hospital considers a $198,000 bill fully paid for $31,600.

That's because it probably only cost them $20,000. (Exaggerating, of course, but only slightly.)

 

[Southernmiss]

Back on topic

Her daughter shared an encouraging update

https://people.com/mary-lou-retton-daughters-share-uplifting-health-update-8358136

 

[Disneychick75]

what i've personally experienced/witnessed regarding retirees opting into the advantage plans is in large part b/c they either don't have retiree health benefits from a private employer OR (VERY COMMON in recent years)-they retired from public service jobs that 'guaranteed' retiree health benefits but those employers no longer offer them to new hires and are doing their best to get those still eligible to opt out by choosing the most obscenely expensive plans that often have retiree premiums at obscene costs (4 figures a month for a single retiree w/no spouse or dependant covered) AND (based on evidence uncovered in a healthcare benefit lawsuit between retirees and my former government employer) are chosen by the employers to further alienate usage by limiting or entirely eliminating reasonable usage/coverage (in my case the only option was a single ppo but they had no preferred providers w/the insurance company pointing out that they are not obligated to recruit/seek them out but simply offer the opportunity for providers to sign on).

i know it's not common anymore for employers (private) to offer retiree health insurance but there was a time when straight vanilla medicare could cover a person fairly well. with the advent of costco, walmart and other lower cost resources for glasses it was'nt a huge burden to be without coverage, dental? honestly i've never had a plan private or public sector that paid a great deal so the average checkups/cleanings/xrays were/are not a big financial burden. where i see the big uptick in cost (average person/average senior meds) is perscriptions. i look at what meds cost today vs. when my mom passed in 2011 and it's insane. vs. what it was costing her with just vanilla medicare in the early 2000's it's out of control.

i opted into the advantage plan b/c i needed to drop my retiree coverage. my biggest consideration was perscriptions. the advantage plan i have offers very good coverage and still allow brick and mortar pharmacy usage-which i found that other perscription coverage plans did not (only mail order unless documented, by their criteria-urgent/emergency). if i was given the option of simply having 'vanilla medicare' and it offered just the perscription coverage i receive now-i would gladly continue to pay the additional premium i'm paying now for my advantage plan and forego all the extras they offer but largly go unused on my part.

We got the dental and vision this time but won't next go round because we've started having dental work done at the university dental clinic and we'll likely start our vision care there as well. Neither take Medicare of any type. Both are very reasonable with dental residents doing the work. Because of an accident years ago, I have a crown. It's broken down and would need replacing. I told the resident that I prefer an implant. What would have cost about $15000-$20000 by a private dentist will cost us less than $2000 at the clinic. Just posting this as a heads up for others who may be contemplating adding dental on their Medicare plan. Check your uni dental clinics as they might be much cheaper.
As for vision, I get a check up and a pair of glasses through Humana Medicare which is no biggie.
I agree with you, barkley, if traditional Medicare covered prescriptions, we'd likely just stay with that. Thing is insurance companies pay lobbyists -----> gov't big $$$$$$$ so I'm not looking for anything to change.

 

[barkley]

I agree with you, barkley, if traditional Medicare covered prescriptions, we'd likely just stay with that. Thing is insurance companies pay lobbyists -----> gov't big $$$$$$$ so I'm not looking for anything to change.

one thing we've seen with our advantage plan perscription coverage that i suspect has led to some cost savings is that some of our meds going to zero copay. stuff like cholesterol meds and others that idealy help maintain health shifted about 2 years ago to zero co-pay. i was surprised when i first learned of it while picking up some scrips but the pharmacist said several of the advantage plans had enacted it and they were seeing an uptick in the number of their senior customers regularly re-filling (hate it when i see folks picking and choosing between which meds to pickup at the pharmacy b/c they are so dang unaffordable ). saw my primary care doc a handful of months later and mentioned it-he said he was thrilled to see it b/c he saw far too many seniors for issues that regular consumption of their prescribed meds could aleviate/prevent.

we underutilize it but another cost savings benefit our plan offers is a quarterly otc allowance (via pre-paid visa card). so many things have gone from scrip to costly otc so if that allowance permits a senior to get their meds and maintain health i'm all for it.

 

[Pink Partridge]

Back on topic

Her daughter shared an encouraging update

https://people.com/mary-lou-retton-daughters-share-uplifting-health-update-8358136

Good news!

 

[Sleepy425]

We got the dental and vision this time but won't next go round because we've started having dental work done at the university dental clinic and we'll likely start our vision care there as well. Neither take Medicare of any type. Both are very reasonable with dental residents doing the work. Because of an accident years ago, I have a crown. It's broken down and would need replacing. I told the resident that I prefer an implant. What would have cost about $15000-$20000 by a private dentist will cost us less than $2000 at the clinic. Just posting this as a heads up for others who may be contemplating adding dental on their Medicare plan. Check your uni dental clinics as they might be much cheaper.
As for vision, I get a check up and a pair of glasses through Humana Medicare which is no biggie.
I agree with you, barkley, if traditional Medicare covered prescriptions, we'd likely just stay with that. Thing is insurance companies pay lobbyists -----> gov't big $$$$$$$ so I'm not looking for anything to change.

What do you need besides the bone graft and implant? Here in Conn one implant would be about $6k.
Unfortunately here in CT the dental school has a LONG waitlist, so it isn't a great option for sending our patients there.