Medicare Advantage
01-07-2011 | 02:07 PM
#13
Joined: Feb 2004
Posts: 63,202
Likes: 3,240
From: Smalltown
$59.00??? That's dirt cheap! Is that for drugs only?
For the heck of it, I looked at the Blue Cross web site for MA. Prices are determined by where you live. An Advantage plan PPO was around $180.00, an HMO around $130.00 and the Medex Bronze was $180.00. Toss in another $55.00/month for drugs if you were on Medex, and this is on top of your Medicare premium.....
No Humana medical plans offered in our area.
For the heck of it, I looked at the Blue Cross web site for MA. Prices are determined by where you live. An Advantage plan PPO was around $180.00, an HMO around $130.00 and the Medex Bronze was $180.00. Toss in another $55.00/month for drugs if you were on Medex, and this is on top of your Medicare premium.....
No Humana medical plans offered in our area.
01-07-2011 | 02:08 PM
#14
Joined: Jul 2003
Posts: 14,440
Likes: 1,693
From: Delawhere???
Originally Posted by canberra,Jan 7 2011, 01:09 PM
I believe the typical Medicare Advantage plan is essentially an HMO... which means your choice of docs is limited to their network roster. To offset this, most Advantage plans try to sweeten the pot with some benefit goodies not typically included in traditional Medicare Parts A & B.
Lainey is spot on..... do your homework! Make sure what you choose is going to work for you.
The traditional Medicare Part A (hospital) which is virtually automatic when you turn 65, and the Part B (doctors) which you must apply for (and pay for) from Social Security and which has a current cost in the neighborhood of $90/month will allow you to use any medical provider. Those providers who 'participate' in Medicare cannot charge you more than Medicare 'allows'. Providers who do not 'participate' in Medicare are not limited in what they can charge for their services.
Medicare supplement plans, like AARP's, come in multiple flavors and costs.... you can choose how broad or limited you want that supplemental coverage to be. It is important to have a supplement that covers Part A & B deductibles (which get bigger every year), and that will cover the differences between what Medicare approves and what a provider charges if you are seen by someone who does NOT 'participate' in Medicare (subject to "reasonable & customary" guidelines). Many Blue Cross plans offer a good range of supplements, and the United Healthcare plan sponsored by AARP works quite well and is very competitive.
The last thing you need to look at is Rx coverage (assuming that is important to you). Once you get past age 65, we are pretty much limited to "Medicare Plan D" programs which again come in a variety of flavors. You can change your Plan D coverage at the end of every calendar year. Blue Cross and United Healthcare are two good sources of Plan D coverages.
If you are looking to keep your coverage as broad as possible, with full freedom to use any doctor/hospital you choose, Medicare Part B, a top supplement plan, and a decent Plan D program all together will probably wind up costing somewhere in the neighborhood of $400/mo. That cost can be reduced by picking a lesser Plan D for Rx, and one of the more limited supplements. You really do not want to go without Medicare Plan B.
'Tis fun being Vintage
Lainey is spot on..... do your homework! Make sure what you choose is going to work for you.
The traditional Medicare Part A (hospital) which is virtually automatic when you turn 65, and the Part B (doctors) which you must apply for (and pay for) from Social Security and which has a current cost in the neighborhood of $90/month will allow you to use any medical provider. Those providers who 'participate' in Medicare cannot charge you more than Medicare 'allows'. Providers who do not 'participate' in Medicare are not limited in what they can charge for their services.
Medicare supplement plans, like AARP's, come in multiple flavors and costs.... you can choose how broad or limited you want that supplemental coverage to be. It is important to have a supplement that covers Part A & B deductibles (which get bigger every year), and that will cover the differences between what Medicare approves and what a provider charges if you are seen by someone who does NOT 'participate' in Medicare (subject to "reasonable & customary" guidelines). Many Blue Cross plans offer a good range of supplements, and the United Healthcare plan sponsored by AARP works quite well and is very competitive.
The last thing you need to look at is Rx coverage (assuming that is important to you). Once you get past age 65, we are pretty much limited to "Medicare Plan D" programs which again come in a variety of flavors. You can change your Plan D coverage at the end of every calendar year. Blue Cross and United Healthcare are two good sources of Plan D coverages.
If you are looking to keep your coverage as broad as possible, with full freedom to use any doctor/hospital you choose, Medicare Part B, a top supplement plan, and a decent Plan D program all together will probably wind up costing somewhere in the neighborhood of $400/mo. That cost can be reduced by picking a lesser Plan D for Rx, and one of the more limited supplements. You really do not want to go without Medicare Plan B.
'Tis fun being Vintage
Looking forward to seeing you and Carole at the MWG!!!
01-07-2011 | 02:23 PM
#15
Thread Starter
Joined: Sep 2005
Posts: 3,169
Likes: 22
I believe that this is the plan that Mike is talking about: This plan is $52. in my zip code.
https://www.humana-medicare.com/Plan...e/details.aspx
https://www.humana-medicare.com/Plan...e/details.aspx
01-07-2011 | 02:38 PM
#16
Registered User
Joined: Mar 2005
Posts: 12,471
Likes: 0
From: Flintstone GA
[QUOTE=Lainey,Jan 7 2011, 06:07 PM] $59.00??? That's dirt cheap! Is that for drugs only?
For the heck of it, I looked at the Blue Cross web site for MA. Prices are determined by where you live.
For the heck of it, I looked at the Blue Cross web site for MA. Prices are determined by where you live.
01-07-2011 | 02:48 PM
#17
Thread Starter
Joined: Sep 2005
Posts: 3,169
Likes: 22
Mike, is the plan that I posted the one that you have? There is one other plan that is $61.00, locally. That may be the one you have. 100% for drugs.
https://www.humana-medicare.com/Plan...e/details.aspx
https://www.humana-medicare.com/Plan...e/details.aspx
01-07-2011 | 03:39 PM
#18
Registered User
Joined: Mar 2005
Posts: 12,471
Likes: 0
From: Flintstone GA
Hell - the link I posted isn't the same page now. 
Try starting here:
http://www.humana-medicare.com/ad/index.as...tAFzEz+Fwpbgzyw
and see if we're apples to apples after you enter your zip code.
Try starting here:
http://www.humana-medicare.com/ad/index.as...tAFzEz+Fwpbgzyw
and see if we're apples to apples after you enter your zip code.
01-07-2011 | 07:19 PM
#20
Joined: Oct 2000
Posts: 18,875
Likes: 31
From: Philly (Narberth)
I've been laboring over all of this for several months, and can offer you some pretty good observations, Glenn.
1. The Advantage plans are cheap, but you "get what you pay for". Also, they provide little coverage if you travel OUTSIDE of your home base for any length of time. They also limit your MD choices to their network, and may not included docs that you are currently using. These plans are most in FLUX due to Healthcare Reform, so some are being cancelled; the companies are not SURE that they'll have the Gravy Train any longer. I decided NOT to consider these "Part C" plans for the above reasons...and that greatly SIMPLIFIES your choice process.
2. Medigap Programs: These are the alphabet series PLANS...not to be confused with the alphabet series PARTS
Living in a pretty urbanized area, there are lots of brokers in this area who seem to get your name/address from Social Security or other source. Most people go with PLAN "C" or PLAN "F". After review with a broker who came right to the house, I went with PLAN "F" from Mutual of Omaha. It's $$$ at $172/month but covers most everything that Part A and Part B of "original Medicare" do not pay for. Out of pocket costs should be very little. I believe that you can go to almost any doc. Btw, all of these alpha PLANS provide the same fixed benefits....so the only thing that varies is the premium. If you work with a broker, the plan can usually be CHANGED in the future...if you think the premium has gone up more than it should. I believe that all of these plans are regulated by your own State Insurance department, so it may be hard to get comparative premiun info.
3. Part D (Rx plans enacted during the Geo W Bush years...surprise!): This one might look confusing but it's easy. Go to www.medicare.gov and sign up on their secure site to get a user name, password, etc. THEN you run through a screening process where you list ZIP code and any regular Rx that you are currently taking (there is a menu with any drug and dosage under the sun); you also have the option of listing your regular nearby pharmacy. Hit the ENTER button and the software will display the most cost effective Part D Rx plan for you in your area, and will TELL you the total annual cost for the plan AND your deductible AND your copays. You can "test" this process w/o any obligation; no info is saved in the system. When you decide what you want to DO, there is an ENROLL button and link built into the website. My plan costs $26/mon in our area. It's hard to believe that the Federal government could design a system that is this good, eh Glenn
***A doctor friend advised me two things about Part D: (1) get the cheapest plan that suits your Rx needs...no need to pay more; (2) make sure that you DO sign up within the stated window b/c otherwise you will pay an UPCHARGE as punishment for late enrollment; and (3) check back online each fall to see if you can save bucks by switching companies.***
**********************************************
As a final word, I will echo some comments of others about AARP. I was initially thinking of going with AARP....that they were "on my side". Seeing the amount of advertising (TV and thru mail) and looking at their premiums, I became convinced that their plans are NOT a bargain. They have a "discount" for the first 3 years, but then the premium goes up about 30% in year 4
I don't like any "teaser" deal like that and threw all of the AARP stuff in the trashcan. I also looked at Blue Cross, which has a huge lock on the regular company health insurance market here in the Delaware Valley; they have some extra online "wellness" bells and whistles, but you also pay for THEIR copious advertising. The premium for their plans was $38 more than my Mutual of Omaha Medigap plan.
Cost summary for my choices in the expensive Philly region:
*Part A- no cost; provided by my Uncle Sam
*Part B- $115/month in 2011
*Medigap- Plan "F"- $172/month
*Part D- $26/month
Total is thus about $315/month for very good coverage
Total cost per year (incl $310 Rx ded for the year) should be a little over $4k for the year that starts Feb 1 for me. Only additional cost would result from any new Rx that get added, but I hope that nothing comes up on this angle.
I've recited the above off the top of my head, as I've been "living" this
for the past month or two. Now I have all my ID cards, sent in my first 3 months payment for Part B in today's mail, and am ready to roll on Feb 1. I am dropping coverage under Kathy's work health insurance and her paycheck will go UP over $800/month after 1/31/11 
1. The Advantage plans are cheap, but you "get what you pay for". Also, they provide little coverage if you travel OUTSIDE of your home base for any length of time. They also limit your MD choices to their network, and may not included docs that you are currently using. These plans are most in FLUX due to Healthcare Reform, so some are being cancelled; the companies are not SURE that they'll have the Gravy Train any longer. I decided NOT to consider these "Part C" plans for the above reasons...and that greatly SIMPLIFIES your choice process.
2. Medigap Programs: These are the alphabet series PLANS...not to be confused with the alphabet series PARTS
Living in a pretty urbanized area, there are lots of brokers in this area who seem to get your name/address from Social Security or other source. Most people go with PLAN "C" or PLAN "F". After review with a broker who came right to the house, I went with PLAN "F" from Mutual of Omaha. It's $$$ at $172/month but covers most everything that Part A and Part B of "original Medicare" do not pay for. Out of pocket costs should be very little. I believe that you can go to almost any doc. Btw, all of these alpha PLANS provide the same fixed benefits....so the only thing that varies is the premium. If you work with a broker, the plan can usually be CHANGED in the future...if you think the premium has gone up more than it should. I believe that all of these plans are regulated by your own State Insurance department, so it may be hard to get comparative premiun info. 3. Part D (Rx plans enacted during the Geo W Bush years...surprise!): This one might look confusing but it's easy. Go to www.medicare.gov and sign up on their secure site to get a user name, password, etc. THEN you run through a screening process where you list ZIP code and any regular Rx that you are currently taking (there is a menu with any drug and dosage under the sun); you also have the option of listing your regular nearby pharmacy. Hit the ENTER button and the software will display the most cost effective Part D Rx plan for you in your area, and will TELL you the total annual cost for the plan AND your deductible AND your copays. You can "test" this process w/o any obligation; no info is saved in the system. When you decide what you want to DO, there is an ENROLL button and link built into the website. My plan costs $26/mon in our area. It's hard to believe that the Federal government could design a system that is this good, eh Glenn
***A doctor friend advised me two things about Part D: (1) get the cheapest plan that suits your Rx needs...no need to pay more; (2) make sure that you DO sign up within the stated window b/c otherwise you will pay an UPCHARGE as punishment for late enrollment; and (3) check back online each fall to see if you can save bucks by switching companies.***
**********************************************
As a final word, I will echo some comments of others about AARP. I was initially thinking of going with AARP....that they were "on my side". Seeing the amount of advertising (TV and thru mail) and looking at their premiums, I became convinced that their plans are NOT a bargain. They have a "discount" for the first 3 years, but then the premium goes up about 30% in year 4
I don't like any "teaser" deal like that and threw all of the AARP stuff in the trashcan. I also looked at Blue Cross, which has a huge lock on the regular company health insurance market here in the Delaware Valley; they have some extra online "wellness" bells and whistles, but you also pay for THEIR copious advertising. The premium for their plans was $38 more than my Mutual of Omaha Medigap plan.Cost summary for my choices in the expensive Philly region:
*Part A- no cost; provided by my Uncle Sam
*Part B- $115/month in 2011
*Medigap- Plan "F"- $172/month
*Part D- $26/month
Total is thus about $315/month for very good coverage
Total cost per year (incl $310 Rx ded for the year) should be a little over $4k for the year that starts Feb 1 for me. Only additional cost would result from any new Rx that get added, but I hope that nothing comes up on this angle. I've recited the above off the top of my head, as I've been "living" this
for the past month or two. Now I have all my ID cards, sent in my first 3 months payment for Part B in today's mail, and am ready to roll on Feb 1. I am dropping coverage under Kathy's work health insurance and her paycheck will go UP over $800/month after 1/31/11