topic Re: HEALTH PLANS in Wellness

HEALTH PLANS

kismet — Wed, 05 Jul 2023 05:29:55 GMT

Thinking of changing health insurance. I have Medicare with a supplement through husband's employer. I'm looking into something else. Can anyone recommend United Healthcare and which Plan. My current through the employer is expensive.

Re: HEALTH PLANS

turtle52 — Wed, 05 Jul 2023 07:08:37 GMT

It really depends what your medical needs are at the time that you select the plan. No one can make that decision for you.

When I selected a supplement for my mother who was in her 90s I took the one that covered everything 100%. Of course it was the most expensive plan but there were no deductibles and copays. She lived to be 101, was in and out of the hospital and had 2 hip replacements. This was an excellent plan for her as she paid nothing for her medical care other than her premiums.

For me I have a plan that covers all but 10% and I have to meet a small deductible. I am in good health and do not have any medical conditions so I am very happy with this plan and I have had it for 6 years. If my health was to change I would consider changing my supplement to meet my needs.

We met with an insurance broker who specializes in Medicare . There was no charge for his services and he helped us to make our decisions. We all have or had United Healthcare and I have been pleased with them. Just know that whatever plan you select can be changed at a later date. Hope this helps!

Re: HEALTH PLANS

Group 5 minus 1 — Wed, 05 Jul 2023 09:53:35 GMT

You really need to meet w/an insurance broker,maybe 1 or 2. AN independant broker not one that works for a company. One that has your interests in mind.

Re: HEALTH PLANS

Mom2Dogs — Wed, 05 Jul 2023 10:50:28 GMT

From what I understand...you can change plans but you have to be accepted by the new health plan....when I thought about switching I would have had to submit an application and may or may not be accepted also there are certain plans for different states and areas within that state...

I would contact an insurance broker to help you navigate your choices. He can let you know what is available in your area.

Re: HEALTH PLANS

kaydee50 — Wed, 05 Jul 2023 10:57:50 GMT

Agree with previous posters about speaking to someone who knows Medicare and can guide you to the best choice.

I have UHC Medicare Advantage but I have no known health problems and take no drugs. My monthly premium is $38. It offers some dental and vision coverage.

Re: HEALTH PLANS

CalminHeart — Wed, 05 Jul 2023 11:00:52 GMT

The federal government sets the rules and coverge that companies have to provide for ALL Medicare supplemental plans. Every plan is the same from company to company. Don't over-pay for coverage.

I seriously looked at United Healthcare through AARP but pay $30 less per month for the same plan with Aetna. I've been on Aetna for 13 months now and it's going quite well.

My WellCare RX policy is $7.50 a month. But I use GoodRX instead of the policy for my expensive prescription since it takes the cost down way below the WellCare co-pay.

Re: HEALTH PLANS

conlt — Wed, 05 Jul 2023 11:22:13 GMT

I have worked in healthcare x 43 years as a RN in home health care. In our business, we primarly take Medicare but we have patients with Medicare Replacement Plans. We stopped taking United Health Care patients because the reimbursment is so low, that it does not cover our costs. These patients have difficulty finding home health care at the very least.

I went on Medicare myself June 1, 2023. I have Part A, B and a supplement. My costs are a lot less than my employers insurance. I have the G supplement that pays all of what Medicare does not except for a $230 or so deductible. Based on my experience, I will never change insurance.

My mother was on the same Medicare as me except she had the F supplement with no $230 deductible. She never had a bill and was in and out of the hospital and skilled nursing facilities. She died at age 93.

I would stick to your Medicare and a supplement if you can. Look at the long term costs. What is your deductible going to be? Out of pocket costs? Will you have your choice of providers?

United Health Care aggressively tried to get me to take their Medicare Replacement Plan. I have seen to many people not get the care that I think they need. The insurance minimized the care.

I am sure some here will disagree, however I was a Director in home health for years, reviewing patient history's and physical, planning care needs. I would not put my life into United Health Care's or any Medicare replacement Plan's hands if I could avoid it.

Re: HEALTH PLANS

I am still oxox — Wed, 05 Jul 2023 12:04:36 GMT

We have Medicare and Aetna as a supplement, this supplemnt was our primary insurance before my huband retired. The premimums are close to 500 per month but I have not paid a penny since my husband retired and I broke my hip and was in rehab earlier this year

Re: HEALTH PLANS

teganslaw — Wed, 05 Jul 2023 12:14:29 GMT

UHC is always sending me flyers advertising their Dual Complete Advantage plan. One needs to have both Medicaid and Medicare to be eligible. I don't have Medicaid, so I wish they would quit bothering me. I'm fine with the supplement I have and don't want UHC. I'm thinking they make money on Dual Complete, otherwise they wouldn't advertise it so much.

Re: HEALTH PLANS

kate2357 — Wed, 05 Jul 2023 12:39:30 GMT

I agree with folks who say talk to an ind advisor to figure out what is best for you and who will explain the pros and cons of coverage options. I wish we had done that before going with UHC Medicare Advantage program. We had UHC thru work and had no idea how poor the actual MC coverage would be until my spouse needed rehab care.

If I had it to do over, I probably would select original Medicare with part G supplemental and rx coverage. Everyone's situation is different, but I really believe the MA programs, particularly UHC, are not the way to go for getting the best care if and when you need coverage for a medical event. IMO, MA is fine for basic care...like mammograms and annual wellness checks.

Good luck and I hope you find the right coverage for yourself.

Re: HEALTH PLANS

Carmie — Wed, 05 Jul 2023 13:09:04 GMT

Please be aware that you may pay more for coverage through another health insurance carrier than you do now through your husband's employer.

United Health Care and most other insurnce companies will charge you more for their insurance if you do not enroll within six months of first becoming eligible for Medicare. There is a penalty.

Also, you will have to buy a seperate coverage for RX drugs. Drug coverge is not included with a supplement.

If the employer coverge includes dental and or vision...forget about it. You will lose this coverage.

All health insurance companies sell the same Medicare supplemental insurance, but their prices are very different.

example: Jiff peanut butter 10 oz jar. Same product sold in all 50 states, but different prices for same product in every different individual store.

The best supplement is currently available is plan G. After that Plan N.

If you live in a state where providers do not have to accept the Medicare allowance as payment in full, you could be billed for the excess fee.

Example: Surgery cost $10,000. Medicare allows $6000. Medicare pays $4800. Your supplement pays $1200. Both payments equal $6000.

If your doctor does not accept, you will have to pay $4000 out of your own pocket.

If you have Plan G, the overage of $4000 will be covered, if you have Plan N, it will not be covered.

There are other plans available as well. Most do not cover the overage charge.

I personally would think twice about changing insurance. If you are really adamant about it, I would NOT talk to an insurance broker. If you buy their insurance, they will get a commission. You are not new to Medicare and are looking to replace your insurance, not buy something new.

I would call your state's health insurance assistance program ( SHIP). You can find their number by googling SHIP and your state. There is no charge and they do not have any skin in the game.

If you have any questions I can help you with, just ask.

Re: HEALTH PLANS

DSD2 — Wed, 05 Jul 2023 13:10:29 GMT

I agree with everyone who has noted that you need to speak with someone who can advise you.

When I retired (during Covid), I had no idea what to do so called an ombudsman at the Council on Aging.. The conversation was eye opening and I ended up choosing a plan I hadn't even considered. It was absolutely the right choice for me.

These professionals are familiar with all the plans and once you are able to provide your specific situation, should be able to advise you.

I wish you the best of luck!

Re: HEALTH PLANS

Sweet Kitties — Wed, 05 Jul 2023 13:17:48 GMT

All I know is an advantage plan wouldn't work for us. There's too many restrictions. I don't trust advantage plans give best care because bean counters are too involved. When my husband retires it's going to be a supplimental insurance plan.

Re: HEALTH PLANS

CelticCrafter — Wed, 05 Jul 2023 13:31:29 GMT

@conlt wrote:
I have worked in healthcare x 43 years as a RN in home health care. In our business, we primarly take Medicare but we have patients with Medicare Replacement Plans. We stopped taking United Health Care patients because the reimbursment is so low, that it does not cover our costs. These patients have difficulty finding home health care at the very least.
I went on Medicare myself June 1, 2023. I have Part A, B and a supplement. My costs are a lot less than my employers insurance. I have the G supplement that pays all of what Medicare does not except for a $230 or so deductible. Based on my experience, I will never change insurance.
My mother was on the same Medicare as me except she had the F supplement with no $230 deductible. She never had a bill and was in and out of the hospital and skilled nursing facilities. She died at age 93.
I would stick to your Medicare and a supplement if you can. Look at the long term costs. What is your deductible going to be? Out of pocket costs? Will you have your choice of providers?
United Health Care aggressively tried to get me to take their Medicare Replacement Plan. I have seen to many people not get the care that I think they need. The insurance minimized the care.
I am sure some here will disagree, however I was a Director in home health for years, reviewing patient history's and physical, planning care needs. I would not put my life into United Health Care's or any Medicare replacement Plan's hands if I could avoid it.

This happened to my neighbors and no one told them until she questioned why all of a sudden they were getting bills.

They are up in their 90's, not without health issues and would have to change doctors they used for 20-25 years.

The plan was part of a retirement package and I don't know what they finally decided to do.

Re: HEALTH PLANS

Catbelly — Wed, 05 Jul 2023 13:44:45 GMT

OMG this makes my head spin. Best bet: see a broker based on YOUR needs. It is so individualized AND depends on your State and even your zipcode. My friend in Philly has much different choices than I do across the bridge in NJ.

Re: HEALTH PLANS

Sooner — Wed, 05 Jul 2023 13:55:02 GMT

I would do a lot of research and asking questions, but I would not go to an insurance salesman. The salesman works for themselves, not YOU.

Re: HEALTH PLANS

Carmie — Wed, 05 Jul 2023 14:06:54 GMT

@conlt wrote:
I have worked in healthcare x 43 years as a RN in home health care. In our business, we primarly take Medicare but we have patients with Medicare Replacement Plans. We stopped taking United Health Care patients because the reimbursment is so low, that it does not cover our costs. These patients have difficulty finding home health care at the very least.
I went on Medicare myself June 1, 2023. I have Part A, B and a supplement. My costs are a lot less than my employers insurance. I have the G supplement that pays all of what Medicare does not except for a $230 or so deductible. Based on my experience, I will never change insurance.
My mother was on the same Medicare as me except she had the F supplement with no $230 deductible. She never had a bill and was in and out of the hospital and skilled nursing facilities. She died at age 93.
I would stick to your Medicare and a supplement if you can. Look at the long term costs. What is your deductible going to be? Out of pocket costs? Will you have your choice of providers?
United Health Care aggressively tried to get me to take their Medicare Replacement Plan. I have seen to many people not get the care that I think they need. The insurance minimized the care.
I am sure some here will disagree, however I was a Director in home health for years, reviewing patient history's and physical, planning care needs. I would not put my life into United Health Care's or any Medicare replacement Plan's hands if I could avoid it.

I think you are meaning to say Advantage Plan, not Medicare Replacement Plan.

The OP is looking to replace her Supplemental Plan with another Medicare Supplemental Plan. United Health Care sells both Supplemental plans and Advantage Plans.

Their Supplemental plans are exactly the same as the supplemental plans sold by other insurance companies. Reimbursements are the same. Supplemental plans only pay 20% of the Medicare allowances or deductibles and so payments after Medicare.

Advantage Plans can be great, or they can be pretty bad. It depends on where you live and what is offered.

I have an Advantage Plan through my employer that pays everything at 100%....everything....even dental, vision and RX drugs and even expenses out of the country. It pays 100% for in-network providers and out-of-network providers. I pay $41 a month for this plan.

I am fortunate. I retired from a health insurance company after more than 25 years.

As a whole, Supplements and Traditional Medicare are the best, but not for everyone. Some people also have limited funds and have to get something they can afford.

There is no perfect plan....except what I have and maybe Medicare and Plan F....which is no longer sold to new enrollees and doesn't include RX drugs, dental, vision or Silver Sneakers.

Insurance has become complicated, that's for sure.

Re: HEALTH PLANS

Effie54 — Wed, 05 Jul 2023 14:15:01 GMT

@conlt What company do,you use for your Medicare Part C (G plan)? We have United Healthcare Plan N. They just went up again. I don't like them much. They're reimbursements are low. I would love to know what company had the best supplement plan for Plan N or Plan G. (Not the Advantage Plan).

Re: HEALTH PLANS

Carmie — Wed, 05 Jul 2023 14:35:47 GMT

@Effie54 How can their reimbursements be low? Your Supplement pays 100% of Medicare copays and deductibles, except the Part B deductible. Medicare determines what the reimbursements are, not individual health insurance companies.

Medicare Part C is an Advantage Plan and not related to Plan N or any other supplement.

Also, you cannot shop around outside your county for Supplements or Advantage plans. You would need to call SHIP to see what is sold in your county or refer to your "Medicare and You" booklet that you receive every year.

If you move out of the area, you may keep your supplemental plan or transfer to an insurance company that sells plans at your new place if residence.

You may not keep your Advantage plan and will have to get new insurance if you move.

Re: HEALTH PLANS

drizzellla — Wed, 05 Jul 2023 15:09:56 GMT

Please check with your Doctor's office before you change insurance.companies. Like @conlt said about her Health Care Company. The office manager at our Primary Physican's office said they do not accept any patients that have a well known insurance company.

We have an insurance guy that keeps us updated regarding annual price changes In fact I just got an email about changing to one company. I would save $600 a year. But after calling the Primary Physican's office, the office manager said she never heard of them handling health insurance. The company is just getting into the health insurance business. This causes me to rethink about changing.

Please talk to your Doctor's office and an insurance person who handles health insurance. It is too important a decision not to do some homework.