Community Chat

[CelticCrafter]

@Carmie, the commercials I keep seeing about zero premium Advantage plans - what's the catch? 

My mother-in-law asked me this morning about it.

[Kachina624]

The ones we have in my area are all HMOs. 

[teganslaw]

I'm not Carmie, but in my area there were Medicare Advantage plans with no premiums. The catch: high deductibles. They ranged from $3,000 to $4,000 and were about to increase in 2021. In these plans Medicare wouldn't cover certain tests until all the dedictible had been paid off. 

Each state is different, so Advantage plans vary, but this is how it was where I live. I have a supplemental plan instead which is more within my budget. 

[CelticCrafter]

@teganslaw we have supplements too so I know very little about Advantage plans other than we didn't want one.

[quilter61]

I have a Medicare zero premium Advantage plan and I love it.   The plan I have has no deductible.   It does copays for some services, like seeing the doctor.   Last year my total out of pocket costs were less than $300.   So far all of my prescriptions have been free, they are all generic.   

[Peaches McPhee]

There is really no catch.  Generally, the less you pay, the less is  covered by the insurance company vs. YOU.  It might be just the ticket for some people (who have few medical expenses, for example).    Higher deductables, or higher copays, or just less covered overall.  

[Carmie]

I would say there is no catch.  The monthly preminum you pay out of your SS benefits for Medicare Part B is forwarded to the insurance company. (not 100% of it).

These zero preminum policies are usually offered in states where there is a large senior population.  The insurance companies make money by having a lot of subscribers.  There is money in the numbers.

In some states, like where I live in PA, the policies are usually HMO plans.  Some of them have higher copayments for services, than a PPO Advantage Plan and mostly they are not so great.

In Florida, they seem to be wonderful. There are many plans to choose from and the benefits are comprehensive with smaller copays.

These Advantage Plans are all so different and especially different depending on what state you live in and even which county in your state.

The good news is that if you choose a plan you are not happy with, you are not stuck with it.  You can change your Advantage Plan each year during open enrollment.  So every January 1, you can have a better plan if you so wish.

That make things less scary and IMO wonderful for those who are healthy today.  That can save them money on insurance and they are assured that as they got older and need more medical services, they can upgrade their coverage.

[SloopJohnB]

@Carmie @CelticCrafter  Yes, here in Florida my mother had the Advantage Plan and it was great.  Since I took care of her and overseeing all her medical and dental visits, I can say firsthand, no complaints at all.

[Love my grandkids]

I have Medicare and a GREAT supplemental plan. Advantage would not have worked for me. In 2017 all f my surgery, chemo, meds and radiation costs were covered. This includes some iron and blodd transfusions due to chemo-induced anemia and a slew of other costs.

I never paid one penny. After each chemo I had to have a chemo pump for 2 days and the cost of THAT alone was $1300 EACH time and I had it 8 times.

No way could I have paid for any of this.

If Advantage works for someone. great, but it would not have worked for me.

[lovesrecess]

What state are you in? My Medicare Advantage plan is through my pension provider...and they have changed me to three different companies in five years.