Medicare Advantage Plans for 2015 - Page 4

GrettaGarbled · ‎09-25-2014

On 10/3/2014 terrier3 said:
On 10/3/2014 Wink said:
You're right. I have been on Medicare for four years, the first two with Aetna and the last two with Blue Cross. I do check each year because as you say, their plans change. In the process of checking out these plans I saw that Aetna had a $0 monthly premium plan and I was rather skeptical and wanted to know if anyone else had such a plan. I know plans are different all across the country even different within the state.

It can be challenging to find the right plan but I'm doing a lot of research before I sign up for anything.

Plans are filed county by county - so a carrier may have different plans within your metro market.

When the Advantage plans began, they were getting such a generous amount of money from the gvt. (over 18% more than straight Medicare) that almost all offered a "0" premium plan. They also took the extra money and created "extras" to appeal to seniors, like Silver Sneakers, acupuncture, message, etc. - benefits not provided under Medicare. They did this to encourage consumers to switch to their plans.

The great experiment to see if Advantage plans would eventually cost less than standard Medicare didn't work - the private insurers have higher operating costs (CEOs making millions a year, advertising, salespeople, etc.) Now the gvt. is forcing Advantage plans to fall within specific guidelines re: percentage of premiums spent on actual CARE vs. percentage spent on administration.

So a lot of the "0" premium plans are going away and plans are being tweaked. They are private companies, so if they find that Medicare isn't profitable, they can even opt out of offering any Advantage plan in a market or a specific county.

"0" premium just means that they feel they can make a profit from just the payment they receive from Medicare to cover your medical needs in the upcoming year. Those plans also may have different drugs in different tiers, and may also have higher co-pays or restrict your network of providers and/or not allow anything except emergency care if you are traveling.

This is why annual research is so important.

Very informative post! Bravo!

kittymomNC · ‎08-09-2012

On 10/3/2014 happy housewife said:
On 10/2/2014 kittymomNC said:
Just remember that a Medicare Advantage Plan is with a private insurance company, and it is not run or controlled the same as regular Medicare although you will have the same basic benefits depending on the plan you choose. So just be sure to compare the benefits of regular Medicare, with a Medicare Supplement and a Part D Prescription plan to what your Advantage plan offers. You can go to any doctor who takes Medicare, and you can go to a specialist without being referred. And BTW, your supplemental plan pays your Medicare deductible.

I have been a very happy camper since going on regular Medicare with the supplemental plans. I haven't paid a single penny out of pocket in 6 years other than for my premiums and one prescription, and that includes a $20,000 overnight hospital bill!

Advantage plans are required to cover everything that medicare covers.

Yes, it does, as I said in my post (bolded above). Smile The difference may be in the out-of-pocket costs.

terrier3 · ‎03-10-2010

On 10/3/2014 kittymomNC said:
On 10/3/2014 happy housewife said:
On 10/2/2014 kittymomNC said:
Just remember that a Medicare Advantage Plan is with a private insurance company, and it is not run or controlled the same as regular Medicare although you will have the same basic benefits depending on the plan you choose. So just be sure to compare the benefits of regular Medicare, with a Medicare Supplement and a Part D Prescription plan to what your Advantage plan offers. You can go to any doctor who takes Medicare, and you can go to a specialist without being referred. And BTW, your supplemental plan pays your Medicare deductible.

I have been a very happy camper since going on regular Medicare with the supplemental plans. I haven't paid a single penny out of pocket in 6 years other than for my premiums and one prescription, and that includes a $20,000 overnight hospital bill!

Advantage plans are required to cover everything that medicare covers.

Yes, it does, as I said in my post (bolded above). The difference may be in the out-of-pocket costs.

Out of pocket costs, co-pays and formularies.

151949 · ‎03-09-2010

On 10/3/2014 Wink said:
HH - I took your advice and went onto Medicare.gov. Since my original post I have done some insurance shopping and have it down to two plans. With the Medicare web site you can compare the programs side by side which is a big help.

Thanks all for you suggestions.

Your welcome - glad to help out. If you want to invest some time in this there are usually ""town hall meetings"" and internet web classes done by AARP that are very informative.

kittymomNC · ‎08-09-2012

On 10/3/2014 terrier3 said:
On 10/3/2014 kittymomNC said:
On 10/3/2014 happy housewife said:
On 10/2/2014 kittymomNC said:
Just remember that a Medicare Advantage Plan is with a private insurance company, and it is not run or controlled the same as regular Medicare although you will have the same basic benefits depending on the plan you choose. So just be sure to compare the benefits of regular Medicare, with a Medicare Supplement and a Part D Prescription plan to what your Advantage plan offers. You can go to any doctor who takes Medicare, and you can go to a specialist without being referred. And BTW, your supplemental plan pays your Medicare deductible.

I have been a very happy camper since going on regular Medicare with the supplemental plans. I haven't paid a single penny out of pocket in 6 years other than for my premiums and one prescription, and that includes a $20,000 overnight hospital bill!

Advantage plans are required to cover everything that medicare covers.

Yes, it does, as I said in my post (bolded above). The difference may be in the out-of-pocket costs.

Out of pocket costs, co-pays and formularies.

Yes, you're right. I just consider all of those combined as what a person pays out of pocket. I consider my own out-of-pocket costs as what I pay for premiums for regular Medicare, a Medicare supplement, and part D, as well as what co-pays I might pay under part D (which is only one prescription that I don't get free). I've had no other out-of-pocket costs under regular Medicare, even when I had a $20,000 overnight stay in the hospital and an extremely expensive test.

151949 · ‎03-09-2010

On 10/3/2014 kittymomNC said:
On 10/3/2014 terrier3 said:
On 10/3/2014 kittymomNC said:
On 10/3/2014 happy housewife said:
On 10/2/2014 kittymomNC said:
Just remember that a Medicare Advantage Plan is with a private insurance company, and it is not run or controlled the same as regular Medicare although you will have the same basic benefits depending on the plan you choose. So just be sure to compare the benefits of regular Medicare, with a Medicare Supplement and a Part D Prescription plan to what your Advantage plan offers. You can go to any doctor who takes Medicare, and you can go to a specialist without being referred. And BTW, your supplemental plan pays your Medicare deductible.

I have been a very happy camper since going on regular Medicare with the supplemental plans. I haven't paid a single penny out of pocket in 6 years other than for my premiums and one prescription, and that includes a $20,000 overnight hospital bill!

Advantage plans are required to cover everything that medicare covers.

Yes, it does, as I said in my post (bolded above). The difference may be in the out-of-pocket costs.

Out of pocket costs, co-pays and formularies.

Yes, you're right. I just consider all of those combined as what a person pays out of pocket. I consider my own out-of-pocket costs as what I pay for premiums for regular Medicare, a Medicare supplement, and part D, as well as what co-pays I might pay under part D (which is only one prescription that I don't get free). I've had no other out-of-pocket costs under regular Medicare, even when I had a $20,000 overnight stay in the hospital and an extremely expensive test.

We considered carefully the costs of medicare premiums, medicare deductibles, and priemums for a supplements and Rx plans against what it costs us for our copays on our $0 advantage plan and decided we would save a bundle with the advantage plan. That does not mean this is the best choice for everyone, but it was best for us.

151949 · ‎03-09-2010

On 10/3/2014 kittymomNC said:
On 10/3/2014 terrier3 said:
On 10/3/2014 kittymomNC said:
On 10/3/2014 happy housewife said:
On 10/2/2014 kittymomNC said:
Just remember that a Medicare Advantage Plan is with a private insurance company, and it is not run or controlled the same as regular Medicare although you will have the same basic benefits depending on the plan you choose. So just be sure to compare the benefits of regular Medicare, with a Medicare Supplement and a Part D Prescription plan to what your Advantage plan offers. You can go to any doctor who takes Medicare, and you can go to a specialist without being referred. And BTW, your supplemental plan pays your Medicare deductible.

I have been a very happy camper since going on regular Medicare with the supplemental plans. I haven't paid a single penny out of pocket in 6 years other than for my premiums and one prescription, and that includes a $20,000 overnight hospital bill!

Advantage plans are required to cover everything that medicare covers.

Yes, it does, as I said in my post (bolded above). The difference may be in the out-of-pocket costs.

Out of pocket costs, co-pays and formularies.

Yes, you're right. I just consider all of those combined as what a person pays out of pocket. I consider my own out-of-pocket costs as what I pay for premiums for regular Medicare, a Medicare supplement, and part D, as well as what co-pays I might pay under part D (which is only one prescription that I don't get free). I've had no other out-of-pocket costs under regular Medicare, even when I had a $20,000 overnight stay in the hospital and an extremely expensive test.

We considered carefully the costs of medicare premiums, medicare deductibles, and priemums for a supplements and Rx plans against what it costs us for our copays on our $0 advantage plan and decided we would save a bundle with the advantage plan. That does not mean this is the best choice for everyone, but it was best for us.

ballyk · ‎03-09-2010

DH and I have 2 totally different companies for our Medicare advantage plans. He has no medical conditions and does not take any medication so the $0 plan works for him. I have several issues and take enough medication to fall in the donut hole so a different plan works best for me. It takes a lot of research and comparison.

kittymomNC · ‎08-09-2012

On 10/3/2014 happy housewife said:
We considered carefully the costs of medicare premiums, medicare deductibles, and priemums for a supplements and Rx plans against what it costs us for our copays on our $0 advantage plan and decided we would save a bundle with the advantage plan. That does not mean this is the best choice for everyone, but it was best for us.

I'm glad you're happy with your plan. It shows that it really does pay to do all the research and make comparisons, because as you say, what is best for one may not be best for another. I feel sorry for people who may not have the capability to understand all the different options, they can get so complicated. I hope they find someone to help them with it.

gardenman · ‎03-09-2010

The co-pays for hospitalizations are the potential bankrupting factor in the Medicare Advantage plans. If you end up with a condition that puts you into the hospital on multiple occasions in the course of a year, you can spend a lot of money out of pocket. My mother considered one, but the year before she'd been hospitalized four separate times and her out of pocket had she been using that plan would have been a big burden. There are people on those plans who will refuse to go to the hospital, even when they really need to and should be in the hospital, to avoid the out of pocket costs. She settled on a Plan N option that has a monthly premium, but protects her from big out of pocket expenses.

What you really don't want is a situation where someone who should be in the hospital refuses to go for purely monetary reasons. The Medicare Advantage plans can easily put people into those types of situations. Especially if they require multiple hospitalizations. Plans that require a monthly premium generally offer far more protection from unexpected hospitalizations.

Fly!!! Eagles!!! Fly!!!