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Health Insurance Question
Old 01-10-2005, 07:39 PM   #1
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Health Insurance Question

Not sure this is the correct place in the Forum for this, but;

When I retire in a couple of years I'll have two different health insurance coverages. One will be from a large municipality and costs me virtually nothing to maintain. Out of the area of that city, and unless I'm living in certain parts of Florida, it doesn't do me much good, but, as I've said, the price is right so I'm keeping it. I will be able to keep MA BlueCross/Blue Shield when I leave the job I'm in now, paying 50% of the premium (I dunno, $5,000 a year??). That is a really good insurance, and is useable around the nation.

OK, here's the question; when transitioning to Medicare, I understand insurance premiums are greatly reduced to consumers as they now become a sort of "bridge" between what Medicare pays and what the insurance company would have paid (please correct me if I'm wrong on this stuff). Is my belief correct, and if so, what should I expect to see in a reduction in the cost of my MA BC/BS policy?

Thanks.
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Re: Health Insurance Question
Old 01-10-2005, 07:59 PM   #2
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Re: Health Insurance Question

Rich,
Sorry I can't answer the premium question but I can the other. If you have Blue Cross./Blue Shield Mass, it will be a supplemental (to Medicare) policy and coordinate to what Medicare allows or pays. And you are correct about using the BC/BS plan nationwide and some international plans as well. The other Blue plans share their discounts amongst each other which reduces your out of pocket.

Hope someone else can answer the cost part.
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Re: Health Insurance Question
Old 01-10-2005, 10:41 PM   #3
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Re: Health Insurance Question

Quote:
OK, here's the question; when transitioning to Medicare, I understand insurance premiums are greatly reduced to consumers as they now become a sort of "bridge" between what Medicare pays and what the insurance company would have paid (please correct me if I'm wrong on this stuff). Is my belief correct, and if so, what should I expect to see in a reduction in the cost of my MA BC/BS policy?
Rich, it varies but here is an example based on the BC/BS policy I have at the moment:

Cost for single plan without Medicare: $493/month
Cost for a single plan with Medicare: $266/month

The family plan premium is reduced by a little more than half ($1153 vs. $532) assuming both are getting Medicare.

As I scan the various plans, it appears that's pretty common; the cost is reduced by roughly half, sometimes a little more than half, sometimes a little less. It appears there are slightly higher Medicare related premium reductions in the fee-for-service plans, and smaller reductions in the HMO plans.
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Re: Health Insurance Question
Old 01-11-2005, 08:51 AM   #4
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Re: Health Insurance Question

So it would appear that whatever the premium I'll be paying when I transition to Medicare, the cost will be, roughly, half.

Thanks all.
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Re: Health Insurance Question
Old 01-11-2005, 09:33 AM   #5
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Re: Health Insurance Question

It depends on the area and the coverage. What you're buying is called a 'medigap' policy, at least in my area. I was looking at them for my Dad last year.

What they do is pay the difference between what medicare pays and what the dr. charges, hence the 'gap' nomenclature.

There are a number of plans, usually denoted by a letter, such as 'medigap A', 'medigap H'. Between suppliers the letter seems to offer the same coverage, eg, one medigap H from pacificare is similar to medigap H from BC/BS.

Some have prescription drugs, some do not, etc.

Cheapest coverage for him ran around a hundred bucks. A fully comprehensive gap filler plan was close to $300.

He found the best deal going with an HMO gap policy. He went with Kaiser Permanente here in No Cal. I believe they're charging him around $80. He pays about a $20-30 co-pay for each visit, although seeing the doctor who recommends a blood test and an x-ray counts as 3 visits. They appear to be holding the pricing steady and just increasing the co-pays to stave off hypochondria. Its nice because there's no paperwork and the cost is very good.

You might therefore look into HMO gap policies to increase your coverage at lower costs. Check with kaiser if they're in your area...I had my coverage with them for the last 3 years until I went on my wifes BC/BS plan and I liked them. Others have had bad experiences with them,
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Re: Health Insurance Question
Old 01-11-2005, 10:57 AM   #6
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Re: Health Insurance Question

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So it would appear that whatever the premium I'll be paying when I transition to Medicare, the cost will be, roughly, half.

Thanks all.
Yes, that's about right for my area as it stands in 2005. This assumes you have good coverage and plan to keep it. What the future holds is a very big question mark. Medicare is in trouble.
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