Medicare Supplement Plans/Extend Health

[REWahoo]

Quote:

Originally Posted by kaneohe I am interested in learning about this aspect also.......the quick skimming that I did gave me the impression that, at least when changing from supplement to supplement, it may not be this simple and that underwriting (pre-existing conditions) could lock you into your current plan which would make it all that more important to pick wisely the first time. Can anyone confirm that this is correct or not. Also how about the other 3 combinations: 2) supplement to Advantage 3) Advantage to Advantage 4) Advantage to Supplement?

This will answer some of your questions: Medicare Part C - Medicare Advantange Plans

Scroll down to "A Few Extra Things You Should Know about Medicare Advantage Plans"

[kaneohe]

Thanks for that link, REW. I must admit I'm still confused........
when you switch to original Medicare, does that imply you can also get
a supplement in addition? Are there other times of the year that you can
switch (is there an open enrollment period when you can switch Advantage Plans, or to Supplements? The link makes it sound like the short period
in 2011 is a special one time only or does it occur every yr? Clear as mud to me and it's no where close to midnight yet.


The Linked Article
A Few Extra Things You Should Know about Medicare Advantage Plans
New—Making changes to your coverage after December 31 Between January 1–February 14, 2011, if you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare. If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

During this period, you can’t do the following:

Switch from Original Medicare to a Medicare Advantage Plan.
Switch from one Medicare Advantage Plan to another.
Switch from one Medicare Prescription Drug Plan to another.
Join, switch, or drop a Medicare Medical Savings Account Plan.

[Nords]

I've been working up a blog post on Medicare supplemental insurance for military retirees.

From the blissfully ignorant view of a military retiree down here in my 50s, you'd think that at age 65 Medicare part "B" and the military's Tricare For Life would take care of all one's medical needs. However I'm hearing that some retirees are covering their gaps with VA benefits. Others are looking for coverage for hearing aids, respiratory issues, and maintenance medications.

Still more are subject to the media's "fear, uncertainty, & despair" campaigns that drive them toward supplemental insurance policies offered by MOAA and AARP. Yet as near as I can tell those supplemental policies are just designed to ensure that a retiree has absolutely zero out-of-pocket costs... not even for doctor-visit co-pays or prescription co-pays. Meanwhile the cost of the premiums may very well be higher than the potential cost of the co-pays.

If any of you "more experienced" military retirees have advice about accessing Medicare & TFL, and whether or not supplemental insurance is necessary, I'd be happy to quote you on it.

[REWahoo]

kanehoe, you can find all the answers here: http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf

Take a look at page 68.

[MichaelB]

Quote:

Originally Posted by kaneohe Thanks for that link, REW. I must admit I'm still confused........ when you switch to original Medicare, does that imply you can also get a supplement in addition? Are there other times of the year that you can switch (is there an open enrollment period when you can switch Advantage Plans, or to Supplements? The link makes it sound like the short period in 2011 is a special one time only or does it occur every yr? Clear as mud to me and it's no where close to midnight yet. The Linked Article A Few Extra Things You Should Know about Medicare Advantage Plans New—Making changes to your coverage after December 31 Between January 1–February 14, 2011, if you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare. If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form. During this period, you can’t do the following: Switch from Original Medicare to a Medicare Advantage Plan. Switch from one Medicare Advantage Plan to another. Switch from one Medicare Prescription Drug Plan to another. Join, switch, or drop a Medicare Medical Savings Account Plan.

You have to enroll in medicare in the 3 month period before you turn 65. To enroll in a Medicare Advantage plan you have the same 3 months plus an additional 4. One you enroll in a plan, you can change by enrolling in a new plan, once per year sometime in the last 3 months (not sure of the exact dates)

[westcoast]

Medicare Advantage plans are slated to be cut because they cost the government significantly more (I've seen numbers ranging from 11-18%) than traditional Medicare. This would be fine except that apparently only about 85% of the additional dollars go to paying for healthcare. The rest stays in the pockets of the insurance companies.

[kaneohe]

Quote:

Originally Posted by REWahoo kanehoe, you can find all the answers here: http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf Take a look at page 68.

Thanks again, REW. Looks pretty much like a corporate open enrollment period in the last quarter of yr. I greatly appreciate not only the link but the driving directions.......better than Google Maps.

I'm tentatively concluding:
1) Advantage/Supplement--->Advantage: easy, no underwriting, annual open enrollment
2) Advantage/Supplement------>Supplement: possible underwriting issues

If I'm wrong, pls correct me.

[wolf]

Quote:

Originally Posted by JOHNNIE36 You are correct. A Medicare Advantage Plan may offer both HMO and PPO coverages. Like most, I prefer the PPO. We are with Secure Horizons by United Health Care. They have the AARP credential affixed but United is just paying AARP to use their name. There is no affiliation. Again, the plan depends on what's available in your area and this information is available on the Medicare.gov website. All of our doctors and surgeons belong to the Secure Horizons plan, all the hospitals and labs in my area are in the plan. It has a mail order prescription drug plan and basic dental like cleanings and exams. We continue to pay the Medicare premium and that is all. Sure, there are deductible and copays and the maximum OOP is still $4500/yr. Copay is $1 for an office visit to primary care physician (you have to pick one), $30 for specialists. I just hate paying premiums for something you may never use. Others feel the opposite. They would pay up front and not have to worry about the nickle and dime stuff.

Just curious. Which Advantage plan had no premiums? Was it HMO or PPO?
Were you able to go to your own dentist? Or was the it a
"network" dentist?

[JakeBrake]

The Megacorp I retired from furnishes retiree Medigap insurance which is in addition to Medicare Parts A&B. This Medigap policy covers dental, vision, medicine, and whatever Medicare Parts A&B does not cover. The cost for DW & me is around $60 per month (the number is blurred for the sake of anonymity).

[tjscott0]

It is important to determine the pricing method as well as the quoted premium.

METHODS:
Issue-Age-Rated--The premium is based on the age you are when you buy (are "issued") the Medigap policy.

Attained-Age-Rated Policies--The premium is based on your current age (the age you have "attained") so your premium goes up as you get older.

Community-rated --The same monthly premium is charged to everyone who has the Medigap policy, regardless of age.
---------------------------------------------------------

Its obvious that one would wish to avoid an Attained-Age-Rated-Policies.

An Issue-Age-Ratedd policy could be a problem if your insurer goes bankrupt. Then you have to find a policy at an advanced age. I don't know if it would be difficult to obtain a Community-rated policy at an advanced age.

[REWahoo]

Quote:

Originally Posted by tjscott0 It is important to determine the pricing method as well as the quoted premium. --------------------------------------------------------- Its obvious that one would wish to avoid an Attained-Age-Rated-Policies.

I'm finding very few no medigap policies that aren't Attained-Age-Rated.

[Moemg]

Quote:

Originally Posted by westcoast Medicare Advantage plans are slated to be cut because they cost the government significantly more (I've seen numbers ranging from 11-18%) than traditional Medicare. This would be fine except that apparently only about 85% of the additional dollars go to paying for healthcare. The rest stays in the pockets of the insurance companies.

This is true but even with the insurance companies skimming off some money they are doing a better job at health care than the government . Imagine the waste in that program. Plus most of our area Physicians will accept those plans Medicare without supplements not so much.

[JOHNNIE36]

Editing my post to read "$10 copay for office visit to primary care physician".

[TN_INVEST]

Quote:

Originally Posted by wolf Just curious. Which Advantage plan had no premiums? Was it HMO or PPO? Were you able to go to your own dentist? Or was the it a "network" dentist?

Rest assured, if there are no premiums, you won't get much coverage. Seems most of the $0 plans are HMOs and really seem to lack good coverage on the hospital side and the prescription drug side.

Quote:

Originally Posted by kaneohe I'm tentatively concluding: 1) Advantage/Supplement--->Advantage: easy, no underwriting, annual open enrollment 2) Advantage/Supplement------>Supplement: possible underwriting issues If I'm wrong, pls correct me.

That's my understanding too. Although I think you can also switch back from an Advantage plan to original medicare with no underwriting (and get a supplement) so long as you do it within the first year (i.e. before age 66). I also think some insurance companies have no underwriting for some of the new plans (M&N).

One thing that really seems seems to be a drawback of the Advantage plans is the doctor network. Like I said earlier, there was a big scuttle-butt a couple years back with a contract and the United Healthcare Advantage plans at one local hospital and one large physician group.

My dad had an Advantage plan and had to deal with some issues when he wanted to go to Houston for some cancer treatment (he didn't live in Texas so the network stuff became a problem).

[Moemg]

Quote:

Originally Posted by TN_INVEST . My dad had an Advantage plan and had to deal with some issues when he wanted to go to Houston for some cancer treatment (he didn't live in Texas so the network stuff became a problem).

Most health care plans have networks . I have Federal Blue Cross & Blue Shield and when I go out of network the cost skyrockets . If you pick a network with a large amount of Doctors realistically how many times in your life are you going to need to go out of network ?These plans do have provisions for emergency care when you travel.The good thing about the plan is if you do not like it you can switch .

[tjscott0]

Quote:

I'm finding very few no medigap policies that aren't Attained-Age-Rated.

I just tried at medicare website & in my zip have 1 community rated-AARP, 4 issue age-transamerican Life Insurance, National States Insurance Co, Combined Inaurance Co of America, Bankers Fidelity Life for Plan F.

AARP my only alternative for a community-rated policy. They write a limited number of plans. To determine what is available in your zip code go to:
https://www.aarpmedicareplans.com/he...rcecode=810107

Hover your mouse over plans section & go to either medigap policies or advantage plans & enter your zip to see what is offered in your area.

While I don't have any love for AARP. They do a good medigap policy that is community rated.

[REWahoo]

Quote:

Originally Posted by tjscott0 AARP my only alternative for a community-rated policy. They write a limited number of plans. To determine what is available in your zip code go to: https://www.aarpmedicareplans.com/he...rcecode=810107

Here's the message that popped up when I put in my zip:

Quote:

Materials for the AARP Medicare Supplement Insurance Plans in TX are not yet available online. Please call for complete plan information. We appreciate your patience.

This makes me uncomfortable for a couple of reasons. Not only am I not a fan of AARP, there are too many reasons to want to 'reach out and touch someone' rather than allow an online comparison.

[westcoast]

Quote:

Originally Posted by Moemg Most health care plans have networks . I have Federal Blue Cross & Blue Shield and when I go out of network the cost skyrockets . .

True of plans for the employed, but not traditional Medicare. Unless you give away your freedom of choice, you can go to any doctor or hospital who accepts Medicare assignment (their fee schedule). If you get a Medicare F supplement, you can (I believe) go to any doctor or hospital, even if they don't accept assignment.

[JOHNNIE36]

Quote:

Originally Posted by wolf Just curious. Which Advantage plan had no premiums? Was it HMO or PPO? Were you able to go to your own dentist? Or was the it a "network" dentist?

Network dentist is answer to last question. The dental benefit is not that great but better than nothing. As to the first question, there are a number of Medicare Advantage plans with no "additional" premium. You continue to pay the regular medicare premium of $115/mo. Medicare sends that amount plus a subsidy to the company offering the Advantage plan. Once you sign up for the Advantage plan, you no longer have any ties to Medicare. The Advantage plan takes care of everything. You can reverse that or go to a different Advantage plan every year. I think a post just before "wolf" was asking about an Advantage plan with a supplement. Never heard of anything like that. Why would you want to. Generally speaking, if you have Medicare alone, you would be responsible for deductibles and copays because Medicare does not cover you 100%. Hence, the supplements from some company. When I was first retired, megacorp provided the supplement through Blue Cross/Blue Shield for a premium they took out of my pension check. There are many companies out there offering supplements.

Like I said, Medicare trenafers your $115/mo premium along with a subsidy to whatever insurance company advantage plan you choose. That subsidy allows the insurance company to offer many "advantages" over just plain Medicare. The competition between those insurance companies is fierce and they are banking huge profits. That is why there is a move afoot in this administration to reduce or eliminate those subsidies.

I mentioned earlier that you should go to www.medicare.gov where you can review all the plans and make comparisons. Select two or three plans and then get into the details of those.

I disagree with TN__INVEST about not getting much coverage for zero premium. All Advantage plans must provide as much coverage as Medicare. They can't short change you there. You have to understand that the subsidy is everything to the company offering the
advantage plan. Under my Advantage plan, I get as much if not better coverage then I got with Medicare and a supplement and it's cheaper.

[TN_INVEST]

Quote:

Originally Posted by Moemg Most health care plans have networks . I have Federal Blue Cross & Blue Shield and when I go out of network the cost skyrockets . If you pick a network with a large amount of Doctors realistically how many times in your life are you going to need to go out of network ?These plans do have provisions for emergency care when you travel.The good thing about the plan is if you do not like it you can switch .

I agree about the odds being slim that you won't be able to find a good doctor in the local network, but with traditional medicare and a traditional supplement (I like the F plan), the network issue is pretty much non existent.

This isn't some scare tactic, but my dad wrestled with things when he wanted to see an out of state cancer specialist (he lived near the state border and Houston was actually a bit closer, plus Houston has a great reputation for cancer treatment). Same with one of the local hospitals in my town. It was the talk of the town for a few months as a lot of folks learned the hard way that at 65 they actually opted off of traditional medicare and went with an HMO/PPO type plan and their network of doctors and hospitals could/did change.

The advantage plans aren't terrible, but it's hard to beat complete, full coverage of an F plan supplement. Odds are, you/we will spend the last months/years of our life dealing with health issues (ain't like folks get healthier as they get older) and that could easily chew up any of the advantages of an advantage plan.

Quote:

Originally Posted by JOHNNIE36 I disagree with TN__INVEST about not getting much coverage for zero premium. All Advantage plans must provide as much coverage as Medicare. They can't short change you there. You have to understand that the subsidy is everything to the company offering the advantage plan. Under my Advantage plan, I get as much if not better coverage then I got with Medicare and a supplement and it's cheaper.

Local $0 plan has $35 in network co-pays for doctor visits, plus $75 co-pays for a bunch of their lab work (like x-rays and MRIs). Their prescription drug list is puny and that too has high deductibles and co-pays (it's been a while, but the $0 plan might not even have a drug plan). Heaven forbid you go to the hospital, then you have co-pays of about $250 a day for the first 100+ days (plus all the nickels and dimes of any work the doctors might do for you while you are in the hospital).

While they do pay for some care and they must meet Medicare's minimum threshold, remember that minimum standard merely means part A & part B of Medicare and not any of the supplements. Compared to the advantage plans and/or supplements that have premiums, I'd say the advantage plans that have $0 premiums don't provide much in the way of benefits (that's just common sense).