Crazy Advertising for Medicare Advantage/Supplement Plans

[Golden sunsets]

I was disappointed to find that FEHB premiums are the same for retirees as active employees even though the coverage is reduced to secondary once you are eligible for Medicare. I guess you can select a lower cost plan but we haven’t looked into it. All Family members say just suck it up and pay both premiums. I need a strategy for IRMAA.

In a sense you are right that the premiums are the same, but some of the plans offered are designed for FEHB annuitants and those still employed would be crazy to sign up for that option. Aetna Direct (which we have) is an example of this. They do benefit the annuitant in that there is a $900 pp/up to $1800/fm give back to the subscriber, which in effect accounts for the fact that medicare is primary. There is also an Aetna Medicare Advantage option within the FEHB group of options, now, so that old criticism of the FEHB system is no longer applicable.

 

[Chuckanut]

My thinking on all the commercials you see, these companies are overpaid if they can afford all that TV time.

According to an article in the AARP Bulletin of 10/21 page 22).

A group called MedPac looked at expenses.

"The Commission estimates that Medicare currently spends 4 percent more per capita for beneficiaries enrolled in MA than it spends for similar enrollees in traditional fee-for-service Medicare"

MA plans dispute this.

 

[AzDreamer]

Medicare Advantage plans vary from state-to-state so what someone in Wisconsin can get doesn't matter at all to what someone in Seattle can get.

You have to talk to someone with deep-knowledge of your options to properly evaluate your choices. Someone living in your area would probably be best.

The Seattle area has over 60 MA plans and they have become much better and are more competitive than they were a few years ago. Some of the plans are better than the plan we had from our employer.

 

[Gotadimple]

OP:
Every state has a senior program that can help in selecting a health plan. These are volunteers, or paid state staff who work with you to make a selection that meets your needs. They earn no commission for their advice. Check your state Attorney General's web page.

Medicare Advantage and Medicare Supplement (Medigap) are very lucrative for the plans - as long as they follow CMS's rules and endure the bureaucratic rules. For Medigap they earn a monthly premium from the member. For MA they earn a monthly portion of the Part B premium plus $0/all of the monthly premium paid my the member.

With this cash they are expected to cover all care subject to deductibles and co-pays. SO if they can attract healthy individuals, there will be few claims other than for routine physicals and lower cost lab work. They are betting you won't get cancer or need a knee replacement. That is why both Medigap and MA compete so hard for members during open enrollment.

 

[Bigbass]

Please help me understand -

Why is Original medicare better than an advantage plan? If I can get an advantage plan with an annual $950 maximum out of pocket. Same price for in network and out of network service. How will that be different from original medicare with a good medigap plan other than the bit higher annual maximum?

I've been with Kaiser plan 40+ years, but as I'm getting closer to turning 65, I'm wondering if I should stay with Kaiser. I have no issues with Kaiser, but then again, I have not had any major health issues. It is my understanding that if I select an advantage plan, such as Kaiser, after the first year, I might have to go through underwriting before being accepted in a medigap plan. Is that correct?

 

[pb4uski]

... It's obscene that we pay decades into Medicare made part B payments only to have our government throw us to the insurance wolves. ..I'm really bent now. The kicker is so few people seem informed.

Totally wrong. You are the one that is misinformed.

Payroll taxes only support Part A... the decades that you paid payroll taxes were only for Part A, not for Part B... so you can now unbend yourself.

The difference between the two programs exists because payroll taxes finance almost all of Social Security, but only one part of Medicare, the Part A program for hospital insurance. Parts B and D (doctors and prescription drugs) don't get payroll revenues; instead, they are covered by premiums and general revenues. But that distinction often gets lost in public discussion of Medicare financing.

 

[pb4uski]

... When the fed gov finally gets around to providing this Cadillac coverage that you receive to all of us and not just an elite few, then the private companies will vanish and the annoying advertising will stop.

The fed gov is wrong to not provide access to the same retiree medical coverage to all citizens as it does to fed retirees.

Youbet: You seem quite hostile, but I'll play your game for now. Despite having coverage via Medicare + federal retiree coverage, I am still curious to figure out if the advertised claims have any merit. If they did, the premiums would be less than ours but provide more coverage, so I posited the question.


Regarding the question on coverage to annuitants versus the general public, are you seriously suggesting that the general public should receive similar coverage for the same price as a person who worked for 40+/- years for an employer who provided a subsidy for retiree health insurance as part of their benefit package? Come on. You're mixing apples and oranges.

... I'd like to see the details and have access to it as an option to the private plans I purchase. My premiums could be set the same way they set Medicare premiums. I'm not sure what that has to do with ordinary citizens having access to the same medical insurance plans that gov retirees do (at appropriate costs). And I'm not sure it's always true. In any case, I think I'm more interested in the zillions of rank and file folks than in the few who manage billion dollar budgets and a thousand employees. Thanks. That's a privilege I don't always get. But I'm not sure you understand what I'm saying. I think it's great that OP and you have fed health insurance and are therefore are bothered/offended by the private companies hawking their policies to us plebeians. And I'd also like to have access to those public plans just as I have access to Parts A and B. They could be priced to us in the same way that Parts A and B are.

I don't want to take anything, not a single thing, away from fed employees. I just want to also be allowed to participate just like I'm allowed to participate in Parts A and B.

Why not give folks access to fed retiree supplemental plans instead of having Medicare Advantage plans?

Just trying to think of ways to have the fed retirees who have fed plans not have to be bothered by the private companies hawking their products at this time of year.

The answer is simple. Golden Sunsets and others who have earned this benefit worked for many years for the federal government and earned the benefit... nothing more to it than that. Many other public employers (state, school systems, municipalities, etc.) offer similar post-employment health benefits to their long-time employees. Also, some, but an increasingly smaller number of private employers offered post-retirement health benefits too.

I'm guessing that like me, youbet didn't work for any of those employers.

I don't get the indignation. It shouldn't come as a surprise to anyone who has been paying attention.

 

[ivinsfan]

Totally wrong. You are the one that is misinformed.

Payroll taxes only support Part A... the decades that you paid payroll taxes were only for Part A, not for Part B... so you can now unbend yourself.

Good grief, you can chill a little too as we do obviously pay thru payroll taxes for part of medicare supplements be it Part A instead of Part B'... a simple it's part A funded through payroll tax not part B would have been enough.


But I actually have a question now is Part B completely stand alone as in, it's a net zero cost to Medicare? I know they change the rate every year... I noticed your quote said part B can be covered by "general revenues"..google says about 72 percent is funded through general revenue....I'm not nearly as bent now...


It's kind of like a stealth ACA credit for people on part b...

 

[Teacher Terry]

Because I retired from the state they give me up to 195/month reimbursement for health insurance/care costs. It really helps because I pay 330/month between part B and my supplements.

 

[RetiredHappy]

Please help me understand -

Why is Original medicare better than an advantage plan? If I can get an advantage plan with an annual $950 maximum out of pocket. Same price for in network and out of network service. How will that be different from original medicare with a good medigap plan other than the bit higher annual maximum?

I've been with Kaiser plan 40+ years, but as I'm getting closer to turning 65, I'm wondering if I should stay with Kaiser. I have no issues with Kaiser, but then again, I have not had any major health issues. It is my understanding that if I select an advantage plan, such as Kaiser, after the first year, I might have to go through underwriting before being accepted in a medigap plan. Is that correct?

You have 2 years, between 65 to 67 without the need to undergo underwriting to switch back to Medigap. We were with Kaiser since that was all that we had known. We moved out of CA and my husband could not get a Medigap plan since he missed the 2-year window, and he was subject to underwriting and failed. We just tried with a different insurer this month, 5 years after he was rejected, and he passed underwriting. We are thrilled and he will be on Plan F starting 1/1/22. He could not get in to see some of the best specialists the whole time he is on Medicare Advantage PPO. He has a couple of medical issues that have come up and we are waiting for first of the year to see the doctors who would only take traditional Medicare/supplement.

 

[athena53]

But I actually have a question now is Part B completely stand alone as in, it's a net zero cost to Medicare? I know they change the rate every year... I noticed your quote said part B can be covered by "general revenues"..google says about 72 percent is funded through general revenue....I'm not nearly as bent now...


It's kind of like a stealth ACA credit for people on part b...

Yes to your last sentence. Those of us with higher retirement incomes pay additional premiums on Medicare B and prescription plans- they're the IRMAA (Income-Related Monthly Adjustment Amount) surcharges. I pay double the base rate. It can go up to 4X the base rate, meaning they get no subsidies at all. It's based on Modified Adjusted Gross Income (the 15% of my SS that's not taxed and also non-taxable interest income get added to regular AGI) so very hard to "manage" your way out of it