Medicare Advantage with MSA

[Maci]

Almost time for me to sign up for Medicare.
An agent has told me about the Advantage plan that includes the Medical Savings Account. The coverage is good anywhere that Medicare is accepted in
the country.

I’ve always been very healthy so this plan sounds really good.
I’m wondering if anyone has experience either pro or con with these relatively
new policies.

 

[REWahoo]

No experience with them but be aware the agent gets a larger commission selling an advantage plan that selling a Medicare supplement (Medigap) plan. Do your homework to be sure you know what you are buying, including co-pays, deductibles, and that you confirm the accuracy of the "good anywhere Medicare is accepted" statement.

Remember, almost everyone can say they were very healthy - until they weren't. And you are buying this policy for when you can no longer say that.

 

[travelover]

........ The coverage is good anywhere that Medicare is accepted in the country......

Ask to see that in writing. What about out of the country?

 

[youbet]

Ask to see that in writing. What about out of the country?

OP has to check his own plan documents thoroughly, but as a point of reference, my DW is on a Medicare Advantage plan whose network is any doc, facility or lab that accepts Medicare. But they're not all that way, for sure.

 

[travelover]

OP has to check his own plan documents thoroughly, but as a point of reference, my DW is on a Medicare Advantage plan whose network is any doc, facility or lab that accepts Medicare. But they're not all that way, for sure.

Right, thus my comment.

 

[MBSC]

An agent has told me about the Advantage plan that includes the Medical Savings Account. The coverage is good anywhere that Medicare is accepted in the country.

This is correct in theory but not in the real world. Unlike MA PPO/HMO plans, MSA plans do not have a provider network. For non-emergencies, CMS regulations require Medicare participating providers accepting new original Medicare patients to also accept MSA patients. Most MSA's even give the member a form letter indicating this to show providers.

However, most providers see it as just another Medicare Advantage plan and don't take it if they don't take the PPO/HMO plans. CMS is not enforcing the regulation and the member's only recourse is to see if the MSA carrier can convince the provider otherwise. IMHO, MSA plans are not ready for prime time until CMS removes them from the Medicare Advantage umbrella and enforces their regulations on provider acceptance.

You might want to take a look at Medicare supplement (Medigap) Plan G high deductible (G-HD). It has a $2340 (2020) 'deductible' but that term is misleading. It acts more like an out-of-pocket maximum. Original Medicare still pays 80% and you pay 20% of the lower Medicare approved amount until your 20% (and Part B deductible) totals $2340. Then, G-HD starts paying the 20%. Premiums usually start in the $40-$50/month range. You would need to purchase a separate Part D drug plan, as you would with most MSAs.

Remember, almost everyone can say they were very healthy - until they weren't. And you are buying this policy for when you can no longer say that.

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