You were looking at the "regular" Aetna Advantage FEHB plan which is open to all employees regardless of being on Medicare. It is unfortunate in my opinion that they named it as such because it seems to cause some confusion (and might be why more people don't seem to be interested). The plan is a two-step process: one has to enroll in the regular plan, then contact them to enroll in the Medicare Advantage Plan option, which does have the $2400 per year reimbursement for self+one. The benefits and perks for the Medicare Advantage Plan are different from the "regular" Aetna Advantage offering. If you drill down once you go to the site you will see the retiree options of Aetna Direct and Aetna Medicare Advantage, then you can see the specific benefits. Let me know if you have any further questions.
New(er) FEHB Medicare Advantage Plans
- Thread starter zl55lz
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You were looking at the "regular" Aetna Advantage FEHB plan which is open to all employees regardless of being on Medicare. It is unfortunate in my opinion that they named it as such because it seems to cause some confusion (and might be why more people don't seem to be interested). The plan is a two-step process: one has to enroll in the regular plan, then contact them to enroll in the Medicare Advantage Plan option, which does have the $2400 per year reimbursement for self+one. The benefits and perks for the Medicare Advantage Plan are different from the "regular" Aetna Advantage offering. If you drill down once you go to the site you will see the retiree options of Aetna Direct and Aetna Medicare Advantage, then you can see the specific benefits. Let me know if you have any further questions.
Just adding to my own post--I sat in on a tele-seminar about this new UnitedHealthcare Medicare Advantage plan through FEHB SAMBA. They verified the zero cost Rx info for certain meds. In addition, they give $80 per quarter ($40 each) to a self+one couple who both opt in, for things like toothpaste, vitamins, etc. Apparently if not used in that quarter it is forfeited? Anyway, that is another $320 per year to go with the $1800 reimbursement (Standard) or $2400 (High option) per year. This is in addition to dental and vision coverage which could maybe save more per year if one is now enrolled in standalone plans but wants to switch and wants to use UHC providers? They did mention that this plan is not like the Advantage plans seen on tv, etc., but rather have regulations required by FEHB/SAMBA. Anyone interested can see the plan options by going to SAMBA and drilling down. It will link to the specific UHC plan site for SAMBA. I am not sure what all the exact differences are between the High option and Standard option other than I saw one has more reimbursement per year and what looked like somewhat better Rx copays/coinsurance. There is a significant premium difference between the two but in my opinion the Standard option looked very reasonable for what appeared to be fairly similar benefits in the Advantage option?
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Another comment about these FEHB Medicare Advantage (MA) plans: one of course still has to pay Part B IRMAA if applicable, but also Part D IRMAA as well if applicable if in these plans as far as I understand, because they do put one in Part D for Rx. Just a heads up.
Also, I was hoping these FEHB MA plans would avoid the issues for approval of services like I have heard about with the normal MA plans offered to the public, but I read today a couple of stories about the same kinds of issues with at least one of these FEHB MA plans.
I personally don't want to deal with this so I am staying with my current "regular" FEHB plan with "regular" Medicare Parts A&B. My opinion. Your situation might be different.
Also, I was hoping these FEHB MA plans would avoid the issues for approval of services like I have heard about with the normal MA plans offered to the public, but I read today a couple of stories about the same kinds of issues with at least one of these FEHB MA plans.
I personally don't want to deal with this so I am staying with my current "regular" FEHB plan with "regular" Medicare Parts A&B. My opinion. Your situation might be different.
Golden sunsets
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Boy that sounds like a confusing process. A plan within a plan. So Part D premium as well, plus B and IRMAA for both. Like you we will stick with Aetna Diect, but I appreciate the discussion. I usually try to vet the new options each year and had not done so. You've done it for me[emoji13]
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We are very pleased with Aetna Direct. Also, any comments I make are just my opinions based on my understanding of reading the materials. Different people have different needs and different plans might work for others. Plans do change so I try to review them yearly to see any new possibilities.
Some further research in my location shows the FEHB "Medicare Advantage Plans" take the top multiple spots on the Consumers' Checkbook guide site. Interesting.
These are followed by Aetna Direct, BCBS Focus, and BCBS Basic, among others.
Of note is that NALC High (as of 2023), while farther down the list and with a higher premium than many others, actually has lower costs for the "most you could pay in a year" column than most if not all other plans in our area, perhaps because of being able to sign up for Self+Family even when only for a couple (Self+Family is cheaper than Self+One for NALC High), and also the low catastrophic out of pockets for medical and Rx.
These things, in addition to NALC High's great rating, great SNF days, and interesting fact that when on Medicare A&B it also covers the situations where the provider charges over the Medicare amount and also up to the "limiting charge" extra, make it a very appealing choice in my situation. I would say at this point that it would be MY second choice after Aetna Direct, and MY first choice if I went without Part B.
These are followed by Aetna Direct, BCBS Focus, and BCBS Basic, among others.
Of note is that NALC High (as of 2023), while farther down the list and with a higher premium than many others, actually has lower costs for the "most you could pay in a year" column than most if not all other plans in our area, perhaps because of being able to sign up for Self+Family even when only for a couple (Self+Family is cheaper than Self+One for NALC High), and also the low catastrophic out of pockets for medical and Rx.
These things, in addition to NALC High's great rating, great SNF days, and interesting fact that when on Medicare A&B it also covers the situations where the provider charges over the Medicare amount and also up to the "limiting charge" extra, make it a very appealing choice in my situation. I would say at this point that it would be MY second choice after Aetna Direct, and MY first choice if I went without Part B.
Just recently read another article about how "Medicare Advantage" plans might see things differently than "Original Medicare."
Whereas Original might let the doctors on the case decide how many Skilled Nursing Facility Days are beneficial, from what I read some companies who offer Advantage plans are hiring third party companies who use some method to determine how many days are beneficial over the recommendations of the treating physician.
What is interesting is one of the biggest Advantage companies has now purchased one of these third party companies. This concerns me.
If the 100 days of SNF these companies offer are not going to be able to be used, what is the point? Who wants a panel owned by the insurance company deciding over one's doctor how many days one needs?
Hopefully the FEHB Medicare Advantage plans don't do this as well, but who knows? I personally feel much more comfortable with Original Medicare and a "Regular FEHB" plan. But, as always, that's just my opinion for our situation. Yours may be different.
Whereas Original might let the doctors on the case decide how many Skilled Nursing Facility Days are beneficial, from what I read some companies who offer Advantage plans are hiring third party companies who use some method to determine how many days are beneficial over the recommendations of the treating physician.
What is interesting is one of the biggest Advantage companies has now purchased one of these third party companies. This concerns me.
If the 100 days of SNF these companies offer are not going to be able to be used, what is the point? Who wants a panel owned by the insurance company deciding over one's doctor how many days one needs?
Hopefully the FEHB Medicare Advantage plans don't do this as well, but who knows? I personally feel much more comfortable with Original Medicare and a "Regular FEHB" plan. But, as always, that's just my opinion for our situation. Yours may be different.
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