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Neither the wife or I had any medical insurance until we went on Medicare. I was self employed and the premiums were outrageous. Now we get supplemental insurance to cover what Medicare doesn't. We have a $0 plan with Humana. We had United Health Care but they raised the monthly fee to $29 for the same coverage that we're getting from Humana. The way these plans work is that SS sends them the monthly fee that we were paying to SS (I think it's around $112/mo) for Part B. Because we didn't take a Part D plan when we went on SS, we have to pay a late fee for drugs , it's around $18/mo. but with the Humana plan if we have our prescriptions mailed to us, there is 0 costs. During our life we just paid whatever medical costs we incurred, which fortunately was very little.
Now we get supplemental insurance to cover what Medicare doesn't. We have a $0 plan with Humana. We had United Health Care but they raised the monthly fee to $29 for the same coverage that we're getting from Humana.
The way these plans work is that SS sends them the monthly fee that we were paying to SS (I think it's around $112/mo) for Part B.
You are on an Advantage plan - and - just so you know -
the VERY LEAST the govt is sending Humana is $700/mo. - FOR EACH OF YOU - each and every month.
In some states (certain areas of FL in an around Miami), the Advantage plans receive $1,300/mo. (or more) per enrollee.
Advantage plans are huge cash cows for the private insurers. If they perform well and do as they promise, they can be convenient and less expensive than a Medigap - until you run into a chronic ailment requiring a lot of care, copays, etc. The max out-of-pocket on MA's can outstrip any Medigap F premium two-three times. And, then there are the network restrictions.
Many long discussions on Medigaps v. Advantage plans, on numerous threads, here:
which is where this thread should be. A lot of us retirees did not want retiree health insurance/Medicare moved to Health Insurance, but it was done anyway against loud objection. And, yet, now, this thread still lingers here.
Last edited by Ariadne22; 12-01-2014 at 05:21 PM..
You are on an Advantage plan - and - just so you know -
the VERY LEAST the govt is sending Humana is $700/mo. - FOR EACH OF YOU - each and every month.
In some states (certain areas of FL in an around Miami), the Advantage plans receive $1,300/mo. (or more) per enrollee.
Advantage plans are huge cash cows for the private insurers. If they perform well and do as they promise, they can be convenient and less expensive than a Medigap - until you run into a chronic ailment requiring a lot of care, copays, etc. The max out-of-pocket on MA's can outstrip any Medigap F premiums two-three times. And, then there are the network restrictions.
Many long discussions on Medigaps v. Advantage plans, on numerous threads, here:
which is where this thread should be. A lot of us retirees did not want retiree health insurance/Medicare moved to Health Insurance, but it was done anyway against loud objection. And, yet, now, this thread lingers here.
Ariadne22, over the past couple of years I have noticed that you do so many people such a great service by sharing your superior knowledge and understanding of Medicare, which is a complicated subject.
I am curious if that is simply a hobby interest of yours or if there is a professional reason for your expertise.
Ariadne22, over the past couple of years I have noticed that you do so many people such a great service by sharing your superior knowledge and understanding of Medicare, which is a complicated subject.
I am curious if that is simply a hobby interest of yours or if there is a professional reason for your expertise.
Just trying to keep the little gray cells alive. Housework bores me. Actually, since I don't doctor, the minutia and nuances of what Medicare approves or doesn't and Catch 22's of payment is an area about which I know little but, thanks to CD, the broad strokes on Medigaps/Advantage I now understand fairly well.
You are on an Advantage plan - and - just so you know -
the VERY LEAST the govt is sending Humana is $700/mo. - FOR EACH OF YOU - each and every month.
In some states (certain areas of FL in an around Miami), the Advantage plans receive $1,300/mo. (or more) per enrollee.
Advantage plans are huge cash cows for the private insurers. If they perform well and do as they promise, they can be convenient and less expensive than a Medigap - until you run into a chronic ailment requiring a lot of care, copays, etc. The max out-of-pocket on MA's can outstrip any Medigap F premium two-three times. And, then there are the network restrictions.
Many long discussions on Medigaps v. Advantage plans, on numerous threads, here:
which is where this thread should be. A lot of us retirees did not want retiree health insurance/Medicare moved to Health Insurance, but it was done anyway against loud objection. And, yet, now, this thread still lingers here.
The payment process to Medicare Advantage plans is called capitation. The amounts vary by regions, not states, and larger states have many regions. The amounts are the average of what Medicare pays for an individual on a fee for service basis within that region.
Here's a bit of trivia for you. Medicare stole the "Advantage" name from Kaiser Permanente. It's what they called their Medicare HMO plan back in the 90s.
I second Escort Rider's post: Ariadne22 and Chyvan are doing an outstanding job of informing us on this board, especially in the "Unemployment" sub-forum. Kudos to you both.
... IMHO if you go in for a checkup at our age (64) you will be asked to take a number of prescription drugs and be put on a treadmill of ever increasing costly procedures to keep the for profit hospital corps wealthy.
You always have the option to refuse drugs and/or procedures.
The whole point of insurance is that a lot of people pay in a little bit. The lucky people never get any of their money back. The unlucky people get that money, and probably wish they didn't need it.
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Actually, since I don't doctor, the minutia and nuances of what Medicare approves or doesn't and Catch 22's of payment is an area about which I know little but, thanks to CD, the broad strokes on Medigaps/Advantage I now understand fairly well.
