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Hi deductible F and the Humana/Walmart drug plan. Don't remember premiums exactly but the two are around $100 a month.
Take no meds and don't go to a doctor unless absolutely necessary so this combination has saved me thousands over the last few years.
We are both on Advantage plans. Although we pay no premium the rates really do go up every year with higher co-pays and coverage changes that drive up max out of pocket. Have to evaluate each year.
We have found this also. We will do a complete revaluation this year and compare the hospital per day co-pays more closely too. We got caught paying 280/day for a 4 day hospitalization.
I have an excellent Medicare Advantage Plan and have opted to take the better of the 2, paying $50 a month premium, rather than the cheap one (no premium) cause the cost of the PCP visit is zero and the cost of the specialists is $10. Even the PT for the hip surgery was just $10 a visit. With these prices, I can see as many specialists as I need to, whereas previously with my other advantage plan, it was $50 each time I went to the ortho, the oncologist, and the gastro guy. It adds up with all these specialists.
I love my advantage plan. All my docs are already in network and I don't have to change any of them. It's one of the good things here and I will miss it if I move. (Cigna Wellspring).
I love mine too and hope it doesn't change. I see doctors really infrequently, once a year for a physical or if something unusual happens like a sprained ankle. With a $0 premium, my primary is $15/visit, specialist $25, and my payment per day for hospital/surgery (up to day 5, and then $0) is $200/day. I'd rather pay those co-pays than a monthly premium. I can change my plan in the open enrollment period, I think it''s Oct–Dec. If I develop something serious I might change.
I am so glad, NYgal2NC that your thread started getting responses. This is something that I need to figure out in the next year and I was really hoping members would chime in.
Through my employer, I've had Kaiser Permanente for almost 33 years now and absolutely love it. Cost is the least of any medical plan offered where I work. I used to say that Kaiser is a fantastic medical plan ... for healthy people. However, I've noticed the past five years or so that they have started pushing really hard toward 'preventative medicine'. They finally figured out that it is less expensive for them to keep people healthy than it is to treat them once they get sick. They have me doing all kinds of stuff these days.
Which brings me to my quandary. When I retire next year, I'll be moving to an area that is not covered by Kaiser. I just don't know what I'm going to do. Do I go with a Supplement plan or an Advantage plan? I just don't know. Even thought about keeping a bogus address so that I could continue with Kaiser and just come back when I needed tests or something else, (but that's illegal, so won't be doing it).
A poster on page 1 provided an excellent site to look at and hopefully help you out. It will show you who to contact in whatever state you move to for information to the questions you have.
When I first went on Medicare and had to find more insurance to add to what Medicare offered, I didn't have much information on where to look and decided to go with what my friends were doing. Well, it was a mistake but I learn best by making them, I guess.
I think most of us have to go through the preventative thing, and I think it's a good idea.
I'm in Houston TX and I have regular Medicare -- and my supplemental, through my company's retirement plan, costs $100/month. Pretty good plan: $300/deductible annually, after which it pays everything that Medicare doesnt. No prescription coverage but, with GoodRX (an awesome program), I'm doing fine.
I contacted an insurance salesman to see if he could get me a better Medicare Supplemental Plan and he said no, that what I have is better than anything else available. Nice to know.
I've been paying 320/mo for a Blue Cross/Blush Shield Advantage Plan. I've already spent 1,00.00 out of pocket mostly for 100.00 MRI copays. I get my prescription statements monthly stating that BC/BS isn't paying anything toward my Rx's. I don't qualify for any low income help.
I'll definitely check out SHIP. Thanks for the info!
I think it would be helpful if those who post on this thread would include what state they live in since there is such variation in insurance from state to state.
We have found this also. We will do a complete revaluation this year and compare the hospital per day co-pays more closely too. We got caught paying 280/day for a 4 day hospitalization.
Many Advantage plans require co-insurance for hospital stays. Premiums are lower or nonexistent, max out-of-pockets are implemented (up to $8k in some cases), hopefully to put a cap on the costs. These max oops do not always succeed in capping costs however, based on comments from other CD posters over the years.
Also, unless the MA is a PPO, anyone who travels can find themselves in a real pickle should disaster strike away from home. ER/lifesaving medical is usually paid, but rehab generally not. We had a case in WI earlier this year where an UHC MA (HMO) insured wintered in Texas every year, had a heart attack. UHC covered ER/surgery, refused to pay for rehab in TX - which was expected to be lengthy. Family needed to hire a private plane to bring him home, b/c commercial airlines would not take him.
Quote:
Originally Posted by RiverBird
I love mine too and hope it doesn't change. I see doctors really infrequently, once a year for a physical or if something unusual happens like a sprained ankle. With a $0 premium, my primary is $15/visit, specialist $25, and my payment per day for hospital/surgery (up to day 5, and then $0) is $200/day. I'd rather pay those co-pays than a monthly premium. I can change my plan in the open enrollment period, I think it''s Oct–Dec. If I develop something serious I might change.
It appears from your profile, you are in Maine - so, you do have options. Most everyone else in the US, outside the six guaranteed issue states, are not so fortunate.
Anyone anywhere can switch Advantage plans during Open Enrollment. However, unless one is in a Guaranteed Issue state, once past the regular guaranteed issue period when reaching Medicare age, you cannot switch to a Medigap or switch between Medigaps thereafter without completing a health questionnaire - even during Open Enrollment - which can result in a denial or a higher premium based on health.
From a poster last year who, because of serious health issues, did extensive research. She never wanted to be in a state where she couldn't change Medigap carriers - or drop coverage and reenroll at later time, if necessary:
Quote:
Originally Posted by Never2L8
The cost AND availability of Medicare supplement policies is a huge factor for me. Having had cancer, I would have a real problem if I lived in a state that allows medical underwriting, and would feel "locked in" to the first policy/company that I chose.
However, NY and the neighboring northeastern states surrounding it are the rare "guaranteed issue" states (NY, NJ, CT, MA, VT and ME)... there is no such thing as enrollment periods and a person can add, drop, change, eliminate, buy, etc a Medigap policy at will, with no worry about ever being turned down.
NY and CT are also "community rated" states, meaning that companies cannot charge anyone more because of their age, medical history, or state of health. It's based purely on where you live and nothing else.
Premiums may be higher in these states but for some retirees, the 100% flexibility and freedom of choice as their medical insurance needs change may well be worth it. It definitely is, to me.
It appears from your profile, you are in Maine - so, you do have options. Most everyone else in the US, outside the six guaranteed issue states, are not so fortunate.
Anyone anywhere can switch Advantage plans during Open Enrollment. However, unless one is in a Guaranteed Issue state, once past the regular guaranteed issue period when reaching Medicare age, you cannot switch to a Medigap or switch between Medigaps thereafter without completing a health questionnaire - even during Open Enrollment - which can result in a denial or a higher premium based on health.
I am in Mass. on an Advantage plan, not a Medigap plan. I can change plans within my Advantage provider, or switch to another Advantage provider, during open enrollment.
But i believe you have to fill out a health questionaire to switch and they have a right to deny you.
In ny we have no questionaire and they can't deny you.
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