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I'm going on orig. medicare starting Dec. 1, so I'm shopping for both a supplement plan, & a prescription drug plan. So far I've looked at mainly the 3 supplement plans in the heading:
AARP (united Health) plan N is $119/month, plan F is $182 (not sure if they were quoting me 2016 rates?). The AARP person was telling me the plan N makes more sense.
The Humana plan F high deductible is around $68. Their N & F plans are quite a bit higher than the United Health ones.
I'm 65, reasonably healthy (I think), on a few prescription meds (I know, I need a Plan D for that), but all generics (for now). I have to go to my Dr. every so often, & she always orders a bunch of blood tests, etc., or an Urgent Care place only occasionally (like for Bronchitis). Also my PCP is always coming up with more & more reasons for me to go to specialists & get extensive tests. A couple of years ago it was 2 echo-cardiograms, now it's an endoscopy, & then I'm sure the G/I Dr. will want to do every other test or procedure they can bill medicare for.
(In case that gives people an idea of what plan might be best for me). I'm leaning toward the AARP (united Health) plan N.
Prescription drug plans: the Humana Walmart RX plan seems appealing. It's $18.40 a month. There are 2 Walmarts each w/in 10 miles of me. I think there's a mail order feature with that plan too?--I need to look into it more. Anyone here have that plan?
There's also a Humana Preferred RX plan for $28.90. And 2 AARP prescription drug plans, at around $33 & $43.
I haven't looked up every med. I'm taking, on each plan, & tried to game it all out, & I just want to make decisions soon. Does anyone see anything wrong with picking the AARP (united Health) plan N, & the Humana Walmart RX plan? TIA for any advice!
Have you looked at Medicare Advantage plans? My husband has a blue shield plan that covers everything with few co-pays and no monthly premium. His drugs are free except for schedule 2 generics which are $10 for 90 days. You might want to check here (advantage plans cover healthcare and drugs) https://www.medicare.gov/find-a-plan...ions/home.aspx
I looked at the Humana Medicare Advantage plan. It seemed very restrictive--I could only see certain Dr.'s in NH & Maine. I live in S. NH just over the Mass. border, & my current Dr.'s are in Mass. I basically want to be able to go to any Dr. that takes Medicare (+ whatever supplement plan I pick).
AARP (united Health) plan N is $119/month, plan F is $182 (not sure if they were quoting me 2016 rates?). The AARP person was telling me the plan N makes more sense.
The Humana plan F high deductible is around $68. Their N & F plans are quite a bit higher than the United Health ones.
I'm 65, reasonably healthy (I think), on a few prescription meds (I know, I need a Plan D for that), but all generics (for now). I have to go to my Dr. every so often, & she always orders a bunch of blood tests, etc., or an Urgent Care place only occasionally (like for Bronchitis). Also my PCP is always coming up with more & more reasons for me to go to specialists & get extensive tests. A couple of years ago it was 2 echo-cardiograms, now it's an endoscopy, & then I'm sure the G/I Dr. will want to do every other test or procedure they can bill medicare for.
(In case that gives people an idea of what plan might be best for me). I'm leaning toward the AARP (united Health) plan N.
I haven't looked up every med. I'm taking, on each plan, & tried to game it all out, & I just want to make decisions soon. Does anyone see anything wrong with picking the AARP (united Health) plan N, & the Humana Walmart RX plan? TIA for any advice!
Plan N has a copay for every doctor visit - up to $20, plus you must satisfy he Medicare Part B deductible of $166 for 2016, first.
So, you will always have some medical expense in addition to the Plan N premium. You have to weigh whether those copays will exceed $590/yr. - ($756 premium differential for Plan F [which covers all Medicare-approved charges] less $166 deductible). $590 = 30 doctor visits.
In addition, Plan N does not cover excess charges. That said, MA does not permit its docs to charge excess charges - so lack of that coverage isn't all that important for you - although it could become an issue if you need specialty care at a place such as Mayo.
High-deductible Plan F (essentially catastrophic coverage which includes excess charges) requires you pay the Part B deductible of $166 and 20% copays until the $2,180 is met. Thereafter, plan pays 100%. Cost $816/yr. v. $1,428 for Plan N. Difference in premiums $612. If you don't anticipate anything major in the next few years, hd-F is the most cost effective v. Plan N. I have an hd-F. My out-of-pocket this year has been about $200.
On Part D, the Medicare site has a very good tool which should help you determine which drug plan is better for you. It doesn't take all that long to run the comparisons. Drug plans are definitely not one-size fits all. Further, you will need to compare drug plans annually, as insurers are constantly changing their formularies and moving drugs among tiers, if not eliminating them entirely.
Quote:
Originally Posted by WoodyWW
I basically want to be able to go to any Dr. that takes Medicare (+ whatever supplement plan I pick).
Good thinking. Provider flexibility is the main advantage of a Supplement. You can go anywhere, travel, see any Medicare doc - no worries about whether the plan will pay for that doctor - or for ongoing care out-of-state if you need it. If you can afford a Medigap Supplement plus Part D, by all means, stick with that. Lot less to worry about if something happens.
Last edited by Ariadne22; 11-11-2015 at 12:15 PM..
I have had the AARP Plan N for two years - mainly because I only see the doctor about once a year for a checkup. AARP sup plans are priced based upon where you live and not by your age. So, it was much less than other providers based upon my retirement state. The premium for plan N actually dropped $50 per month when I moved from PA to DE. I am OK with a $20 co pay.
I started with AARP RX super saver for Part D two years ago. I don't take any medications. The monthly cost went from $22 to $28 to now $34 in 2016 and a $360 deductible. I am now only 2 miles from a Walmart - so for 2016 I am switching to the Humana Walmart Part D plan. My monthly premium will be $18.40 AND if I should need a generic tier 1 or tier 2 drug in the coming year they are excluded from the deductible! Switching to Humana only made sense because I am near a Walmart. The closest Walmart where I had lived in PA was 15 miles away. No way I would have driven 30 miles round trip when I was sick to pick up a prescription.
The one thing I learned is you MUST review your plans every year - even if your health situation has not changed- because the plans and what they cover changes every year. Just because your plan had a drug in tier 2 this year does not mean that it will not change to tier 3 (more expensive) next year. And provider A may consider it a tier 2 drug, while provider B may consider it a tier 3 drug. Of course they may change it every year!
I was pleasantly surprised that Humana Walmart plan D excludes tier 1 and tier 2 drugs from the $360 deductible - the AARP part D plan requires you meet the deductible first for all tiers.
You MUST review your plans every year even if your health status has not changed
The one thing I learned is you MUST review your plans every year - even if your health situation has not changed- because the plans and what they cover changes every year. Just because your plan had a drug in tier 2 this year does not mean that it will not change to tier 3 (more expensive) next year. And provider A may consider it a tier 2 drug, while provider B may consider it a tier 3 drug. Of course they may change it every year!
I was pleasantly surprised that Humana Walmart plan D excludes tier 1 and tier 2 drugs from the $360 deductible - the AARP part D plan requires you meet the deductible first for all tiers.
You MUST review your plans every year even if your health status has not changed
Amen to that. I started Medicare in August 2014 and I will be starting my third different prescription plan in January. I'm even having to switch my pharmacy. My new one will have a total annual cost of $700; to stay with CVS where I have been for 20 years would cost me around $900.
It took a while to run through the costs for the different plans at the different pharmacies. No wonder so many people just stay with the same plan year after year.
I would suggest that if you are considering Humana that you also look at Aetna and how their plans work given that they are in the process of buying Humana. It probably won't make a difference for 2016 plans, but for the future. Aetna might not be available now in your area so you might have to look elsewhere just to get a feel for their plans.
High-deductible Plan F (essentially catastrophic coverage which includes excess charges) requires you pay the Part B deductible of $166 and 20% copays until the $2,180 is met. Thereafter, plan pays 100%. Cost $816/yr. v. $1,428 for Plan N. Difference in premiums $612. If you don't anticipate anything major in the next few years, hd-F is the most cost effective v. Plan N. I have an hd-F. My out-of-pocket this year has been about $200.
I found, thanks to Ariadne22, a HD Plan F for $375 a year, $33 month, I feel I made a good choice and is is for catastrophic illness only to supplement my Med A&B
I found, thanks to Ariadne22, a HD Plan F for $375 a year, $33 month, I feel I made a good choice and is is for catastrophic illness only to supplement my Med A&B
Best:
You didn't mention Part D coverage -- do you have a part D plan as well? If not, and you have an income over $17,655 (single) or $23,895 (couple), you'll be accumulating late enrollment penalties of increased Part D premium costs of 1% for every month without Part D coverage (or a Medicare Advantage plan to cover your drug costs.
Last edited by Inquring81; 11-14-2015 at 08:28 AM..
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