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My husband has basic Medicare A&B and uses my Federal employee (retired) Blue Cross. And he has care from the VA.
I will have to sign up in two years. I expect I'll follow his lead. We rarely have bills, he has a $183 deductible from Medicare each year.
That's exactly what we have, ie, Medicare A&B with secondary insurance through my husband's federal retiree FEPBlue plan. He also uses the VA for much of his healthcare, mostly because he prefers going there, having been a VA employee for 32 yrs and he is happy with the care he as gotten.
We have no out of pocket expenses for medical care (the Medicare deductible is also covered), relatively small copays for our prescription meds, and very good customer service. It might seem that the $558 monthly premium for our Self Plus One policy is somewhat pricey, I figure it's comparable to rates (when you divide that $558 by 2 for rates for each of us) for individual Medicare supplemental plans, plus the FEPBlue covers prescription drug plans.
We've also been told that in the event Medicare denied needed services, our FEPBlue would cover them under the terms of the contract, ie, deductibles and copays would apply. I've no had occasion to see this practice in action, but it's certainly reassuring to know there is a backup plan in place.
I'm not about to change to another Medicare plan during Open Season.
Well, I'm in my initial enrollment period and just now got back from the Social Security office. I enrolled in traditional Medicare, Parts A and B. Now to decide whether or not to get part D and maybe a Medigap supplement. I can get a hi-deductible plan F in El Paso TX. for around $46.00 a month. But I have no idea how much the premium increases each year. I might not bother with one.
Advantage plans are great unless you get sick or injured and seek help out of your network. $$$$ to pay in that case. Just don’t travel to be safe
I look at the regular ongoing costs of medical care as a regular cash flow expense up to about $1K. What I have always looked at in insurance is the stop-loss amount, where once you reach that amount in co-pays and costs you are covered 100%. My current stop loss per year is about $5K even with out-of network use. Stop loss is vital, as it is what keeps people from medical bankruptcy, and I wouldn't even consider a plan without one. Between $1K and $5K would get covered from my emergency fund.
My advantage plan will be United Healthcare PPO, so network is nationwide.
you can be charged up to 110% or so of medicare limits when using an out of network provider with a ppo , instead of the negotiated rates the insurer has with its providers .
personally i much prefer the freedom of medicare and a supplement as well as having any for profit insurer dictating my course of treatment and having the final say .
Are there any websites that let you compare options? Consumers Checkbook provides a detailed FEHB (Federal Employee Health Benefits) that (for a cost) provides plan details, coverages and costs for everything offered. Even the basic FEHB web site (BENEFEDS.com) provides plan comparison info. The same for the Federal Dental and Vison plans (https://www.benefeds.com/
Doesn't anything like Consumers Checkbook exist for Medicare and Medicare Advantage plans?
As opposed to the OP's opinion I thought Medicare did a great job helping people choose the plan they want to pay for. It could have been a nightmare without the plans defined by the different letters.
you can be charged up to 110% or so of medicare limits when using an out of network provider with a ppo , instead of the negotiated rates the insurer has with its providers .
personally i much prefer the freedom of medicare and a supplement as well as having any for profit insurer dictating my course of treatment and having the final say .
Yes, so would I, but since my former employer is paying for it, they made the choice of advantage PPO, so that's what it will be, unless I find out that paying for a supplement plan and drug coverage myself could somehow be cheaper on my own than employer paid. I guess it comes down to calculating the deductibles and excess charges that I actually end up paying on the advantage vs the cost of buying supplement +Plan D on my own plus the supplement's deductibles. My head is going to probably explode after all I guess!
Advantage plans are great unless you get sick or injured and seek help out of your network. $$$$ to pay in that case. Just don’t travel to be safe
Not always true.
My advantage plan has "Passport" which, when I am gone from home, will still cover me for doctors in a different county. I used it to go back to my GI doc who is in Maricopa Co, and I live in Yavapai.
In addition, the monthly payment goes down to $43 a month from $47 starting next year.
Gap Coverage
In 2018 once you and your plan provider have spent $3,750 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 35% for brand-name drugs and 44% on generic drugs unless your plan offers additional coverage.
also it has no limit on out of pockets on drug coverage. the 6700 max out of pocket does not apply as far as i can tell.
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