Medicare Health Plans (insurance, homes, live in)

[donsabi]

Which Medicare Health Plans are the best for this area? I went on the Medicare website and there are so many it is hard to make a decision. I'd like to hear your thoughts on the subject both good and bad.
Thanks

[TN.RidgerunninGal]

donsabi:I work in the senior health care market and in East Tennessee it really doesn't matter what plan you have as all are accepted at the major hospitals (Weelmont and MSHA). If you have a chronic illness or at some point feel you may need the services of a skilled nursing facility (nursing home) check out the co-pays and elgilibilty and benefits first. For instance Humana Gold has co-pays up to $125.00 per day for days 1-20 of skilled care. United Health Care, Secure Horizons, and AARP Medicare Complete and John Deere (all part of United Health Care) co-pays can range from 0 - over $125.00 per day from days 1-7. The average is $15.00 per day for days 1-100. Traditional Medicare pays skilled facilities at 100% for days 1-20 and 80% days 21-100. Co-pay for medicare is $137.50 per day after day 20. The benefit of plans is in the monthly payment and drug program. So if you are healthly and do not anticipate long term or even short term rehab - and cost is a factor - look to a good plan which pays for your meds and has low co-pays for dr visits and specialists. If you don't want to gamble with your health - stick with traditional Medicare and get a supplement from BC/BS or another good company. Ask lots of questions and check with friends and family who have been the nursing home route. It can be very costly. Good luck to you.

[Mountain Sprite]

Originally Posted by HomegrowninTN

donsabi:I work in the senior health care market and in East Tennessee it really doesn't matter what plan you have as all are accepted at the major hospitals (Weelmont and MSHA). If you have a chronic illness or at some point feel you may need the services of a skilled nursing facility (nursing home) check out the co-pays and elgilibilty and benefits first. For instance Humana Gold has co-pays up to $125.00 per day for days 1-20 of skilled care. United Health Care, Secure Horizons, and AARP Medicare Complete and John Deere (all part of United Health Care) co-pays can range from 0 - over $125.00 per day from days 1-7. The average is $15.00 per day for days 1-100. Traditional Medicare pays skilled facilities at 100% for days 1-20 and 80% days 21-100. Co-pay for medicare is $137.50 per day after day 20. The benefit of plans is in the monthly payment and drug program. So if you are healthly and do not anticipate long term or even short term rehab - and cost is a factor - look to a good plan which pays for your meds and has low co-pays for dr visits and specialists. If you don't want to gamble with your health - stick with traditional Medicare and get a supplement from BC/BS or another good company. Ask lots of questions and check with friends and family who have been the nursing home route. It can be very costly. Good luck to you.

I'm in CA looking to retire in your area. When I had to put my dad in a rest home four years ago Medicare covered all of his costs, and my mom needed hospice, and they covered all of that. Is this different just in your area? I have asthma, so I may have some issues there, but the big thing for me now is the meds. Medicare covers all of my other drugs. I'm on disability so I get SSI and SSDI.

[TN.RidgerunninGal]

Medicare pays only for the first 100 days regardless of where you live. Each state has a state health plan known as medicaid. In nursing homes medicaid pays for room and board. Your social security or retirement check can be used to partially pay known as liability - $50.00 each month which given to the resident. SSi is different. There is no liability and you get $30.00 per month as a resident. With hospice, Mwdicare has a special benefit just for hospice care. In a nursing home, Medicare will pay for the hospicel care - nursing, medicines,pain control etc, but either medicaid, private insurance or private pay is used for room and board. In home hospice care is different. Hospice pays for nearly everything and is one of the best kept secrects in Medicare beecause it does not affect your Medicare hospital or N.H days eligibility. It can be confusing so always ask lots of questions.

[Mountain Sprite]

There's no such thing as a dumb question, right?
I'm in pretty good health now but I'm only 51; a lot can happen in 30+ years. This move will be the last one we make, so I have to think ahead about what to do when I do need help. I'll be leaving all of my family behind me in CA.

[donsabi]

Thanks HomegrowninTN.

Mountain Sprite,
I wouldn't worry about setting roots down until you live in an area for a year or so. I think you said you are on Medicare and if so I suggest you make sure you can find a local doctor that will accept you before going to the expense of moving here. It took me four to five months to find a doctor that accepted Medicare and I have met a few people from FL who moved back to FL because of the same reason. I suggest calling the local hospitals and asking for help finding a new doctor. Good luck!

[Mountain Sprite]

Thanks for your kind reponses to my questions. I will look into this further the closer we get. I may have to move out there first by myself to check things out, and if things pan out have DH come out later.