selecting a managed care plan (health insurance, deductible, cost of)

[gogoamy]

I'm trying to help someone enroll in a Medicaid Managed Care Plan in NYC. There are so many options, it's overwhelming. Does anyone have experience with this? I'm usually good with comparing insurance options but this is too much.

The choices are: Affinity, Fidelis, HIP, Health Plus/Amerigroup, Healthfirst, MetroPlus, United Healthcare, WellCare.

Any insight appreciated!

[Kefir King]

I have the same problem with Medicare Advantage plans. This year my current plan got pricier but I stayed with it because of the old "devil you know" scenario and I have a world renowned cardiologist.

Of your choices I think I would first consider United Health Care.
What is important is that if you are really locked into a particular specialist, make sure he is on the plan.


Do you have any co-pays with the Medicaid Managed Care plans?

[gogoamy]

Originally Posted by Kefir King

I have the same problem with Medicare Advantage plans. This year my current plan got pricier but I stayed with it because of the old "devil you know" scenario and I have a world renowned cardiologist.

Of your choices I think I would first consider United Health Care.
What is important is that if you are really locked into a particular specialist, make sure he is on the plan.


Do you have any co-pays with the Medicaid Managed Care plans?

I should have clarified in the first post, United is the Community Plan and it seems like not nearly as many providers accept that one. I think the co-pays are small. Any experience with HealthPlus, HealthFirst or MetroPlus? I hear HIP is especially awful.

[Kefir King]

I guess you will have to wait until someone with Medicaid experience weighs in. I have only had private plans and then Medicare.

[city living]

Originally Posted by gogoamy

I should have clarified in the first post, United is the Community Plan and it seems like not nearly as many providers accept that one. I think the co-pays are small. Any experience with HealthPlus, HealthFirst or MetroPlus? I hear HIP is especially awful.

Do you have any favorite doctors that you go? If so, I'd check around and see if they accept these plans.

[mathjak107]

we are starting to look in to plans now. my wife goes on in august.

we are going to go with medicare and a supplemental plan. we are staying clear of advantage plans.

[Kefir King]

Originally Posted by mathjak107

we are starting to look in to plans now. my wife goes on in august.

we are going to go with medicare and a supplemental plan. we are staying clear of advantage plans.

A big plus of my (and many) Advantage Plans is the free gym. That's worth about a grand at NYSC.

If you take plain vanilla Medicare and a Supplemental you also need the Part D drug plan.

But there is no denying that a lot of the cost of Obamacare came out of slashing Medicare Advantage plans and they are not what they once were.

But still, a supplemental plan will likely cost you over $200 and the same for your wife...so that's upwards of $5 grand a year, not chump change.

There is an old saw about insurance that I think might be pertinent: Never insure your deductibles, it never pays.

[mathjak107]

heck , we were paying 14k a year for health insurance pre obama plans.

last year we went to an obama gold small business plan. we are coming in this year at about 10k, saving 5k with the gold plan. the small business plans have lower deductables and lower out of pockets than the individual plans on the exchange.

we get zero subsidy.

anything less will be a plus.... marilyn will go on medicare when i retire in july and i will cobra a single gold plan until i am old enough.

[Coney]

Originally Posted by gogoamy

I'm trying to help someone enroll in a Medicaid Managed Care Plan in NYC. There are so many options, it's overwhelming. Does anyone have experience with this? I'm usually good with comparing insurance options but this is too much.

The choices are: Affinity, Fidelis, HIP, Health Plus/Amerigroup, Healthfirst, MetroPlus, United Healthcare, WellCare.

Any insight appreciated!

Did you mean Medicare Managed Care Plans as opposed to Medicaid?

If you can, go over to the SIBIL library, bottom level. They have a bunch of brochures about it. You can also make an appointment to meet with a counselor who will go over your options and try to answer any questions. It is a free service. I can't vouch for their counselors because I have never used it, but I know that this service is available and you don't have to have a library card.