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I researched for over a year as I approached Medicare. Personally, my health care premiums were not bad at 64 ($300/month), but I welcomed even that cost going down when I went into Medicare.
Medicare Advantage has been an exceptional choice particularly for those of us on fixed incomes. The government made it very attractive for insurance companies to offer it. Now they regret that move, but let's not get political about it. I will only say that those of us in Medicare Advantage will not to be to keep our current coverage as we were promised we would be able to do under health care reform.
There are many Advantage plan choices and I've been very happy with mine. It is EXCELLENT coverage and not because of glasses or gym memberships. I have an Advantage PPO through United Health Care and I am dreading the day it all goes away. Right now I pay only my Part B premium of $96.40 (deducted from my SS monthly payout). And for that I receive excellent benefits.
However, under the new health care plan that will all go away. So come October when the new plans are offered, the 11 or so million of us under Advantage will be faced with huge choices because now we are going to have to pay a lot more money to receive the same medical care we now enjoy.
So things change everyday. There is no simple source to research and you have to stay on top of it particularly if your budget is tight like ours. As of this moment in Florida, supplemental plans (other than HMO's) are very costly ... in the $200/month range in addition to the $96.40. Hopefully the M and N plans that I read will be offered toward the end of the year (an alternative to Advantage) will be a little lower.
Every state has a senior health insurance counseling program that offers free assistance to all Medicare beneficiaries and those imminent of Medicare eligibility. It's likely listed under Social Services in the phone book, can certainly be found on your state aging/senior department's web site or can be reached through your local Area Agency on Aging. They will offer information and assistance at no cost and don't represent or recommend any particular Medicare supplement insurance companies, plans or programs.
Last edited by Curmudgeon; 04-28-2010 at 08:08 AM..
I think it is unrealistic to say that it is unlikely that one will wind up in a hospital. It's certainly more likely than having your house burn down - but most people have fire insurance. And the older you get - the more likely it is you will wind up in a hospital for one thing or another.
The biggest downside of Medicare Advantage plans IMO is that they are likely to work on an PPO/HMO basis - restricting your choice of doctors/hospitals. May not matter while you're healthy. But if you get sick - especially very sick - you may not want to get your care from providers or at places on your "approved" list. With regular Medicare - you can go anywhere (assuming the person/place accepts Medicare patients). Note that certain places - like the Mayo Clinic here in JAX - will accept Medicare patients - but not Medicare Advantage patients (and Mayo isn't on the list of approved places on the Medicare Advantage Plan my husband looked at). Robyn
I researched for over a year as I approached Medicare. Personally, my health care premiums were not bad at 64 ($300/month), but I welcomed even that cost going down when I went into Medicare.
Medicare Advantage has been an exceptional choice particularly for those of us on fixed incomes. The government made it very attractive for insurance companies to offer it. Now they regret that move, but let's not get political about it. I will only say that those of us in Medicare Advantage will not to be to keep our current coverage as we were promised we would be able to do under health care reform.
There are many Advantage plan choices and I've been very happy with mine. It is EXCELLENT coverage and not because of glasses or gym memberships. I have an Advantage PPO through United Health Care and I am dreading the day it all goes away. Right now I pay only my Part B premium of $96.40 (deducted from my SS monthly payout). And for that I receive excellent benefits.
However, under the new health care plan that will all go away. So come October when the new plans are offered, the 11 or so million of us under Advantage will be faced with huge choices because now we are going to have to pay a lot more money to receive the same medical care we now enjoy.
So things change everyday. There is no simple source to research and you have to stay on top of it particularly if your budget is tight like ours. As of this moment in Florida, supplemental plans (other than HMO's) are very costly ... in the $200/month range in addition to the $96.40. Hopefully the M and N plans that I read will be offered toward the end of the year (an alternative to Advantage) will be a little lower.
Note that there are 3 different price zones in Florida for Medigap coverage. The highest (by far) is south Florida. About 40% more than our rates here in most of north Florida (and some parts of north Florida are about 10% cheaper than our rates in St. Johns County). Robyn
I think it is unrealistic to say that it is unlikely that one will wind up in a hospital. It's certainly more likely than having your house burn down - but most people have fire insurance. And the older you get - the more likely it is you will wind up in a hospital for one thing or another.
The biggest downside of Medicare Advantage plans IMO is that they are likely to work on an PPO/HMO basis - restricting your choice of doctors/hospitals. May not matter while you're healthy. But if you get sick - especially very sick - you may not want to get your care from providers or at places on your "approved" list. With regular Medicare - you can go anywhere (assuming the person/place accepts Medicare patients). Note that certain places - like the Mayo Clinic here in JAX - will accept Medicare patients - but not Medicare Advantage patients (and Mayo isn't on the list of approved places on the Medicare Advantage Plan my husband looked at). Robyn
The network in my health plan is massive .... virtually everyone I look up is included as well as any hospital I would even consider being admitted in this area. I'm not speaking about HMOs because that's entirely different. I've been in PPO's exclusively before and after Medicare. I will always steer clear of HMO's as long as I can possibly do so.
And you're welcome to go outside the network. It just costs a bit more. In addition, there is a maximum out of pocket for all covered Medicare costs of (in my plan) about $3500. Plus I go to a dentist outside the network and have a really decent reimbursement for general care ... a nice bonus. These things add up!
So I may not be able to go to Mayo (which in this area I would be likely to anyway), but for what I pay I couldn't afford to without supplemental insurance. Believe me, I would much prefer to have Medicare plus supplemental; that's ideal if you can afford it. It's just that if money is an issue (which for the majority of seniors it is), then Medicare Advantage has been there for us.
And it's being taken away. Many seniors don't know this and they are in for a rude awakening when they see what's going to happen.
Going outside a network means more than a little bit more as the provider will bill full porice liely and that is what you owe. Most insrers do not apy the same to out of network preoviders except where there is one but that does make much difference when your outside the contract on providers charges.As far as coverage in POO I was on company insurance board. We always made sure the insurer was a national company that allowed insured to go to any provider within their national approved providers list.That way a person could move to a new state in retirement and just switch a new listing of providersor when traveling just call the network for a local provider getting the contract rate.Lookig at the just passed healrhcare bill is like looking at a unfinished work.The new CXBO adjusted estimate on cost means even more changes will be coming than waht aleady is planned. One cahneg I think will be here by 2014 is that all comapny contributions will be taxed as income.Its liikely not to come as a change in the healthcare bill but in tax reform after the deficit commission just started completes its work.Its not teh only benfit provided from workig or from government in combination with other income that will be taxed.
...we will know who is right, McMolly. I think you are unduly pessimistic about how much the cost of Medicare Advantage Plans will go up, but I do not know that for sure. Maybe I'll be writing on October that you were right, but for all of our sakes, I hope I am right. By the way, my opinion is not based just on wishful thinking, but is the distillation of the general slant of some articles I've read on the subject.
...we will know who is right, McMolly. I think you are unduly pessimistic about how much the cost of Medicare Advantage Plans will go up, but I do not know that for sure. Maybe I'll be writing on October that you were right, but for all of our sakes, I hope I am right. By the way, my opinion is not based just on wishful thinking, but is the distillation of the general slant of some articles I've read on the subject.
It's not even a question of whether or how much the Advantage plans will go up, it's a question about whether they will exist at all. We all know the reasons they are going the way of the Edsel, and we could debate whether it's right or wrong in a political forum, but the fact is the plans we now have are going away.
My understand is that something resembling Advantage will exist minus many of the extras, but they are going to cost similar to supplemental plans. They have to; there's no way around that.
Remember $500 billion is being extracted from Medicare (money Medicare doesn't actually have btw) to pay for insurance coverage for people who have no coverage now. So they are taking away from the elderly to give to a younger generation.
So something has to give, someone has to make up that difference. It's going to fall on the seniors and most of us are on fixed incomes and it's going to be a massive problem.
It's not a question of pessimism ... it just is what it is.
Although there is no certainty in the area of Medicare Advantage as of today - this seems to be the general consensus: "But you seniors who get additional benefits by paying for Medicare Advantage programs, will likely see some insurers either drop those programs or cut the benefits."
For someone who is making a decision - one factor to consider is that your Medigap policy rate is based on your age when you first buy it. If you buy at age 65 - you will always pay the age 65 rate. If you buy when you're older - like when you're 67 - you'll always pay for that older (higher) rate (which - at least in the case of UnitedHealthcare - is the 66-69 age bracket). Robyn
...............For someone who is making a decision - one factor to consider is that your Medigap policy rate is based on your age when you first buy it. If you buy at age 65 - you will always pay the age 65 rate. If you buy when you're older - like when you're 67 - you'll always pay for that older (higher) rate (which - at least in the case of UnitedHealthcare - is the 66-69 age bracket). Robyn
Very good point and thanks for the reminder! That's the reason this year I'll be looking at Medicare supplements instead of Advantage while I'm still in that age bracket.
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Come October...
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