Tuesday, May 21, 2024

Is Medicare Good Or Bad

Don't Miss

How Much Are Humana Medicare Rates

Medicare Advantage Plans Explained: The Good, the Bad, and the Fine Print

Humana makes it easy to find their healthcare rates, displaying them right next to the plan overview as part of the comparison.

For Humana Medicare Advantage, we already noted that one plan has does not have an additional premium beyond the base Medicare premium. The second plan came in at $20.40 a month for our sample area.

The three available Part D plans start at $20.40 a month for the base plan and increase up to $82.80 a month for the most expensive, no deductible plan.

The quoting system requires a little more information for Medicare Supplement insurance rates we quoted a 65-year-old non-smoking female.

The Plan A rate came back at $188.27 a month, Plan F at $265.46 a month. With the high deductible option, Plan F came back at a much more affordable $67.20 a month.

Overall, we found Humanas rates for our sample to be mainly reasonable and even on the low side. The exception to this is the Medicare Supplement insurance rates both Plans A and F were much higher than what we have seen elsewhere. That said, the high deductible Plan F rate was lower than most other places, so the value in Humanas Medicare Supplement insurance coverage really depends on the plan.

Medicare Advantage Plans May Actually Cost Less

Even though you may still owe the Part B monthly premium, you could end up paying less overall if you have Medicare Advantage.

Your cost-sharing may also be less with a MA plan. If you only have Original Medicare, you will owe 20 percent of covered services, and Original Medicare will pay 80 percent of approved costs.

To illustrate what this looks like, lets say you see your doctor because you have the flu. Your doctor charges Medicare $100. Medicare approves the charge and you owe $20.

Many MA plans have copays of $10 or less for doctors appointments. That $10 savings for one doctors visit may not seem like much, but it adds up over time.

How Do Medicare Advantage Plans Make Money

Medicare pays Advantage carriers based on a bidding process. The carriers submit their bid based on costs per enrollee for medical services Original Medicare covers. These bids are compared to benchmark amounts and will vary from county to county.

If the bid is higher than the benchmark amount, the enrollee will pay the difference in the form of monthly premiums. This is why some Advantage plans are free and others come with a monthly premium.

Recommended Reading: Do Medicare Advantage Plans Cover Chemotherapy

Best Medicare Advantage Providers Ratings

  • Over-the-counter drug coverage
  • Other services that promote health and wellness

You cant be enrolled in a Medicare Advantage plan and Original Medicare at the same time. To obtain Medicare benefits youve earned through payroll deductions before retirement, you must choose one of these plans.

During the open enrollment period, which runs from Oct.15 to Dec. 7 each year, you can join, switch or drop a plan for your coverage to begin on Jan. 1. If youre already enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or Original Medicare during the Medicare Advantage open enrollment period, which starts on Jan. 1 and ends on March 31 annually. You can only make one switch during that time period.

If youre already enrolled in Original Medicare , you may be eligible to switch to a Medicare Advantage plan . You must be at least 65 years old or have certain disabilities, such as permanent kidney failure or amyotrophic lateral sclerosis . If the Medicare Advantage plan you choose doesnt already have prescription drug coverage, you will have the option to enroll in Part D.

Aarp Unitedhealthcare Medicare Advantage Review

SlantRight 2.0: Obamacare: Good or Bad for Medicare?

With 26% of all Medicare Advantage enrollees receiving their coverage through AARP UnitedHealthcare, it’s the largest Part C provider in the country. Because of its size, AARP UnitedHealthcare is able to offer both rate stability and a broad range of plans for every budget and lifestyle.

  • Most plans offer dental, vision, and hearing coverage

  • Unlimited virtual visits with $0 copay

  • $0 doctor visit copay for many plans

  • Above average satisfaction rating

  • Wide variety of preventive services and disease management programs

  • 24-hour nurse line

  • Most complaints filed are regarding coverage issues

  • Availability in 24 states

  • Limited online resources

AARP UnitedHealthcare provides coverage to one quarter of the 24 million Medicare beneficiaries who enrolled in a Medicare Advantage plan in 2020. Because of the size and scope of the company, AARP UnitedHealthcare is able to offer a variety of plans to meet your needs for a reasonable price.

Each plan offered by AARP UnitedHealthcare is given a star rating by Medicare. On average, the company’s plans receive three-and-a-half stars to four stars, which is considered above average but not excellent. One area that AARP UnitedHealthcare plans did receive five stars for excellence was in customer service.

Read Also: What Benefits Do You Get With Medicare

Medicare Is Good When Paired With The Right Coverage

So is Medicare good or bad? All in all, its pretty great. While no program is perfect, we see people here all the time who are spending over a thousand dollars a month on Cobra benefits. Transitioning to Medicare is a relief for them. Medicare Part A costs nothing for most people and Medicare Parts B and D are reasonably priced.

Working with a qualified agent here at Boomer Benefits will help you make the most of your Medicare benefits. Give us a call if we can help! You can reach us at 1-855-732-9055.

Editors note: this post was updated in 2021.

Should You Choose Medicare Advantage Or Original Medicare

From the perspective of peace-of-mind, original Medicare + Medigap + Medicare Plan D Drug plan can be a better financial investment if you get sick. But its definitely an investment, given the premium costs of Medigap and a Medicare Part D plan for prescription drug coverage. Like auto insurance and homeowners insurance, the goal is to budget for the most protection you can afford.

Also Check: Will Medicare Pay For Handicap Bathroom

Medicare Advantage Plans Offer Additional Coverage

More and more Americans sign up for Medicare Advantage plans each year, and enrollment is expected to keep growing in the future. In fact, enrollment was at 24.1 million in 2020.2

Medicare Advantage plans offer beneficiaries an alternative way to get Medicare benefits through plans sold by private insurance companies that contract with the Centers for Medicare & Medicaid Services .

You get all the Medicare program benefits of Part A hospital insurance and Part B medical insurance, together known as Original Medicare,* when you enroll in Medicare Advantage. Plus, many Medicare Advantage plans can also provide additional benefits at a minimal cost. These services are essential to older Americans who may otherwise go without them.

Eligibility For The Initial Coverage Election Period

The Good, the Bad, and the Rumors about Medicare Advantage Plans

To sign up for a Medicare Advantage plan:

  • You must have both Medicare Part A and Part B
  • You must permanently reside in the service area of the plan and
  • In most cases, you cant have end-stage renal diseaseEnd-Stage Renal Disease , also known as kidney failure, is a condition that causes you to need dialysis or a kidney transplant. People with ESRD are eligible for Medicare coverage regardless of age…. .

Most commonly, youre eligible for Medicare Part A and Part B:

  • At age 65.
  • As of your 25th month of disability benefits.
  • As of the first month that you start receiving disability benefits based on amyotrophic lateral sclerosis .

If you are electing to join a Special Needs Plan, you will have other eligibility criteria. A Special Needs Plan is a special type of Medicare Advantage plan for people with certain financial or healthcare needs.

Recommended Reading: What Age Am I Medicare Eligible

Does Advantage Have A Leg Up

Under President Trump, some critics contend, the Centers for Medicare and Medicaid Services, which administers Medicare, has become a cheerleader for Advantage plans at the expense of original Medicare.

Advocates and some lawmakers have complained about bias in educational and outreach materials on enrollment, and in public statements about Advantage by the agencys administrator, Seema Verma.

One flare-up was provoked by a draft release of the 2019 Medicare & You handbook, an important annual guide mailed to all enrollees and made available online. Advocates and some lawmakers criticized language describing Advantage as a less expensive alternative to original Medicare. But despite the data on patients average spending, no figures are available on their specific out-of-pocket costs.

We know absolutely nothing about what people actually pay for services, Dr. Neuman of Kaiser said. If someone is really sick and uses a lot of covered services, they could pay less with traditional Medicare coupled with a Medigap policy than they would in a Medicare Advantage plan, even after taking into account Medigap premiums.

The handbooks language was revised before its final release, but communications from the Centers for Medicare and Medicaid Services during last falls Medicare enrollment period do appear to promote Advantage plans.

There does seem to be a strong philosophical preference for private insurance over public programs in this administration, Dr. Neuman said.

Poverty And Illness In The Elderly Population

Despite general improvements in the economic situation of the elderly population over the last 3 decades, many elderly Americans continue to struggle to pay living expenses on low or modest incomes. Forty-one percent of the Nation’s 31 million elderly people living in the community have incomes below twice the Federal poverty level and 1 in 5 are poor or near-poor .

In 1994, the FPL was $7,100 per year in income for a single elderly adult and $9,000 for an elderly couple. Twelve percent of the elderly population3.7 million people had incomes below the poverty level and another 7 percent2.2 million people were near-poor with incomes between 100 and 125 percent of FPL . Together, these 5.9 million poor and near-poor people comprise Medicare’s non-institutionalized low-income elderly population. Another 1.4 million elderly reside in nursing homes and receive assistance from Medicaid .

Distribution of Elderly, by Poverty Level: 1994Percent of the Elderly Who Are Low-Income, by Age, Sex, and Race: 1994Characteristics of Elderly Medicare Beneficiaries: 1992Percent of Elderly Medicare Beneficiaries Reporting Fair or Poor Health: 1992Percent of Elderly Medicare Beneficiaries With Selected Conditions: 1992Percent of Elderly Medicare Beneficiaries Needing Help With ADL Limitations: 1992

Recommended Reading: Should I Sign Up For Medicare While Still Employed

Why Is Medicare Advantage Bad

Whether good or bad, Medicare Advantage plans have increased their presence in recent years. You probably havent been able to turn on the TV or listen to the radio without hearing someone raving about the latest and greatest updates to Medicare Advantage. Whether its Jimmy Walker or Joe Namath, these Medicare TV Commercials are confusing the heck out of folks.

Are these plans worth all the commotion? Why do some people insist that these plans are bad?

Youll have to decide that for yourself, but to help you do so, youll need to understand how Medicare Advantage plans work and how they compare to other kinds of Medicare plans on the market.

Medicares Private Option Is Gaining Popularity And Critics

Are Medicare Advantage Plans Bad?

As more Americans sign up for Medicare Advantage, detractors worry that its helping private insurers more than patients.

  • Read in app
  • Send any friend a story

    As a subscriber, you have 10 gift articles to give each month. Anyone can read what you share.

    Give this article

  • Read in app

When Ed Stein signed up for Medicare eight years ago, the insurance choice seemed like a no-brainer.

Mr. Stein, a Denver retiree, could choose original, fee-for-service Medicare or its private managed-care alternative, Medicare Advantage. He was a healthy and active 65-year-old, and he picked Advantage for its extra benefits.

The price was the same, I liked the access to gyms, and the drug plan was very good, he recalled. After a pause, he added: Never in my wildest dreams did I think Id be facing a crisis like the one Im having now.

In November, at age 72, Mr. Stein received a diagnosis of aggressive bladder cancer that would require chemotherapy and a complex surgical procedure. The doctor who he determined was the best local specialist for his condition was not in his network, so Mr. Stein decided to switch to original Medicare for 2020 a move that would allow him to see nearly any health care provider he chose.

That was when he ran up against one of the least understood implications of selecting Advantage when you enroll in Medicare: The decision is effectively irrevocable.

Recommended Reading: When Can You Start Medicare

How To Compare And Choose A Medicare Advantage Plan

Find a knowledgeable insurance agent, says Joe Valenzuela, co-owner of Vista Mutual Insurance Services in the San Francisco Bay area. Having an agent doesnt cost the member anything. Medicare insurance agents are subject matter expertsmany have spent years learning the ins and outs of each plan they represent. There are also many nuanced differences between Medicare Advantage plans. An agent can narrow down the search to only those plans that most closely align with the clients needs.

Valenzuela recommends asking what is most important to you when choosing a Medicare Advantage plan and keeping that priority top of mind. He also suggests paying attention to the fine print in the plan you select.

Once you narrow your search down to one or two plans, ook through the plans benefits line by lineyou dont want any surprises, he says. For example, a plan may have a low premium and copayments but might cost you much more each month in prescription copays.

A couple of important benefits to look at are the plans annual out-of-pocket maximum and your prescription drug costs, adds Valenzuela. Check all your medications on the plans formulary so youre aware of the prescription copayments, deductibles and any restrictions.

Champva Coverage Outside The United States

If you live or travel overseas , youll get the same benefits and coverage as if you were in the U.S.

Reimbursement for health care claims in foreign countries is based on reasonable and customary billed amounts.

Your deductible and cost share will be the same as if you were in the U.S.

Claims written in English will be processed faster because there is no need to arrange for translation.

If the billing and medical documentation is written in a foreign language, translation will be arranged at no cost to you, but takes longer to process.

All payments are made in U.S. dollars.

You May Like: Is There A Copay With Medicare Part D

Why Medicare Advantage Plans Are Bad: 7 Top Complaints

by David Bynon, December 11, 2021

One of the most common questions we get here at MedicareWireMedicareWire is a Medicare insurance consulting agency. We founded MedicareWire after seeing and hearing how confusing and frustrating it is to find, understand, and choose a plan. Our services are free to the consumer…. is, are Medicare Advantage plansMedicare Advantage , also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare …. bad? So, if youre trying to figure out the top advantages and disadvantages of Medicare Advantage plans for yourself, read on. In this article, we will explore this exceptionally important question by contrasting the private health plan option vs. Original Medicare and Medigap.

Is Supplemental Medicare Insurance A Waste Of Money

Is Medicare Advantage a Good Deal? – Good and Bad Medicare Advantage

Home / FAQs / Medigap Plans / Is Supplemental Medicare Insurance a Waste of Money

If youre on Medicare, you might be wondering if Medicare Supplement plans are worth it. Consider that Medicare only covers a portion of your medical costs, leaving you to pay the remaining balance. Add deductibles as well as copays, and suddenly Medigap premiums make sense.

Were here to help answer frequently asked questions about supplemental insurance. Youll walk away knowing whether its worth looking into Medigap, as well as other supplemental insurance.

Also Check: What Is The Cost Of Medicare Supplement Plan F

Some Plans Require Doctor Referrals

Many Medicare Advantage plans are HMOs, which require you to select a primary care provider . In most cases, your PCP will need to give you a referral before you can see a specialist.

To illustrate what this looks like, lets take the example of a man* who has a MA HMO. The man notices a mole thats changed in size and shape. He knows he needs to see a dermatologist because hes had skin cancer before, and the new mole likes like his previous carcinoma.

The man cant just go to a dermatologist, however. He needs to first make an appointment with his PCP, and the PCP can then refer him to a dermatologist. The man will owe a copay to see his PCP, and then hell need to pay the dermatologist a copay, too. Specialist copays are usually higher than PCP copays. You may pay $10 for a PCP visit, but $40 for a specialist.

On the flip side, because the man went to his primary physician first, he got a really good recommendation and was able to see one of the best dermatologists in his town on short notice. That doctor referral requirement may have brought more help than harm.**

*This example is not real and only represents a possible circumstance.

**Not all doctors will be able to see you on short notice, regardless of your plan.

Is Medicare Part D Worth It

If youre going with a Medigap plan rather than Advantage, prescription drugs wont be covered. Therefore, its advised that you enroll in a Part D plan. If you delay enrollment, you could face a penalty for the life of your policy.

If you dont take any medications, you might wonder why you would enroll in such a plan today. In reality, it can easily be worth it, considering the money you could save on future penalties.

You May Like: Does Medicare Pay For Chiropractic

More articles

Popular Articles