$0 medicare advantage plans??

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I'm shopping medicare plans for my 77yo mom. She is currently on a "managed andemnity??" from UHC that my dad had from his work before he passed away in 2014. I live a state away from my mom so getting details from her about what this UHC insurance covers is like pulling teeth. She doesn't want to change due to sentimental reasons and acts all confused when I ask for the papers they sent her. BUT they are charging $350/month on top of her $130 deduction from her SSI check. Many folks around her have plans with Humana and others and are paying the $130SSI deduction + < $30/month for their insurance.

I figure if I save her the $4200/year, I would have to pick a pretty bad insurance to make her OOP expensed go up by that much with a different insurance. She does't see the doctors much but is on expensive medicine. Even some of the generics are expensive (100/month).
smirk.gif
Yes I am using the pharmacy that is best for that insurance. Outrageous that pharmacies have difference prices for medicine but that is a different topic.

I found a plan called Aetna Medicare Freedom Plan on Medicare.gov that has the lowest prices for my moms long list of prescription drugs. Thing is, it has a $0 monthly premium.

Brings up two questions.

1) How can the premiums be free and Aetna still make money?

I learned long ago that when large dollars are moving around and no-one is asking for a fee....you better look through the details.. you are betting bent. (Yes Merrill Lynch I'm looking at you...)

2) Has anyone been on this plan or evaluated it to find any glaring coverage holes compared to similar plans? From the terms I see it looks fine to me. About equal across the typical players in the New Orleans area.

Not looking for a detailed analysis just stories of people using it and any negative surprises that were not clearly spelled out in the summary pages.

thanks
 
Some of this has to do with how long the plan will pay for a care facility and what type. You need to talk to a Medicare Supplement plan expert on this.
 
1) How can the premiums be free and Aetna still make money?

I learned long ago that when large dollars are moving around and no-one is asking for a fee....you better look through the details.. you are betting bent. (Yes Merrill Lynch I'm looking at you...)

2) Has anyone been on this plan or evaluated it to find any glaring coverage holes compared to similar plans? From the terms I see it looks fine to me. About equal across the typical players in the New Orleans area.

Not looking for a detailed analysis just stories of people using it and any negative surprises that were not clearly spelled out in the summary pages.

thanks

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Aetna, or other companies offering these plans, get a set amount from the government for each patient and that's why they can charge $0 premiums. My wife and I have AARP medicare complete advantage plan and we love it. Our plan also includes drug coverage. Here's the key to these plans. They are HMO's where you have to go to the doctors, labs, clinics, hospitals in their network. We have great doctors and good hospitals so we are very happy. Check out the doctors and facilities in their network.
One more thing. These plans are required by law to cover everything Original Medicare covers. They are legit and very popular here in Arizona.
 
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I have never liked Advantage plans over supplements. Why, once you go to an advantage plan you can probably never go back to a supplement becasue you have to go through underwriting and will be rejected. Also, you save a ton on premiums with Advantage, that is until you go into a hospital and then the advantage plan is more expensive than a supplement. Advantage plans are great when you are healthy, get sick and the co pays and out of pocket costs add up. They do offer some add ons like some dental or hearing etc but you are limited to docs, out of service area stinks and if the pharmacy formulary changes you may be out of luck unlike a Part D plan where you can switch every year.
 
Five more days and we won't have to listen to has been football personalities hawking Medicare Advantage plans. Especially tired of looking at Broadway Joe trying to keep his choppers from departing while yammering on about it all being "free". Those people opting for this high powered hawking of advantage plans will get a big surprise if they ever have a major illness that puts them in the hospital. Ain't nothing free.
 
Medicare Advantage is much better than a Medigap or any employer based insurance I had. It's not zero cost, they get the sizable amount of Medicare funding as capitation fees. Never paid extra for an Advantage plan although my tax bracket is high enough to raise my Medicare costs a great deal.
 
One other thing. Last time I checked Medicare Advantage plans cap non Medicare D expenses and Medigap didn't. I've been on Medicare Advantage plans for nine years and haven't rechecked but I don't think there's a stoploss on medigaps. At least there wasn't. Think tomorrow is the enrollment deadline unless I'm getting the date confused with the ACA.
 
I'm shopping medicare plans for my 77yo mom. She is currently on a "managed andemnity??" from UHC that my dad had from his work before he passed away in 2014. I live a state away from my mom so getting details from her about what this UHC insurance covers is like pulling teeth. She doesn't want to change due to sentimental reasons and acts all confused when I ask for the papers they sent her. BUT they are charging $350/month on top of her $130 deduction from her SSI check. Many folks around her have plans with Humana and others and are paying the $130SSI deduction + < $30/month for their insurance.

I figure if I save her the $4200/year, I would have to pick a pretty bad insurance to make her OOP expensed go up by that much with a different insurance. She does't see the doctors much but is on expensive medicine. Even some of the generics are expensive (100/month).
smirk.gif
Yes I am using the pharmacy that is best for that insurance. Outrageous that pharmacies have difference prices for medicine but that is a different topic.

I found a plan called Aetna Medicare Freedom Plan on Medicare.gov that has the lowest prices for my moms long list of prescription drugs. Thing is, it has a $0 monthly premium.

Brings up two questions.

1) How can the premiums be free and Aetna still make money?

I learned long ago that when large dollars are moving around and no-one is asking for a fee....you better look through the details.. you are betting bent. (Yes Merrill Lynch I'm looking at you...)

2) Has anyone been on this plan or evaluated it to find any glaring coverage holes compared to similar plans? From the terms I see it looks fine to me. About equal across the typical players in the New Orleans area.

Not looking for a detailed analysis just stories of people using it and any negative surprises that were not clearly spelled out in the summary pages.

thanks
I was advised to stay away from these types of plans. I was told Drs. sometimes have a hard time receiving their money from said companies and Drs. frown down on them.
 
D....your Mom is obviously on Medicare Part A & B. This covers most all hospital and doctor bills as most of them have agreed with the Govt to accept what Medicare pays. Part A (hospitals) is free. Part B (doctors) is what people pay for out of their SS checks; $130 in your Mom's case. No idea what she gets for the $350 she's paying. I've found it much simpler, for me and my wife, to stay on A & B rather than go with one the Advantage plans. Some years ago when I was handling it for my Mom, it was onerous each year end to figure what was best as they sometimes changed plan offerings and costs. Fortunately the prescription costs were low. Downside is A & B does nothing for prescriptions. Sounds like that is important for your Mom. Most Advantage plans, Humana, Aetna, United (AARP), cover prescriptions. Most offer plans where you go to any Dr or Hosp you want....IOW...its not an HMO. You will likely have to pay a fee monthly for this. Otherwise, most do not charge other than what you pay for Part B.
 
Every insurance situation is different, but there are some zero cost Medicare advantage plans available that dovetail or coordinate with your Medicare B coverage and another secondary or supplemental health plan. For instance I'm signed up for Medicare B plus United Healthcare Primary Advantage for xxx dollars a month for my self plus one, and with only a phone call to United Healthcare they added on a Medicare Advantage component at no additional monthly charge. It depends on your situation.
 
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Every insurance situation is different, but there are some zero cost Medicare advantage plans available that dovetail or coordinate with your Medicare B coverage and another secondary or supplemental health plan. For instance I'm signed up for Medicare B plus United Healthcare Choice Primary for xxx dollars a month for my self plus one, and with only a phone call to United Healthcare they added on a Medicare Advantage component at no additional monthly charge. It depends on your situation.
Plan name is corrected above. My situation is different because I'm a federal retiree. My United Healthcare Choice Primary plan costs me $310 a month for self plus one, and the Medicare Advantage add on component is free. The other great benefit is that UHC will rebate us $3,470 a year from our Medicare B premiums. With my old plan, I'd be paying $431 a month with no premium rebate. As mentioned, navigating healthcare insurance is one giant morass.
 
You get what you pay for.
You are exactly right
Medicare Advantage is much better than a Medigap or any employer based insurance I had. It's not zero cost, they get the sizable amount of Medicare funding as capitation fees. Never paid extra for an Advantage plan although my tax bracket is high enough to raise my Medicare costs a great deal.
As long as you don't get really sick. With medigap Part F as long as the service is approved by medicare you pay zero. Not true with the unregulated Advantage Plans. You have obviously not done the research.
 
ugh the You are exactly right
, altho
As long as you don't get really sick. With medigap Part F as long as the service is approved by medicare you pay zero. Not true with the unregulated Advantage Plans. You have obviously not done the research.
Advantage plans have a stop loss of about $3K. My girl friend was in a teaching hospital for most of the summer. Kidney failure. Probably close to a million dollars. Only had to pay three grand not counting Medicare D charges which would be identical.
 
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