59YO on SSDI, New to Part B, PFFS Vs PPO Vs HMO

yorkriver1

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Virginia
Least of the not so attractive options, given the specialist for RA is not in any network for MAPD. I have another client with RA who has used the same specialist on a PFFS.

The out of pocket for PFFS, if agreed to, is better than MAPD PPO.

Will check with the specialist before going with the plan, what is their decision on accepting PFFS for 2015. Medicare beneficiary covered w/spouse on group until end of 2014. Saving money, I am recommending non Medicare spouse get HSA and load it up for OOP's on Medicare covered spouse. Yes, other spouse's HSA can reimburse those expenses, Medicare eligible spouse just can't open an HSA.

No matter what I do, it will be something of an ouch compared to the Cadillac group, have to keep reminding them that they are going to be paying tax deductible dollars for the OOP's.

T65 for this one can't come too soon.
 
I have a number of clients that are losing their beloved individual plan. Quite a few of them had the Humana Monogram with $7500 deductible. H is offering them $4850 ded for 2x (or more) current premium.

Even moving them to $6300 Bronze doesn't move the premium needle downward by much.
 
I was talking Medicare MAPD, but I am also in the situation you describe with individual health clients, being the on the scene "grief counselor" for their shock at the new plans.

The Medicare client did the PPO, wise choice. Will just deal with specialist situation. Income sufficient to deal, is stuck with MAPD in our state until T65, a few more years.

It is practically a given that anyone switching from a pre-2014 plan will have the 7 stages to go through about their choices. I need to remember that going in.
 
Sorry, I thought you were asking about the non-Medicare spouse. My brain is fried at this point.
 
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