Med Advantage Question (newby)

[Tim Resnick]

Hi all,

Question from a Newby.

I have a Florida neighbor who retired from the school board and who is looking to switch from her present insurance plan. She's 70yrs old and is in great health. (her premiums right now are over $600 mth).

1. She travels in the summer to California,...would she be covered by a MA plan?
2. Would she have to enroll during open enrollment or could she enroll at any time?
3. Any idea on what range her MA premium might be for Humana or United (those are the biggest carriers in my area)?

I sure do appreciate it and Thanks for any constructive input you can offer...!



.

 

[Chazm]

Have you looked at her Medicare card? Does she have part a and part b or just part a?

If she doesn't have part b she'll need to sign up for it to start when she wants her group plan to end.

She can do a MA plan and if it's a HMO she'll have ER and urgent care in CA only. With a PPO she may have access to doctors in Ca in network and out of network.

Both UHC and humana have zero premium plans in FL.

What part of FL?

 

[FLM2]

Have you looked at her Medicare card? Does she have part a and part b or just part a?

If she doesn't have part b she'll need to sign up for it to start when she wants her group plan to end.

She can do a MA plan and if it's a HMO she'll have ER and urgent care in CA only. With a PPO she may have access to doctors in Ca in network and out of network.

Both UHC and humana have zero premium plans in FL.

What part of FL?

UHC MAPD does not have Passport in CA

 

[Denniston]

Why not show her a Medicare supplement, if she is in good health. Could be as much as 2/3 less than what she has been paying, no co-pays or and only has the $183 part B deductible. (as mentioned above, she will need part A & part B regardless).

 

[YouGotMyMoney]

BlueMedicare Regional PPO is the best option for nationwide network.

 

[Chazm]

UHC MAPD does not have Passport in CA

Still has out of network with UHC. And that's why I was saying may or may not. Humana ppo is fine and Aetna ppo too. But I have no idea what part of Florida the client lives.

Florida blues ppo network is nice and all but if you're going to pay somewhere around $50/month for a high copay plan, just go with a plan N med supp

 

[indiana260]

Hi all,

Question from a Newby.

I have a Florida neighbor who retired from the school board and who is looking to switch from her present insurance plan. She's 70yrs old and is in great health. (her premiums right now are over $600 mth).


[*]She travels in the summer to California,...would she be covered by a MA plan?
[*]Would she have to enroll during open enrollment or could she enroll at any time?
[*]Any idea on what range her MA premium might be for Humana or United (those are the biggest carriers in my area)?


I sure do appreciate it and Thanks for any constructive input you can offer...!

.

I run across this exact scenario all the time. I always lay out the options and they always choose med supp. Cuts their springing in half and provides full coverage.

 

[FLM2]

Still has out of network with UHC. And that's why I was saying may or may not. Humana ppo is fine and Aetna ppo too. But I have no idea what part of Florida the client lives.

Florida blues ppo network is nice and all but if you're going to pay somewhere around $50/month for a high copay plan, just go with a plan N med supp

The OON charges for the UHC Regional PPO could be through the roof, not a good plan for someone who spends lots of time in CA during the year.

 

[somarco]

Prospective client moved from Tallahassee to rural Georgia. She is on the state plan with BX as the carrier/administrator.

Very rich plan. Low deductible, low OOP (in network). She has A & B.

Also has non-alcoholic cirrhosis diagnosed a few months ago via liver scan.

No network providers in her area. Had to drive 70 miles to get scan and paid $150 for a scan that would have been "free" in Florida.

She and husband have been trying to decide if she wants to stay on the MA plan or switch to Medigap. Husband turns 65 in September.

They have been researching options since June. Called me last week. Referral from an agent in their town I know that does not handle Medicare.

During the initial phone conversation they mentioned the OON "problem" and the $150 scan. Asking for details, they said it was a liver scan and gave me the diagnosis.

We have a problem.

She turned 65, enrolled in A & B in March.

They waited until 7 months later to call and with her diagnosis she won't pass underwriting.

She will keep her MA plan.

Took app for husband.

 

[Tim Resnick]

Hey Thank you Guys,

She has Medicare part A and B. But like i said, her premium is over $600 mth, and doesn't have Part D either.

I understand that MA is actually Part C and was hoping that going with a Private MA plan might save her $ (but I'm not sure---like i said, i'm a Newby so please forgive my ignorance).

Anyway, does anyone have an idea on how much her premium might be for a Med Adv Plan?

• She's 70 yrs old, in good health, and we live in S.fla.?
• Are there dis-advantages to having a Med. Advantage Plan?

Thanks again...!