Choosing Health Plans: Medicare + WHAT?

chisueNovember 12, 2009

I've put in I don't know how many hours trying to decide what plan(s) are best for us in 2010. Anyone else hate this whole 'sign-up' period every autumn?

I *think* we'll continue with an Aetna Medicare Integration Plan. It's served us well for 2009. (Although the plan premium went up 30% for 2010!) It picks up everything Medicare doesn't cover: the extra 20% for doctors, tests, etc., and it pays the Medicare deductibles for MD's and for hospitalization ($135 and $1068 ea.). There's another plan that's identical for a little less, but it leaves us paying those two deductibles out of pocket. I'm not willing to risk the bite for hospitalization to save $300 with the cheaper plan.

DH only takes one cheap generic, so only I need a Part D plan to cover my expensive Advair ($550 retail for 90-day supply). My present 2009 Part D plan premium went up 50% for 2010, and my cost for Advair under that plan went up too, so I had to hunt again.

We'll keep the small dental plan that just barely pays for itself, and we'll add a vision plan for 2010 because we are both due for eye exams. I know I need new lenses and frames.

Anyone who thinks health care costs will be all easy sledding once you are Medicare-eligible is in for a big surprise. We spend as much for drugs, health care and insurance for health care as we do for groceries! We aren't even *sick*, and require only ONE expensive maintenance drug.

Medicare Part B for DH and me is $2314 a year. The Aetna supplement plan is $1044. My Part D for drugs plan is $480 including the deductible. My cost for just Advair under the plan is $244. The Dental is $360. Vision Plan is $245. That's about $4700, and would be more if we didn't have access to group insurance from my DH's former employer.

Curious to know how others are coping.

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I'm not sure what type of insurance you are talking about, I am assuming the supplemental for medical. I use Blue Cross Blue Shield plan 65 and I don't have to renew every year. They send me a package with an option to change, but I don't have to do anything. I will not change to save a few dollars then have to go to the hospital of "their" choice. I don't pay anything for medical or their deductibles. I do have to pay for shots like tetanus. I don't have dental or for glasses, don't need either. The insurance would cost more than I spend on teeth or eyes. I don't have a prescription plan for meds again it would cost more than I spend. My step daughter has insurance for meds and she pays $30 for a med we both took at one time. That's after insurance and I paid $6.75 for the generic without insurance. I haven't had a prescription that has cost me over $25.

    Bookmark   November 13, 2009 at 3:27PM
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maime -- I'm talking about health insurance to cover what Medicare does not cover: the 20% of Medicare-approved rates that Medicare does not pay to a doctor, a hospital, for X-rays, CT scans, blood tests, etc. I also have to buy drug insurance to get a reduced cost for a non-government-regulated retail price on Advair at $550 retail/90 day supply).

We are like you; don't want a HMO-type plan. You're fortunate not to have to take any maintenance drugs that are expensive. I probably wouldn't still be here without the asthma medication Advair, and it isn't about to go generic for it anytime soon.

In deciding on the Medicare supplement plan, I have to figure the annual cost of the premium for the insurance, plus any deductibles. I think we'll keep the Aetna plan that runs $1044/year for the two of us. (This is of course, in addition to the Medicare Part B costs of $96.40/month per person.) So, even before the drug plan for me, we are paying $3358 for our health insurance.

For my drug plan I have to figure the cost of the premium for the plan, plus any deductibles, plus what my Advair will cost under the plan. I've found one that costs $330, plus a deductible of $150 = $480 base. My Advair will run $60/90 days supply ($240 for the year). So...for purposes of comparison with other plans, this Part D plan costs me $720 a year. (But I'm not paying $2200 retail for the Advair, and I shouldn't reach the drug plan 'gap' before the end of the year even with the odd prescriptions for antibiotics or other meds.)

May I ask about what your BC / BS plan costs per year?

    Bookmark   November 13, 2009 at 6:39PM
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It is $150 a month, depends on your age, I am 72. I have no paper work to fill out at all. My sis won't use BCBS because of the cost, but she has paper work and does pay part of her medical bills and she has had bad luck with her companies moving or going under. I have been on cholesterol meds, blood pressure med, pain and stomach meds, none high priced. I did stop the chlor. meds had a lot of pain on it. My doctors are very good prescribing less expensive meds.

    Bookmark   November 13, 2009 at 10:18PM
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Thanks for that, maime. You're paying $2956 a year for Medicare Part B + the supplemental policy for one person. We're paying $3358 for two people for the same coverage. Not bad for either one, and both have the 'crossover' with Medicare so there's no filing claims.

I encouraged my DH to drop the cholesterol drug after reading online how many people developed bad reactions. Now he doesn't KICK me in his sleep! More important, I think his mind is working back at full speed. He was only borderline high on cholesterol to begin with, ten years ago. He's supposed to have a re-test after being off a couple months. I think the whole cholesterol thing is overblown -- certainly for people our age. (DH is 71 and I'm 68.)

Here's hoping we'll all stay well through 2010! DH and I will be heading to Maui in mid-January for six weeks, NOT hoping for a repeat of last year! He got bronchitis and I got pneumonia -- firsts, and I hope lasts, for both of us.

    Bookmark   November 14, 2009 at 10:52AM
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chisue, I don't know about medicare part B and I am not saying I pay less than you. I am paying $1800. a year for BCBS supplemental for one person because it is the best I have heard of. My medical insurance has been free for most of my adult years because my husband worked for a company that paid it. I am not going to worry about what I pay now as long as I can afford it. There are 2 very easy ways to loose your life savings and one is inadequate medical insurance, the other is a lawsuit. I am protected from both.

    Bookmark   November 15, 2009 at 1:36PM
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"So, even before the drug plan for me, we are paying $3358 for our health insurance."

Chisue, check your plan/policy. Nearly all of them include drug coverage--Part D. At the 2 seminars I've gone to, they stressed to be careful not to sign up for a stand alone Part D, or it will make your other chosen plan invalid. No idea why it works that way but it does.

I'll see if I can find it in print and post it from them for you. Just to make sure it's explained properly.

I agree, this can be awful to sort out and decide. I've spent considerable time reading and comparing. When the headache gets too bad, I put to down for a while. :)

    Bookmark   November 15, 2009 at 6:33PM
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OK that's for Medicare Advantage Plans. Don't know about what they call the medigap ones.

    Bookmark   November 15, 2009 at 11:23PM
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Check that your doctors will accept Medicare Advantage Plans. Most doctors stay away from them because of interference in treatment and low payment. Many Medicare patients use AARP and are happy with it. Seems to cover everything.

    Bookmark   November 16, 2009 at 9:27PM
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I don't think AARP offers insurance. They're not an insurance company. It appears to me that the organization lends an AARP endorsement to various policies. I don't know if the insurance companies pay AARP. I haven't investigated that much because we have better opportunities (group insurance) through DH's former employer.

I see that some Advantage plans include drug coverage. If they do, you don't need a separate Part D. I think it is illegal for a company to sell you one that would duplicate drug insurance.

It looks like we're sticking with the Original Medicare coverage (A and B) plus the Aetna Integration policy ('Medigap' policy) for us both. We'll add a separate Part D for me.

We did that combination for 2009 and it has been good for us. The policies are still reasonable for 2010 ($522 each for the Aetna Integration plan -- which pays the Medicare deductibles for MD's and hospitals). We can use any MD or hospital -- no HMO's or in-network requirements. We paid nothing out-of-pocket in 2009 because the Integration policy picked up the 20% Meidcare doesn't pay. We filed no paperwork. We haven't run into an MD or hospital that didn't take Medicare as our primary (in Chicagoland or on Maui).

We could buy another Aetna Integration plan for less. The *only* difference is that it doesn't pick up the Medicare doctor and hospital deductibles ($135 and $1068). It's unlikely that either of us will be hospitalized, BUT if either of is, we'd lose what we'd saved by taking this policy instead of the more generous one.

I suppose I shouldn't be surprised that premiums for insurance are stated in monthly fees, because the annual costs are staggering! I'm also surprised to see people *thrilled* with low co-pays for generic drugs or doctor visits -- not taking into account huge premiums they're paying for the policy.

We have to be decided by Saturday since our insurance is coming via DH's former employer. I've juggled the numbers as long as I can. My arms are tired!

    Bookmark   November 17, 2009 at 11:27AM
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AARP licenses its name to insurance companies. They are not an insurer themselves.

    Bookmark   November 18, 2009 at 9:39PM
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My Husband and I plus our two grandchildren that we adopted are all covered by my husband's retirement plan. My husband and I are both on medicare now so we have medigap coverage plus part D supplied by retirement plan. The girls have regular health care ins by Unitedhealthcare. Our cost, $10/person. My hubby and I each have $1800 maximum out-of-pocket coverage. The girls have $300 max out of pocket. Our company has treated us very well.

    Bookmark   December 2, 2009 at 10:32PM
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