COPD Support Discussion Boards Active Users: 143 / Visits Today: 2659
Highest Active Users: 202
COPD Support Discussion Boards
Home | Profile | Register | Active Topics | Members | Search | FAQ
Username:
Password:
Save Password
Forgot your Password?

 All Forums
 COPD Forums
 COPD Support - COPD Information
 Medicare Supplements
 New Topic  Reply to Topic
 Printer Friendly
Author Previous Topic Topic Next Topic  

MDC
Member

439 Posts

Posted - Jul 31 2019 :  08:40:07 AM  Show Profile  Reply with Quote
Hey All. Hope all are as well as possible. Been awful hot here in Arkansas, been taking it easy as possible.

Quick Question. In November I have open enrollment and am looking at Plan G or Plan N. Am I wrong or does Plan N just have the part B copay and copays for Dr visits and ER but covers your oxygen after you have met your plan B deductible.? Would like to get Plan N through AARP but UHC just offers Plan G at $143 a month and BCBS has Plan N for $110 a month. $20 copay for Dr is ok for me. Any other reputable companies would also be fine.

Thanks,
Mike

Wish you all well!!!!!!!!!!!!

Before you criticize someone, walk a mile in their shoes. That way you’re a mile away, and you have their shoes too.

Edited by - MDC on Jul 31 2019 08:41:56 AM

jmrommes
Contributing Member

2015 Posts

Posted - Jul 31 2019 :  09:18:19 AM  Show Profile  Reply with Quote
Plan N won't cover: Medicare Part B deductible and you may be responsible for what your Plan N and Medicare don't cover for O2 and any other services. That really depends on the provider of the service, so you may have to pay for some things but not others. You will also have the doc's office and ER co-pays. In order to really compare Plan N to Plan G, you need to look at what BCBS has for a Part G. Comparing plans from two different companies is comparing apples and oranges.

The SHIP office in your state ought to be able to give you a listing of all the companies that offer Medigap insurance in your state including the premiums. Be sure to look at your state only as prices vary significantly between states.

Exercise not only lets me live, it enables me to have a life.
Go to Top of Page

MDC
Member

439 Posts

Posted - Jul 31 2019 :  2:40:57 PM  Show Profile  Reply with Quote
Yes, I did some digging and calling and Plan N will cover 100% of DME 02 as long as the provider accepts medicare assignment, no balance billing.

$20 for Dr visits I have no problems with and all area providers appear to accept medicare assignment,no balance billing, that seems to be the key, excess charges.

I am now going to pay the extra for United Health care as I and my wife will get a 5% AARP Discount for family coverage which for her is a bundle being a plan F and under 65 ($338.25 mo.)and we will both get 5% also on any existing and future rate increases.

Thanks for the help Jeanne.

Mike

Before you criticize someone, walk a mile in their shoes. That way you’re a mile away, and you have their shoes too.

Edited by - MDC on Aug 11 2019 11:20:06 AM
Go to Top of Page

MDC
Member

439 Posts

Posted - Aug 11 2019 :  11:23:17 AM  Show Profile  Reply with Quote
Just found out United Health Care has Plans N and G select, which is substantially lower. Only catch is thr hospital for part A must be a Select provider. Now I need to find out what the difference is in a hospital that accepts UHC and one that is a Select provider. I guess back on phone tomorrow.

quote:
Originally posted by MDC

Yes, I did some digging and calling and Plan N will cover 100% of DME 02 as long as the provider accepts medicare assignment, no balance billing.

$20 for Dr visits I have no problems with and all area providers appear to accept medicare assignment,no balance billing, that seems to be the key, excess charges.

I am now going to pay the extra for United Health care as I and my wife will get a 5% AARP Discount for family coverage which for her is a bundle being a plan F and under 65 ($338.25 mo.)and we will both get 5% also on any existing and future rate increases.

Thanks for the help Jeanne.

Mike


Before you criticize someone, walk a mile in their shoes. That way you’re a mile away, and you have their shoes too.
Go to Top of Page

jmrommes
Contributing Member

2015 Posts

Posted - Aug 11 2019 :  2:09:56 PM  Show Profile  Reply with Quote
Usually, I find in Iowa, anyway, most providers are part of pretty much everyone's preferred provider plan, which is what your "Select" plan really is. I think that's pretty typical of states where the population is pretty low relative to the geographic size of the state. There is really no difference between what a "select" hospital will provide and any other hospital. The hospital either decides to be part of United's select group or not. So the difference really is critical only if there are particular hospitals in your area that you prefer and do they belong or not.

Here in Des Moines, where I live, there really isn't any difference between the two major groups in terms of lung health care but there is a big difference in cardiac care. I can go to either, but if I were in a place where I had to choose based on the preferred provider plan, that might make a difference in which plan I picked.

Exercise not only lets me live, it enables me to have a life.
Go to Top of Page

MDC
Member

439 Posts

Posted - Aug 13 2019 :  08:33:41 AM  Show Profile  Reply with Quote
Wow, I taked to UHC and AARP reps yesterday and there is quite a difference in select providers and regular UHC providers. I looked at list of select Hospitals, Doctors are no problem, and not one even close to me. Even in 100 mile radius all the good hospitals do not participate.

The AARP rep said near all select members changed to Reg G plan which is allowed. With G I can go to any provider that accepts medicare.

Guess I will pay a little more for G. With the AARP discount for family members, we will save almost $30 a month. And increases will be 5% less also.

Mike

Before you criticize someone, walk a mile in their shoes. That way you’re a mile away, and you have their shoes too.

Edited by - MDC on Aug 13 2019 08:35:19 AM
Go to Top of Page

Jocopd
Member

USA
192 Posts

Posted - Aug 13 2019 :  09:37:23 AM  Show Profile  Reply with Quote
I am trying to understand the insurance plans a-z or whatever there are. I know they vary by state, age and provider as to the monthly premium. So say the average is $300.

Then you have to pay the medicare $130 ish if not covered under the plan

And then you also have to pay for a drug plan - min $40/month.

So all this could wind up costing $500 a month yet you can get an advantage plan free that includes drugs and once you pay the max of $5000 or even $2500 a year out of pocket then the plan picks up the balance. This is for visits etc not prescriptions which are separate on the donut.

Yes you might have to pay $17 a month for your oxygen but how are those expensive plans better if the free plans pay it all once you hit the max for the year?
Go to Top of Page

jmrommes
Contributing Member

2015 Posts

Posted - Aug 13 2019 :  10:39:12 AM  Show Profile  Reply with Quote
The problem with the Advantage plans for some people is that they see so many docs and have ER visits that between the co-pays and meds, they end up spending more. The other problem is that Advantage plans require a preferred provider, and if your docs aren't part of the provider network, you can be sol. Even once there are no more co-pays, you still have that 20% that they don't cover for hospitalizations, etc. I think I'm right, but do check. Things may have changed. Let us know what you find out. I'd call the SHIP office in your state for the best information and a chance to talk with people who know the system, but aren't selling anything. You'll get good information. Look up the Senior Health Insurance (SHIP) phone number in the blue pages of your phone book. Every state has one.

Exercise not only lets me live, it enables me to have a life.
Go to Top of Page

Dave-OH
Administrator

USA
4262 Posts

Posted - Aug 13 2019 :  11:04:37 AM  Show Profile  Reply with Quote
I have a Medicare Advantage PPO. I can see any doctor, but the co-pay is larger out of network. And a hospital stay is capped similar to Medicare to 5 or 7 days at $250 or $350 a day depending on the 5 or 7 day rule. My co-pay for almost 4 weeks in the hospital was $1,750.

Dave, Forum Administrator
COPD Support, Inc. http://www.copd-support.com/
Your source for peer support and COPD Info


My Site: http://lungresources.com
Go to Top of Page

jmrommes
Contributing Member

2015 Posts

Posted - Aug 13 2019 :  3:56:21 PM  Show Profile  Reply with Quote
Dave, thanks the clarification regarding docs. When I said sol, I meant that you'd pay more, not that you couldn't see them. As MDC found, it makes a big difference some places and practically none in other places.

Exercise not only lets me live, it enables me to have a life.
Go to Top of Page

Dave-OH
Administrator

USA
4262 Posts

Posted - Aug 13 2019 :  5:51:54 PM  Show Profile  Reply with Quote
The cost of F for me is $155.20 a month, plus Rx of drug plan of say $40 a month. So $195 a month. I pay $57 a month for both. I do not spent $140 a month on health care, but part of that is the VA. I pay $45 a quarter for my lung doctor. That leaves the difference to cover the occasional hospital stay.

Dave, Forum Administrator
COPD Support, Inc. http://www.copd-support.com/
Your source for peer support and COPD Info


My Site: http://lungresources.com
Go to Top of Page

MDC
Member

439 Posts

Posted - Aug 15 2019 :  08:52:43 AM  Show Profile  Reply with Quote
Yeah I have UHC advantage plan now and it is great with a good drug plan for $43.00 a month. But I would have bought supplement if available in Arkansas for disabled.

Mine has a max out of pocket on medical of $6,700 a year, which is a chunk, $50 co-pays for Specialists and $10.00 for fam Dr. I just had an outpatient Mohs surgery that will cost me 20% which I have not received yet but if you have a biggie the thought of $6.700 kinda makes me nervous. If I had Tricare I would not sweat it. Why buy insurance. Here with tricare you go to regular drs or specialists and they pay 100%. Scripts $1. The problem with advantage plans is not the length of stay but the number of admissions. Your might pay that $1500 for 4-5 times a benefit period. There is no limit. but they are good. Mine was good for me. But right before I got it I had a $25,000 bill for 3-4 days. Thank goodness I had BCBS. but I see what you mean, I would come out ahead with my adv plan too if things went as tyhey have last 2 years, but with my luck..lol The risk/reward for me $1000/$6,700 makes G worth it for me.

Before you criticize someone, walk a mile in their shoes. That way you’re a mile away, and you have their shoes too.

Edited by - MDC on Aug 17 2019 08:21:26 AM
Go to Top of Page
  Previous Topic Topic Next Topic  
 New Topic  Reply to Topic
 Printer Friendly
Jump To:
COPD Support Discussion Boards © Copyright COPD-Support, Inc. Go To Top Of Page
Snitz Forums 2000