I just signed up for a Med Advantage policy for dh - probably an additional $200/month as it covers all out of pocket expenses. However, I started wondering - does he really need a supplemental, doesn't Medicare cover all but 20% and he doesn't make trips to the hospital - 2 in the last 30 years. I know all of you have similar circumstances with your spouses with the AD - do you have supplemental insurance, does it really save you any $'s?
Insurance premiums, for one thing or another, amount to at least 1/3 of our disposable income. I'm so tired of being held up by the insurance companies and I simply don't want to give them one red nickle more than I have to . I'd really appreciate any words of wisdom from my favorite data base here. Thanks!
mother I think I would yes keep the policy in force with our spouses. I continue to carry his supplemental around 200 too just in case. in the event they have to transport for any reason to a hospital it can be thousands even if medicare pays most. the supplemental covers the additional. non of us want added coverage or expense if we don't have to but with any terminal disease I wont be taking a chance. I am sure others will weigh in on their ideas. there are the basic supplementals that cover main stuff and not a lot of extras. maybe one of the basic ones would give enough coverage. we can never know when it will be used. its like carrying higher limits on car insurance. we never know when we will need that coverage or not. and its more money but affords protection. divvi
mother, as I understand it, you can enroll in a traditional medicare plan (Part A & Part B) or a Medicare Advantage Plan. The traditional Medicare Part A & B have deductibles and premiums associated with them. Part A has a hospital deductible of @ $1000/ hospitalization, but no premium. Part B costs you (and me) currently $104/mo in premiums which are automatically deducted from your ss payment and has about $143 deductible before it pays the 80%. The traditional part B coverage is 80/20%, meaning you will pay 20% of all costs under Part B. and there are several costs, such as non-emergency ambulance transport that are not even covered under part B, so you would have to pay the full amount.
Medicare Advantage Plans are offered to replace the Medicare Part A & B plans (meaning if you're enrolled in a Med Advantage Plan, you're not enrolled in traditional Medicare Parts A &B). Depending on the plan you choose, you may have to pay no more than the $104/mo premium, or if it is a more encompassing plan, you may have to pay more/mo in premiums. The advantages of the Medicare Advantage plans is that they typically offer more benefits, but may have more restrictions on access of care (HMO requires PCP referrals, only can use in-net doctors, etc).
I would advise you if you truly have a Medicare Advantage Plan and not the traditional Medicare Parts A & B, that you study closely what the plan covers, what restrictions it has (like PCP referrals, only in-net doctors) and the costs-both premiums and copays. Your Medicare Advantage plan may cover costs at 90/10%, for example. Or there is no additional cost if you see an in-network doctor, but a huge cost (like 40%) for using an out of network doc. Unfortunately you truly have to understand the plan provisions, what is covered, the co=pays and deductibles before you can know if you need an additional supplemental plan. If you only have traditional Medicare Parts A & B a supplemental plan is probably a good investment.
You should be able to do plan comparisons on the medicare.gov website to determine if you would need a supplemental plan to cover unpaid expenses.
We are both enrolled in a Medicare Advantage Plan,we pay no premium( prescription insurance is included),there is a very small co-pay for Dr,visits,a 10% copay for some procedures(based on medicare amt.allowed).$5000. out of pocket limit. Even with Sonny in hospital for 10 days and another time for 4 days, 4 trips to ER we still do not come close to the $5000.The NH would like me to switch to a traditional medicare supplement plan( I think it is easier for them) but with pres.coverage it would cost about $250. a month for each of us. Have to decide what to do.
My husband is under 65 so we're unable to get a supplemental policy on him that would be affordable. I could have added him to my plan at work but like yourself I don't like to pay insurance premiums. I enrolled my husband in a Medicare advantage plan. I've heard others complain about it but took a chance anyway. It's with United Health Care and costs $104/month.
My husband had seizures & falls Labor day weekend and ended up in the ER & hospital for 6 days. The hospital bill alone was $71,000- not including all of the doctors & tests. Our share of the hospital was $1485, $65.00 for the ER visit & $400 for the ambulance to the hospital and a non-emergency transport to the nursing home where he now resides. Our total was less than $2000 - in my opinion was well worth not having a supplemental policy or adding him to mine. I was very happy with how United Health Care handled all of the expenses. Unfortunatly UHC is discontinuing coverage and I need to find another Advantage plan for next year. My husband is now on Hospice and I'm not sure if he'll make it into 2014.
I'm so sorry to hear that your husband is now on Hospice, Trish. So many things we have to deal with to care for our spouses and ourselves. When you get to where you are in the journey, these other things must seem so unimportant. God bless you and your dh.
If you go with a Medicare advantage plan be prepared to review your options every year. My father was on one (Kaiser) and the monthly fees seemed to go up by $50/month every year. But we were happy with the care he received. Her was on a Prudential Mediare advantage plan when he was in Florida and it sucked, after a hospital visit it was clear that he couldn't live in his house by himself but they wouldn't cover a rehab stay in the hospital or a nursing home (they did cover OT and PT at home).