Humana Advantage Plans
- Thread starter DocFather
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MTPockets
Well-known member
We don't have the advantage, but many friends do have it and really like it. We stayed with Medicare but added Humana supplement. We feel Humana is a very good choice. Our reason for staying with Medicare is we travel 7 months/yr and felt this was the best for us. Had we stayed mostly near Humana hospital areas, we probably would have done the Advantage plan.
This was not my reason for starting this discussion, but when traveling, if you need to go to an Emergency Room, the whole concept of "Network" does not apply. An E.R. visit is always considered "in-network" and if you have to be admitted for medical or surgical care it is also "in-network" if admitted through the E.R. even if it is not a "Humana Hospital."
My discussion was more informative as to the Humana Advantage "Health and Wellness" benefits. I have been on Medicare for almost 4 years. The Humana Advantage plan I have offers so much $$ a month for over-the-counter items they offer on their website. The first year I had a $10 allowance/month. I never even looked at the website!! The next year it was increased to $35/month (OK - now I looked). This year it is $50/month. They have some fairly usable items that I find quite useful. Toothbrushes, toothpaste, allergy tablets, cough suppressants, blood pressure cuffs (not the high-end stuff but still accurate), lotions, Q-tips, cotton balls, "sharps" containers, first aid items, etc.
It is there for the asking if you know about it.
Well, you have got my attention. I have to go on Medicare starting in February, and for some reason I am scared to death about it. I have been flooded with mailings for every company under the sun. I am a retired auto/union worker. Someone told me month ago to don't even read these mailings. Can someone clear my head and assure me its not as difficult as it may seem ?? And maybe give me some advise. PLEASE !!!
danemayer
Well-known member
First, check with the union to see if they have arranged help for making your Medicare selections.
You need Medicare Part A, Hospitalization, and Medicare Part B which is like a private insurance Major Medical Policy. It generally covers 80% of doctor visits and related care. It doe NOT cover any prescription costs, except glucometer supplies and perhaps a handful of other things.
The next decision point is whether you want additional coverage (at additional expense) to avoid copays and deductibles, and to pay the 20% not covered by Parts A & B. It's basically prepaying those costs. If you have a lot of medical visits, especially things like imaging, you'll definitely want this. Keep in mind that 1 trip to the ER can result in a 20% billing that could exceed the cost of additional coverage.
If you opt for additional coverage, you can purchase a Medigap Policy or a Medicare Advantage Policy. In our case, we opted for Medigap Plan F which has no copays, no deductibles, and pays the balance due on everything after Part B pays. Our Medigap Plan allows us to see any doctor or facility that accepts Medicare. We were planning on being away from home for quite a bit of the year, so being able to see any doctor made sense for us. Medigap Plan F is no longer offered to people coming onto Medicare, so it you want a Medigap policy, you'll need to compare the various plan choices available to you.
Medicare Advantage may restrict you to the policy issuer's in-network doctors. In a true emergency, you can probably go to any ER and be covered, but don't confuse Urgent Care with ER. An out-of-network Urgent Care visit could cost an enormous amount of money that a Medicare Advantage plan probably would not pay. Medicare Advantage plans often provide prescription drug coverage and other benefits at no extra cost.
If you don't purchase a Medicare Advantage plan that includes Prescription Meds, you should consider purchase of a Plan D offering like WellCare's entry plan for $5.50 per month. For common generic meds, a GoodRx card is an alternative. But if you need something like Advair Diskus, or Farxiga, or another tier 3 drug, you'll be better off with a Plan D. Coverage is complicated, but you can probably find a selection tool that allows you put in your prescriptions and compare all available plans based on total out of pocket cost including premiums and copays.
If you become eligible in February, I'm not sure if the enrollment deadline of November 12 (I think) applies. But don't blow past it unless you're sure.
Hope this helps.
JohnDar
Prolifically Gabby Member
The Medicare A & B will be automatically deducted from your monthly Social Security check once you’re enrolled. Read the fine print on any supplements you consider since they’re not all created equal.
My only supplement is Tricare for Life which covers prescriptions and some of the costs that Medicare doesn’t. They recently added a dental and vision supplement options at additional cost, putting military retirees on a par with other federal plans.
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My only supplement is Tricare for Life which covers prescriptions and some of the costs that Medicare doesn’t. They recently added a dental and vision supplement options at additional cost, putting military retirees on a par with other federal plans.
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southernlady5464
Well-known member
Plan F is no longer available to new enrollees. If you had it already with no gap in coverage with it you can maintain it. I got in under the deadline the year I turned 65.
MTPockets
Well-known member
I'm in the group that feels traditional Medicare with a supplement is the way to go. Once you change to any of the Advantage plans, you can never go back to Medicare. Advantage plans all have certain additional coverages, but nothing is free, so you'll pay for them in the end.
jerryjay11
Well-known member
If you don't mind I'd like to add to this...
This is a good point to be aware of for those out there that are Medicare + Tricare. You are still required at age 65 to take Medicare and it is automatically deducted from SSI. Even if you decide to get an advantage plan of some kind you'll still be paying for part B Medicare, part A is normally free. Don't get fooled with the commercials that you'll get $1500 back to your Medicare. That $1500 is the cost of added benefits of Medicare part D. I have Medicare and Tricare for Life and have had many different procedures in and out of hospitals. The most I had to pay for a hospital stay is $25.00. Sometimes I don't have any hospital cost. With Tricare my average pharmacy bill is around $5.00. I have Delta Dental and vision is covered by the VA. So for me as a retired service member I don't see any advantage to pay for an Advantage Plan.
If I am missing something I would appreciate to be filled in as I had been confused about these advantage plans and think I've got a handle on it now.
To Terry & June I looked at Medicare advantage plans and all are addition to Medicare part B. All the plans state they don't cover the $148.50 cost of part B so you are still obligated to pay for Medicare with advantage plans. If I am wrong please point me in the right direction. Thanks!
This is a good point to be aware of for those out there that are Medicare + Tricare. You are still required at age 65 to take Medicare and it is automatically deducted from SSI. Even if you decide to get an advantage plan of some kind you'll still be paying for part B Medicare, part A is normally free. Don't get fooled with the commercials that you'll get $1500 back to your Medicare. That $1500 is the cost of added benefits of Medicare part D. I have Medicare and Tricare for Life and have had many different procedures in and out of hospitals. The most I had to pay for a hospital stay is $25.00. Sometimes I don't have any hospital cost. With Tricare my average pharmacy bill is around $5.00. I have Delta Dental and vision is covered by the VA. So for me as a retired service member I don't see any advantage to pay for an Advantage Plan.
If I am missing something I would appreciate to be filled in as I had been confused about these advantage plans and think I've got a handle on it now.
To Terry & June I looked at Medicare advantage plans and all are addition to Medicare part B. All the plans state they don't cover the $148.50 cost of part B so you are still obligated to pay for Medicare with advantage plans. If I am wrong please point me in the right direction. Thanks!
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