By: Pat

Pat — Tue, 15 Dec 2009 19:53:36 +0000

It is certainly good advice to Medicare beneficiaries to explore their options for covering Medicare deductibles and co-pays and for making an informed choice of a Part D prescription drug plan. But do very carefully read all the terms of any plan you are considering. And if there are provisions you don’t fully understand, ask someone who does (not the insurance agent selling the plan).
In exploring options on the Medicare website, it is important to distinguish between a) supplemental Medicare insurance plans and b) Medicare Avantage plans. Supplemental plans are just as the name suggests. They are a supplement to your traditional Medicare insurance. They cover some of the Medicare co-pays and deductibles and may include some additional coverage. The terms of these plans are regulated by the federal government and are quite straight forward.
Medicare Advantage (MA) plans replace your traditional Medicare plan. There are HMOs, PPOs and private fee-for-service MA plans.
The fee-for-service MA plans may not explain the limits of their coverage in plain English. For this reason, it is extremely important to understand the terms, conditions and limitations of their coverage. For example, what physicians (including specialists) you might want to use accept the MA plan’s terms and payments? What if you go to a physician who turns out not to accept the MA plan’s terms? [If the physician does not accept the terms of your MA plan, you will have to pay this physician out-of-pocket as you are not covered by traditional Medicare while you are enrolled in the MA plan. ] Does the plan cover Part D prescription drugs?
Here’s a good explanation of private fee-for-service Medicare Advantage plans:
http://www.kff.org/medicare/upload/7648.pdf
Pat

Comments on: I Will Save Over $2,000 on Medicare Insurance in 2010! I Compared Plans.

By: Pat