Health Insurance options

I should explain the difference between an Advantage plan and a supplement. Medicare Advantage plans get a chunk of money from Medicare and the plan is then responsible for all expenses. If they deny enough claims they make a profit. Supplement plans are a supplement to Medicare and Medicare remains your primary insurance coverage. The companies selling the supplement are more or less tied to pay the amount of the contract. That is why Medicare doesn't change but Advantage plans do.

A Medicare Advantage plan is not anything like a true Medicare supplement. I would not, normally, want an Advantage plan. The supplements from C-M are uniform products but every company can have their own pricing. The best way to get coverage is to set up residence in a lower priced area. Here in Holland the rates are about half of what they are in Metro Detroit but the coverage is the same wherever you happen to need care. I do have all the rate books and applications for the entire state.

bsinmich wrote:

Gjac wrote:
Medicare plans change from year to year as to your health conditions so what was good for you last year may not be the best plan this year. All of the plans have emergency care provisions in any state that you get sick in. My wife and I had to use a walk-in in Fla twice in the winter. If you don't have a chronic condition like heart disease I would opt for the advantage plan with a max out of pocket cost of $5600 or less. Even if you hit this number it will still be less than any non medicare plan premium.

Medicare plans do not change from year to year but the deductible and co-insurance amount can vary. On a high ded. F Medicare sets the deductible each year.

The first year I had BCBS with a $3700 deductible and free Silver Sneakers, the next year the silver sneakers was no longer free and deductible went to $4600. To me this was a substantial change so I switched to another Advantage Plan.

Gjac wrote:
Medicare plans change from year to year as to your health conditions so what was good for you last year may not be the best plan this year. All of the plans have emergency care provisions in any state that you get sick in. My wife and I had to use a walk-in in Fla twice in the winter. If you don't have a chronic condition like heart disease I would opt for the advantage plan with a max out of pocket cost of $5600 or less. Even if you hit this number it will still be less than any non medicare plan premium.

Medicare plans do not change from year to year but the deductible and co-insurance amount can vary. On a high ded. F Medicare sets the deductible each year.

Medicare plans change from year to year as to your health conditions so what was good for you last year may not be the best plan this year. All of the plans have emergency care provisions in any state that you get sick in. My wife and I had to use a walk-in in Fla twice in the winter. If you don't have a chronic condition like heart disease I would opt for the advantage plan with a max out of pocket cost of $5600 or less. Even if you hit this number it will still be less than any non medicare plan premium.

Medicare Plan F is the best plan. There is also a high deductible plan F that is considerably less in premium. The deductible is set each year by Medicare. For a relatively healthy person the HD F makes a lot of sense.

If you can find insurance, it will be pricey. Unless you are eligible for Medicare, and you might still consider that pricey. Adjust your expectations.

When I retired at age 58 to travel, I signed up with an Aetna "Traditional" plan that covered wife and me nationally (80% with very high deductibles and out of pocket maximums) for about $2200 a month premium. When traveling outside the U.S. we also bought travel insurance with emergency medical coverage. Premiums are high for "take it anywhere" coverage using nationwide networks, and it will never be 100%, can be as low as 50% for out of network.

So leading up to Medicare, I paid almost $200,000 in health insurance premiums for coverage we didn't use for five years, until my wife's terminal illness, which cost the insurance plan at least $900,000 and cost us another $150,000 over three years for deductibles, co-pays and treatments not covered by insurance.

Since her death, I've been on Medicare, paying about $6000 a year in Part B, Part D and Supplement premiums, deductibles and co-pays. So far, Medicare and the supplement pay almost nothing because I don't need much medical care, it all falls within deductibles.

I know things have changed with the ACA, for those not on Medicare, and the nationwide coverage options are probably fewer now, but when you find insurance for travel, be aware that it will not be cheap. To meet the "affordable" part, insurers have moved more into HMOs, localized providers, and managed care. Carte blanche will be expensive, and if you find an insurer that still offers that type of policy, premiums will be very high and coverage less than 100%.

If not yet on Medicare, you need to find an insurance broker and explain your needs, but expect to pay high premiums.

If on Medicare, taking Part B and an F supplement (UHC covers nationally) will provide the most complete coverage, N supplement will cover about 80% with slightly lower premiums.

What is your age? Are you covered by Medicare? If so What do you have for a Medicare supplement? What state do you live in?
An insurance agent.

"own State's coverage is not good, or basicallly non-existent as soon as we leave our home state"

I'm not sure this statement is 100% accurate but I just retired and looked into this over the past year as I lost my employer healthcare and I will be travelling out of state.

Here in NJ (and I assume throughout the US), the healthcare provider is state centric, so you get all the health benefits as long as you are in your home state. When you venture out of state then you are covered for all emergency situations but not for "regular" non-emergency procedures.

Out of all the insurance companies operating in NJ, I only found 1 that offers out-of-state services equal to home state services BUT the premiums are much higher.

So to answer the OP, you are covered when you venture out of state
but with reduced services. Always check with your insurance company for the facts.

Gerry

sdianel wrote:
you might look into Blue Cross Blue Shield.

...unless your domicile is TX or if don't mind an HMO.

Link from ML's post.