Medicare Supplement Plans, All equally accepted on the road?

[PandS]

We're still 2 years from retirement and full timing, but we're researching our options for budgeting purposes. We'll have the choice of three different providers for Medicare Supplemental plans, discounted through my previous employer. All are fairly similar, with a few minor differences in co-pays and drug costs. The plans are offered by Tufts, Harvard Pilgrim, and Blue Cross Blue Shield. BCBS is a little more expensive than the other two, and does not cover vision and hearing like one of the cheaper plans.

All three insurance plans say they'll be accepted by any doctor who accepts Medicare. Have you found that to be true? Or is BCBS better known nationwide, and therefore easier to use?

[jrp]

PandS wrote:
... The plans my former employer offers are Medicare Supplement Plans, and they all include Medicare Part D Prescription Coverage. These are not plans offered to the public....

If its not one of the official Medicare Supplement Plans A to N available to the general public, then technically its not a medicare supplement, its a "retirement health plan". Your employer may refer to it as a medicare supplement and it may have similar coverages, but since its a private plan it does not come with the universal acceptance that the real medicare plans come with. My comments above were all related to the publicly sold medicare supplement plans. We have no way of knowing what a private employer plan may or may not include, its not regulated like the publicly sold plans. So you should not assume this private employer plan would be accepted anywhere except the providers who agreed to participate in this private plan. check the plan details

as it says on this Medicare site

https://www.medicare.gov/supplement-other-insurance/retiree-insurance/retiree-insurance.html

"Retiree coverage isn't the same thing as a Medigap policy but, like a Medigap policy, it usually offers benefits that fill in some of Medicare's gaps in coverage—such as coinsurance and deductibles. Sometimes retiree coverage includes extra benefits"

[PandS]

I thank everyone for their responses and the discussion. I think my original question has been answered, in that whichever company's plan we choose, it will be accepted anywhere Medicare is accepted. The plans my former employer offers are Medicare Supplement Plans, and they all include Medicare Part D Prescription Coverage. These are not plans offered to the public. My research is showing that they're exceptionally good plans, and a great retirement perk! We'll certainly be doing more detailed research as our retirement & fulltiming date gets closer. And I'm sure we'll have more questions for those of you who are already living our dream!

[BarbaraOK]

For some of us, in academia or other very large employers, we do not have a Medicare supplemental, as such, but rather our former employers continue us on the employee health insurance program as retirees with the caveat that Medicare is first, then they cover what Medicare doesn't. We retired from U of Texas (Tyler) and never, ever see a bill. Since we are on these plans, the caveat is that they have to be comparable to Medicare supplements - same with our prescription coverage; we get a statement every year that the plan is comparable to Part D coverage. Unlike some other organization, we are fortunate in that we don't have any co-pays except for our meds. And we also can get Vision & Dental since those are available to all employees. Also helps that big organizations (like the UT System) are self-insured and just use BCBS to administer the program.

Not to say there aren't some problems - like with our prescription plan - the formulary (list of meds they will cover) often change each year because the group doing the review are all at med schools or campuses that have a Pharmacy School. So they do academic studies and each year there will be a new list of drugs (usually combinations) that will no longer be paid for and we have to go with similar and hope they work as well.

[Corky12]

I was one of those "idiot billing clerks" for a number of years. There is a ton of misinformation in these responses. I cannot tell you how much misery I saw caused by choosing a plan based on "Cousin Bob's" advice. Go to www.medicare.gov and order the "Medicare and You" publication. There are many community organizations in our area that present seminars on coverage. Make sure they aren't selling something before you go if you find some in your area. You are doing the right thing by starting your search early.

[jrp]

Sorry, that's not correct. All "medicare supplement" plans are secondary to medicare by definition and law. They used to be called Medigap policies because all they do is cover the gaps, copays and deductibles of medicare. To be sold as a "medicare supplement" they need to comply with the definitions & requirements set by Medicare. All medicare supplements are universally accepted anywhere medicare is accepted, that's a requirement when the provider signs up as a medicare provider.

However, with a medicare advantage policy, you are basically trading your Gov controlled Medicare coverage for a private insurance policy that can cover anything that private company chooses to cover, and yes it is your primary policy because you no longer have medicare coverage. Advantage plans are also frequently geographically limited or network limited.

Some companies purposely try to confuse you with supplement vs advantage as part of their marketing claims, but its apples to oranges, do your homework.

The only exceptions to those are, I believe, Mass and Minn where the state has dictated slightly different rules for medicare policies.

bob_nestor wrote:

In my own experience this isn't entirely correct. There are two basic types of Medicare Supplement plans - those that are primary with Medicare being secondary and vice versa. ....

[Johno02]

Yes, go to Medicare.gov, and you can have a copy mailed to you, download it, or just read it all online. We get two copies mailed to us each year.

[bob_nestor]

jrp wrote:

A real medicare supplement plan will be honored anywhere in the country. If a provider accepts medicare, then by law they must accept your medicare supplement, regardless if its BCBS or xyz company. The doctor or hospital bill Medicare, then Medicare coordinates with your medicare supplement company. The doctor or hospital rarely has any contact with the supplement company and gets the same payment regardless if its BCBS or xyz.

In my own experience this isn't entirely correct. There are two basic types of Medicare Supplement plans - those that are primary with Medicare being secondary and vice versa. There are many doctors and hospitals that accept the first type but not the second type, the reason being with the first type they bill the Supplemental Insurance who then deal with Medicare. If your Supplemental Insurance is primary then you shouldn't have any problems any and doctor or hospital that advertises they accept Medicare patients will take you, but if your Supplemental Insurance is secondary to Medicare then only some (somewhat limited) doctors and hospitals will take you even though they advertise that they accept Medicare patients.

[avan]

Mountain Mama wrote:
Is it possible to get a printed copy of the Medicare & You book? When there is so much reading & comprehending to do, we prefer an in hand book.

If you are currently eligible for Medicare, you automatically get a hard copy mailed to you every year at enrollment time (unless you signed up for the electronic only version). Then of course, you can always use your printer to convert your digital copy to paper (less than a half ream of paper).

Two yrs before eligibility is certainly not too early to educate oneself. It is not wasted time. It is time to actually specifically track one's annual medical expenditures by category (including all costs paid by current insurance) In order to categorize, one needs to know what the categories are (Parts A, B and D). Without that knowledge it is difficult/impossible to reasonably forecast the upcoming year and without a well considered forecast by category, it is impossible to make an educated selection between the various Supplemental Plans to determine risk/reward/value. Actual Traditional/Original Medicare does not go through upheaval style changes from year to tr but rather tweaking.

Of course one can just wait until forced to make a Medicare coverage decision and then make one based solely on desperation and cost perhaps picking a Part C Medicare Advantage insurance only to find out that there are geographical restrictions amongst other things. Early homework is good.

[jrp]

"" The differences between them being the amount of co-pays, and one that also covers vision and hearing ""

If so, then that one is Not a real medicare supplement. The medicare supplement plans A thru N must comply with the federal definitions & requirements for each plan. Medicare does not cover vision, hearing or dental, therefore No medicare supplement plan covers vision & hearing. Any company that says their medicare supplement does cover those is lying. Only "Medicare Advantage" type plans cover hearing & vision, and those are not real medicare supplement plans. don't be tricked into thinking an advantage plan is the same as a supplement plan, they are completely different animals.
A real medicare supplement plan will be honored anywhere in the country. If a provider accepts medicare, then by law they must accept your medicare supplement, regardless if its BCBS or xyz company. The doctor or hospital bill Medicare, then Medicare coordinates with your medicare supplement company. The doctor or hospital rarely has any contact with the supplement company and gets the same payment regardless if its BCBS or xyz.

However, a medicare advantage plan has no such guarantee. Its not backed by medicare, its purely private insurance and no one has to accept it, anywhere.

[Mr__Camper]

Stop by your local Medicare office but they will only have the 2016 edition.

[Mountain_Mama]

Is it possible to get a printed copy of the Medicare & You book? When there is so much reading & comprehending to do, we prefer an in hand book.

[NCWriter]

I agree with choosing a Plan F Supllemental (Medigap) plan. I chose Blue Cross Blue Shield in NC. Had no trouble when I moved to Florida.

Keep in mind you will need Part D drug coverage which is not included in Medicap plans. Shop around to get the best price you can, and you can change annually if you wish. If you don't purchase Part D when you are eligible, you'll pay a penalty if you wait to buy it later, so get the cheapest plan you can find if you take no drugs or cheap drugs.

[PandS]

Thank you all for your responses. Yes, we're two years from retirement and medicare, and we know things can/will change by then. Last time we looked into what insurance my old school system offered retirees, they only offered Massachusetts-based primary care physician plans. It was a pleasant surprise to look now and find three medicare supplemental plans offered that state they're for people who retired in Massachusetts, but who live anywhere in the country. The differences between them being the amount of co-pays, and one that also covers vision and hearing. We'll certainly be doing more research before choosing a plan.

[BarbaraOK]

PandS wrote:
My school also offers regional plans, but we wouldn't be interest in them. The three supplemental plans we'd be interested in all state that they are for people who live anywhere in the country, and will be accepted by any doctor or hospital in the country who accepts Medicare. I'm just wondering if providers out west will balk at Tufts or Harvard Pilgrim which are known in New England. Both of those plans appear to be a bit better bang for the buck than the Blue Cross Blue Shield plan offered.

This is what we have and have had no problems using it. We moved to primary care physicians in Arizona since that is where we spend our winters, Medicare pays and then our BCBS is billed and pays the rest. The only problem we have had is that one of our physicians has a group practice and they way they bill causes it to be rejected by the BCBS commupter (Medicare pays it) and we have to call each year and they make a manual correction and pay the bill. So I have one call each year, that's it. Otherwise, everything has been taken care of without question. Ours is through U Texas - so don't worry, and no problems.

Barb