Kevin Knauss: Health, History, Travel, Insurance
Posts focusing on Medicare Parts A, B, C and D, Medicare Advantage, Supplements, changes in benefits, enrollment.
Of all the Medicare plans, the Part D Prescription (PDP) plans are the most confusing. The confusion arises because Medicare allows the Part D plans to offer alternate plans that differ from the standard plan. The alternate plans must be as good as the standard plan for the average Medicare beneficiary. Cost Sharing of the […]
If you find yourself in a Medicare Advantage plan you do not like, you have an escape hatch to another plan. The Medicare Advantage Open Enrollment Period is a short period of time when you can escape from your current enrollment, switch to another Medicare Advantage plan, or return to Original Medicare with a Part […]
Medicare Advantage plans, that cannot be paired with a Medicare Supplement plan, is another way to divert much of the storm of health care costs to the gutters and downspouts. The Medicare Advantage plans usually have the Part D drug plan embedded within the total package. There will still be some leaks from copayments and coinsurance with the Medicare Advantage plans.
The team at FairStreet had to overcome my built-in skepticism. One aspect of their company that they inadvertently revealed to me was that they were not a sales company. They had a different approach and perspective. The emphasis was on providing clear information for appropriate analysis of Medicare options. This is what we need in the senior Medicare market. We need less emphasis on sales and more focus on education, information, and beneficiary compatibility with the Medicare plans.
There are 2 levels of extra help, full and partial. With full extra help, there is no plan premium, plan deductible (if the Part D plan has one), and prescription drug costs are capped at $4.15 for a 30 day supply of generics and $10.35 for brand-name drugs.
Comparison of how community rated and attained age rated Medicare Supplement plans differ and discount to make them competitive.
Once you know which plans support your providers, you can begin to build your benefit comparison spreadsheet. I have broken this spreadsheet into 3 categories: medical, prescription drug, and supplemental benefits. I created a fictitious plan sponsor, Solar System Health Plans, and fictitious plan names: Mercury 212, Venus 72, and Saturn 25. The benefits and costs are similar to what might be available in your area.
Part of the blame for the increase in complaints lies with Medicare. First, Medicare allows plan sponsors of the Medicare Advantage plans to offer multiple plans with almost identical names. Second, Medicare is allowing the plan sponsors to offer non-health supplementary benefits – benefits not covered by Original Medicare – within the Medicare Advantage plans. These two elements lead to confusion on the part of the beneficiary and agent when comparing multiple plans.
In a switch from saving in a bad health year, Plan A with lower benefits delivers more savings than Plan G for the 65-year-old. This is because the premiums are lower and the only Medicare expense category covered is the Part B coinsurance. At age 75, because of the higher premiums, it costs the plan member more in premiums for the Medicare Supplement Plan A or G than the plans deliver in cost savings.
The higher asset limit applies to non-exempt assets. Generally, assets exempt from the calculation are an individual’s house as a primary residence, one car, burial plot, up to $1,500 in a burial expense account, furniture, and other household and personal items. What has stymied many people from being eligible for some Non-MAGI Medi-Cal programs are the non-exempt assets such as savings accounts, stocks, bonds, or other assets that could be liquidated to pay for health care services.
