Kevin Knauss: Health, History, Travel, Insurance
Posts related to Medicare Advantage plans which are original Medicare health benefits provided by private companies.
Not all plans include the SSBCI support. You can enroll in a Medicare Advantage plan that has the SSBCI even if you don’t qualify for the extra benefits. You can search on Medicare.gov for plans that include SSBCI. You can also ask your insurance agent to search for Medicare Advantage plans that include SSBCI that might support you.
It’s also important to learn if you or your family member will have any other coverage like an employer group retirement plan, VA (Veterans Administration) or Tricare for life. Sometimes you do not want to leave an employer group plan because once you leave you may not be able to get it back. Sometimes people will stay with VA for drug coverage but need additional help for healthcare services through a Medicare Advantage plan. Talk with those organizations to make sure that none of the changes you may be making such as enrolling in a drug plan or Medicare Advantage plan will for some reason terminate coverage in that existing group plan.
The monthly insurance premium for Part B of Medicare is $185 for individuals who had earned less than $106,000 or $212,000 for a married couple filing a joint federal income tax return. As the household income increases, the insurance premium for Part B increases. For individuals who earned over $500,000, the Part B premium is $628.90 per month for 2025. Remember that the monthly premiums are per person. If a married coupled earned over $750,000 and are eligible for Medicare, each person will pay $628.90 for Part B.
The impacts of so many Medicare plans not paying an agent commission will suppress the number agents who are willing to assist enrollments for no compensation. In other words, some Medicare beneficiaries may have a tough time finding local agent help to evaluate their Medicare plan options.
Other plans may have an out-of-network deductible of $500 to $750+. The out-of-network deductible must be satisfied before the plan begins to share in the cost of the health care services or out-of-network services.
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 […]
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.
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.
The great thing about Medicare is that you can build your train the way you want. You can change the train cars every year. But the important aspect is that you own the Medicare engine. You are the engineer and you can build your train the way you want it.
In California, there are thirteen counties where the Medicare Advantage capitation amount will exceed $1,000 per enrolled member. This does not include any possible bonuses based on quality scores OR for any Part D Prescription drug benefits included in the Medicare Advantage plan. The lowest capitation amount is $841.14 in Imperial County and the highest is $1,158.97 in Inyo County. These figures are from the Medicare RateBook2020 that lists the capitation amounts for all counties in the United States.
