What's The Catch With These Zero Monthly Plan Premiums For Medicare Advantage Programs?.....

[global1]

We are in an open enrollment period for Medicare Plans. I've been getting a barrage of mailings from the insurance companies to switch to their plan. One of the things I'm noticing is that they are promoting '$0 Monthly Plan Premiums'.

For some reason I just don't trust these insurance companies and their hype. What is the catch here as you never get something for nothing?

Anybody have a feel for this or are we being manipulated again? What is the trade-off?

[Zen Democrat]

1. You are in an insurance network. Limited to their doctors, hospitals, etc. Just another HMO.

[moriah]

2. Aren't those 0 on top of your standard Medicare premium?

In that case, it's just costing as much as your Medicare premium.

[DURHAM D]

3. Well, the insurance company does get the $105 deducted from

your SS check each month.

[grasswire]

4. advantage plans are often junk insurance

You are right to mistrust them.

The best co-insurance is a Medigap plan, standardized coverage by the federal government. Many DU-ers go for plan F of Medigap and swear by it.

The advantage plans are often sketchy and are unregulated as to coverage.

Look into Medigap.

[Nye Bevan]

5. My kids' allergists office has signs up saying that they do not accept any Medicare Advantage plans,

but that they do accept traditional Medicare.

It seems that these plans offer significant advantages to regular Medicare, but only if you stay in the network:

Not only do most Medicare Advantage plans significantly reduce the out-of-pocket cost of health care to just a few thousand dollars annually, compared to tens of thousands of dollars an extended hospital stay could cost under Original Medicare, they also offer greatly expanded benefit packages, including dental, hearing, podiatry, chiropractic, acupuncture, and vision coverage, as well as health club memberships and other services which are also not covered by Medicare, such as transportation to and from clinic appointments. Once the out of pocket maximum is reached for an individual, the plan will pay 100% of services for the remainder of the calendar year, with no lifetime maximum, so long as individuals use in-network providers. Persons who enroll in a Medicare Advantage HMO cannot use certain specialist physicians or out-of-network providers without prior authorization from the HMO, except in emergencies. This can be a problem for people who need to use specialists or who are hospitalized and are forced to use out-of-network doctors while in the hospital. Enrolling in a PPO, if available, can help solve this dilemma, because PPO plans permit a subscriber to use any physician or hospital without prior authorization, but at somewhat higher expense.

By law, however, if a patient's in-network physician orders tests or procedures that are not available or provided by any in-network facility or specialist's office, the Medicare Advantage plan must pay for the patient's procedures or services at an out-of-network location at no additional cost to the patient, so long as the necessary services are normally covered by Medicare.

Most Medicare Advantage plans typically do not have annual deductibles, offering members "first-dollar" coverage instead. Original Medicare has a potentially recurring (more than once per calendar year) deductible for each hospital admission under Part A and an annual deductible for Part B.

http://en.wikipedia.org/wiki/Medicare_Advantage

So the critical thing to check is whether all of the doctors and hospitals that you use or may want to use participate in any Medicare Advantage plan that you are thinking of taking out.

[SheilaT]

6. They get your Medicare Part B money,

and your Part D money as well if it includes a prescription medication plan.

Advantage Plans are not scams. I have one and I'm in awe of how good it is so far.

Do read very carefully what is being offered. Make sure your regular doctor is in the plan you want. Check out if your current prescription meds are included.

Where I live it looks like all the doctors take most of the Advantage Plans available here. My doctor does. I no longer pay ten dollars for each prescription a month, but get a three month supply for free.

The trade off is the same any insurance company offers: they hope to enroll enough people who don't need a lot of doctor visits, meds, surgery, and so on, to make a profit.

Also, every year is open enrollment where you can change plans if you wish, so you'll continue to get at least some mailings every year at that time.

Most of us are used to being in whatever plan our employer offers, with few if any choices. Medicare gives you the opportunity to pick and choose among plans, which can be highly confusing. It was for me when I stopped working and went on Medicare. Just read everything, and call up any provider you are considering to make sure you do understand what's involved in their plan.

[SomethingFishy]

7. My wife took one with United Health care..

It's $25 a month out her S.S. check and we save way more than that on prescriptions alone..

So it works for us as well...

[DavidDvorkin]

8. My wife and I both have those plans

Through United Health Care. They're okay. We're sticking with them.