Medicare Advantage Plans - Available in this Area
Types of Insurance Available
for Seniors:
•
Medicare Only
–
You pay Medicare Part B fee
–
You pay 20% of doctors charges
–
You pay hospital deductible
–
You pay for prescription drugs
•
Medicare Supplement Plans + Separate
Prescription Drug Plans (Part D)
–
Jerry covered this last week
•
Medicare Advantage Plans (Part C)
–
The insurance company operates as a contractor
for Medicare
–
The plans usually cover both medical and drug
costs
–
You use a single private insurance card
–
You pay a “copay” when you visit the doctor and
receive no bill
–
The plans pay doctors and hospitals at Medicare
rates
–
You still have to pay the Medicare Part B fee
Medicare Advantage Plans:
•
Health Maintenance Organization (HMO) Plans
•
Preferred Provider Organization (PPO) Plans
•
Private Fee-for-Service (PFFS) Plans
•
Special Needs Plans (SNP)
•
Only HMO and PPO Plans are covered in this
presentation because they are the only ones that are available in this area.
HMO vs PPO
•
An HMO provides full coverage for only a fixed
network of doctors and hospitals
–
Network covers part or all of a single state
only
•
A PPO provides coverage for
–
A fixed network of doctors and hospitals, plus
–
Doctors and hospitals outside the network
•
PPO costs may be significantly higher for
doctors and hospitals outside the network
–
Copays
–
Maximum out-of-pocket costs
–
Deductibles
HMO Plans:
•
Aetna
–
Medicare Value Plan
–
Medicare Standard Plan
•
ConnectiCare
–
VIP Prime 1
–
VIP Prime 3
•
United Health Care
–
MedicareComplete Plan 3
–
MedicareComplete Plan 2
–
MedicareComplete Plan 1
•
Anthem
–
MediBlue Value Plan
PPO Plans:
•
Aetna
–
Standard Plan
–
Select Plan
•
ConnectiCare
–
Option 3
–
Option 1
•
United Health Care
–
AARP MedicareComplete Choice
Aetna Plan Estimated Cost Comparisons
Column 1:
Medical - one chronic condition or multiple health issues
Drugs – 3
generic prescription drugs
Column
2: Medical
- more than one chronic condition and an occasional major procedure
Drugs – 2
generic prescription drugs and 2 branded prescription drugs
Plan
Name & Type
|
Column 1
|
Column 2
|
|
Cost, $/Year
|
Cost, $/Year
|
HMO:
|
|
|
Aetna Medicare Value Plan
|
|
|
Premium
|
0
|
0
|
Medical
|
1068
|
2647
|
Drug
|
459
|
5834
|
Total
|
1527
|
8481
|
Aetna Medicare Standard Plan
|
|
|
Premium
|
1416
|
1416
|
Medical
|
893
|
2601
|
Drug
|
459
|
5834
|
Total
|
2768
|
9851
|
PPO:
|
|
|
Aetna Medicare Standard Plan
|
|
|
Premium
|
1200
|
1200
|
Medical
|
832
|
2371
|
Drug
|
459
|
5834
|
Total
|
2491
|
9405
|
Aetna Medicare Select Plan
|
|
|
Premium
|
1668
|
1668
|
Medical
|
427
|
1064
|
Drug
|
108
|
5712
|
Total
|
2203
|
8444
|