Medicare Coverage in Retirement
Under a Medicare HMO plan, you will need to choose a primary care physician, just like you did on your group HMO plan. If it is important for you to keep your current doctor, you might want to ask him/her if they accept any Medicare HMO plans. If they do, they can probably also advise you which of the plans they offer provide the better coverage and are the easiest to work with. If your doctor does not accept Medicare HMO plans, you may also consider a Medicare Supplemental Health Insurance Plan that will provide you with more comprehensive coverage than Medicare Part A and Part B, but will allow you to continue using your current doctor. 2 CommentsLeave a comment |
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I recently turned 65 and I have enrolled in Medicare Part A, Part B and Part D. I had great insurance all of my life through my employer and I would like to have the same type of coverage again. I had to only pay $10 when I went to my doctor and it covered everything. I would like to have that same type of coverage now. Is it available?
It sounds like you are accustomed to HMO coverage through your group health plan. There are many insurance companies that offer Medicare coverage with similar types of benefits. These are referred to as Medicare Advantage HMO plans and are offered through private health insurance companies. If you enroll in a private Medicare Advantage HMO plan, you are no longer covered under Medicare. The private health insurance company assumes the responsibility of your health care and you pay your monthly premium directly to that insurance company. In addition to receiving your monthly premium, the insurance company is also compensated by the Federal Government for assuming the risks associated with your health care costs.
Hello
I am disabled and I have been told I am supposed to pick out a Medicare plan soon. My question to you is this: The area where I live does not offer me any HMO Medicare plan or PPO. When I go online to the Medicare website and search in my local area, all I get is PFFS (Private Fee for Service). How do I choose which one to go with? I am looking to get a plan that doesn’t require me to pay so much out of pocket. When I talked to my doctors office about it, they wouldn’t or maybe could not tell me much, they only told me they would accept whichever health plan I chose. They just told me to go to the Medicare website and find a plan, but they are all PFFS for my zip code. Why is this? Which plan do I choose? Really, I just don’t want to pay so much out of pocket.
Comment by Marie — June 9, 2009 @ 10:29 pm
Ok, so I am looking over a lot of PFFS plans at the moment from various different insurance companies and I want to ask you about these type of plans. Are there any problems with doctors and is there balance billing on the Coventry plans? What I like about these plans is that they seem to allow for freedom of choice and have flexible coverage. That is a priority for me as I have had bad experiences in the past with certain doctors and I appreciate the option to make my own choices and judge health care options for myself. I actually have two questions for you:
How does HMO and PPO Medicare advantage plans compare to PFFS plans for consumers?
Which of these plans use balance billing if any:
Humana
Coventry
Aetna
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Thanks! I appreciate your expert advice!
Comment by George — June 28, 2009 @ 6:38 am