With the enrollment period for Medicare starting this month I would like some feedback after my first full year on traditional Medicare. My secondary health insurance termed last November and now I need coverage for dental and vision. I have been reviewing the Medicare Advantage plans and I'm stumped as to which one would be better.
@Von Jones - For last 5 years we have had Care n Care Advantage plan. Which has worked great for us. The dental plan not great unless you take out more coverage. if you do not have teeth and gum issues should work fine for you. vision is about the norm. Our issue now, is moving out of state, we have totally different plan, as CnC not offered in that state. It is a pain taking decision for sure.
Our advantage plan (Aetna) doesn't include vision or dental, unless it's a surgery of some kind. We have separate coverage for those.
That's what my secondary insurance covered separate from Medicare. I had it since 2014 after I got laid off. It cut off when I became eligible for Medicare.
Dental & vision are tough things for folks to get on their own. When I first signed up for Medicare, I went to a local senior help center for guidance. One thing I found that was interesting is that when I bought my supplemental Medicare insurance, I was talking with the AETNA supplemental insurance broker about dental & vision insurance, and he told me that he was not licensed to sell those products in my state (I believe he was in Tennessee.) I would definitely begin with a local advising resource because these things are gonna be region-specific. I also think that any Medicare plan that includes them all are gonna be like HMOs and restrict your choices on regular doctors.
I'll add that I have AETNA for my secondary health insurance and am happy with it. I usually end up paying $10 or $20 for most doctor's visits. My dental and vision plans are through AMERITAS. They are barely worth the cost, meaning that the premium is not that much less than the annual benefit. If I don't use them to their maximum every year, then they are costing me money. Medicare covers most of my routine annual eye exam because of a preexisting condition (detached vitreous sac.)
This is a little long, but here goes: We both have regular Medicare A/B, a Supplement and Humana for any emergency drugs/meds. When we talked to a Medicare Rep in an office, we were told not to get the Advantage Plan. Something about the Advantage Plan can cost more (out-of-pocket) than Regular Medicare. However, there are those that have it and are very comfortable with it. What we do know is that both monthly Medicare payment and yearly deductible seem to go up each year, right along with a COLA raise. Add those two to the cost of a Supplement and a Drug Plan..........really costly! Then, there are those that rely on a job retirement medical insurance. That is what a friend of our does. Then again, his gets and outstanding Ford Motor Company Retirement Pension also. I have both VA Medical, Medicare, Supplement and the Humana Drug Plan. I get all of my prescriptions from the VA, but, due to my wife's current job salary, we have to pay a small co-pay. I also have a VA doctor for my "once a year" checkup. I've only had one surgery thru the VA and that was in 1988. My one rotator cuff surgery and laser cataract surgery were paid partly by us and Medicare and my Supplement. Thru Medicare, we get one free eye exam per year, due to being Diabetic II. The exam is free, but we have to pay but my wife has to pay for new glasses, if needed. Unfortunately, with VA Medical, any serious stuff, like an ER visit, a Veteran or family member, has to be close to a VA Hospital. A regular hospital visit/stay is somewhat covered by our Medicare. When discussing Medicare, it can be "the good, the bad" and sometimes even "the ugly". We pay close to $1000 for the both of us for our medical, supplement and drug plan. For Dental and Vision, we have to rely on our Aetna Discount Cards that cost us somewhere over $100 per year. They are discount cards, so we have to pay something.
From what I have read, dental care is not worth the cost. Medicare helps pay for a yearly exam but doesn't pay for glasses. It pays for eye surgery and if you need new glasses after cataract surgery, it pays for them. I don't see the benefit of having a vision policy.
I have had a Humana Medicare Advantage plan for several years now, and I am totally happy with Humana. We do have an allowance for dental and vision with our plan, as well as as coverage for my heart medications, or any other medications that we need. Our plan, here in Alabama, also includes something called Healthy Benefits, which is a $35 (each) food allowance that can be used at Walmart, and maybe other places. Our Silver Sneakers fitness benefit pays for our gym membership, plus we have an OTC (over the counter meds) program for $175 quarterly (each), and it can be used for most anything that you would buy at the drug store, like aspirin, muscle rub, hand lotion, vitamins, and even medical equipment. Both Bobby and I got a Fitbit with our OTC allowance, and there is a whole catalog of things that can be purchased with the OTC benefit. If we have a doctor appointment, and need transportation, we can just schedule it ahead of time, and that is provided free as part of the plan. So far, we have always been able to drive to our doctor appointments, but it is good to know that they would provide transportation if we needed it. Probably, one of the things that I like the most with Humana, is that they have a program called go365, which gives you rewards for exercising, and even things like wellness checks, and bone density screenings, and many other things. Just for walking at least 500 steps per day, I get a $10 gift card each month, and when I have any of the other allowed procedures or checks, then I get points for those, too. For whatever reason, they can’t connect with my Apple Watch, so Bobby and I both got a Fitbit with our OTC benefit, and the go365 syncs with that. All of my medications are mailed to me, and most of them are no-copay, or a very small one, and I can take care of everything online from the Humana websites. I am not sure if I have covered all of the benefits we get from our Humana Advantage plans; but this is at least a good run-down of what they offer, and I am totally happy with my plan. We do have a local insurance agent here, and he goes over the new plans for us each year, and I definitely recommend having a regular agent that you can call and talk with if necessary.
Uh, Shirley, from what we know, and we get a yearly eye exam that is paid by Medicare, but that exam is free due to both of us being Diabetic II. I had laser cataract surgery and Medicare paid a rather large portion of the surgery. However, for the special lens that I had put into each eye, we had to pay the full cost. But, after the surgery of both eyes, I no longer needed to wear regular glasses. Sometimes I have to put on reading glasses for up-close/small print reading, but that's it. Like I stated in my reply #7, we have Aetna Vision & Dental Discount Cards. They are not insurance, but both cards help by discounting the costs of my wife's glasses and dental work. Now, the important word here is "discounting", not totally paid for by Aetna.
Sort of. We have a list of doctors that accept Humana Insurance, and it is on the Humana website. You can look up any doctor to see if they accept Humana, if you have a name. If you do not have a doctor in mind, then you can look through the list and see which doctors are close to you. We have changed doctors several times, and i will be doing that again this year, since I am absolutely furious with the doctor that i had this year and have been having a real battle with her about my thyroid medication. Now that I have the refill, and know I won’t run out; I can look for a different doctor and change over once I find one that looks good to me. If I were traveling, and had to see a doctor, then I can see any doctor , regardless if they are in our Humana network or not, according to what i read. I have never had to do this, so I do not know from experience how this works.
We will all get a pretty sizeable boost in our SS this January so be prepared to lose SSI benefits based on a new income level. I hope not but something to think about and maybe explore a bit more in depth.
@Yvonne Smith since we are moving out of state soon we will need different insurance . We use an advantage plan also. But the state we are moving to is weird. Only certain plans are allowed in certain counties. Humana is suppose to be one of them. But they charge like $42 a month? We don't pay extra for ours. Do you know which plan nbr your own?
We so not pay extra for ours either, @Hedi Mitchell . My suggestion would be to find a local agent who carries all of the available insurance companies, explain to him/her what you need and see what they recommend, since it sounds like there are a lot of different plans in different areas where you are moving. We have a regular agent here who takes care of all of our insurance, and he looks at the new plans each fall and lets us know if he sees something that we might prefer. So far, I have not found anything that compares with my Humana plan. It is called Humana Gold SNP, or something similar to that.