How To Pick Medicare Advantage Plans in Ct For 2017
So after a hectic 2016 annual enrollment period we are already gearing up for medicare advantage plans in ct 2017. As many of you may or may not know some of the co-pays and premiums actually went down for 2017 on medicare advantage plans. At least that was the case with one medicare advantage company here in Connecticut. Most of the insurers went up in cost and and co-payment. Which is not unusual for these medicare advantage plans or for that matter health insurance in general.
In any event today I would like to go over the basics of medicare advantage plans in ct 2017. I should take a quick moment to introduce myself and tell you why you should listen to some of my advice. My name is Rob and I have been working in the insurance business for the past 20 years. I mainly have focused on the retiree market, where I enjoy teaching people about medicare supplement plans, medicare advantage plans, and long term care insurance. Today the focus will be on medicare advantage plans in ct. For 2017 not too much has changed from 2016. As I mentioned one company actually lowered their premiums and copays, while the rest of the medicare insurers in ct raised their rates and co-pays. Unfortunately I cannot mention names of carriers in this article, as I would need to get permission from each one, which takes months to get approved. I can tell you however that I have access to all the various medicare advantage insurers here in ct.
How Do Medicare Advantage Plans in Ct 2017 Work?
As most of you probably know medicare is a federal program and does not really change from state to state. If you own a medicare supplement plan in California, it has to pay the same way as it does in Connecticut. This rule also applies for straight medicare as well. Medicare has to pay out the same way no matter where you live in the country. Now with medicare advantage plans things are slightly different around the country and from state to state. First I want to stress that if you enroll in a medicare advantage plan, you always have medicare. However once you are enrolled in that plan the private health insurer now becomes your primary payor for your healthcare bills. Your plan does not follow what the traditional deductibles or co-payments are for part a and b. You would follow the guidelines highlighted in the medicare advantage plan that you enroll in. Now with that being said, medicare advantage plans have to include everything that original medicare covers and sometimes more. So for example some plans in California, might decided that they are going to offer benefits for prescription glasses above and beyond what original medicare may offer. Another example is a medicare advantage plan in Alabama may offer additional money for hearing aids that original medicare does not. Lastly a medicare advantage plan in ct may offer a free gym membership with their plans that other states do not. Again most of these extras on these plans are designed to help medicare enrollees with a better quality of care.
How Do Medicare Advantage Plans in Ct Operate and What Do They Cover?
As mentioned about medicare advantage plans have to offer everything that original medicare offers and sometimes more. For the most part medicare advantage plans operate off of co-pays more so than deductibles. So for example you may have to pay 10 dollars when you do to see a primary care physician. Likewise you may have to pay a higher amount like 40 dollars to go see your specialist if you need to. Blood work or lab work may only cost you around 10 dollars to have done. If you have to be admitted into the hospital, the co-pays typically run around 300-400 dollars per day, but are usually capped to 3 or 4 days. Then the plans usually pick up all costs from there. If you need outpatient services or durable medical equipment the plans usually charge 20%, which is similar to what original medicare would have charged you. Of course mental health is also covered under these plans and also most include your Part D prescription drug coverage. Most of the plans have 5 tiers of drug coverage and you would pay a co-pay for these prescription drugs.
How Much Do Medicare Plans in Ct Cost?
Medicare advantage plans in Ct for 2017 vary in premiums. So companies offer a 0 premium plan. Yes that is correct folks, a 0 premium plan. Many ask how is it that I pay nothing for this plan and also they think it must not be good. In all actuality neither is true. During people's working years, they paid into social security and into medicare through their taxes. So in essence they paid for these plans long ago, however they are just getting the benefit now. As far as a 0 premium plan not covering much, that is not true at all. Remember what I said early on, medicare advantage plans all have to cover the same thing that original medicare covers. With 0 premium plans, your co-pays are going to be higher then those plans that have premiums. Also I must mention that all of these plans have out of pocket maximums. So for example a 0 premium plan may have a 6,700 dollar out of pocket max, whereas a premium plan may only be 4,200 for example. So what is the range for the premium plans as far as cost? Most medicare advantage plans range anywhere from 29 dollars a month to 45, some run 100 and lastly I have seen them as high as 200 dollars a month. So premiums can be all over the map. What you really need to do is look at each co-pay vs premium and decide if it is worth it or not to pay a higher premium for these plans. This is something that you should discuss with an agent.
So What Are the Downsides to These Medicare Plans?
Well first off these plans are network based. If you have ever heard the term HMO or PPO that is
what these plans are. So for example you have to see a doctor that is within the plan's network usually within the service area you reside in. This also applies to hospitals and rehab centers as well. For the most part many urban areas have excellent networks and getting access to doctors is usually not a problem. Some plans even allow you to cross state lines to see other doctors in other states, however this is not true of all plans. With original medicare you can go and see any doctor that accepts medicare anywhere that you want. You are not tied to a network at all, so this could be a down side of you live in rural areas. Also if you have to go to the doctor often or are receiving therapy you may end of spending quite a bit in co-pays throughout the year. In that case you may have been better off by going with a medicare supplement plan if you can afford it. The premiums for medicare supplement plans might end up being cheaper than the co-pays that you shelled out for the year. Again it all depends on your personal situation and health. If you were in generally good health the previous year, then a medicare advantage plan might be right for you. For example if you enrolled in a 0 premium plan and didn't see the doctor at all that year- then guess what you didn't pay anything for your healthcare that year. Except for your part B premiums, which I should point out. You still have to have part B to get enrolled in these plans. So in a nutshell if you think you may be interested in a medicare advantage plans in ct 2017 give me a call today. 860-268-3953
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