Tuesday, March 8, 2011

A Long Life TogetherI heard something recently that remained stuck in my mind for a few days. It was a quote from Cheryl Mathias of AARP, who said, “If you make a Medicare Advantage choice, and you don't realize you've agreed to a limited network of doctors and hospitals, and you suddenly go to a different doctor or hospital, [then] you could wind up with a very big bill that you would have to pay out of pocket.”

Since a number of Medicare Part C Advantage plans cover less medical expenses than Parts A and B, and have higher deductibles and copays, they were touched on in the ObamaCare legislation. Beginning this year in 2011, Medicare Part C Advantage Plans cannot charge higher cost-sharing requirements beyond the initial Medicare for specific services, such as skilled nursing care, dialysis and chemotherapy. This could mean a range of different outcomes, because - at least according to one site, there are five basic types of Medicare Advantage.

Utah a Case Example

Medicare clients in Utah who are on the Medicare Advantage plans should have gotten notices already about any changes that they can expect to see in those plans, including if the plans will no longer be available in your state. In the event that these plans are no longer offered in your state, it is critical that you make the appropriate changes to your plans or you may risk losing your Medigap benefits that cover your expenses beyond the regular reimbursements from Medicare.

When you sign up for a Medicare Advantage Plan, you are able to use the insurance card from your plan for health care. In the majority of these plans, there are typically additional benefits as well as lower copays than is offered with the original Medicare plan. However, you may not be required to go to doctors who belong to the plan or specific hospitals to get the treatment that you need.

Medicare Premiums Seen to be Increasing

Although premiums may decline this year, Medicare Advantage beneficiaries will most likely see an increase in cost sharing. Also beginning in 2011, Medicare Advantage plans are not able to charge anything more than regular Medicare for dialysis, chemotherapy, skilled nursing care or any other service that is deemed appropriate by CMS.

photo credit: mikecogh


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