Pros and cons: Humana vs BCBS $0 Premium Medicare Advantage Plans (Charleston: how much, income)

[Kaisermust]

I've gotten all the info from both Humana and BCBS on their $0 premium Medicare advantage plans and need to make a decision soon. Looking at PPO plan in either case and both companies benefits seem comparable to one another (for Doctor visits anyways). Just wondering if one is better than the other as far as coverage area should we need a hospital, here in MB area or if we need to go south to Charleston for anything. Any other "cons" of one over the other one can only learn through experience? I know you can change every year but a year with the wrong company, or one where we incur a lot of unexpected bills on our retirement income is a l-o-n-g time. Thanks.

[CTyankee54]

Assuming your are looking at PPO Medicare Advantage plans (I would never consider an HMO), the best way to compare plans is to enter you drugs into the plan finder so that it can automatically determine what your cost of Rx will be under each plan. The plan finder will also estimate your overall costs for each plan. Once you've got those numbers, then start looking at those benefits you will most likely use and compare your out of pocket costs. In many plans, the most common features are very similar...$0 copay vs $10 copay for primary care office visits, cost of hospital copays, specialist copays, etc. If those items are similar, then look at what "extras" are included (vision benefit, dental benefit, OTC benefit, etc) and how much those are worth to you. Finally, make sure all of your providers are in-network.



It really boils down to looking at what services you think you will use the most in a "typical year" and then look at "worst case" scenario. If things are all equal, the plan with the lowest out of pocket maximum may be the best bet...you know what the most you will end up paying for medical care will be got the year in a worst case scenario.



In my case, I'm looking at the AARP United PPO plan vs the Humana PPO plan. They are very similar. One (Humana) has a little bit better vision plan but higher copays for office visits. I wear glasses and don't go to the doctor that much, so the Humana plan may be better. On the other hand, the United plan has a lower out of pocket maximum (5900 vs 7550) and a better OTC allowance (40 vs 25) and lower PCP copay (0 vs 5). So, maybe I decide I don't need glasses this year and go with the United plan? Still undecided but that's the thought process.



If you're biggest concern is the potential for a lot of unexpected bills on your retirement income for a long time (year maximum), perhaps the best option is to protect your long term interests by paying a little more for your routine care or giving up the OTC benefit. It's really an individual decision. Good luck!!