Alternative to medical insurance..

[happyscooter]

Several years ago when my mother still worked, she had health insurance through her employer. I think she paid some money but it wasn't alot since her company picked up the majority. She had Medicare also. When she retired, I asked her why didn't she drop the additional insurance. She could no longer get what she had at her company so she bought something through AARP. Because AARP was considered her primary insurance, she was required to go to those doctors that accepted AARP. Which meant a visit to a town 20 miles away that she couldn't drive to. One day I suggested canceling her AARP and putting the money into an account earning interest and if she needed the money for a doctor bill, she would have it. If she didn't need it for a doctor bill, then she hadn't pay any insurance premiums. In addition to keeping her money, she could go to a doctor near home who accepted Medicare and could drive herself.
She choose to not do what I suggested, but I was wondering if any of you or your parents have done that. Again, she had Medicare so it wasn't like she didn't have coverage. Thanks for your opinions.

[Deleted]

Isn't the AARP plan some sort of plan that covers the out-of-pocket costs of Medicare? I know for prescriptions, these can be really costly. The other out-of-pocket costs may be similar.

I know that my husband, who also has Medicare, pays the $180 a month premium to be on my health insurance as well. He still has to pay our deductibles, but he says it is worth it.

I'd research what exactly the AARP plan is covering. It may be that she needs a different plan rather than no plan. Medicare is ok, but there is a reason why medical care takes up a high percentage of seniors' expenses.

[2kids10horses]

scooter,

You really should have titled this thread something like, "What are alternatives to paying for AARP Medicare add-on insurance".

Just say'n.

[happyscooter]

Her insurance was something around $150 a month. On top of medicare payments. So all I suggested was to put the $150 into an account (this was late 90s so rates were better than they are now) and if she needed it she would have money to pay medical bills. If she didn't need it for medical bills, she could use it for home repairs or property taxes, etc... Again, I wasn't suggesting she be without medical coverage as she did have medicare. And she could go to local doctors as opposed to asking a family member to drive her 20 miles to the BIG CITY.

[happyscooter]

Her insurance was something around $150 a month. On top of medicare payments. So all I suggested was to put the $150 into an account (this was late 90s so rates were better than they are now) and if she needed it she would have money to pay medical bills. If she didn't need it for medical bills, she could use it for home repairs or property taxes, etc... Again, I wasn't suggesting she be without medical coverage as she did have medicare. And she could go to local doctors as opposed to asking a family member to drive her 20 miles to the BIG CITY.

[Deleted]

Some doctors limit the number of Medicare patients they'll take because of Medicare's low reimbursement rates. Before your mother drops the AARP plan she should make sure the local docs would accept her as a Medicare patient.

[Gardening Grandma]

Because AARP was considered her primary insurance, she was required to go to those doctors that accepted AARP.

I find this surprising. I have Medicare with a supplemental policy. The Medicare is considered primary and anything they don't pay is sent to the supplemental ins.

I'd consider a Medicare Advantantage policy if it's available in her area. If not, I'd look at genuine supplemental policies - the ones that kick in after Medicare, not primary. The premium would likely be lower. (It sounds as if your mom just isn't comfortable self insuring beyond Medicare).

I kept the same dr as before Medicare - I've had no problems with dr's accepting Medicare.

Is the Medicare premium being taken out of her SS?

[phil5185]

I find this surprising. I have Medicare with a supplemental policy. The Medicare is considered primary and anything they don't pay is sent to the supplemental ins.

This what I do also. But I don't use AARP for supplemental, I avoid AARP. Whenever I research one of their plans I shake my head, disagree with their politics, ideology, etc.

[Gardening Grandma]

Mar 24, 2011 11:05:50 GMT -5 phil5185 said:

I find this surprising. I have Medicare with a supplemental policy. The Medicare is considered primary and anything they don't pay is sent to the supplemental ins.

This what I do also. But I don't use AARP for supplemental, I avoid AARP. Whenever I research one of their plans I shake my head, disagree with their politics, ideology, etc.

<karma>
Personally I really dislike AARP. They pose as advocates for seniors, but their real agenda is to sell overpriced (imo) insurance.....

[happyscooter]

Well, I should have specified that my mother passed away last summer. But DH and I were talking about this the other day. Would it pay you to just have Medicare (we aren't that old) and save the other money?

[The Walk of the Penguin Mich]

Your mom likely had a supplemental policy through AARP, which paid what Medicare did not pay. I *believe* that Medicare pays 80%, leaving you with 20% to pay out of pocket if you have no supplemental policy. All that it would take is one good illness where you walk out with a $100K hospital bill and you'd find yourself $20K in the hole quite easily. I know that I just received my bill for a hip replacement and it was $68K. Definitely glad I was not looking at paying >$13K out of pocket for that!

Seems to me that $150/mo is cheap insurance, especially during end of life issues where needing a doctor becomes a frequent occurrence.

My mom had AARP for her Medigap insurance when she died and they covered 100% of her final illnesses - not inconsiderable as she spent almost 4 months in the hospital with lung cancer. I'd hate to see what her final bills were, but know that they were paid in full.

[shanendoah]

It is very rare for Medicare to not be the primary insurance. The only times I ever saw it when I worked as a medical receptionist were when people were on Medicare (either their own or through a spouse) but were still working. In those cases, the work insurance was primary and Medicare was secondary. In all other situations, Medicare was primary.
The main reason to have secondary coverage to is the coverage of the 20% (of Medicare allowable charges) that Medicare doesn't cover. For hospitalizations of greater than 60 days, that can be very expensive. After 150 days in the hospital (each year) Medicare does not cover anything.
There are also Medicare deductibles. For 2011, the Part A deductible is $1,132 and Part B is $162. I don't know about Part A, but I do know for Part B that 10% (or less) of Medicare Secondary plans actually cover the deductible.

Medicare Advantage plans can be a great choice for people, especially since they often have maximium out of pocket limits, even the ones that you don't pay any extra for. The ones that you pay extra for offer coverage of a variety of services that Medicare doesn't cover (like routine foot care for diabetics). With an Advantage plan, you don't pay the Medicare 20%, but a co-pay. That way, you always know what your doctor visit will cost. (You could be paying more or less than the Medicare 20%.)
However, Medicare Advantage plans are limiting in who you can see. Instead of going to any doctor who takes Medicare, you have to go to one who is paneled with that insurance company. Depending on where you live and what Advantage plan you choose, that can be a problem.
When Advantage plans first came out, they weren't always well administered. I worked for specialists who were contracted with a number of Advantage plans. One of the companies had 2 distinct panels of doctors. Patients were automatically placed in a panel based on who their PCP was. If the PCP changed panels (which they did), suddenly the patient had to change all their specialists, because the insurance company didn't allow cross-paneling. (Well, we could see patients who were on the other panel and charge them their co-pay, but the insurance company wouldn't pay us and contractually we were prevented from charging the patient.)
I think most Advantage plans are little better run now, but they do not work exactly like Medicare and really require people to read and understand their rules and regulations.

[alabamagal]

Since this is no longer an issue for your mother, I'm not sure what you are trying to look at. If you guys aren't "that old", likely things will greatly change by the time you are eligible for medicare. I won't even try to predict, but I foresee there being changes and most people having to pay more.

[Gardening Grandma]

Mar 24, 2011 11:41:21 GMT -5 happyscooter said:

Well, I should have specified that my mother passed away last summer. But DH and I were talking about this the other day. Would it pay you to just have Medicare (we aren't that old) and save the other money?

Well as georgiagal already pointed out, you aren't all that "old", so by the time it matters, the entire picture may be very different.
FWIW, here's my .02

I pay $13.98 for my supplemental (my former employer pays part of the premium). If it did not cost so little, I'd opt for a high deductible supplemental. That way, I'd not be stuck with an expensive premium, but if worse came to worse, I'd have coverage against a catastrophic situation.
The other factor is whether the supplemental policy had prescription drug coverage. If you opted not to have any supplemental coverage (effectively self insuring against the 20%), then you'd need to have coverage for prescriptions. My supplemental covers prescription drugs (although I don't take any).

ETA - Right now, if you chose to just go with Medicare and do not have a prescription drug plan, and then later down the road, if you do decide that you need pres drug coverage, there is a very stiff penalty.