Just like last year, we are seeing insurance carriers shrinking their Medicare PPO plans. If you are losing medicare advantage ppo plan coverage in 2017, we have options. With ever increasing premiums and rising member copays and out of pocket costs, it was only a matter of time before PPO options in the Medicare Advantage market would cease to exist in New York.
For those of you who have been notified that your existing Medicare Advantage PPO plan will be terminated on 12/31/16, you might be asking “What should I do?”
In the past we would recommend both Medicare Advantage PPO plans (MA) as well as Medicare Supplement Plans. However, with the exit of PPO MA plans from the market, we are not comfortable writing limited HMO plans that reduce provider choices to a small network of doctors and hospitals during a time in your life when you are most likely to be utilizing services.
With this thought in mind, we are suggesting the following 3 options:
1- Enroll into an AARP Medicare Supplement plan F that we offer. Pair this with an AARP Medicare Preferred Part D Rx plan for your prescription needs. Total premiums for this type of plan combination run approx $272 for Plan F, plus $81 for the Preferred Rx Part D plan (PDP). You will have NO limited network of providers under this scenario…you get to go directly to any provider or hospital who participates in the Medicare system. This is the highest benefit combination we can offer, and comes with the highest premium.
2- Enroll into an AARP Medicare Supplement plan N that we offer. Pair this with an AARP Medicare Preferred Part D Rx plan for your prescription needs. Total premiums for this type of plan combination run approx $179 for Plan N, plus $81 for the Preferred Rx PDP. You will have NO limited network of providers under this scenario…you get to go directly to any provider or hospital who participates in the Medicare system. This option allows for mid-level premiums by requiring small copays at the doctor’s office amongst a few other small differences.
3- Enroll into a High Deductible Medicare Supplement plan F thru Globe Life of NY. This plan runs $62 per month on Long Island. In 2016 you pay the first $2180 of charges not paid by Medicare A and B, and then most charges are covered in full. Keep in mind Medicare A and B will be covering a portion of each claim – such as 80% of doctor visits after the part B deductible, so you will only be responsible for the 20%. Once your share of what Medicare does not pay for covered services reaches $2180, the plan then pays all costs covered by Plan F. Pair this plan with a Part D Rx plan from AARP for a reasonably priced program that allows you to see any provider or hospital that accepts Medicare. $62 HDF Plan + $81 Preferred Rx PDP. This is the lowest priced option we can offer and is also a solid choice for those who might not be using services as much, or who can afford a higher deductible plan.
Pair Medicare Supplements
You can also pair any of the 3 Medicare Supplement plans we recommend above with a PDP plan offered by any of the 50+ PDP carriers in NY. You would do this on your own directly with the PDP carrier, and we would just handle the Medicare Supplement processing.
While the options above might cost slightly more than having a Medicare Advantage HMO, we believe that having more choices of doctors and hospitals using traditional Medicare A&B coupled with a Supplement and PDP plan far outweigh the slight savings you might find from enrolling in a limited network HMO Medicare Advantage plan. Most Medicare Advantage HMO plans limit your hospitals…such as Memorial Sloan Kettering, whereas the AARP or Globe Life of NY plans do not limit where you can go for services.
Just like the case is with Medicare Advantage plans, all scenarios above require you to continue to pay your Medicare Part B premiums in addition to the premiums noted above.
Please call (631) 207-180 or email us to request more detailed information on the 3 scenarios outlined above. We would be happy to assist you!
This article should not be considered a sales piece and is only our personal recommendation and opinion. For full plan details including rates, applications, and any questions please email or call us.