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Researching Medicare Supplements

17 years ago

I'd like to run a plan past the forum. Do you see problems with the following?

DH's former employer offers dental and health insurance. For 2009 we plan to take the dental coverage and an Aetna medigap policy that picks up 100% of the fees Medicare doesn't pay. (Those ran me $2000 in 2008.)

The company doesn't offer a Medicare drug plan. DH's prescriptions total only $212 per year, but I take Advair, which retails at $500 for a 90-day supply, plus my chronic sinusitis results in some antibiotics every year.

I'm looking at buying a drug plan just for me. Coventry Insurance (Anyone know about it?) offers AdvantraRX - Value Plan. It runs $25.50/mo. They say they will provide Advair for $48 per 90-day supply via mail order or a bit more from local pharmacy. (Our 2008 plan charged $70/90-day supply for Advair but the policy premiums were MUCH higher.)

See any 'holes' in this plan?

Thanks for reading.

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Comments (4)

mariend
17 years ago
Check with Blue Cross/Blue Shield for a comparison. Also check with your state insurance dept to make sure they are licensed to sell the insurance in your state. This state does restrict certain companies. Ask your pharmacist. Watch the rates as Humana just raised their rates alot for the coming year. I have heard about Coventry, but don't know anything about it. There are alot of changes coming up, so whatever you get make sure it is for the year 2009 (in writing).
chisue
Original Author
17 years ago
Thanks Marie. The AdvantraRX has several plans listed in our 2009 Medicare handbook for the Chicago area. I called them and they are mailing us a registration package. We'll read it carefully and ask questions. It does sound too good to be true for something that's not HMO-connected.
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You really might want to consider the former employer's pharmacy plan - but where I'm a bit confused... if your husband goes for the pharmacy plan for drug coverage and that proves satisfactory - why would there be a need for a switch to the Medicare Part D in 2012? He would, in effect, be dropping his creditable coverage and that creditable status doesn't carry over to a new plan (ie Medicare Part D because they don't care what you might have had), and would be subject to the forever penalty. Creditable is just comparing what you have against whatever else is out there. An actuarial firm determines that your plan offers Rx coverage that is equal to or better than Medicare Part D. Should be easy enough for him to get the boiler plate notice of "creditable" insurance for drugs from his former employer to keep in his files if he goes with what they're offering. In fact, it's a requirement that the notice be sent each year. It's an unimpressive few sheets of paper stating simply: The Society (I'm retired from the Nat'l Geographic Society) is required to issue this annual notice to participants. Then it goes on to explain Medicare Part D, why I don't need it, why I can't be covered for drugs under more than one plan, and what happens if I drop what I have for something else. I still think that the Medicare Part D penalty is imposed whenever it is not signed up for when you initially become Medicare eligible at 65. Guess I would check with the former employer - HR there should be on top of what they offer. And I'd call Medicare too - or your closest SS office. I found the people at our Social Security office really helpful - on the phone and in person.
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dockside_gw
17 years ago
DH and I are going with AdvantraRX for 2009 after being with Humana this year. Google Medicare Part D ("I'm feeling lucky" to go directly to Medicare site). You can put in all your meds and your zip code, etc., and Medicare will show you all the plans in your area and the costs for each so you can easily compare and decide which plan to go for.

We also have a Medicare Advantage plan (not a supplement) for $70 a month, each, for 2009 and no co-pays, no deductibles, 25% co-pay only for radiation therapy with a $1000 stop-loss. It's the best plan we have ever had. You can also check, on the Medicare website, for the best plans for Medicare Advantage which are ususally cheaper than supplement plans. Big variations, however. The first plan my DH had was cheap, but had co-pays with no stop-loss. Didn't think that would be a problem, but he had open heart surgery and contracted MRSA as a result and the co-pays ended up being about $4,000. We are almost finished paying them off, 2-1/2 years later. Learned a very expensive lesson. Make sure there is a stop-loss if you have any co-pays.
stargazzer
17 years ago
about the dental..i read an article that said dental insurance is not always necessary. i see a dentist every year and that is cheaper than insurance. if your teeth are in bad shape insurance would be the cheaper way to go.

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