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Anthem MediBlue Select HMO

Anthem MediBlue Select HMO is a Medicare Advantage plan with prescription drug coverage (MAPD).   In fact, Anthem Blue Cross Blue Shield offers this plan only in Hartford county in the state of Connecticut.   This, like all HMO plans, require that participants use in network providers.  If you choose to use out of network providers, this plan will not cover your expenses.  An exception to this would be urgent or emergency care which allows of of network services.

The plan has a monthly premium of $26. This would be in addition to the part B premium of $121.80.  There are no referrals required for this plan. Co-pays for a primary doctor are $15 and $40 for a specialist.  The plan has an annual out of pocket max of $6,100 per year.  Annual maximum indicates the most the insured would need to pay in medical claims for  the year.  You can not apply either Monthly premiums or cost-sharing for part D prescription drugs to the maximum out of pocket amount.

You can add dental services to the plan for an additional premium.  In Addition, Silver Sneakers is included in the $26 monthly premium and pays a local gym membership monthly fee.   If you use approved diabetic supply vendors your diabetic supplies are covered at 100%.

This plan offers prescription drug coverage with $220 annual deductible.  This deductible applies only to tiers 2-5.  The plan excludes both Tiers 1 and 6 from this deductible.  There is no limit to how much the plan will pay.

A Medicare Advantage plan should not be confused with a Medicare Supplement plan (also called Medigap).

MAPD plans offer both medical and drug benefits combined with the insurance company as the primary insurance.  With a Medicare Supplement, original Medicare is primary.  The insurance company would be the secondary insurance.  As a result, a Medicare Supplement plan does not have a network.  Because members may see any provider that participates with Original Medicare, it is different from an Advantage plan.

 HMO summary of benefits Anthem MediBlue Select

Anthem MediBlue Selelct HMO application

Click here to request a personal Medicare review.

Aetna Medicare Plan HMO Connecticut

Aetna Medicare Plan HMO Connecticut is a Medicare Advantage Plan (MAPD).  This plan is  offered in Fairfield, New Haven, and New London counties.  Aetna refers to this plan as the Shoreline plan. They also offer a similar version of it called “inland”.  The inland plan includes Hartford, Litchfield and Tolland counties. The Aetna Medicare Plan HMO Connecticut is an HMO plan. Members must use in network providers (except for emergency and urgent care).  If  you choose to use an out of network provider in an non emergency or urgent care situation, there will be no coverage at all.  Medicare A and B will not provide the standard 80% part B coverage when going out of network on a Medicare Advantage plan.

In addition to a $6,700 maximum out-of-pocket contribution (for medical expenses only), this Aetna plan is a $0 premium offering and requires referrals to see specialists.  You only need to obtain a referral once per specialist each calendar year.  The plan features very low co-pays for a $0 premium plan. With a $10 primary doctors copay and a $40 specialist copay. Most other co-pays are also low compared to other plans offered in the same market such as a $600 inpatient hospital co-pay and a $150 major radiology copay (basically means MRI’s, CAT and PET scans).

The prescription drug plan (included with benefits of plan)

is one of the few that does not have a deductible on tier 3, 4 and 5 drugs.   Overall, this is a solid plan with a large national network of providers that can be accessed anywhere in the country.  The one benefit that should be noted with this plan is the fact that it does have an annual deductible of $1,000 for some services such as Inpatient hospital, major radiology, Outpatient surgery, ambulance and some other services. A plan summary has been provided below for review.

CLICK HERE FOR AETNA MEDICARE PLAN HMO CONNECTICUT PLAN SUMMARY

Click here for a free Medicare review and quote.

United Healthcare Medicare Complete Plan 2 Connecticut

United Healthcare Medicare Complete Plan 2 Connecticut is a Medicare Advantage plan with Prescription Drugs (MAPD) offered by United Healthcare Medicare.  Medicare offers the Complete Plan 2  in Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland as well as Windham counties. This plan is a HMO and has both a $29 monthly premium and an annual out of pocket max of $6,000 (Medical only). It features co-pays of $15 for primary doctor visits as well as $40 for specialist visits.  Subscribers do not need specialist referrals.

United Healthcare pays %100 of preventative care as part of this plan. This includes;  annual physicals, mammogram, cardiovascular screenings as well as certain vaccines.   Plan 2 includes; home health care, podiatry services, hearing services, vision services and also basic dental services.  The drug plan has a 5 tier copay plan with a $200 deductible for Tiers 3,4 and 5 only.

Like all other part D and MAPD drug plans in CT, there is a Coverage Gap ( donut-hole) that applies to this RX benefit.  Although it is an HMO plan, the Medicare Complete Plan 2 does offer the 2016 UHC Passport Program at no additional cost.  The Passport program provides access to doctors in other states on an in-network basis.   Although the CT plan includes Passport,  every state does not offer the Passport progam.  For an additional premium,  your coverage can include a dental benefit rider.

Please note:

A Medicare Advantage Plan with Prescription Drugs (MAPD) is NOT a Medicare Supplement plan (Also called Medigap). With an MAPD plan, Medicare is not the primary or secondary insurance.  The company offering the MAPD is your primary insurance and services must be obtained through participating providers in most cases.   A Medicare Supplement plan is secondary to Original Medicare and does not include Part D prescription drug coverage.   With a Medicare Supplement there is not a network, instead, the insured would go to any provider that accepts or participates with Original Medicare.

A 2016 Summary of benefits and 2016 application are available in the links below.   You can send applications back to us  either by email at Admin@croweandassociates.com or by fax at 203-567-6235.

Click here for a UHC Plan 2 Summary of Benefits – Connecticut

To download a UHC Plan 2 application – Connecticut Click here

Click here for a no-obligation Medicare quote.

CT Medicare Advantage and Supplements

There are many choices when it comes to CT Medicare Advantage and Supplements.  These choices can confuse anyone. We can help you feel comfortable not only with your choice of health care plans but the cost as well.  Crowe and Associates is one of the region’s leading Medicare brokerages.  Are you looking for CT Medicare Advantage and Supplement information in Connecticut?  We can help. Crowe and Associates is an independent brokerage agency that works with all major Medicare Advantage and supplement plans.  We work with clients everyday to help them understand the difference between Advantage plans and supplements. We use that knowledge to choose the best plan and company for them.  The insurance companies pay us so you will never receive any type of bill or fee for our services.

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Medicare Advantage Plan Connecticut

This post is for Medicare Advantage Plan Connecticut –  A Medicare Advantage plan is an insurance plan offered by a private insurance company.  Advantage plans are also called Part C plans as they are filed under Part C of Medicare.   When someone enrolls in a Medicare Advantage plan, they are taking a plan that replaces original Medicare A and B.   This means that when they receive medical services, the providers will bill the Medicare Advantage plan and not Original Medicare.   If the member discontinues the Advantage plan, they will go back to original Medicare A and B.

Medicare Advantage plans are copay plans.

The member would need to pay copays for medical services received from providers.  Copays vary in amount depending on the type of service received.   Some examples based on plans in Connecticut…

Primary doctor visits- copay ranges from $10 to $30 a visit depending on the company

Specialist doctor visits- copay ranges from $30 to $50 a visit depending on the company

Major Radiology- Can be a 20% cost share or copay ranging from $100 to $275 depending on the company.

This is just a quick example.  (There is a link below to all the plan benefit summaries for Connecticut plans below. )

Medicare Advantage plans also come with drug coverage (They include a Part D drug plan with the coverage).   These Part D plans are very similar to many of the Part D drug plans you would purchase on a stand alone basis.

Bottom Line:  With a Medicare Advantage plan you include your medical as well as your drug benefit in one package.  In fact,  in Connecticut, there are 5 companies that currently offer Medicare Advantage plans.  Finding the right one can take some time.

CLICK HERE FOR BENEFIT SUMMARIES AND APPLICATIONS

CLICK HERE TO SEE HOW AN ADVANTAGE PLAN IS DIFFERENT THAN A MEDICARE SUPPLEMENT

Medicare Advantage and Medicare Supplement Comparison Connecticut

In this post we will give you Medicare Advantage and Medicare Supplement Comparison Connecticut.  Medicare Advantage plans and Medicare Supplement plans (also called Medigap plans) are very different.  There are positives and negatives of each depending on an individuals medical needs.  This post will provide a description of both and compare them in order to make an educated decision when choosing a plan.  The plans outlined in this post are applicable to Connecticut and may not be available in other states.

Medicare Advantage Plans  (CLICK HERE FOR MEDICARE ADVANTAGE APPLICATIONS)

Medicare Advantage Plans are offered by private insurance companies.   They offer medical and Rx benefits in one plan and act as the primary insurance instead of original Medicare.  There are 5 companies offering Medicare Advantage plans in Connecticut.  The companies are Connecticare, United Healthcare (with and without AARP logo), Aetna, Anthem BCBS and Wellcare.

Positives:

• Many have $0 monthly premium.   You will still pay your part B premium to Medicare however.
• They include the medical and Rx benefit in one package.  You do not need/cannot purchase a separate Part D Rx drug plan when you have a Medicare Advantage plan.  The Medicare Advantage plans include the Part D Rx coverage in the benefits.
• Extra benefits- some Medicare Advantage Plans provide for extra benefits such as dental, visions, podiatry visits, gym memberships, etc….

Negatives:

• Medicare Advantage plans have networks. Since the Advantage plan is your primary insurance, the provider must be in network in order for his servicesnto be covered by the plan. There are a limited number of Medicare Advantage Plans in Ct that provide out of network coverage as well.
• Copays-  You do not pay a monthly premium with Advantage plans but you do pay copays for medical services such as doctors visits, lab work, inpatient stays, etc….
• The last negative is that Medicare Advantage plans are able to make benefit changes every January.  This means that they may have a major increase in co-pays and cost share on renewal in January.  You are able to make a plan change every January.  Although, you cannot change your plan after February 14th.

CLICK HERE IF YOU WANT MORE INFORMATION ABOUT ADVANTAGE PLANS

CLICK HERE FOR MEDICARE ADVANTAGE PLAN APPLICATIONS

Medicare Supplements (Also called Medigap Plans)    (CLICK HERE FOR SUPPLEMENT APPLICATIONS)

Medicare Supplement plans are secondary to Original Medicare.  When someone purchases a supplement, the provider will bill Medicare first and then the supplement will cover a portion or all (depending on the supplement you choose) of the remaining costs.  Medicare Supplement plans cover Medical services only and do not include Rx coverage.  Those that want Rx coverage purchase a stand along Part D drug plan.   Supplements are standardized in Connecticut.  This means that there is no variance in benefits from insurance carrier to insurance carrier.  In Connecticut there are 10 supplement plan options with plans F, N and L being the most popular.

Due to the fact that the benefits are standardized, purchasing a supplement usually comes down to who has the best rates.   Currently in Connecticut the United Healthcare AARP branded Medicare Supplements have a large rate advantage over all the other companies.   In other words, it really doesn’t make sense to purchase a Medicare supplement through a different company.

Positives:

• Medicare Supplement plans are secondary to Medicare.  This allows you to see any doctor that accepts Medicare.  There is not a network to follow.  As a result, Medicare supplements are very convenient for people that travel.
• You can determine how much coverage you want. For example, if you want 100% medical coverage, Plan F supplement would provide it or for 75% coverage you could use a plan L.
• Medicare supplement do not have prior authorization requirements

Negatives:

• Medicare Supplement plans have monthly premiums in addition to the Part B premium.  For example, the lowest cost plan F in Connecticut is $220 a month.  (cost is per person)
• Medicare Supplements do not include Rx coverage.  You must purchase Rx coverage separately with a Part D Rx plan.  Part D plans range in monthly price from $14 a month to $100 a month depending on the plan chosen.
• Medicare Supplements will only cover a procedure that is covered by Original Medicare.

CLICK HERE TO LEARN MORE ABOUT MEDICARE SUPPLEMENTS

 FOR MEDICARE SUPPLEMENT APPLICATIONS – CLICK HERE

Please contact us if you have any questions.  You can either call Crowe and Associates at 203 796 5403 or email  us at Edward@Croweandassociates.com.

AARP Medicare Complete is a general name given to a number of different United Health Care Medicare Advantage plans with the AARP logo.   United Healthcare also offers a number of different Medicare Complete plans without the AARP logo.

United has an AARP Medicare Complete branded product in most states.  In some states they have multiple plans.  The AARP branded Medicare Complete plans come in three types: HMO, POS and PPO.  The plans all have the same basic copay structure and more or less operate in the same manner with the only real difference being that the POS and PPO plans have out of network coverage.

Do you have other questions or do you want to see more detail on these plans?  I have a number of blogs on this topic or you may contact the office for more information.

Most people are eligible for Medicare when they turn age 65. Being eligible for Medicare means you will be able to get Medicare Part A and B. If you are already receiving your social security payments, you will be signed up for Medicare A and B automatically.  If you are not electing your Social Security benefit, you will need to take a few steps to get signed up.

First off, you need to have worked and paid Social Security taxes to be eligible for Medicare part A.  You may also qualify through a spouse that worked 40 quarters.  There is no monthly premium for Part A.   Part B can then be elected for a cost of $104 a month per person. (can be more based on income)

As stated, if you already get Social Security payments, you will automatically be signed up.  The effective date of your Part A and B is the first of the month you turn 65.  If you have not elected Social Security, you will need to call your social security office and tell them you want to sign up.  You may also go online to get this accomplished for those that rather use the web.  The site to go online is here CLICK FOR MEDICARE.GOV SITE 

Once you are signed up, you need to then determine how you want to cover the gaps in Medicare A and B and determine if you want drug coverage.  There are 3 basic categories of choices:

• Buy a Medicare Supplement plan (Medigap) and a stand alone drug plan
• Sign up for a Medicare Advantage plan (Managed Care Plan)
• Sing up for a part D plan only

Most people are eligible for Medicare when they turn age 65. Being eligible for Medicare means you will be able to get Medicare Part A and B. If you are already receiving your social security payments, you will be signed up for Medicare A and B automatically.  If you are not electing your Social Security benefit, you will need to take a few steps to get signed up. Read more

One of the biggest points of confusion for seniors seems to be making a decision between a Medicare Advantage Plan and Medicare Supplement Plan. I receive phone calls on a daily basis from people either turning 65, moving from an employer plan to Medicare or just trying to decide what to do for the Medicare Annual Election period. Often they are confused and feel overwhelmed by the amount of information and plan choices available.

The reality is that it is actually very easy to learn enough to make an educated decision. This article is going to point out the basic differences between the plans and point out the strengths and weaknesses of each. With this info, anyone will be on their way to having enough information to make a confident decision on the best plan for them. (This Article is for people in Connecticut and NY- I will write one for other states in the next few days) Read more