Tom Schrette and Alan Cash

Tom Schrette and Alan Cash

J.L. Sousa

Dear Tom and Alan:

I’ve been on a Medicare Supplement plan through my retirement.

It’s a PPO through United Healthcare and I’ve been very satisfied with it (except the price keeps going up!)

I understand PPO means lots of doctors. I just got a letter saying my old plan is going away and I can choose between a Kaiser HMO plan or a “Medicare Advantage PPO” through United Health.

The cost for either one is about half what I’m currently paying and I have to decide before Dec. 31 this year.

I’m old enough to be skeptical about a 50 percent discount plan. What do you think?

Undecided

Alan: Hmmm. This is a puzzler for us, too. We currently have only two Medicare Advantage plans in our area: Kaiser and SCAN.

They are both Health Maintenance Organizations (HMOs), so you are required to choose a Primary Care Physician (PCP) and the network is quite limited.

I do remember that Blue Cross had a Medicare Advantage plan that was a Regional Preferred Provider Organization (RPPO), but that was limited to a few counties and went away quickly.

One big drawback to Advantage plans in general is that they can simply go away and leave people scrambling for a new plan.

Tom: Since we’re in the Annual Enrollment Period (AEP) until Dec. 7, you’re not limited to the two offerings from your retirement group.

Not only could you sign up for any Medicare Advantage plan in your area, you could also sign up for a Medicare Supplement plan because you have a “… reduction of coverage under a group-sponsored health plan.”

Anything you enrolled in now would begin Jan. 1.

If you change your mind about your Advantage plan, there is a Medicare Advantage Disenrollment Period (MADP) each year from Jan. 1 to Feb. 14 (yes, Valentine’s Day).

This is when you can drop the plan, add drug coverage, and go back to Original Medicare.

Al: For those in a position of guaranteed acceptance, like our reader, my default recommendation is to sign up for Medicare Supplement Plan F. The main proviso is: “If you can afford it.”

In “Undecided’s” case, I would say compare the cost of a supplement, plus a drug plan with the cost of the proposed new plan.

If a supplement, plus a drug plan, is simply not affordable, then, of course, take one of the retirement plans offered.

On the other hand, if the supplement plus drug is affordable, take that. The AEP is available every year to switch to an Advantage plan.

Tom: The Affordable Care Act (ACA, or “Obamacare”) did not affect senior plans, so the election results do not alter the current landscape.

We have no idea what’s going to happen with Covered California, but we’ll be writing about it.

Submit questions or reach the Health Insurance Guys at Schrette Insurance, 1556 First St., Suite 105, Napa, 94559; 255-9511; schrette@gmail.com; or alancash@gmail.com

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