Is it worth getting supplemental insurance?

Hubby and I are in our late 70s and have medicare and a PPO from a national company which costs us each $150 a month. The healthcare facilities bill a huge amount then Ins pays them the medicare allowed amount. There are co-pays but we know each year what the co-pays will be. For example $10 to visit a PCP $40 for a specialist and $150 - $175 for something like an MRI. We have drugs included in the plan, and as long as the meds are on the ins co formulary the co-pay is reasonable.
Last year my bills totaled a million dollars so I was very glad not to have to find 20% of that.
So yes I would say supplemental insurance is well worth the money unless you can qualify for Medicaid

Brandywine 1949, Do you actually get bills where you are billed the 20%?? and your supplement pays? I never see that on a bill. Medicare has an allowed amount and that is all my mom is usually billed for.

I too am wondering about this. When you say you are not paying anything, are you looking at your EOBs? is your supplement insurance paying anything or is Medicare paying ALL that you owe? my mom pays $210 for a supplement and it occasionally pays a few dollars. even after an emergency trip to the hospital (no overnight) her supplement plan only had to pay $40 over what Medicare covered and she didn't owe a dime more! does anyone have any actual examples to share where Medicare paid an amount and the supplement paid another amount. Has anyone every been billed the 20% and had it picked up by the supplement plan?? or the deductible?? I am wondering if we are just giving money away to the insurance companies???

I too am wondering if the supplement is worth it. My mom pays $210 a month. sometimes the supplement pays a few dollars over what Medicare pays. usually there isn't anything due after the Medicare amount. Even when she went to the hospital for emergency HBP. she did not stay overnight. The Supplement had to pay $40!! I'm wondering if anyone has experience with a hospital stay. Are you really billed for 20% and then the supplement pays it. When people say they don't pay anything, are you looking at your EOBs? is it because the supplement pays part of it?? or is it because Medicare covers all? seems like there is little reward for paying over $2400 a year.

Agree with brandywine, hubby and I also have a BC/BS PPO and it is absolutely worth it as you get older and suffer increasing problems. A couple of days in an ICU would soon eat up the cost of the policy.

DH and I have medicare and a BC/BS supplement. I say you absolutely need it. It has helped us tremendously and I wouldn't be without a supplement. Medicare pays 80% supplement pays 20%. Please don't drop it b/c you need it.

The one thing our supplemental is good about is prescription coverage. Al has LBD and one of his drugs would be $200 a month. With the supplemental, we pay only $10.

Read David Belk's article in the Huffington Post on supplemental insurance dated 9/16/2013. Bottom line, you DON'T NEED IT, if you have Medicare Part B. You are MUCH better off just paying what little is not covered by Medicare. My parents were paying $5,000 per year for United Healthcare endorsed by AARP. And over the past two years it paid less than $400 per year for all hospital stays, doctors visits, X-rays, etc. In other words, it cost them $5,000/ year to save $400/year.

amott6: Ok, whatever you feel is the best plan for your own personal situation.
I didn't realize that Al was still working. Good Luck!


Norene

N1K2R3: I'm 76 and Al is 77. We've had BC/BS for probably 40 years through his work. When we went on Medicare, it became the supplemental. We didn't realize how little it paid until my surgery. We currently pay $102 for both of us because his company pays the rest, but I think one of the other Advantage plans would give us the same coverage for less.

Playagrandma, That's the chance you take when buying health insurance. That supplemental plan is very expensive. Do the math. If you are only 65, and your husband 75, you may not need anything more than Medicare Advantage......no monthly premiums, or very small premiums, no deductible, and the PCP visits are only $10.00- $15.00 for each visit. Specialists are $35.00- $40.00 per visit. Do you feel lucky?

I had extensive surgery last year and will need another in the future. However, as I explained, BC/BS didn't pay anything but a few pennies on any of the bills. That is why we were looking at other options. However, we had invested in a couple of rentals hoping to have a little income from them. We had to evict one tenant who left owing us $4000 and the place needed $6000 in repairs. Now, the water heater exploded in the other one. The bill for that is another $4000 of which our insurance is paying only $1300. The stress of this has made Al's PD worse, so we've decided to table the decision on BC/BS until next year. He is simply not able to deal with the added stress right now and time is running out. But thanks for the answer.

We have a Medicare PPO through BC/BS next year our monthly premium will be $116 each. PCP is $10 a visit and specialist is $25. generic drug co-pays are very little and mostly from Walmart $4 a month. We have to pay next year $175 a day for the first five hospital days then nothing. So far we have been very satisfied.

amott6: Don't give up the ship. I would give more consideration to either Humana, United Healthcare or AETNA instead of BC/BS. You know that they all offer no monthly premiums and very little co-pays.....under the Medicare Advantage Plan.. If you think that a long-term hospital stay is coming along, or perhaps expensive surgery, then Medicare Advantage is not for you. Otherwise, why not try Med Advantage?

We're giving up the search for this year, so we'll stay with BC/BS for now. Al is under too much other stress right now to make a decision. It was part of his retirement plan. So far, Medicare pays most of the bills. We also bought a long-term policy years ago that is paid off now.

The search continues.........for the most appropriate plan for you. Medicare is a given, right, amott6?? The remaining 20% is yours to pay, or to obtain a Supplemental Plan. Nothing is automatic. Not in this life. You choose to apply or not. I chose Plan F, United Healthcare for the supplemental for many years, and found that I was paying TOO MUCH. I never got sick, and it was money down the drain. About two years ago, I chose Medicare Advantage with no monthly premiums, no deductible and only a very small co-pay with each doctor's visit. $10.00 to my doctor ( still is) and, $35.00 to a Specialist. ER visits are $65.00 and long-term hospitals stays are $3,500.00 total.
Of course things my change someday, but right now, this is something that works for me. You should look into such a Plan.

GrannysMommy: When we went on Medicare, our BC/BS plan automatically became the supplimentary. It pays very little on anything except for medications. I recently had major surgery and learned that it paid all of .03 on my MRI (other things they paid .01) Surprise -- it finally paid .55 on one bill. We are looking into other plans to see if we'd pay less for medication coverage. BC/BS is a joke.

GrannysMommy, First of all, see if there is a senior "helper", that is free in your state or county. They can help you "muddle" through this mess!!!!!!!!
In my opinion, they want to confuse us! Remember that lawyers write the laws!!!
It is difficult for me to understand how someone who has a college education and has worked in the medical field and I still cannot understand how they word things.
In my opinion a lot of it is "lawyer speak"!
This whole thing is a gamble as I see it, no matter what you choose. For a year, you hope that your "prediction" for the next year was a good one! If you are fairly healthy and then oops! get sick, you may be stuck with bigger bills than you might have imagined! So you really need to think about what monetary resources you have and would you be able to pay it out of pocket!!! If not then I would choose the best possible, for what you can pay for per month.
Leave it to the government to write it in English, and we still can not understand or comprehend it!!!!!!!!!!!!!!!!!!!!!
If you are confused, the only comfort is that you are not alone in this confusion!!!!!!!!!
And depending on your monthly income, you may actually qualify for MEDICAID, AND then it is a totally different "ball game".

Are eligeble for medicaid ,that solves a lot of problems

What is the Medi-care Part B deductible and also I am confused on the definition for Medi-care Excess in Part B? I am trying to help my 84 year old mom decide which plans to sign up for this year...it is all soooo confusing. Thanks for any help.

Also one other thing of course i forgot to say that with part B you pay $100 every month which is deducted from your ss check so you really dont miss it. Althought the part f is the best its also the most expensive We have the part N-which really there is very little difference. The one difference-there is a $20 co pay for the dr if they choose to bill you for that. So far we have had only two dr do that. And $50 billed by the hospital if you should go to the ER but waived if admitted to the hosptial. Currently my 75 year old husband pays $147 60 month but if that goes anymore we will probably switch next year to the advantage

On my United Health Care Medicare Advantage I do not pay a monthly premium. There are co-pays which I think might be 20% but not in all cases. This plan also includes prescription coverage at $6 each, but in the new year that is going down. Also, doctor visits now are $10, but go to $0 in the new year. It is not offered in all counties but you should surely check it out. It has worked really well for my family.

So if you pay no premium per month with Medicare Advantage, is that through United Health Care??? do you have much higher out of pocket costs, ie. deductibles? I am just beginning to read the brochures and tried to get to some of those communities meetings but they are held at times that my father is just not moving so quickly or sleeping... just never seem to get out the door in time.

Playagrandma, Thanks for the explanation of Medicare and Medicare Advantage.. Ishould read that brochure that they send every year, and perhaps I could understand the programs. Everyone gets Part A when they begin receiving Social Security. I didn't like the $189.13 every month, now going up to almost $200.00, so I checked out Medicare Advantage. So far it's working for me......no monthly premiums. If I should become ill, and of course that will happen someday, I have enough money to pay the hospital and doctors. The end-of-life issues are a different story. Hopefully we'll all know wht to do at that very special time.

N1 -everyone gets part A when they turn 65-covers hospital only. If you go on any type of supplemental insurance and that would include the medicare advantage, $99 is deducted from the social secuirty check every month. Having said that, I have a few questions regarding medicare advantage. As I understand it you do not pay any premiums with that however do you know if and when you would have to pay out of pocket and what is the percentage if lets say I would end up in the hospital with some catastrophic. I always say if its too good to be true well its not good at all.

Question : Do you want to avoid out-of-pocket expenses every month, well/sick/ or not, or, do you want to overcover yourself in case of catastrophic illness? My choice in 2012 was Medicare Advantage. I assume that any cost was taken out of my S S check. No monthly premiums because I am fairly healthy.
Prior to that I had Medicare Parts A and B with United HealthCare Plan F (the most expensive). The monthly premiums for that were $189.13 per month, and I never got sick. That's when I changed to Medicare Advantage. Still not sick, and I have NO out-of pocket expenses for healthcare.

Kattie5315 - my guess is that your dad's out of pocket cost with the co pays of meds is 2700 per year. Then this year after you reached that amount you had to pay 1/2 of the cost price of the med. It used to be all of it!!!! If I remember right, by 2014, it should be down to 0 after the 2700!!!!!!!!!!!!!!!! Anybody, remember something different?

I have no idea what plan my dad has on AARP but I do know that it is $179 per month. He still have copays for meds though. He does not have copays for the doctor and when he went in the hospital there was no out of pocket cost to my dad. I think his annual cost out of pocket is something like 2700 per yr, that is meds only, he was taking a ton of those. Now I have him on baby aspirin and his blood pressure meds... the rest are supplements so I am not chasing those side effects all over the place. He is doing great but the wallet is being depleted rather quickly since herbal supplements and vitamins are covered by no one

Also, I really wish we had universal health care. then ins. companies could not rule, doctors would make more money because they wouldn't have as many expenses and the Gov. would just write the check each mo. to whom ever is running the program.

I am 77 and have AARP supp. ins. plan L. and pay 115. per mo.I get assistance ,I am handicapped with a service dog, I only get 28 dollars a mo. food stamps and they tell me that includes my dog. I was getting 140. before the other agent retired and the new one really doesn't care. I cannot afford to keep my supplement so my question is, if I drop my supplement will Obama care pay my health bills?