Quote:
Originally Posted by blake5676
It 100% IS very confusing. Which is one of the reasons I personally believe that Medicare Advantage plans are getting more popular. They're a simple pitch....we'll give you coverage under our name you're familar with (Blue Cross, United, Humana, etc) and it won't cost you a penny more than your payment for normal Medicare. And we'll throw in drug coverage and some other benefits as well. It's certainly "cleaner" on the surface to have one card for all health needs.
And that option is a good one for some people I suppose. That being said, the certainty of total out of pocket expense with traditional Medicare and a supplement is the safest overall choice if you can navigate the confusion and see the big picture for MOST people.
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MA plans have MOOP as well though. I'm not very familiar with Regular Medicare since I haven't worked with Medicare as a company but I've seen members come to our MA plan and their total OOP limit for any Part A & B services traditionally hovers around $3k - $4k. We just introduced a new plan for $1.1k but that plan is meant for diabetics and we usually only put MediCal members on that plan so they never really meet that maximum OOP in one year anyways (genius selling idea). Also most MA plans have supplemental drug coverage included in all of their PBP (plan benefit packages) our company sure does!
Part D though is the one thing that won't count towards a members maximum OOP for the year so I'm not sure how Medicare navigates that with their Maximum OOP system. However, Medicare Part B drugs are covered under that maximum OOP limit, so services like chemotherapy etc when you hit that 3-4k payment range for the year, the plan picks up the rest of the services for that calendar year.
Also agreed, 100$ confusing. Luckily I can read EOC's pretty well for MA plans but I still urge anyone who wants to sign up for a MA plan, hear the sales pitch but request an EOC before any decision is made!