Florida Blue Advantage Plan
 

My wife received her booklet today concerning changes for 2015 with Florida Blue's advantage plan.The monthly premium which right now is $0 per month will be $36 per month..Has anyone with a different insurance company heard anything about next year's changes in their advantage plan?

Yep, the full weight of Obamacare hasn't even kicked in yet. '15 and '16 increase going to hit harder.

Report: Seniors to Lose Benefits and Choices as a Result of CMS' Proposed Cuts to Medicare Advantage

On February 21, CMS, released the 2015 advance notice, which include proposed changes to Medicare Advantage payments for next year. According to a new report from Oliver Wyman, these changes, if finalized, would result in a 5.9 percent cut to Medicare Advantage payments in 2015. This would result in seniors facing benefit reductions and premium increases of $35-$75 per month, or $420-$900 for the year, according to the report.

If the new changes proposed by CMS are implemented, the program would be hit by a double-digit cut over just a two-year period, causing cost increases and benefit reductions for seniors of $65-$145 per month, or as much as $1,740 over two years, according to the Oliver Wyman analysis.

Cuts of this magnitude could result in a “high degree of disruption in the MA market,” including the “potential for plan exits, reductions in service areas, reduced benefits, provider network changes, and MA plan disenrollment,” the report stated.

Seniors across the country would feel the impact of these cuts. An updated analysis by Oliver Wyman examines the state-by-state impact of these cuts.

The Affordable Care Act already includes more than $200 billion in payment cuts, the vast majority of which have not gone into effect yet, and imposes a new health insurance tax that begins this year. These were real cuts in payments – not reductions in rates of projected growth.

Seniors will see the impact of any new payment cuts in late October 2014, when they begin enrolling in their 2015 Medicare Advantage coverage. Another round of payment cuts would mean seniors learning that out-of-pocket costs are higher, benefits have been cut, provider access is restricted, and choice of plans is more limited…….

America's Health Insurance Plans - Medicare Advantage

Well, it always did seem strange to get something for nothing. I heard many years ago, before the Affordable Care Act, that advantage plans were not going to last because of the expense. I have always wondered who is footing the bill for the free advantage plans.

We have a supplemental that is more expensive than $0, but it is accepted everywhere in the country (and my husband's is accepted overseas), and there are no copays. We travel a lot, and it's peace of mind that I don't object to paying for, especially since Medicare has made such a difference in our lives in terms of the overall cost of our health care.

I have Fl Blue HMO Advantage plan and my premium is $104.90 per month.

What plan has a $0 premium?

My husband has this plan and $104.00 is paid from his SS monthly......

When was the last year before Obamacare that health insurance rates didn't go up. My last employer (4 years ago) canceled everyone's health insurance because it kept going up every year, and he was tired of negotiating with new companies every year. Pretty tough for employees over 50 to get reasonable insurance. At least now they would have Obamacare.

Which supplemental plan do you use?

Thanks to ACA my employer is stepping back from providing a health care supplement and has forced us to shop insurance providing up to a max amount. ACA has created an unstable and unpredictable market. It has placed undue pressure in the medical community and created chaos in the insurance field. What it hasn't done is help create a better quality healthcare system

Insurance companies that provide Advantage plans receive around $10,000 from the government to completely cover the individual with all Medicare Benefits and whatever (such as HMO vs PPO) else the Insurer adds as benefits. This "whatever" is what makes the Advantage premiums vary from actually receiving part of your $104 Medicare deduction back, to $0 premium, to $95 premium, and so on. Obama is taking money from the Advantage plans and putting it into Obama Care thus reducing this $10,000ish amount the Insurer will receive. The Insurer will then pass this reduced revenue they receive and increase Advantage Plans premiums to make these reductions up. Understand that the Medicare non- advantage plans, called Supplemental, will also be increasing with Obama Care. And since I contributed to Medicare all of my working life I will not be receiving something for nothing, but many who choose the entitled lifestyle will receive something for nothing with our premium increases.

Also remember that you paid into medicare most of your working life.

Full confusion on this page and this info. No Medicare Advantage plans can be discussed by any Insurance Agent until 10/01/2014 and no paperwork until 10/15/2015. So if someone knows they should not be telling according to CMS guidelines

And you have been paying for those who had no medical coverage before Obamacare through increased insurance rates and hospital costs, so remember that too.

You are getting a lot more return for your money than you ever paid into Medicare. You were also covering costs of those getting advantage plans for nothing or reduced costs through taxes you paid. It had to come from somewhere.

Florida Blue has already sent their information out to its subscribers.My wife received her information in the mail yesterday.

We're not agents...just plain ole folks discussing Medicare.

,,,,

What is the "advantage" to have an advantage plan over Plan F?

I Believe This E-mail Sent Me Explains
 

I received an e-mail that explains what is affecting Florida blue Advantage and other plans.

The 10,535 pages of ACA condensed into four simple sentences:

"In order to insure the uninsured, we first must have to uninsure the insured.

Next, we require the newly uninsured to be reinsured.

To reinsure the newly uninsured requires extra charges to the reinsured.

The extra charges are required so that the original insureds who became uninsured and then became reinsured ,can pay enough extra so that the original uninsureds can be insured which will be free of charge

This is called redistribution of wealth or by its more common name SOCIALISM"

Just think, if Congress were ever in town they could vote to repeal the ACA. [emoji6]

We have advantage plans and they are not "free". The premium is paid monthly from our SS to the tune of $104.90 each. Just because you do not sit down and actually write a check or have a draft drawn does not make anything free when it is deducted from your check be it a SS check or a paycheck with a deduction for company insurance. There are co-pays for doctors, hospitals, ambulance, etc. Does not translate to "free", either. Even with the co-pays, it is still a better deal than traditional Medicare plus supplements, which continue to rise each year you are enrolled.

Now to the difference. I used to have traditional Medicare and a supplement plus a drug plan. The Medicare deduction was taken from my SS then, too. I also paid almost $200 a month for my supplement and almost $50 a month for Part D (mandated drug coverage). They do allow for balance billing in most instances (not allowed with our plans). That means that if everything is not allowed, you often get stuck for the extra. The Plan F only pays for the 20% that Medicare picked up the 80% on. If you are billed $120 and Medicare approves $100, then they pay $80 and Plan F pays $20. Sometimes, not always, you get to pay a portion of the other $20.

Now with the advantge plan, the drug coverage is included and the out-of-pocket expense caps at $10,000 if you use both in and out of network (drugs do not count toward this). Medicare has no cap and there is a big deductible everytime you are hospitalized, which in turn will drive up the cost of your supplement over time.

Mine is a PPO, not HMO. PPO you get to choose your doctors as long as they accept your plan and do not have to get a referral from your primary (I call those referral plans Mother-May-I plans).

My husband and I have advantage plans with the same company. Before that, he did not have a supplement to his traditional Medicare and guess who got to pick up the 20+ percent? Everytime he was hospitalized, there was a deductible of $1684.00 which is not a yearly deductible. It is an event deductible. He did not have to have a Part D plan because most of his meds came from the VA. If he could not get them from the VA (very few he couldn't, thank goodness), then it was full price unless the pharmacy offered a senior discount. With the advantage plan, the co-pay is so much per day for the first 5 days in the hospital. The Medicare deductible applied regardless of how many days, even just one.

Wordy, I know, but hope it helped to explain the differences.

I have the Freedom Advantage plan.Of course Soc.Sec.deducts the $104 every month for medicare.I pay $0 for the monthly premium.And of the $104 deducted for Social Security,under Freedom's Plan I get $72 of that back because of a preexisting diabetic condition.Freedom is starting seminars Oct.2 to explain the changes for 2015.

Dillywho - that was an excellent explanation. What you didn't mention was the penalty that was probably imposed on your husband for each year he did not have an advantage or supplement plan. Don't know if the penalty was waived for his part D because of VA eligibility???

AARP MedicareComplete Regional PPO is maintaining 0 premium for next year, though some copayments are going up. This excludes the $104.90 Part B premium. I know because my husband's book came today.

Of course the only Advantage plan The Villages accepts is United Healthcare.

There is no penalty for not having an advantage or supplement plan (other than the fact that we got to pay the 20% that would have been paid by a supplement). The penalty comes in for drug coverage and yes, it is waived for those enrolled in the VA system since it qualifies as being equal to or better than Medicare Part D. I signed up as soon as it came into being so have had no penalty.

When he went back to work at his old job after retiring, he dropped his supplement thinking that he would be able to pick it back up when he retired again. I tried my best to convince him that it didn't work that way, but what did I know.....I am just a wife.:doh: His company insurance became his primary insurance and his Medicare his secondary. He kept telling me that he didn't want to pay premiums to both.

Lesson to anyone who has retired and goes back to work after getting on Medicare and purchases a supplement. Don't drop your supplement! You get one shot at it with no questions asked within so many days. After that, you have to prove insurability. Since he had suffered a debilatating stroke, he was not insurable at any price for a supplement.

It just really bothers me when people (especially the younger generations), say that seniors are getting a free ride. We paid all our working lives, as did our employers with matching funds on our behalf, and we are still paying! Participation was not and is not optional. When you have paid and are still paying, I would like for someone to explain to me what I am getting for "free". As for receiving more than we put in, that is true of any insurance regardless of the entity. When you file a claim against your insurance company, your benefits are always above what you pay in, and most of those you have not paid into for almost an entire lifetime.

Life insurance, car insurance, medical insurance, any insurance, is a highly sophisticated game of chance (gambling). They're betting you won't ever need to make a claim, and all the while you are paying premiums, and you are betting that at some point you will file.

We got our new benefits booklet today and our co-pays have gone up, but that is no surprise. Name me something that hasn't.:pray:

Hope this answered your questions that you asked me. If not, I'll be happy to try again.

The same for me, the premium is still ZERO, and the primary doc copay goes from $10 to $15 with specialists staying the same....it works for me!!

According to a recent Tampa Bay Times article, this was a major reason for the University of South Florida pulling their specialists out of The Villages Health system (not enough enrollees in United Healthcare's Advantage program).

Of course the problem with all of this discussion is that increases to premiums are given as are the increase in co-pays co-insurance and the like because as a whole half of the participants will be fully financed by the government

Dillywho - thank you for the correction - I was confusing the part B penalty. My apologies.

Just dawned on me that Medicare pretty much works like Obamacare - if you don't sign up you get penalized if and when you do choose coverage.