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 Posted: Sun Nov 14, 2010 10:26 pm Post subject: Medicaid Advantage Plan |
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I recently heard of something called the Medicaid Advantage Plan.
Can someone please explain this to me? What is it? What does it do? What insurance companies use it? |
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Nicholas_peters_
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| Posted: Mon Nov 15, 2010 5:00 am Post subject: |
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No such thing as MEDICAID ADVANTAGE!!
There is something called MEDICARE ADVANTAGE -- which is an HMO or PPO substitute for Original Medicare Parts A & B. It's available in most, but not all areas of the US.
Most people would save money on a Medicare Advantage plan, and should include the Part D prescription drug benefit. Not surprising, because it involves the US Government paying money to insurance companies, Obama wants to end or reduce the Medicare Advantage program.
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MaxHerr
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| Posted: Mon Nov 15, 2010 1:16 pm Post subject: |
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| Please don't get confused between Medicaid and Medicare. One is for the seniors, while the other one is for the low income group. |
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steven
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| Posted: Mon Nov 15, 2010 3:12 pm Post subject: |
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| Quote: | | One is for the seniors, while the other one is for the low income group. |
While Medicare is designed primarily for persons age 65 or older, there are younger persons who are disabled (have been collecting Social Security Disability benefits for 24 consecutive months, are diagnosed with ESRD or ALS) who are covered by Medicare.
There are also many seniors who are covered by Medicare and also receiving benefits under Medicaid because they are also "medically-indigent" persons and cannot afford those things Medicare will not cover (primarily Long Term Care). These persons are affectionately known as "Medi-Medi" beneficiaries. They cannot be sold a Long Term Care policy or a Medicare Supplement policy (they are not supposed to have the money to pay the premiums), and they are generally ineligible for Medicare Advantage plans (especially if there is an additional premium for the Medicare Advantage plan [including prescription drug benefits]).
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MaxHerr
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| Posted: Sun Nov 21, 2010 12:22 am Post subject: |
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I heard of somethng called MediBlue HMO and Mediblue PPO policies with BCBS. Is that what you mean by the Medi-Medi beneficiaries?
Also, I knew someone who had Medicaid and Medicare would get cash from her assistance and send it to her life insurance policy. |
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Nicholas_peters_
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| Posted: Sun Nov 21, 2010 2:32 am Post subject: |
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| Quote: | | I heard of somethng called MediBlue HMO and Mediblue PPO policies with BCBS. Is that what you mean by the Medi-Medi beneficiaries? |
NO! "Medi-medi" means a senior who is receiving Medicare and Medicaid benefits simultaneously (mostly persons who are in long term care) due to limited income.
A person might be receiving SSP or SSI payments under certain circumstances. They are supposed to be getting the money because they cannot afford to live and eat, not pay for life insurance (although it would not be prohibited) or to enter a Texas Hold 'Em po-ker tournament.
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MaxHerr
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Alston
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| Posted: Tue Nov 23, 2010 5:22 am Post subject: |
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| Quote: | | basically come down to whether you will need routine care outside of the network. |
That's not quite accurate. If the MedAdvantage plan is a PPO, out of network care is still available, just with somewhat higher out of pocket expenses.
The bigger question is whether the MedAdvantage plan (HMO or PPO) offers a more robust benefit platform, as most do, compared to Original Medicare Parts A & B (with or without a Supplement of any type). Most HMOs and PPOs include as covered services many of the things that Medicare excludes.
Plus, in a side-by-side comparison, a single hospitalization of 150 days (not very common anymore, but still possible) utilizing all of a beneficiary's Lifetime Reserve Days for the hospital stay under Original Medicare Part A means an out of pocket expense of at least $44,000+. Under a MedAdvantage HMO or PPO, the out of pocket maximum in many plans would be no more than about $2500-$5000, in or out of network.
MedAdvantage is a great program, and it's utterly appalling that Obama has his heart set on eliminating the program because commercial insurance companies get money from the Government to handle those patient claims.
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MaxHerr
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