Who has the best Medicare Advantage PPO plan? Sterling
Total Comments: 2
Posted: Wed Dec 22, 2010 07:13 am Post Subject:
Medicare advantage PPO plans are of 2 types - Regional and local. The regional one offers protection for Medicare Part-A & Part-B. It might cover you within a single-state area or a multi-state area depending on the 26 regions set by Medicare.
Posted: Wed Dec 22, 2010 02:23 pm Post Subject:
The OP has contacted me to indicate that he would like coverage in both California and Nevada. I believe he is in or near Fresno County according to the area code of his telephone number.
The only MAPD PPO available in California is from Anthem Blue Cross and it operates by county. Coverage in two states may only be possible in a few areas that actually border Nevada where services may be limited, such as the Lake Tahoe region, or eastern San Bernardino County.
Otherwise, where one resides would be their IN-NETWORK coverage area, and the other location would be OUT-OF-NETWORK with its higher out-of-pocket expenses. Fresno County is "land-locked" and would not offer such dual-state coverage in a PPO, and even the plan that covered someone on the Nevada side of the Lake Tahoe area would not cover them IN-NETWORK in all of Nevada -- such as Clark County where Las Vegas is -- or any other part of California outside the local area.
All other MAPD managed-care plans available in California (mostly at no premium cost and many with $0 deductible Part D coverage) operate as HMOs, and would not solve the OP's "two-state coverage" requirement properly.
An MAPD Private Fee For Service (PFFS) plan is an option, but would have significantly higher OUT-OF-POCKET expenses that could make it financially unattractive. And it requires finding physicians who are "Medicare-approved" which is getting harder to do as Medicare reimbursements are declining (as they will continue to do under the formula Congress approved seven years ago and which it has repeatedly ignored every year since, including this year's demand from the Trustees to reduce provider reimbursements by more than 20% to get back on track after the multiple years of Congressional tinkering).
And, socialist that he is, Obama would prefer to do away with the Medicare Advantage program for the singular reason that it means the Federal Government sends money to commercial insurance companies that he detests -- aside from the fact that they will save the government billions of dollars, even trillions over the long haul. And with a more than $73,000,000,000,000 shortfall in the Medicare Trust Fund between now and 2080, what better plan is there than Medicare Advantage?
Posted: Wed Dec 22, 2010 07:13 am Post Subject:
Medicare advantage PPO plans are of 2 types - Regional and local. The regional one offers protection for Medicare Part-A & Part-B. It might cover you within a single-state area or a multi-state area depending on the 26 regions set by Medicare.
Posted: Wed Dec 22, 2010 02:23 pm Post Subject:
The OP has contacted me to indicate that he would like coverage in both California and Nevada. I believe he is in or near Fresno County according to the area code of his telephone number.
The only MAPD PPO available in California is from Anthem Blue Cross and it operates by county. Coverage in two states may only be possible in a few areas that actually border Nevada where services may be limited, such as the Lake Tahoe region, or eastern San Bernardino County.
Otherwise, where one resides would be their IN-NETWORK coverage area, and the other location would be OUT-OF-NETWORK with its higher out-of-pocket expenses. Fresno County is "land-locked" and would not offer such dual-state coverage in a PPO, and even the plan that covered someone on the Nevada side of the Lake Tahoe area would not cover them IN-NETWORK in all of Nevada -- such as Clark County where Las Vegas is -- or any other part of California outside the local area.
All other MAPD managed-care plans available in California (mostly at no premium cost and many with $0 deductible Part D coverage) operate as HMOs, and would not solve the OP's "two-state coverage" requirement properly.
An MAPD Private Fee For Service (PFFS) plan is an option, but would have significantly higher OUT-OF-POCKET expenses that could make it financially unattractive. And it requires finding physicians who are "Medicare-approved" which is getting harder to do as Medicare reimbursements are declining (as they will continue to do under the formula Congress approved seven years ago and which it has repeatedly ignored every year since, including this year's demand from the Trustees to reduce provider reimbursements by more than 20% to get back on track after the multiple years of Congressional tinkering).
And, socialist that he is, Obama would prefer to do away with the Medicare Advantage program for the singular reason that it means the Federal Government sends money to commercial insurance companies that he detests -- aside from the fact that they will save the government billions of dollars, even trillions over the long haul. And with a more than $73,000,000,000,000 shortfall in the Medicare Trust Fund between now and 2080, what better plan is there than Medicare Advantage?
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