Shopping For Medicare-Medigap Insurance-NJ

[shoes99]

We live in NJ and DH is turning 65 in March 2010. Open enrollment for 2010 is Nov 15th to Dec 31st, so I am shopping.
DH is healthy, goes for an annual checkup once a year and only takes a generic HP medicine.
Looking for insurance to cover unexpected expenses with no or little copays.
Aetna Medicare Dual Advantage Plan (HMO) is $35.00 per month ..
Aetna Medicare Standard Plan (PPO) is $108.00 per month...
I will doing further research for plans in NJ but wanted to reach out to the DIS community too.
In Patient Hospitalization:
The HMO has an in-patient hospital copay of 0.
The PPO has an in-patient copay of $200 per day for the first 7 days.
Thanks.

[Stumpy]

Not much information provided on the two plans to make an honest opinion and based simply on what you quoted the HMO has no co-pay and is $73 cheaper per month, is that correct? If that is the case, then it is obviously better but apparently there is more to the story if the PPO costs considerably more.

I work in the billing department of a hospital so I can definitely state that Medicare does not cover nearly enough and you have to pay additional premiums for parts B and D. With that being said, while your husband is healthy now as he ages the likelihood of increased medical costs do as well. Are there any medical conditions that run in his family that may be a future potential issue? Anticipating possible treatments such as hospitalizations, etc. would play heavily into what each Medigap policy covers. And, since Medicare has an out of pocket annual deductible of $1068 in addition to other co-pays and non-covered costs the additional premiums paid for the more expensive medigap policy may be recouped very quickly.

[shoes99]

Thanks, thats why I want something that will cover medicare deductibles, and hospitalization if necessary.
We have gotten about 10 flyers so far, so I am gathering info, and will also check with his primary care office for their recommendations.

[Stumpy]

Companies tend to want to bombard Medicare recipients to get their business and it can be confusing. Look for a medigap policy that may offset some of the costs of the Part D prescription co-pays. I see quite a few patients with multiple medications and the co-pays quickly add up. Also, from business experience I have found that Aetna and Humana are much easier to deal with than Anthem/Wellpoint/BlueCross BlueShield. However, whether it's easier for consumers to deal with one or the other I cannot say.

Hope this helps a little bit.

[disney1990]

Have your looked into the AARP plan?

[shoes99]

Originally Posted by disney1990

Have your looked into the AARP plan?

Not yet, but they are on my list...Thanks...

[geffric]

I am an Illinois certified SHIP ( Senior Health Insurance Program) counselor.. pm me if you want to talk and I can explain the various plans and the differences or go to your local senior center and ask for an appt with their SHIP volunteer.. we are free and can help one understand the maze of medicare..

[shoes99]

Originally Posted by geffric

I am an Illinois certified SHIP ( Senior Health Insurance Program) counselor.. pm me if you want to talk and I can explain the various plans and the differences or go to your local senior center and ask for an appt with their SHIP volunteer.. we are free and can help one understand the maze of medicare..

Thanks, I'll do that next week in New Jersey...
Question for you?
The general open enrollment period is 11/15 to 12/31. DH does not turn 65 until 3/2/2010. I've been given information from some aggressive agents via phone that unless I sign him up during the open enrollment, he will not be able to get a plan/program without a physical. I find that hard to believe, so that question is in my "shopping list"..