High Deductible Plan F VS MA Plan

azmedsupagent

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I know that there are more than enough threads debating whether a med supp is better than an MA plan however I have never seen that compares a high deductible plan F VS a run of the mill advantage plan.

Heres my argument... A high deductible plan F with a $50 premium has a deductible of $1900 after which the beneficiary has no more deductibles, no more copayments,no more coinsurance and can go to any doctor or hospital in the country without a referal. While the beneficiary is within the deductible they are paying the 20% part b coinsurance, 135 deductible and part A deductibles. In arizona the average cost to see a doctor is about $100 so 100 x 20% equals an out of pocket of about $20 to see a doctor etc... If the part A deductible is 1068 for 60 days thats $17.8 dollars a day in the hospital(most MA plans are 200-$500 a day). The high deductible plan F would essentially give them a max out of pocket of $1900 which is much lower than most MA plans, and the out of pocket costs to see a doctor is very similar to most MA PPOs ($10-$20 copay) and 17.8 dollars per day in a hospital for 60 days a lot better than 2-$500 a day for most MA plans. So essentially I think that a $50 dollar premium high deductible plan F is better than just about any MA plan out there. Esepcially if the med supp company offers a free RX discount plan, vision, discounts, and hearig discounts.

What are your thoughts?:GEEK:
 
It's better than an MA plan because it gives the person the freedom of seeing any Medicare provider. Your assessment of the hospital deductible though is incorrect. It's the FIRST $1,068, not spread out over 60 days.

Rick
 
Yes I know but I can see how it may have sounded like I didn't. You pay 1068 whether your there for 1 day or 60 days. What I was trying to illustrate is that 1068 for 60 is a better rate by dividing out the 1068 over 60 days and that its a better rate than 200-500 a day on an advantage plan
 
I think the deductable for 2009 on a HD plan F is $2000. If the price is in fact $50 per month that's $600 per year reaching a total of $2600 if maxed out.
I have to hand it to you, I have never even given this a thought until now that is. You might just be on to something here!!
 
Do MA plans include premiums in thier max out of pocket if there is a premium for the MA plan? I would guess that they do not include premiums... Maybe Im wrong.
 
Do MA plans include premiums in thier max out of pocket if there is a premium for the MA plan? I would guess that they do not include premiums... Maybe Im wrong.

NO. Premiums do not count towards the MOOP.
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I know that there are more than enough threads debating whether a med supp is better than an MA plan however I have never seen that compares a high deductible plan F VS a run of the mill advantage plan.

Heres my argument... A high deductible plan F with a $50 premium has a deductible of $1900 after which the beneficiary has no more deductibles, no more copayments,no more coinsurance and can go to any doctor or hospital in the country without a referal. While the beneficiary is within the deductible they are paying the 20% part b coinsurance, 135 deductible and part A deductibles. In arizona the average cost to see a doctor is about $100 so 100 x 20% equals an out of pocket of about $20 to see a doctor etc... If the part A deductible is 1068 for 60 days thats $17.8 dollars a day in the hospital(most MA plans are 200-$500 a day). The high deductible plan F would essentially give them a max out of pocket of $1900 which is much lower than most MA plans, and the out of pocket costs to see a doctor is very similar to most MA PPOs ($10-$20 copay) and 17.8 dollars per day in a hospital for 60 days a lot better than 2-$500 a day for most MA plans. So essentially I think that a $50 dollar premium high deductible plan F is better than just about any MA plan out there. Esepcially if the med supp company offers a free RX discount plan, vision, discounts, and hearig discounts.

What are your thoughts?:GEEK:

Perhaps you did not see an earlier post where I indicated that to compare Med Sups to MA plans by cost analysis, one must add the MA Premium and the MOOP together to get a fair comparison. In the case of MAPDs, make sure you add the cost of the PDP to the Med Sup...

Bottom line though>>> Med Sup premium is a fixed cost. MA and MAPD plans are "pay as you go"... IOW, if you don't incur the expense, you don't incur the co-pay, so a healthier beneficiary will generally do better financially on a MA plan.
 
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HHHmmm indeed... Perhaps I did not see this earlier post you speak of. I understand what you are saying as far as a standard plan f VS a standard MA plan however I am not comparing a standard plan F. In this thread we are comparing a high deductible plan F with a $50 premium and it sounds like you are talking about MA Vs a standard plan F med supp. What are your thoughts on a high deductible F VS a typical MA?
 
Some HD F plans offer an enhanced rider for office visits ($5 co pay), vision and so on. In CA, Anthem has SmartChoice standard and both a plus and preferred option. SmartChoice is the HD F, Plus includes a LTCi rider, and Preferred has no LTCi rider but does cover office visits $5 co pay, vision and chiropractic outside of the deductible.

In my area, it runs very nice for Age 65:

SmartChoice $27 a month
SmartChoice Preferred $45 a month
SmartChoice Plus $66 a month

I don't really like the Plus or any of the AdvantageCare F riders for LTCi as they have 1 year elimination period then only one year of benefit. You can do better for your client with John Hancock.

So, the basic Smartchoice will run $324 a year for premium with a $1900 deductible (it's 1900 not 2000 for 2009).

Total out of pocket.........$2224 (premium + deductible)
Add in a PDP like that which comes with Freedom Blue $360

Total HD F with PDP would be $2524 give or take.

MAPD at zero premium (Freedom Blue) costs $0 premium with $4,000 OOPM. Includes PDP so no extra charge.

HD F with PDP................. $2524 out of pocket max
HD F w/rider with PDP........$2800 out of pocket max
MAPD..............................$4,000 out of pocket max

By the numbers, either HD F will provide the client with a less expensive coverage, depending on utilization.

With full utilization, HD F is a better choice. With low utilization, MAPD might be cheaper out of their pocket.

Also, I believe HD F can be used outside of CA. MAPD with Anthem (Freedom Blue) cannot be used across the state line (except emergencies I'm sure would be covered).
 
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MAPD with Anthem (Freedom Blue) cannot be used across the state line.

Since the Freedom Blue will pay both in and out of network (medicare reimbursement limits), how do you figure it wouldn't pay in other states? Also, all MAPD plans cover at the very least emergency coverage anywhere in the US. I believe this might be one of the rare times you are incorrect.

Rick
 
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