Medicare Soup - A, B, C, DI’ve spent the evening on the Internet and still have few answers. A salesman from Mom’s HMO visited her last week. Apparently they are now offering a PPO option. Mom mailed me the materials, which don’t tell me a lot. This plan seems to have no premium, but doesn’t list the Part B premiums and is unclear on the Part D premiums.
I called the salesman, who knew almost nothing. He said this is a Medicare Part C plan. I didn’t realize there was a Plan C. My research tonight showed me that Part C is the Medicare Advantage Plan, which is what their HMO plan is, which is different from a Medigap plan. I thought the HMO was a Medigap plan.
I asked for a side-by-side comparison between the HMO and PPO. That seems reasonable, since the same company is offering both plans to the same clients. It would make sense to offer a comparison so seniors can make an informed choice. Well, the salesman didn’t have or know of any such comparison, but assured me that the PPO plan is better. It has to be. “They can’t offer a plan unless it’s better. There are insurance laws, right?” Right…
This plan seems to have higher co-payments for many services, but also has an annual out-of-pocket maximum of $3,200. So depending on utilization, you might come out ahead. Or not. And there’s still no provision for coverage in the donut hole.
I finally found a side-by-side on the company’s website, about six layers deep. It gives me more information than I had before, but is still lacking. I continue to be amazed at how confusing all this Medicare stuff is. And I have a degree in hospital administration! There’s no way any of the seniors I know would be able to figure it out.
So tomorrow, in the midst of my workday, I need to find time to call the company and ask more questions. I hope I don’t have to sit on hold for 20 minutes, which is what usually happens. And so far, I’ve not been impressed with the knowledge (or lack thereof) of the employees I’ve spoken to. When I was trying to get information on Part D, it took three calls to find an employee who even understood my questions, which were clearly not part of their memorized scripts. So I hope I can find someone who can help me so I can get back to work.