The
Hilton Head Sun
PRSRT STD ECRWSS US POSTAGE PAID BLUFFTON, SC PERMIT NO. 135 POSTAL CUSTOMER
November 2, 2024 • Volume 27, Issue 11 • Complimentary • HiltonHeadSun.com
Thousands of Beaufort and Jasper County residents slated to lose their How to Medicare Advantage Plans tackle
BY CHRIS DEWEY Contributor
Thousands of folks on Medicare Advantage were notified last week their plan is terminating on January 1, 2025. Five Humana advantage plans and two Aetna plans are leaving our service area. Don’t panic because sometimes the worst thing that can happen turns into the best thing. Why? Because if your plan is exiting our area for 2025, Medicare offers you a Guaranteed Issue right. This right allows you to avoid medical underwriting and purchase a Medicare Supplement with no health questions asked. Why change to a supplement rather than an advantage plan? Supplements allow you to go to any provider in the country including the Mayo Clinic. Providers like the Mayo Clinic or MD Anderson will not take your advantage plan. You will not deal with prior authorizations, routine denials, or a restrictive doctor network that’s constantly changing. You pay a monthly premium with no out-of-pocket costs other than a small annual $240 deductible. Many of my clients had the Humana Choice PPO advantage plan with a $3450 max out of pocket. In 2025, the Humana advantage plan that includes drug coverage in our area has a max-out-pocket of $9,350 per year. Consider changing back to Original Medicare and
get a supplement with no underwriting. For a 69-year-old married couple the husband would pay $100 per month with no out of pocket costs other than monthly premium and a $240 deductible so regardless of your health, you’ll pay $1440 per year with no other out of pocket costs ever, and you’ll have the luxury of seeing the doctors you want without the hassle of a managed care plan denying care or requesting prior authorizations for routine procedures. The 69-year-old wife will pay $92 dollars per month for a Plan G Supplement.
If you were 65 or over on January 1st of 2020, you’ll enroll in the Plan F, which pays all bills Medicare does not pay, but if you were under 65 on 1/1/2020, you’ll enroll in the Plan G supplement. Advantage Plans are great for folks under 65 on disability with Medicare, folks with both Medicare and Medicaid, and those who receive extra help for paying their prescription drugs. Lower income seniors on Medicare who can’t afford a medigap plan should find an agent that can look up drugs and doctors as well as help you with appeals when your managed care plan denies claims or requests a prior authorization. Medicare Advantage is NOT Original Medicare. My advice: take back your original Medicare rights you worked your entire life for. With Original Medicare you’re in the driver’s seat. You control who you see and what you get done; with advantage plans, a private insurance company manages your care and decides what and where you get procedures done. Chronically ill folks losing their advantage plans have a golden ticket they should cash in by enrolling in original Medicare with a stand-alone drug plan. Consider a Medicare supplement with no more copays, coinsurance, restrictive networks, or prior authorizations. Chris Dewey is the founder of May River Medicare Insurance in Bluffton.
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