Monthly Archives: November 2013

Questions about Humana Gold Plus (HMO)

Please Answer few Questions? I Have Medicare(Part A and B). My supplemental Insurance is 0 premium Humana Gold Plus(HMO). 1. How much Government pay to Humana monthly flat fee for me. 2. What if I have out of state medical problem? 3. What if I have out of country medical problem? 4. What if I can not find Specialty Doctor in network? Thank you very much

Answer:

1.  The government does not release the exact figures on how much they pay for your Medicare Part C Advantage Plan.  A recent article stated, “A Medicare beneficiary enrolled in a regular Medicare Advantage plan in Sacramento County with a three star rating will have the CMS pay the insurance company $830.89 per month or $9,970.68 per year as an insurance premium on their behalf.”

2.  You can receive emergency treatment at a hospital out of state but you will need to be in your coverage area for regular treatment.

3.  Most Medicare Advantage Plans do not cover you out of the country.

4.  Your HMO will have in network and out of network pricing, It will be much better to see doctors in network.

I would like to recommend that you consider changing from a Medicare Advantage Plan like you have now to a Medicare Supplemental Insurance Plan.  You can read more about the differences between Medicare Supplement and Medicare Advantage on this webpage : http://www.medicare-supplement-advisor.org/Supplement-or-Advantage.html