In my state Aetna's Advantage Plan would be--after premium, Medicare, and rebates--cheaper than UHC's Advantage Plan by about $300/yr. Aetna Direct is almost $2,000 more, but, of course, it is nice to have Medicare as primary.In my opinion the plan looks great, the premium is amazing and actually is lower in 2025 (self+ one anyway), and the HRA is great, but yes, I couldn't risk the network issue in our situation. Maybe I don't understand how it truly works, but I wasn't comfortable with it. In other locations perhaps it would be more fitting?So you steered clear of Aetna's Advantage Plan?There are now quite a few FEHB plans offering Advantage (MA) plans, a nice perk being the Medicare Reimbursement, but some regular plans do this too. Several of the MA plans do not show our providers as being "in-network" so I pursued them no further as my spouse uses a lot of healthcare and I did not want to be wondering all the time if there was going to be a coverage issue, even though the plans stated one could see any provider who accepts Medicare and who is willing to treat. However, the UHC MA plans I looked at do at this time have all our providers in-network so I was interested in the GEHA Standard MA option.UHC has interesting language on that issue. "Flexibility to see any provider—in-network or out-of-network—at the same cost share, as long as they accept Medicare and are willing to bill UnitedHealthcare."
Is it anyone who takes medicare ........ AND ...... agrees to accept your insurance?
just an example, from GEHA: "You can see any out-of-network doctor or health care provider that participates in Medicare and accepts the plan. "
https://retiree.uhc.com/geha/find-a-provider
I wondered, what provider wouldn't bill UHC? My spouse has one essential provider who is out of network. While I knew they take Medicare, I asked them if they would bill UHC. They were just very confused about why I was even asking them the question. It took a long time before I got someone who, after I read them UHC language, finally said "yes."
For our other local providers, it looks like they are (at least in 2024) in network.
However, our current plan currently (Aetna Direct) will be a lower premium for 2025 (for self+one anyway), also has Medicare Reimbursement, great Rx coverage with the Part D option, and since we are still considered "Original" Parts A and B with the FEHB plan as secondary, can see almost any provider almost anywhere.
If you are on Medicare A&B, does Direct really only provide 60 days skilled nursing care?
Statistics: Posted by Tdubs — Tue Oct 01, 2024 7:40 pm — Replies 50 — Views 3532