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Posted 7/11/2015 8:53 AM (GMT -5)
Ok, I have retired from my University, effective mid-August. On September 1st., I will have new insurance (actually back in the Michigan teachers retirement system).

I will have MediCare Advantage, specifically BCBSM (ie: BCBS of Michigan). I will also have Dental and Vision and the drug plan is run by Catamaran.


I guess I am seeking comments. I assume (but I may well be wrong) that the BCBS Advantage plans are the same for each State? I remember Tall Allen may have said otherwise (ie: it differs by region and there are about 10 regions). Down the road (hopefully not too soon) I suppose I might be on Xtandi or Zytigia or Xofo or whatever. I hope this insurance will "cooperate."


I'm not really sure what specific questions to ask. I know I had a "Cadillac" plan at work.

So, any comments?

Mel
Posted 7/11/2015 11:10 AM (GMT -5)
I spoke yesterday, with BCBS in NY as i am going on medicare in November. They told me that while i should check with the Union, their understanding is that the overall coverage will be the same as it was before, just that Medicare becomes primary. I am talking about Hospital only, for medical i have GHI-Emblem Health and they told me the same thing.
Posted 7/11/2015 11:16 AM (GMT -5)
I can only hope my coverage would be the same as I had before.

You may remember my discussion about my Mayo experience.

They actually covered a huge portion of my Mayo cost (I think I paid about $1000 out of a $15000+ bill) and they also had a provision that reimbursed both of us for our plane fare and lodging.

It was indeed a cadillac plan. There were significant issues getting them to abide by the contract, and then significant issues with Mayo (they were in network but acted like they were out of network in terms of charges).

It got worked out.

Mel
Posted 7/11/2015 11:17 AM (GMT -5)
Read thru your contract then call them with your specific questions. Some of the stuff in my contract is about as clear as mud. Even if they authorize something they won't make a decision to pay it (or not) until they get the bill from the provider.
Posted 7/11/2015 11:27 AM (GMT -5)
Mel,

Plans can be very within the same area. There is no one standard plan. Your plan will have its own schedule of network providers, deductibles, co-pays, drug prices, etc. As goats said read your contract. Also go on their website where they should have all the particulars for your plan.
Posted 7/11/2015 12:06 PM (GMT -5)
JNF:

These contracts can get very confusing!

That's why I hope to garner some others' experiences in terms of the reality and what to watch out for!

I would think many would have a BCBS Advantage Plan. Not sure if that would be identical to the BCBSM Advantage Plan

Mel
Posted 7/11/2015 12:56 PM (GMT -5)
Thank the lawyers!!!! It would be much easier if left to the mathematicians!!

I think there are a lot of guys who have the Medicare Advantage plan, some through BCBS. But remember, they are in different states and many BS+CBS companies are state specific so there will be differences.

I am in the same boat as I am coming up on Medicare and am trying to compare plans. A month or so ago I asked for some of what you are asking and I got some very good anecdotes from members. I will try to find the thread for you to review.
Posted 7/11/2015 3:07 PM (GMT -5)
Mel,

Don't assume that even policies in the same company are similar, much less in a state.

I have a friend who does insurance consulting for seniors, but only in one state. She keeps the entire staff busy just keeping up with the changes year-to-year in the same policies.

Drug coverage can change without warning. I had one name prescription that went from being refillable for a year to requiring Rx confirmation from the doc for each refill, and that happened in July. They are trying to force me into a cheaper drug, since mine has no generic, but I can't because I react badly to the generic.

So now getting a refill goes from picking up the pills at the pharamacy to several phone calls and a fax each month.
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