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Comparing health plans. (Medicare or otherwise.)

From former employees of HP and HPE.  (Nov 7, 2022)  Question? Email: info@hpalumni.org 

Join the HPAA's Benefits Forum Covers topics such as COBRA and retiree health benefits, annual enrollment, and transition to Medicare.

Heads up! When considering health plans, compare the details.

Health plans provided through employers to retirees and current employees are "group" plans that have been customized for the specific employer.

- Group plans Premiums reflect the cost of care across the HP or HPE retiree population, and are rapidly increasing. Group policies can be much more expensive -- but may have better features -- than similar individual plans purchased on the highly-competitive open market.

- For group plans, HP says: "Premiums reflect the underlying cost of care across the HP [or HPE] retiree population."  Why HP group plan costs are going up. hpalumni.org/health-cost

- For open-market plans, HP says: "Premiums are based on the competitive market. They reflect the underlying cost of care across all the customers of a particular insurer." --2022 HPInc Enrollment Guide

- A group plan may be better for your specific situation -- dependents, pre-existing conditions, or medications. While there are government specifications for open-market Medicare Advantage and Supplemental policies, employer plans do not have to match those specifications.

- Group plans and open-market plans with similar names from the same carrier may have very different coverage features.

From our discussions on the HPAA Benefits Forum, of the many factors involved in selecting a health plan, there are several key issues:

- Whether the plan has an annual out-of-pocket maximum or a lifetime cap. You could get wiped out financially by a major health issue.

- If you have pre-existing conditions.

- What medications you currently take. Can make a huge difference in your cost via co-pays.

- Other co-pays. For example, the co-pay for hospital stays can vary from zero to hundreds per day.

- Whether your current doctors -- and the hospitals and specialists they use (such as anesthesiologists) -- accept each plan. ("In-network" vs. "out-of-network.")

- How coverage works if you are traveling, if you spend time at a child's home, or if you have two homes.

- Dependent coverage.

Member Question? Email:

"For Part D plans, do your research on Medicare -- https://www.medicare.gov/plan-compare/ -- and on the web sites of the plans that interest you. Always generate a drug cost for the pharmacy that you prefer to use. Take Aon's drug costs with a grain of salt. If they happen to agree with Medicare and the plan, then trust them. Otherwise, ignore them."

"If you run the numbers early in the enrollment period, consider rerunning them later, because things can change. Check the out of pocket and deductibles. In CA the HP Kaiser group plan has much lower amounts for the same cost as the Kaiser individual plan."

"Donít throw out the baby with the bath water. HPís Humana Gold Advantage program in Colorado is great and no additional charge."

"I'm insuring my college age son. He's on UHC PPO 650 which is a much better insurance than what is available with 'Affordable' Health Care insurance. Once he graduates and is on his own, I'll go to either AARP/UHC, Aon/UHC or the open market. The HP group insurance isn't competitive for those on Medicare but again, in my case I have to insure a dependent who is not of Medicare age."

"Just make sure you are comparing apples to apples."

You can compare benefits and costs for all open-market policies -- Advantage, Drug, and Medigap -- available in your ZIP code on the official Medicare site. Gives estimated cost -- and contact info -- for each policy. (Notes: No sales agency, including ARHS, offers all policies available in your area. The official Medicare comparison site does not have information on any group policies, such as HP/HPE, that you might be qualified for.) https://www.medicare.gov/plan-compare 

Medicare next step: Medicare - HP or HPE  If receiving benefits from HP or HPE

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