In Stanislaus County, seniors who want more than traditional Medicare coverage have plenty of choices.
For the fall enrollment period that runs through Dec. 7, the seven insurers offering Medicare Advantage plans in the county made nickel-and-dime changes in their monthly premiums, except for Humana, which slashed its monthly cost for 2018.
Effective Jan. 1, the cost for Humana Gold Plus will drop from $73 to $29 a month, more than a $500 reduction for the year.
Humana says it has network agreements with Memorial and Doctors medical centers in Modesto, Emanuel Medical Center of Turlock, Oak Valley Hospital in Oakdale and Stanislaus Surgical Hospital in Modesto.
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The monthly premium is not the only thing to consider in choosing coverage under the Medicare Advantage program. The plans have co-pays for hospitalization, physician visits, prescription drugs and other services. And patients need to make sure their physician visits and prescription drugs are covered by the plan.
According to a plan comparison from the Health Insurance Counseling and Advocacy Program, Humana will charge a $300 daily co-pay for the first five days in the hospital, or a total of $1,500, and then no co-pay for additional days of hospital care. The Kaiser Permanente basic plan, costing $25 a month, will charge $285 for the first seven days in a hospital bed, or $1,425 for five days and $1,915 for seven days.
Alignment Health has an AllCare Preferred plan with no monthly premium and no co-pays for the first four days of hospitalization. After that, the co-pay is $100 daily for the next five days of hospitalization.
Humana Gold Plus and seven other Medicare plans in the county have a $3,400 out-of-pocket maximum for the year.
The federal government subsidizes the Medicare Advantage plans offered by private insurers, which cover the basic Medicare services and usually the out-of-pocket costs that patients are responsible for with basic Medicare. In addition, almost all of the plans in Stanislaus County include vision benefits and optional dental.
The premiums for Medicare Advantage plans are on top of Medicare's Part B premium, set at $134 a month next year.
Maria Profeta, program manager for HICAP in Stanislaus County, said some retirees have been paying less than the $134 a month Medicare Part B premium but will pay the full amount next year because of a Social Security cost-of-living increase.
The Kaiser Senior Advantage enhanced plan will cost $80 a month, same as this year. The $25 premium for Kaiser's basic plan is a $5 monthly increase; the plan's out-of-pocket maximum is $6,700.
AARP Medicare Complete Secure Horizons will cost $97 a month for Plan 1 and $7 a month for Plan 2, which has higher co-pays. Both of the Secure Horizons plans have annual out-of-pocket maximums of $4,900. Plan 1 has a $200 maximum co-pay per hospital stay.
The Alignment Health My Choice Plan will cost $19 a month in 2018, same as this year.
Two other plans with zero premiums include the Anthem Blue Cross CareMore StartSmart Plus and Golden State Medicare Health Plan Gold HMO.
Anthem CareMore Value Plus is priced at $48 a month for 2018. CareMore's Medicare Advantage plans, which are known for their care centers designed for senior health needs, are changing to the Anthem Blue Cross brand, effective Jan. 1.
HealthNet Healthy Heart is the most expensive plan in the county. The monthly premium will remain at $157.
Medicare recipients may compare the benefits of the Advantage plans available in Stanislaus County by using the Medicare Plan Finder at www.Medicare.gov.
The Health Insurance Counseling and Advocacy Program in Modesto, at 3500 Coffee Road, Suite 19, offers free counseling for county residents with questions about Medicare coverage. Call 209-558-4540.