Is Humana Gold Choice better or worse than regular Medicare with a supplement policy???

Question

My husband and I have been doing well on Medicare with a supplement policy, and then a representative sold us a Humana Gold Choice last night and I am very worried. Please send us information on this.

Answer 1

The Humana agent was probably required by law to provide you with a comparison illustration. He/She would have been in Florida. Before replacing any insurance, I have to sign a form stating that the customer is aware that the insurance is being replaced, and that they approve of the move. Then, I have to state why the replacement is taking place. I do not write insurance for Humana Gold Choice, so I don't really feel qualified to answer as to whether you made a good move or not. The one thing I WILL say is that in my home area (North Florida), MANY doctors are pulling out of Humana for whatever reason.

Answer 2

It all depends on your individual circumstances. As stated it is a private fee for service Medicare Advantage Plan, not a Medicare Supplement, and it works entirely different. I sell these plans with Humana, I also spend the necessary time insuring my clients understand the difference in how these plans work. I get calls from people who have purchased one of these type plans and cannot reach the agent who sold it to them; they never seem to fully understand their plan, they just know it is supposed to save them some money.

I personally never replace a Medicare Supplement for a Medicare Advantage unless it is a have to situation, meaning they cannot afford the supplement and will lose it anyway because they can no longer pay the premiums. What will you do with the extra dollars you will be saving each month? Will you actually be saving? Do you see specialists and require a lot of services? Can you afford to keep paying the supplement, or is it stretching you too thin?

Don't get me wrong, Medicare Advantage Plans are an excellent fit for people who are under 65 and disabled, for those who did not purchase one during their 7 month guarantee period of turning 65, and now are in bad health and cannot qualify for a supplement, and for some who have supplements now, and can no longer afford the higher premiums. The people I have placed on one of these plans have stayed with it and are pleased to have predictable copays, these are mainly people who have just been using their Medicare and needed more coverage. I have signed up a few people who have dropped their supplement to join one of these plans, and they are all happy with their decision.

The main thing is getting together each year with your agent to review the plan for the next year because these advantage plans have to be approved by Medicare, and their contract with Medicare is good for one year at a time. What this means to you is that these plans can, and every one I sell has, since inception in 2006, increased the monthly premium, increased the copay amounts to the primary care physician, and specialist, and the big change to look out for is the amount you must pay per day if you go into the hospital. Humana changed from $180 per day for the first 5 days to a flat $450 per admission. Your supplement, well the only thing that changes is the monthly premium, and I know that rates have went up everywhere, so these advantage plans look real good to some folks right now.

Call the agent back that signed you up and relay your fears to him or her. Maybe the agent just needs to explain a little more to you and there is no need to worry.

You do have the guaranteed right to go back to a supplement without answering the health questions within 12 months, so that should give you some peace of mind.

Best wishes.

Answer 3

It's not a case of whether the plan is better or worse, it is different. It is a Medicare Advantage plan. The question should be is it better or worse FOR YOU. Everybody's situation is different so there is no way for a bunch of strangers on this website to tell if you made a good move. I do sell Medicare Advantage plans, including Humana, as well as Medicare Supplements. I have replaced Supplements with Advantage plans and I have replaced Advantage plans with Supplements. It all depends on the client.

Better or worse is subjective and I use cost effective instead.

Since I don't know you I can only speak in generalities but IN GENERAL a Medicare Supplement is more cost effective if you are in poor health and use medical services frequently. If you go to the doctor 2 or 3 times per month and go into the hospital 2 or 3 times per year the higher premium for a Supplement is offset by not having any additional out of pocket costs.

A Medicare Advantage plan has many benefits that a Supplement generally does not have, including an annual physical and skilled nursing without a three day hospital stay requirement. Even though you have co-pays the Medicare Advantage plan is more cost effective if you don't use medical services as often.

The Gold Choice is a Private Fee For Service Medicare Advantage plan. It works differently from a Supplement. You can go to any doctor but the doctor has to agree to accept the plan. There are no doctor networks so it can take more work on your part to find a doctor willing to take the plan. The doctor can accept the plan today and not accept it tomorrow. He can accept it for you but not for your spouse. He can change his mind at any time. In practice it does not happen very often but it is a possibility.

Don't be too worried about the plan. Try it out and if it doesn't work you have a guarantee to get your previous Supplement back without underwriting within 12 months.