Executive shares how Medicare Advantage plans can survive, thrive amid regulatory scrutiny

Executive shares how Medicare Advantage plans can survive, thrive amid regulatory scrutiny

Humana Inc. announced the week it will be offering an additional Medicare Advantage plan in Will County.

Medicare Advantage plans are disturbed through private insurance companies like United Healthcare and Branded with the AARP logo, but are ultimately insured through United Healthcare. With these plans, members can enjoy all the benefits of original Medicare, as well as prescription drug coverage on most plans along with added benefits and important financial protections.

Medicare drug plans frequently change the list of drugs that they cover and their premiums every year.

Those eligible for Medicare throughout Will County continue to have the choice of Humana's other Medicare Advantage plans, including the Humana Gold Plus HMO; local and regional Humana Choice PPO plans; and stand-alone Part D prescription drug plans. For these restrictions, people who are insured for their health through a Medicare Advantage Plan receive benefits such as 100% payment for Medicare services (Not 80% like original Medicare), additional benefits; like gym memberships, nurse aid services, emergency response and world-wide emergency coverage and even some have transportation benefits.


I must acknowledge and debunk the myth that seems to be floating around that you lose your Medicare when you sign up for a Medicare Advantage Plan. There are special Medicare Guarantee rules which you must abide by. The number of MA plans with prescription drug coverage receiving three and a half stars was 139, while 98 plans earned four stars and 26 earned five stars. And, you may need to stay in the plan's provider network, unless you're willing to pay more to go outside the network. Examples include being in a network, living within the plans coverage boundaries and perhaps some costs for services.

You are applying for a Medicare Supplement will be a completely different experience than your wife's Medicare enrollment because she is new to Medicare. If the plan decides to stop participating in Medicare, you will have to join another Medicare health plan or return to Original Medicare.

There's a good comparison of Original Medicare and Medicare Advantage in the "Medicare & You" handbook.

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