Best Medicare option for Massachusetts snowbird

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protagonist
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Best Medicare option for Massachusetts snowbird

Post by protagonist »

My head is spinning over this.
I currently have an Advantage Plan. Tufts Medicare Preferred Basic Rx HMO. I pay $45/mo. for this.
But as of late 2021 I now own property in Florida as well, where I intend to spend roughly 5-6 months/year.
I also travel internationally about 3-4 weeks/year so I need foreign emergency travel insurance.
I am a MA resident, and intend to remain one for the time being, but I am entertaining FL residency in the future if it makes much financial difference.

The issue is that I spend a fair amount of time out-of-network when I am away, and whereas the Tufts coverage out-of-network including international travel is not bad, I am concerned about the lack of limits on out of network expenses if my health declines.

I am 70 y o and in very good health though I had a minor heart attack in 2015. I currently purchase almost all of my medications via GoodRx rather than using my insurance because I almost universally get a better deal that way. My prescription drug costs are currently quite low.

Massachusetts does not have the same supplement insurance options as the rest of the US (further explained below).

I am considering:

1. An Advantage plan with good out-of-network benefits and, in particular, one that would not bankrupt me in case of a catastrophic event (really the main reason I carry health insurance in the first place). Perhaps a Mass. PPO with good coverage in the St. Petersburg FL area.

2. Switching from an Advantage plan to a low cost Part D prescription plan plus either MA plan Supplement 1 (similar to national plan F) or Supplement 1A (similar to national plan G). Since the price differential between Supplement 1A and Supplement 1 tends to be greater than the Part B deductible I would lean towards the cheaper Supplement 1A, which costs about $200/month or a bit less, depending on provider, and the premium is not age-dependent (by MA law). That would cost me about $150/month more than what I am currently paying the Tufts HMO Advantage plan, plus the cost of a drug plan (D) and I would lose some of the benefits I get with Tufts (e.g. basic dental, eye care, health club reimbursement). I don't pay anything close to that in average out-of-pocket health care costs per month currently. But I would have more peace of mind if something catastrophic happened in Florida. I don't know if it is worth the extra annual cost.

If I understand correctly (from when I researched this 5 years ago), Massachusetts is somewhat unique is that they allow you to switch plans during any enrollment period free of charge or underwriting. That seems like a major benefit. Also, a FL agent told me that, since MA offers different options than FL, if I became a FL resident at some point I could enroll in FL as a "new customer" and avoid underwriting if I get a FL supplement plan.

If you are also a snowbird, and especially (but not exclusively) if you live in MA, please let me know what you are doing about this, and your logic behind it.

Thanks in advance,
protagonist.
Shire hobbit
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Re: Best Medicare option for Massachusetts snowbird

Post by Shire hobbit »

I am not a snow bird, but I too am a Mass resident, my preference is to have traditional Medicare with a part D and Medex back up. I get coverage out of state as there is no network like an Advantage plan and Medex (Mass Medigap insurance) covers emergencies when out of state. My preference is to be able to "set it and forget it" and then travel and not have to worry about healthcare coverage. Yes I will pay a bit more for it, but peace of mind is priceless :)
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Chip Munk
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Re: Best Medicare option for Massachusetts snowbird

Post by Chip Munk »

protagonist wrote: Wed Aug 10, 2022 2:35 pm 2. Switching from an Advantage plan to a low cost Part D prescription plan plus either MA plan Supplement 1 (similar to national plan F) or Supplement 1A (similar to national plan G). Since the price differential between Supplement 1A and Supplement 1 tends to be greater than the Part B deductible I would lean towards the cheaper Supplement 1A, which costs about $200/month or a bit less, depending on provider, and the premium is not age-dependent (by MA law). That would cost me about $150/month more than what I am currently paying the Tufts HMO Advantage plan, plus the cost of a drug plan (D) and I would lose some of the benefits I get with Tufts (e.g. basic dental, eye care, health club reimbursement). I don't pay anything close to that in average out-of-pocket health care costs per month currently. But I would have more peace of mind if something catastrophic happened in Florida. I don't know if it is worth the extra annual cost.
I'm not a snowbird but I am a resident of Massachusetts. I have a Medicare Supplement 1A plan from Tufts. I chose it over their Supp 1 plan for the reason you mentioned -- the savings from the lower monthly premium of the Supp 1A plan more than covers the Medicare Part B deductible. Just as an FYI, Tufts includes the following as extra benefits in their Supplement 1 and Supplement 1A plans:
  • one routine eye exam each calendar year.
  • $100 reimbursement for eyewear or contact lenses every calendar year
  • $150 per year reimbursement towards fitness club membership, instructional fitness classes, and/or nutritional counseling
  • $150 reimbursement per year for fees related to weight management programs like WeightWatchers, Jenny Craig, iDiet or hospital-based programs
I don't know how those benefits compare to what you are getting now with your Medicare Advantage plan, but it's better than nothing. Not all insurance companies include the first two of those extras.

ETA: I purchased the least expensive Part D plan. My premium is about $7 or $8 per month. Unfortunately I owe IRMAA this year. The Part D IRMAA charge is more than the plan's premium.
Topic Author
protagonist
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Re: Best Medicare option for Massachusetts snowbird

Post by protagonist »

Chip Munk wrote: Wed Aug 10, 2022 5:08 pm
protagonist wrote: Wed Aug 10, 2022 2:35 pm 2. Switching from an Advantage plan to a low cost Part D prescription plan plus either MA plan Supplement 1 (similar to national plan F) or Supplement 1A (similar to national plan G). Since the price differential between Supplement 1A and Supplement 1 tends to be greater than the Part B deductible I would lean towards the cheaper Supplement 1A, which costs about $200/month or a bit less, depending on provider, and the premium is not age-dependent (by MA law). That would cost me about $150/month more than what I am currently paying the Tufts HMO Advantage plan, plus the cost of a drug plan (D) and I would lose some of the benefits I get with Tufts (e.g. basic dental, eye care, health club reimbursement). I don't pay anything close to that in average out-of-pocket health care costs per month currently. But I would have more peace of mind if something catastrophic happened in Florida. I don't know if it is worth the extra annual cost.
I'm not a snowbird but I am a resident of Massachusetts. I have a Medicare Supplement 1A plan from Tufts. I chose it over their Supp 1 plan for the reason you mentioned -- the savings from the lower monthly premium of the Supp 1A plan more than covers the Medicare Part B deductible. Just as an FYI, Tufts includes the following as extra benefits in their Supplement 1 and Supplement 1A plans:
  • one routine eye exam each calendar year.
  • $100 reimbursement for eyewear or contact lenses every calendar year
  • $150 per year reimbursement towards fitness club membership, instructional fitness classes, and/or nutritional counseling
  • $150 reimbursement per year for fees related to weight management programs like WeightWatchers, Jenny Craig, iDiet or hospital-based programs
I don't know how those benefits compare to what you are getting now with your Medicare Advantage plan, but it's better than nothing. Not all insurance companies include the first two of those extras.

ETA: I purchased the least expensive Part D plan. My premium is about $7 or $8 per month. Unfortunately I owe IRMAA this year. The Part D IRMAA charge is more than the plan's premium.
Thanks.
What is your Part D provider?
Jack FFR1846
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Re: Best Medicare option for Massachusetts snowbird

Post by Jack FFR1846 »

I am still working, so only signed up for Medicare A, but have been continually researching and it is clear to me to steer clear of any Advantage plan. Why? They are pretty much HMOs with limits on where you can go and who you can see while doing traditional A, B and a supplement gives you the ability to see any provider who works with Medicare patients.

I get the in/out of network problems as I have that with my work insurance. DW has worked extensively as a nursing case manager and will literally spend hours on the phone to find out if an upcoming appointment will actually be in network, including labs and anything else. I look forward to when we no longer have to do this. It will also be nice when we have to pick a new doctor to not have the insurance list literally give us as the first 3 choices a doctor who is dead, one who left the state 3 years ago and one who is no longer at the practice.
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Chip Munk
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Re: Best Medicare option for Massachusetts snowbird

Post by Chip Munk »

protagonist wrote: Thu Aug 11, 2022 10:27 am What is your Part D provider?
I chose the least expensive plan available to me, "Aetna SilverScript SmartRx". The premium is $7.40/month. Co-pays for my medications are $1 for a 30 day supply.

The Medicare website will show you the plans available to you. https://www.medicare.gov/plan-compare/# ... 22&lang=en

You can enter medications you currently take and it will show you the total annual cost (premiums plus co-pays) for the available plans. It also allows you to see how the co-pays vary between pharmacies so you will know which pharmacies are "preferred" for each plan. Insurance companies typically offer multiple plans and while one plan might have CVS for example as a preferred pharmacy, another plan from the same insurance company might not so it's important to check which pharmacies are preferred pharmacies for each plan you are considering. It will also show you the cost for mail order.
Topic Author
protagonist
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Re: Best Medicare option for Massachusetts snowbird

Post by protagonist »

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Last edited by protagonist on Thu Aug 11, 2022 12:17 pm, edited 5 times in total.
jpohio
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Re: Best Medicare option for Massachusetts snowbird

Post by jpohio »

I am a snowbird (Ohio & Florida). My wife and I have standard Medicare A & B plus Medicare Supplement part F, plus part D plan from Silverscript. The Medicare Supplement plan we purchased from a regional insurance company in NE Ohio, but obviously you can buy Med Supplement plans from a variety of companies. Ohio residents for now, but have established relationships with local doctors in Florida, and used them for several non-emergency stuff. The part D plan works fine in both places as well.
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