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Bob Loblaw  
#1 Posted : Sunday, November 7, 2021 12:51:42 PM(UTC)
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I’ve been looking at the 3 United Healthcare Medicare Advantage choices for my area (Northern Virginia). They are the Choice Primary, Choice Plus Advanced, and Choice Plus Primary. For Self Plus One they range from $1000-$1400 less per year than the Aetna Advantage Medicare Advantage plan (which is itself some $2000 per year less than the BC/BS Basic + Medicare I have now). I’ve been reviewing the different brochures, and they of course have various benefits, deductibles, and in-network requirements. It’s a little confusing trying to compare them, but it seems like when you add the MA option to the main plans it tends to make them very similar…no copays, no deductibles, no network requirements (other than participating with Medicare), etc.
here’s the Summary of Benefits from the UHC website

https://uhcvirtualretire...of%20Benefits%202022.pdf

and from Aetna

https://www.aetnafeds.co...agePlanBenefitsGuide.pdf

What am I missing? Since the benefits are all similarly based on Medicare coverage it seems like the benefits from the cheapest UHC plan are about the same as the Aetna Advantage plans. Has anyone determined the difference between them (or, for that matter, between the various UHC MA plans)? Why shouldn’t I just choose the least expensive MA plan?

Edited by user Sunday, November 7, 2021 12:54:05 PM(UTC)  | Reason: Not specified

Sante123  
#2 Posted : Tuesday, November 9, 2021 10:00:52 AM(UTC)
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FEHB UHC plans that feature a Medicare Advantage option similar to the Aetna Medicare Advantage option are identified by a “Retiree Advantage” label. The UHC Retiree Advantage option is the same for all plans to which it is attached. However, the original plans themselves are not the same. There are five such UHC plans that offer the Retiree Advantage option: Choice Primary, Choice Plus, Choice Plus Advanced, Choice Open Access and MD-IPA. While deductibles, copays, coinsurance and service area healthcare delivery restrictions disappear under the Retiree Advantage option, the original service area enrollment restrictions continue in force for each of these plans. That’s because enrollees must remain eligible to enroll in the original plan in order to enroll in the Retiree Advantage option. This means you must live in the service area of the plan in question.

There are far too many variables to answer questions like “Which plan is best?” or “Which plan should I choose?” And only you can know answers to the following: Do you need hearing aids? Do you need specialty drugs? How important to you is access to acupuncture or chiropractic services? How important to you is the number of free non-emergency transportation trips provided by a plan? How important to you are included dental benefits? How important to you is the most you could pay in a year? The FEHB Aetna and UHC MA plans pan out slightly differently with respect to these items.

To get a full understanding of FEHB MA plans, you have to carefully read the plan brochure, the Evidence of Coverage (EOC) document and the official Summary of Plan Benefits. When you do, you find the following basic considerations:

Service Area:
For FEHB MA plans, there are two meanings to this term. One is meant to describe the areas in which the plan has in-network providers and in which you must live in order to be eligible to enroll. In this respect, the Aetna MA plan is available for enrollment nationwide, while the UHC plans have a much smaller area of enrollment availability. (I tested various Aetna MA non-listed counties and found that the Checkbook Guide still showed them as available for enrollment. The same was not true for UHC non-listed counties or states.)

The other meaning is meant to describe the areas in which you can obtain services from providers regardless of whether they are in-network. Providers simply have to accept Medicare and the plan. If they do, you receive covered services at prices set by Medicare. In this respect, both the Aetna MA plan and the UHC MA plans offer access to services throughout the US and its territories. In addition, they both offer reimbursement for covered urgent and emergency services worldwide.

NOTE: the lists of service area counties and states found in the respective brochures is mostly relevant to the non-Medicare variant of these plans. In that respect, whether in-network providers are available in a given area is very important because if they are not, your cost sharing can be very different. And in the case of the UHC Choice Primary, UHC Choice Open Access and MD-IPA HMO plans, non-emergency benefits are generally not payable at all unless you use an in-network HMO provider. It would appear that such restrictions no longer apply once the Retiree Advantage option is chosen. However, this should be confirmed by speaking with a UHC customer rep.

Premium Costs:
It’s easy to spot that the UHC $148.50 Part B premium reduction is better than the Aetna MA $75 Part B premium reduction. But you must also factor in that all five UHC Retiree Advantage option plans have higher plan premiums than Aetna, two of which are way higher, and one of which even has different plan premiums for different parts of the US. If we blend in the cost of plan premiums, the cost of Part B premiums, together with the respective Part B premium reductions, and compare that result to the equivalent result for the Aetna MA plan, we arrive at a net combined premium savings vs the Aetna MA plan. The list below shows that there are clear net combined premium savings for three UHC Retiree Advantage option plans, while the other two UHC plans (and regional variants) have a higher net premium cost than the Aetna MA plan. I have used Self+1, pre-IRMAA numbers to illustrate the comparison.



Plan Code>> Plan Name>> Net Premium Savings vs Aetna MA
Y83 Choice Primary RA $1314.84
AS3 Choice Plus Primary RA $865.56
L93 Choice Plus Advanced RA $1081.44
KT3 Choice Open Access RA - West ($3609.12)
KK3 Choice Open Access RA - Southeast ($3155.88)
LR3 Choice Open Access RA - Northeast ($2507.76)
LJ3 Choice Open Access RA - Central ($3844.08)
JP3 MD-IPA RA ($5012.76)
Z26 Aetna MA $0.00

Edited by user Wednesday, November 10, 2021 8:33:24 AM(UTC)  | Reason: Clarify the basis for the premium savings calculation.

thanks 2 users thanked Sante123 for this useful post.
FlowerGirl on 11/9/2021(UTC), sandhill on 11/9/2021(UTC)
sandhill  
#3 Posted : Tuesday, November 9, 2021 10:30:09 AM(UTC)
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My head hurts. LOL 😂 I’ve been trying to go through the same exercise and it is exhausting. I may just stick with traditional Medicare for now.
Bob Loblaw  
#4 Posted : Tuesday, November 9, 2021 11:25:42 AM(UTC)
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Thanks again, Sante. I really do appreciate the time and effort you’ve contributed to this forum.
sandhill  
#5 Posted : Tuesday, November 9, 2021 11:32:04 AM(UTC)
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Ditto. Lots of good info.
Sante123  
#6 Posted : Tuesday, November 9, 2021 12:43:40 PM(UTC)
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Originally Posted by: sandhill Go to Quoted Post
My head hurts. LOL 😂 I’ve been trying to go through the same exercise and it is exhausting. I may just stick with traditional Medicare for now.


I understand where you’re coming from, sandhill. It’s a shame OPM can’t publish a straightforward brochure for each MA variant plan. However, think of it this way: it’s a breeze to log in and select an FEHB plan. But, afterward, plenty of folks experience problems with how their plan works. It’s the other way around with FEHB MA plans. Signing up is a bit bizarre, but from that point on you get a steady stream of EOB’s, all of which show that the amount you have to pay for each non-Rx claim is ZERO. One card to use. One EOB to read. No tedious coordination issues between the plan and Medicare. Which would you rather have?

Having had several top-notch plans over the years, I can say my Aetna MA plan is the best of them all for where I live. No surprises. No hassles. The three UHC MA plans mentioned above seem ready to deliver a very similar experience for those who live in their service areas.
thanks 1 user thanked Sante123 for this useful post.
sandhill on 11/9/2021(UTC)
sandhill  
#7 Posted : Tuesday, November 9, 2021 12:52:35 PM(UTC)
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Thanks, Sante. It helps having someone with firsthand experience to share and who has obviously researched the plans so thoroughly. I was tempted to sign up last year; maybe this year it's finally time.
Bob Loblaw  
#8 Posted : Wednesday, November 10, 2021 1:48:40 PM(UTC)
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I went ahead and pulled the trigger on the UHC Choice Primary plan (the cheapest MA plan for my area). I’m sure it will work out great, but the beauty of the FEHB is that if a plan doesn’t work out you can always switch next year.
sandhill  
#9 Posted : Thursday, November 11, 2021 2:53:24 PM(UTC)
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I just signed up for Aetna Advantage. Just need to complete the second step of calling Aetna in 7-14 days.
Sante123  
#10 Posted : Tuesday, November 16, 2021 8:57:52 AM(UTC)
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@ sandhill and @ Bob Loblaw: Congratulations on making your choices…..and doing so early in Open Season.

For everyone else, let me pass along some enrollment advice. FEHB Medicare Advantage plans require a two-step enrollment process: step one to enroll in the non-Medicare version of the plan and step two to contact the plan to provide your Parts A+B info. The plan controls how long it takes to complete your enrollment in step one. You are asked to wait 7-10 business days before initiating step two, but the waiting period is often less than that. As for step two, the plan will take your Medicare info and pass it along to HHS for verification.

Your enrollment in the Medicare Advantage variant of the plan you select is not final until HHS completes its verification. You are protected so long as you have provided the step two info to your new plan before the end of Open Season. However, for those who wait until the last few days of Open Season to do that, please be aware that HHS can get backed up towards the end of the year. The plan does not control how long HHS takes to complete its verification of your Medicare enrollment. If you expect to receive covered services early in January, it’s possible that you will not yet have received your Medicare Advantage plan ID cards by then. To avoid this predicament, it’s wise to complete both enrollment steps for your chosen Medicare Advantage plan as early as possible.

Reminder: after step one is completed, you will be sent plan ID card(s) for the generic variant of the plan. However, Medicare-enrolled members don’t actually use them. Upon completion of step two processing, you will be sent the final Medicare Advantage plan ID card(s). These are different and are the only ones used throughout the year by Medicare-enrolled plan participants.

Edited by user Thursday, November 18, 2021 6:33:57 AM(UTC)  | Reason: Not specified

thanks 1 user thanked Sante123 for this useful post.
jerry60 on 12/31/2021(UTC)
sandhill  
#11 Posted : Thursday, November 18, 2021 6:40:21 AM(UTC)
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Thanks! Your note about the second step was something that I wondered about, especially for those who typically wait until the last minute to select a plan. Excellent point.
Bob Loblaw  
#12 Posted : Monday, December 13, 2021 7:52:46 AM(UTC)
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So, signed up for UHC Choice on 11/10. Called a few days later to get the Retiree Advantage plan. Received our UHC Medicare Advantage cards by the end of November. Looked at my 1/2/2022 annuity statement on the OPM website and the $148.50 Medicare reimbursement is credited on the statement. So everything has gone smoothly and my wife and I are saving around $300/mo vs BC/BS Basic + Medicare.

Edited by user Monday, December 13, 2021 7:59:27 AM(UTC)  | Reason: Not specified

OUtside  
#13 Posted : Monday, December 27, 2021 9:45:13 PM(UTC)

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This article presents an interesting aspect of this discussion:

https://www.msn.com/en-u...ar-AAS8Vmg?ocid=msedgntp

Edited by user Monday, December 27, 2021 9:45:58 PM(UTC)  | Reason: Not specified

Bob Loblaw  
#14 Posted : Wednesday, December 29, 2021 8:32:13 AM(UTC)
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I read that article. Interesting, but the Fed version of the MA plans appear to eliminate most of the issues pointed out, such as limited network providers and required pre-authorization. We’ll see as the year goes by….I can always select a different plan next Open Season if it seems problematic.
OUtside  
#15 Posted : Wednesday, December 29, 2021 8:18:41 PM(UTC)

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Good point.
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