Question/Answer about My Senior Advantage

Below is correspondence I had with my health provider about the benefits of Senior Advantage which one can join at age 65 with some insurance carriers i.e. Kaiser Permanente which is my health care provder. I am happy with my coverage at Kaiser but wondered about what I get for joining Senior Advantage. Obama says the government could save money by eliminating that program. What is left out to be fair is what alternative the President or Congress would provide, if anything, for those of us who prefer something other than basic Medicare plus Medigap coverage. Obviously it is in Kaiser's interest to keep Senior Advantage. Any ideas on this one? By the way, my question was answered within a very short time so this advice forum for Kaiser members is quite helpful.

Name: Sharon Raphael
State: CA
Question: I am on Senior Advantage and am a Kaiser Group Member. I work at CSUDH as a ferper, retired faculty. Obama says he want to get rid of Senior Advantage because it costs the government 14% more than straight medicare. I don't understand why this is so. What advantages am I getting from Senior Advantage and if this were changed what would I lose? I want universal health care to pass but I don't necessarily want to lose my senior advantage unless you can make some sense out of this for me. Thanks. Sharon Raphael, Long Beach

Sharon,

Under a Medicare Advantage plan, like the one you have with Kaiser, the federal government pays your insurance carrier a monthly fee for assuming the responsibility of your health care expenses. This amount, according to statistics, is 14% higher than the claims incurred by Medicare Part A and Part B recipients, for which Medicare is fully liable. So, the government is suggesting that by eliminating Advantage plans, and not contracting with insurance carriers to assume claims liabilities, they will save money. Part of the reason why claims are less on Medicare A and B is because the covered benefits are limited. You can visit Medicare.gov, where they provide a comprehensive comparison of which benefits are offered under Medicare Part A and Part B. You will see that there are substantial sacrifices in coverage from what you have now on your Advantage plan. Medicare Part A is standard coverage, Medicare Part B will cost you a $96.40 a month. But, if you want prescription drug coverage, you will also need to purchase Medicare Part D. Combined, these Medicare programs will fall short of your current benefits and will include things like hospital deductibles and gaps in prescription drug benefits. If you have Medicare, you can still purchase additional Medigap coverage, but these plans can be quite costly and may still not equal the comprehensive coverage you receive under your Advantage plan.


Best Regards,
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