Our plan iS a PPO, Humana Medicare Advantage PPO.dm200 wrote: ↑Mon Jan 13, 2020 4:46 pmVery informative - in my opinion.Broken Man 1999 wrote: ↑Mon Jan 13, 2020 3:01 pm2019 Medical/Pharmacy Expenses for Broken Man 1999 and Mrs. Broken Man 1999
DW and I both on Medicare Advantage Plan PPO via Humana, courtesy of MegaCorp retiree insurance.
01/01/2019 through 12/31/2019
Medicare Part B $135.50 x 2 retirees x 12 months = $3,252.00
DW Medical claims out of pocket = $2,327.79
DW pharmacy claims out of pocket = $64.72
MY medical claims out of pocket = $368.44
MY pharmacy claims out of pocket = $352.18
Total out of pocket for 12 months = $6,365.13
Total average monthly out of pocket = $530.42
Other than the Medicare Part B premium, the largest out of pocket for 2019 was wife's share of knee replacement, and co-pays for many, many PT sessions to regain her range/motion. She worked very hard, and the results are very good.
DW has scheduled her other knee replacement for June of this year. Some of the durable medical equipment she purchased for first knee can be reused.
It is likely my pharmacy expenses will decline as one of my non-generic drugs is my fast-acting insulin. However, there is a generic option working through the various Humana plans. Usually 90 day supplies of generics are free. Currently my fast-acting insulin is $40/90 day supply. It is very affordable, but free would be even better.
We are both very appreciative of MegaCorp's continued support of excellent and affordable insurance plans ($0 premiums for our plan) for retirees. How long that support remains is unknown, but we are good until the end of 2020, at least.
Broken Man 1999
Any idea how much MegaCorp's contribution saves you both per month? You also have a potential benefit of a PPO Advantage plan - if that might be better for you.
Such retiree support after Medicare eligibility has nearly gone away in the private sector. Seems to me that yours could go away at any time. A few years ago, a friend of ours retired from a MegaCorp about when she became Medicare eligible. This Megacorp once was known for providing outstanding benefits - including health/medical for retirees - including those on Medicare. It turned out that this MegaCorp terminated all health/medical benefits for retirees eligible for medicare within a month or so of when our friend retired! So, now, she has Kaiser medicare - paying the same as if she never worked for that megaCorp.
In our Kaiser Medicare plans, first tier generics are zero $$ for refills by mail. I have one of these and DW has one.
Your plan seems very good for part D drugs!
As of now (age 74), I have no knee or hip issues/problems, and I hope it stays that way. My wife (now age 69), however, does seem to be having some joint issues. It sure seems like we know so many folks getting/needing hip or knee replacements.
I don't know about your Humana Advantage plan, but our annual out of pocket maximum (does not count part D drugs) is $6,700. While DW and I have never even come close to this amount, I understand that if we needed Chemotherapy - it might be easy to hit that several years in a row. I understand this financial risk of a Medicare Advantage plan. What I hope and expect is that the yearly savings, so far, we get on our MA plans will offset possible large annual expenses for such things as Chemotherapy.
No idea what MegaCorp pays for our coverage, but we are near a major metro area, and pretty much all the Medicare Advantage PPO plans are reasonable. So, I'm really not too worried about the possibility I might lose coverage provided by MegaCorp. Every year MegaCorp pays is one less year I have to pay.
Our max OOP is $3,000 each, and we have no deductibles, so Humana starts paying immediately. Doctor visit $5.00, specialist visit $20.00.
I'm happy, no reason not to be. Life is good.
Broken Man 1999