Personal Finance (Not Investing) • Re: Caltech retirees - 2025 Aetna cost increases

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I am therefore looking around for other, non Caltech-subsidized plans and found a few:
- United Healthcare HMO
- SCAN HMO
UHC gets really bad reviews, while SCAN gets good reviews.

Any feedback from retirees in a similar situation? Have you looked at other plans and which ones have you considered?

I don't know anything about United HealthCare's HMO but their Supplemental (ie., Medigap) plan is great. After you get past the yearly deductible. Medicare will pay their 80% and pass the remaining 20% of the bill to your supplemental plan, whoever it is. UHC even pays faster than Medicare since there is nothing for them to decide. Medicare makes the rules and tells them what their 20% is. (This is true for all Supplemental plans.)

To me 25% is a lot. As far as re-joining a Caltech plan, a representative told me that one can do it during the enrollment period at the end of each year. For 2025, after spending hours (literally) comparing a myriad of plans, I ultimately chose a Humana HMO plan with giveback; it will be a new experience and will influence what I do in a year.

If you are on a Medicare Advantage plan, you can change the HMO at the end of each year. But if you choose a Supplemental Plan, if you live in California, the "birthday rule" allows you to change to another supplemental plan in your birthday month.

As my wife and I get older, we may end up going with Medicare Supplemental plans as we may incur more expensive treatments, including hospital-based procedures, as well as expensive drugs.

Thoughts?

You can always change from a Supplemental plan to a Medicare Advantage plan, especially if you find you can't afford the supplemental premiums. But once you start a Medicare Advantage plan, you can't go to a Supplemental plan unless you pass the medical underwriting questions. So if you want the option to go wherever you want, stick with a Supplemental Plan.

If you ever need to go to one of the UC specialists, know that they don't accept any Medicare Advantage plans since the HMOs are so slow to pay. (And HMOs may not give you a referral if they already have that specialty in their network.) (Our UC referrals were from specialists we chose to see locally (while on UHC Supplemental) who couldn't do some of the latest treatments that are being taught at the UC med schools.)

Statistics: Posted by celia — Fri Nov 15, 2024 3:07 am

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