NLIC.org

Olga Said:

i turn 65 in january,what co insurance compares to humana's plan?

We Answered:

Medicare Advantage plans like the Humana Choice are county specific. That is, the Humana PPO may not be available in the counties surrounding yours and, if it is, it may be different. You need to speak to someone that knows what plans are available in you county.

Generally speaking, all Medicare Advantage plans must follow the Medicare guidelines and all must offer the same benefits. The difference will be the amount you pay in co-pays as well as any additional benefits that may be offered on the plan. For example, most but not all Humana plans offer some dental coverage but that coverage will be different depending upon your county.

Another big difference will be drug coverage. For example, most generic drugs are a tier one medication, with a co-pay of around $5 - $10. However, not all generics are considered a tier one with all plans. Some plans may have certain generics at a tier 3 with a co-pay of $60 - $90.

You need to find a local agent that works with all of the major plans in your area. The agent can find out how much your medications are, whether your doctor participates and in which plans, and can find the best plan for you. There is no extra charge using an agent.

Angel Said:

What's the difference between Co-pay and a deductable?

We Answered:

The short answer is: a copay is a set dollar amount that you pay at each visit. It is deducted from what the doctor gets paid. The deductible is an amount that you have to pay before the insurance pays anything.

For example: If a doctor bills $85 for a simple sick visit, the insurance is contracted to pay $55.17 for that visit. (There's a negotiated rate for every participating doctor for every insurance - they have to take this payment, they can not expect anything extra.) If you have a $20 copay, the insurance is going to send the doctor a check for $35.17 - it's expected that your $20 copay will make up the rest of the $55.17. Now, for that same visit, if you have a deductible, you will be expected to pay the full $55.17, and the insurance will inform the doctor in writing that you are to be billed for and pay that amount. You will do something like that every time you see the doctor until your deductible is met. (And deductibles range from $50 to $5000 a year.)

Now, if you have "co-insurance" - you'd be paying a percentage of the visit. (Of the $55.17, if your co-insurance is 15%, you pay $8.28, the insurance pays the rest.)

Because insurance company contracted rates are WAY cheaper than cash prices, I advise people with deductibles and co-insurance to let their insurance be billed FIRST, because the insurance will figure out how much the patient owes. If they have a copay, providers are obligated to take that at the time of service.

Michele Said:

FDIC verses Insurance Co.?

We Answered:

I don't get your correlation here. The FDIC is an insurance product for depositors at banks. It is backed by the full faith & credit of the u.s. government.
John Hancock is backed by that company. To me, there would be no contest here. I would much rather have FDIC protection, rather than JH protection.