Horizon Medicare Blue HMO Plan Question

Does anybody have Horizon Medicare Blue Advantage (HMO)? If you do have this plan do you like it? We are getting ready to select a Medicare Plan and want to know what other people's experiences are/were. We know we can check with the provider of the service, but would like to know what actual experience of users in our area have been. Thank you so very much!

Mrs. Pipes Mrs. Pipes
1 week ago

Having been on the side of seeing the reimbursement, I would suggest not taking an HMO plan. They end up covering next to nothing, and then you end up coming more out of pocket. There is a lot of little print that no one reads when it comes to these HMO plans. I would suggest sticking with straight Medicare and getting AARP as the supplemental. Expensive but worth it in the end. But just my opinion.

I have Medicare Part A, Part B, and Aetna (PPO) supplemental at $0 for the Aetna part. Copays are $10 for office visits, $0 for blood tests with the copays for MRIs, Ultrasound, or specialists under $100 copay. My meds (blood pressure and other meds) are no cost so far and dental is covered by refund after you submit the bill. I will be checking other plans but AARP doesn't work for me. It's more per month for almost the same coverage. Remember you must have Medicare Part B at $148 (rate is income dependent) a month to get the supplemental

As long as you stay in nerwork
The HMO is fine

Yes, if you stay in network you are ok. However...keep in mind - if you end up in the hospital for some reason, just because that doctor saw you in the hospital doesn't mean he/she is in your network. All physicians are contracted with the hospital and usually have their own insurance guidelines. You could end up with a ton of bills. Most physicians who take Medicare A & B will also take AARP - but good chance they will not take an HMO.

Similar to Medicaid. Physicians usually take Medicaid, but do not take the HMOs like Americhoice, Amerigroup, Horizon Mercy, etc. - and can balance bill you for the difference.

This is the same plan that I have for my mom. We like it. Office visits are $10 and specialist is $25. Where one of the big differences are is if you need skilled nursing home care, say even for a rehab. The amount of days allowed under an advantage program is way different than the regular medicare, where they give you 100 days. I don't recall how many the advantage give but it's probably about 20. Every time my dad ended up in rehab I was warned about this issue.

Also, I learned from a county seminar a few years back that if you get an advantage medicare program you can't change to a regular medicare program, say you should get in the above situation for an example. I was told to first go with a regular medicare plan and then after a year change to an advantage program. Then, if you wish to change back to regular you can.

At this seminar I also learned that all plans are the same. Plan N in Etna is the same as plan N is BCBS, for example. It's the price that you pay that is different.

Hope I helped you some at least.

Thank you all for the time you took in responding to my question. Your answers will be very helpful in our decision making.

Mrs. Pipes Mrs. Pipes
1 week ago

Re: Horizon Medicare Blue HMO Plan Question

If you are an AARP member you might be receiving this in the mail soon. Got mine yesterday.

3wbdwnj 3wbdwnj
7 days ago

You can get a good rundown of plans on the Medicare website, it shows the benefits available on them if you want to compare.

Time consuming BUT read the book we all got in the mail from the government "NJ and You".

All plans are in this book plus monthly prices. Also one can call the department of aging in Belvidere.

You will be surprised what you learn that you think you know.

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