Medicare Advantage PPO Plan in California

Anthem Blue Cross has brought a popular plan to California called Anthem Medicare Preferred Standard PPO. This plan is similar to the old Freedom Blue that thousands of Medicare beneficiaries were enrolled in. On September 16, 2011 Agents and Brokers were notified to cease and desist the marketing of that product until further notice. About 2 weeks later, a notice was sent out of the new Anthem Medicare Preferred or AMP plan.

This plan is also offered in other states but here in California it is now a Local PPO as opposed to a Regional PPO, which means its limited to certain counties The plan used to cover the entire state of California and now only a handful of counties will be able to have access to Medicare Advantage PPO network. In addition. only 3 of the counties will continue to receive the "Zero Cost" option; Los Angeles, San Diego and Ventura. All other counties will now have a monthly premium for this plan ranging from $40-131/mo. For some this is no problem but for many Medicare beneficiaries who are dependent upon Social Security or on a fixed income, this raises huge issues. 

Other Medicare beneficiaries were not so lucky if they live in rural parts of California. Many of the central counties in the state have very little to no options for any Medicare Advantage plans. This means they will have to either go back to Original Medicare and just carry a Part D (prescription plan) or pay higher premiums for a Medicare Supplement plan. 

As for the Anthem Medicare Preferred plan, it is expected to perform well in the available counties but has no official rating from CMS (Center for Medicare Services) just yet. It continues to offer the Anthem PPO network of Doctors and Hospitals, one of the largest in the state. The plan has a $300 deductible which applies towards Outpatient type services and does apply towards the Maximum out-of-pocket expenses. The $3,400 maximum out of-pocket-expense is the most you will have to spend in the calendar year, including co-pays and deductibles, which is one of the lowest amounts compared to most other Medicare Advantage plans. 

Anthem Medicare Preferred has an included Part D plan with reasonable co-pays for a 30 day supply and even lower for 90 day mail-order. In addition, you will have access to Silver Sneakers, which allows a monthly gym or fitness center membership for free at participating locations. There is also optional Dental and Vision benefits for an additional premium of course. 

So for those of you who are seeking true Medicare insurance solutions that will allow you to keep your physicians and not have to worry about asking for referrals, the Anthem Medicare Advantage Standard PPO plan is a great value. Make sure you get more information on specific co-pays for your county as they do differ from one county to the next. Also be sure to complete the correct application as those are also different and you need to use the appropriate one per your county. 

Medicare Advantage HMO Plan

The Medicare Advantage plan in California known as Secure Horizons from United Healthcare is now called the Medicare Complete Secure Horizons plan. United Healthcare launched Secure Horizons, the nation's first Medicare HMO plan, 27 years ago and has since been one of the most recognized Medicare Advantage plans for many years. The MAPD plan currently administers healthcare benefits for over 360,000 Medicare beneficiaries in California alone, where the company is headquartered.

Depending on which county you reside in you may have several Medicare Advantage plans to choose from. To enroll in a plan, you must be eligible for Medicare Part A and continue to pay your Medicare Part B premiums every month. With the Medicare Complete Plan (HMO) you will receive care by using a group of local contracted doctors and hospitals that coordinate your care. Your annual Out-of-pocket costs are usually lower for these types of plans than most other plans.

Overview of Benefits of the Medicare Complete Secure Horizons HMO

The Medicare Complete HMO plans offer all of the benefits covered under Original Medicare A & B and more. While the exact benefits vary depending on your specific plan (because they vary by county), the plans provide:

·         Access to medical care through a trusted network of contracted doctors, specialists and hospitals

·         Assistance with financial protection through annual limits on out-of-pocket health care expenses

·         Annual Preventive care services at no cost ($0 co-payment) including an annual routine physical

·         Worldwide coverage for emergency care

If you choose to go to a doctor or hospital that is outside of the covered network, you must pay for these services yourself, except in certain situations such as emergency care. Neither the Medicare Complete Plan nor the Original Medicare Plan will pay for these services. While the exact benefits vary depending on the specific plan for your county, the plan may also include:

•  Medicare Part D prescription drug coverage (includes a 4 Tier Formulary Drug List)
•  Coverage for additional preventive services such as routine vision, hearing, and dental

Optional Dental, Vision & Hearing Aid packages are available with Medicare Complete HMO ranging from $6 - $39/mo.

All of these great features and benefits for little to no cost - now that is value! So if you are like most retirees in today's world that are on a low or fixed income, or if you are in great health and you never go to the Doctor, the AARP Medicare Complete Secure Horizonsplan is perfect for you! This way you only spend your hard earned money when you really have to use your benefits.