Medicare advantage PPO and their mullti state networks

[jwalker67 8]

We spit the year between Florida (legal residency) and Missouri and currently have Humana Supplemental F-high deductible. A "professional" advisor told me today that the Humana Medicare Advantage PPO would save us a lot of money since our doctors are in both Humana networks, that it doesn't make a difference that the networks are in different states. Is this correct? We would be registered in the Florida network but could use our doctors in Missouri who are in that Humana network and be fully covered?

 

[Mack]

I don't think that is correct with Medicare Advantage. I think you would need to use the doctors in your home area. In your "away" area you would be covered for Emergency Room visits and Urgent Care visits only.

To verify, check with Humana, they could have changed it.

 

[MBSC]

Advantage plans have started recognizing their short-falls with people who travel frequently or snowbird and have made gains in correcting those issues in the past couple of years.

Some MA PPO plans now have national provider networks. You still have to change plans if you permanently move out of your plan's service area . If you have to see a new specialist, they may not be in the PPO network so higher cost sharing may apply. MA plans still have other issues such as making it more difficult to obtain proper rehab care after a stroke. IMHO, MA plans still are not quite there yet and I would continue to pay the HD-F and Part D premiums if you can afford them.

If you are very healthy and can pass medical underwriting, United American has competitive Medigap HD-G premiums in Florida ($58/mo for a 67 y/o for example). HD-G has the same $2340 deductible and the Part B deductible counts toward the $2340 just like with HD-F.

Here is one Humana national provider network PPO available in the Jacksonville, FL area.

(Page 14): Travel Coverage: As a member of a Humana PPO, you have the benefit to use Humana's network of providers across the U.S. (not available in all counties). If you are visiting another Humana PPO service area, simply access a Humana network provider to receive your in-network level of benefits for up to twelve consecutive months. You pay your in-network copay or coinsurance when you visit a participating provider for non-emergency care, including preventive care, specialist care and hospitalizations.

Plan Summary: https://www.humana-medicare.com/BenefitSummary/2021PDFs/H5216070000SB21.pdf