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Medicare Advantage Plan Rates for Retirees
Through carefully constructed contracts with Blue Cross and the MA plans, we hope to hold health care expenditures to $285 million in FY08. But, we can’t rest in our efforts to keep the plans affordable. Each 1 percent we don’t spend now - $2.9 million – means lower increases next year, keeping the plans affordable longer.
Each retiree who enrolled in an MA plan for 12 months in 2007 saved the city about $5500, for a total of $6.3 million. That translates into real money for you, because those same retirees saved over $2.7 million in premiums in 12 months. And, you can calculate what lower copayments mean to your wallet.
Your contribution for the Medicare Advantage plans is still 25 percent of the premium. The city will contribute 75 percent of the cost. You now have three choices that cost less than $55 per person per month! Here are the costs for January 2008:
The Medicare Advantage plans offer distinct financial advantages. If you are a PPO member living outside Texas paying $400 per month, you now have another financial option worth serious consideration. If you are an HMO member, you have 5 affordable options for health coverage. Keep reading, and learn how to calculate your savings.
See the chart for the new contributions.
Contribution chart for January 2008
Use the chart below to find the contribution for the coverage you elect. First, look for the category in the left-hand column that fits your situation, then select the corresponding rate for the plans of your choice. If you have family members who remain in the HMO or PPO, select the rate based on the age of the oldest family member keeping the HMO or PPO plan. Your total monthly contribution is the sum of the rate for HMO or PPO, plus the rate for Aetna, TexanPlus or Texas HealthSpring.
Contribution chart for January 2008 |
Family Coverage Category |
Monthly Retiree Contributions |
|
Aetna |
TexanPlus |
Texas
HealthSpring |
HMO* |
PPO* |
Retiree Only (Has Medicare) |
|
|
|
$131.44 |
$399.60 |
1 Retiree elects an MA plan |
$54.00 |
$7.81 |
$15.75 |
– |
– |
Retiree + One (Both have Medicare) |
$256.36 |
$440.72 |
2 Both elect the same MA plan |
$108.00 |
$15.62 |
$31.50 |
– |
– |
3 Each elects a seperate plan |
$54.00 |
$7.81 |
$15.75 |
$131.44 |
$399.60 |
Retiree + One (Only one has Medicare) |
$262.96 |
$1,049.76 |
4 One elects an MA plan / one keeps city plan (less than 65) |
$54.00 |
$7.81 |
$15.75 |
$136.22 |
$458.02 |
5 One elects an MA plan / one keeps city plan (age 65+) |
$54.00 |
$7.81 |
$15.75 |
$421.38 |
$621.80 |
Retiree + Family (Two have Medicare) |
$407.56 |
$1,047.30 |
6 Two elect the same MA plan / one keeps city plan (less than 65) |
$108.00 |
$15.62 |
$31.50 |
$136.22 |
$458.02 |
7 Two elect the same MA plan / two keep city plan (both are less than 65) |
$108.00 |
$15.62 |
$31.50 |
$401.98 |
$1,178.10 |
8 Two elect the same MA plan / two+ keep city plan (all are less than 65) |
$108.00 |
$15.62 |
$31.50 |
$626.86 |
$1,647.88 |
9 One elects an MA plan / two keep city plan (1 is 65+, 1 is less than 65) |
$54.00 |
$7.81 |
$15.75 |
$262.96 |
$1,049.76 |
10 One elects an MA plan / two+ keep city plan (1 is 65+, 2 are less than 65) |
$54.00 |
$7.81 |
$15.75 |
$447.00 |
$1,140.24 |
Retiree + Family (Two with Medicare + one 65+ w/o Medicare) |
$407.56 |
$1,047.30 |
11 Two elect the same MA plan / one keeps city plan (age 65+) |
$108.00 |
$15.62 |
$31.50 |
$421.38 |
$621.80 |
12 Two elect the same MA plan / two keep city plan (1 is 65+, 1 is less than 65) |
$108.00 |
$15.62 |
$31.50 |
$884.90 |
$1,305.74 |
Retiree + Family (Three w/ Medicare) |
$407.56 |
$1,047.30 |
13 Three elect an MA plan |
$162.00 |
$23.43 |
$47.25 |
– |
– |
14 Three elect the same MA plan / one keeps city plan (1 is less than 65) |
$162.00 |
$23.43 |
$47.25 |
$136.22 |
$458.02 |
15 Three elect the same MA plan / two keep city plan (both are less than 65) |
$162.00 |
$23.43 |
$47.25 |
$401.98 |
$1,178.10 |
16 Three elect the same MA plan / two+ keep city plan (all are less than 65) |
$162.00 |
$23.43 |
$47.25 |
$626.86 |
$1,647.88 |
17 Two elect the same MA plan / one keeps city plan (age 65+) |
$108.00 |
$15.62 |
$31.50 |
$131.44 |
$399.60 |
18 Two elect the same MA plan / two keep city plan (1 is 65+, 1 is less than 65) |
$108.00 |
$15.62 |
$31.50 |
$262.96 |
$1,049.76 |
19 Two elect the same MA plan / two + keep city plan (1 is 65+, 2 are less than 65) |
$108.00 |
$15.62 |
$31.50 |
$447.00 |
$1,140.24 |
20 One elects an MA plan / two keep city plan (2 are 65+) |
$54.00 |
$7.81 |
$15.75 |
$256.36 |
$440.72 |
21 One elects an MA plan / two+ keep city plan (2 are 65+, 1 is less than 65) |
$54.00 |
$7.81 |
$15.75 |
$407.56 |
$1,047.30 |
Retiree + Family (Only one has Medicare) |
$447.00 |
$1,140.24 |
22 One elects an MA plan / two keep city plan (both are less than 65) |
$54.00 |
$7.81 |
$15.75 |
$401.98 |
$1,178.10 |
23 One elects an MA plan / two+ keep city plan (all are less than 65) |
$54.00 |
$7.81 |
$15.75 |
$626.86 |
$1,647.88 |
24 One elects an MA plan / two keep city plan (1 is 65+, 1 is less than 65) |
$54.00 |
$7.81 |
$15.75 |
$884.90 |
$1,305.74 |
25 One elects an MA plan / two+ keep city plan (1 is 65+, 2 are less than 65) |
$54.00 |
$7.81 |
$15.75 |
$1,516.98 |
$1,617.64 |
An example of how to calculate your rate
As Medicare Advantage retirees, you have the option to split your family election. You and your eligible spouse may enroll in different MA plans. You may enroll in an MA plan, and your spouse can remain in the HMO/PPO, or vice versa. If that’s your election, your monthly contribution will be calculated as described below.
Refer to the contribution chart.
Example 1: You and your spouse currently have Medicare & the HMO plan
Go to line 3 on the chart: Both elect a separate plan
| Add the HMO rate |
$131.44 |
| To the Texas HealthSpring rate |
+ $15.75 |
| Your new contribution amount |
= $147.19 |
| Amount you pay for HMO |
$236.36 |
| Savings |
Almost $109 |
Example 2: You and your spouse currently have Medicare & the PPO plan
Go to line 3 on the chart: Both elect a separate plan
You elect TexanPlus, your spouse elects Aetna
| Add the TexanPlus rate |
$7.81 |
| To the Aetna PFFS rate |
+ $54.00 |
| Your new contribution amount |
= $61.81 |
| Amount you pay for PPO |
$440.72 |
| Savings |
Almost $379 |
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