Assignment 1: Analyzing Medicare

Your son has taken the job at Costco and made friends with a colleague who is retiring at age 65. She is impressed by your son's knowledge of the Costco health plan. At 65, she will sign up for Medicare Parts A and B. She wants help deciding whether to buy a supplemental Medigap policy, a Medicare Advantage plan, and/or Part D. Your son needs help from you again to help his friend. Be sure you have read all the materials for this week as they contain the information you need to complete this assignment.

For the assignment, assume that Bertha will move to Columbus, Ohio (zip code 43221, Franklin County), upon retirement. She has a preretirement income of about $55,000 and will have a retirement income of about $45,000 per year. Bertha DOES plan to take her Social Security benefits in the coming year. Bertha does not qualify for any Medicare subsidies. She is in good health, but her family has some history of high blood pressure and cardiovascular problems. She will be signing up for Medicare for the year for which the most recent plans are available on the Medicare site. (Be sure you are using the most recent data available.) She takes only one generic non-steroidal anti-inflammatory daily for minor arthritis at this time, She is willing to use a local or mail order pharmacy. Bertha prefers to be able to go to a well-known doctor recommended by a friend in Columbus.

Visit the Medicare Web site (http://www.medicare.gov) and browse the site to see how it is organized. This is the only source you should use for data submitted. You will need to understand how Medicare defines terms to answer correctly. You may consult other sources to help you understand the data found on the Medicare site. Be sure to be familiar with the general rules for signing up for Medicare and those regarding prescription drug coverage.

Explore the Medicare site to locate the Medicare Plan Finder, designed to help enrollees find and compare the plans offered in their geographic area. Use the information about Bertha cited in the situation above. You are using the same site that Medicare enrollees use. As you look at it, think about how easy it is to navigate.

On the Analyzing Medicare Table provided, we have preselected four insurance options for Bertha. (These are not necessarily the best of all the options available but are good for comparison purposes.) You are asked first to supply certain prices or values for various features. Then you are asked to make some overall comments about her choices.

Considering the following for this assignment:

Assume hospital stays of less than five days (notice the rules about benefit periods)

Assume outpatient preferred generic and preferred brand drugs from retail pharmacies and for one month only

Assume all services considered for this activity are Medicare-covered;

Assume billed charges within Medicare limits.

Whether the Part D gap coverage should figure into Bertha's decision Each block should contain either a clearly labeled number or as few words as possible to make your point.

Feature	Humana Gold Plus (HMO) (H8953-005-0)
Total monthly premium (including Part B premium)
Out-of-pocket limit (In-network if applicable)
Part A Relevant deductibles (consider in-network if given choice)
Part B Relevant deductibles (annual, consider in network if given choice)
Drug deductible (up to donut hole)
Ability to choose doctors
Doctor visit costs Primary (in-network if applicable)
Doctor -specialist (in network if applicable)
Hospital costs (in stay of less than 5 days)
Diagnostic X-ray costs (in-network when applicable)
Preferred generic outpatient prescription drug costs for one month supply (drugs not covered by Part B)
Preferred brand outpatient prescription drug costs for one month supply (drugs not covered by Part B)
Gap coverage Outpatient Prescription drug costs for one month supply (drugs not covered by Part B)
Mammogram cost