Insurance answers

After my phone call to my mom's insurance plan management company, I think I have now fairly well figured this out. In reading the paperwork I had copied during my last visit to mom I am more understanding the "role" this company has in the retiree's medical program.  Prior to 2020, the company my dad retired from had a "company sponsored program" that offered two group health plans to choose from. In 2020, they moved the retirees to the the state based "Health insurance Marketplace". The company made this change because the previous 2 group plans offered to retirees were limited and expensive (mom was paying $340/mo and directly to this management company, not Kaiser. Now in 2020, she is paying Kaiser directly). There are fewer than 650 retirees in the program and enrollment shrunk by 25% between 2015-2019 (probably because people could get basically same thing for a lot less,on their own). With this switch the company is using a different company to assist in making choices/signing up. Or.....a person can just sign up on their own for these exact same plans.

I spent more time on the phone having my mom give them permission to talk to me than I did actually figuring it out, once I was able to ask my questions, LOL. Learning how to do that 3 way calling on my cell phone has been very helpful! Basically, they needed my mom to give me "power of attorney" (verbally over the phone) in order to manage her account with them. She was a bit confused by the lady rattling off all the legal stuff and trying to explain to her that had 2 options - give me full POA on her account or limited access.

Finally, all that got taken care off, mom left the call and I explained to the lady what I am needing help figuring out. Since she had a choice of many plans for 2020, would any of them work in Montana? She kept trying to tell me I needed mom's new address, in order for her to figure it out. I kept saying, she hasn't moved yet, obviously I need to get the insurance figured out BEFORE moving. I was just about to just give her my address, when she came back on the line and said the best thing would be for me to go to their website, put in the zip code and see what plans are available. I was able to do that and saw that there were 3 Humana Plans - the exact same 3 plans I had come across earlier (while waiting to call my mom when she was up and about for the day).

The hospital and their providers/clinics in this area also showed they are contracted with Blue Cross/Blue Shield Medicare Advantage. I did some more digging on BCBS website and finally found their plans - they have 2 advantage plans.  I then also went to Medicare.gov website and did a search for this area and it came up with the same plans offered for this area: 3 Humana plans and 2 BCBS plans. Costs ranging from $0 premiums to $131/mo.

So, those are the choices and I think I'll be able to pick one that is similar to what she currently has. I was also able to go online and figure out what exactly her current plan's coverages/limits, etc are, so I can compare to these choices.

I know mom is confused by it all. She keeps saying "I need to call and figure out my health insurance". I keep telling her I am handling it. She actually did call Kaiser about a week ago to see if they cover Montana and they told her no, only for urgent care, but she seems to have forgotten she made that call. When she called and told me that, she says "well, I guess that would work" I said no, if she has to go into the hospital for something or needs surgery/specialists, etc, we need to have her on an insurance plan that covers seeing doctors here. 

My uncle called last night, after he talked to her and said she seems pretty concerned about figuring out her health insurance to move. I'm trying to keep it all as simple as possible in explaining it to her (but nothing about Medicare is simple!) and hopefully today, I can just tell her I figured it out and we'll be able to change her to a new plan so she can see doctors and hospital here. And just try not to go into much detail with her. I'm kind of leaning toward the Blue Cross/Blue Shield plan over Humana. I feel better now that this is basically figured out and not on my to-do list anymore (other than actually getting her signed up for the new plan, when that time comes).