Fresenius HMO?

[micron]

When I was dropping labs off at the clinic this morning, they had a table for information about a Fresenius HMO.  Has anyone looked into this as supplemental insurance?  It includes dental so I'm planning on looking into it vs. keeping employer based supplemental insurance.

[iolaire]

Fresenius HMO. 

I know nothing about the plan.

I'd be scared of an insurance plan that only has dialysis patients!  We all know our care is costly. I don't see how a plan could survive on high cost patients without charging very high rates or limiting services.

[Charlie B53]

It would HAVE to be heavily subsidized, otherwise the premiums for most on fixed incomes could not afford it.

Where could that much money come from?

[Zach]

Here's more info:
http://www.esrdplans.com


At Fresenius Health Plans, we understand the specific challenges faced by people who need dialysis treatment. This led us to create a Medicare Advantage Special Needs Plan (SNP) designed around the specific healthcare needs of those diagnosed with end stage renal disease (ESRD). These plans expand upon the coverage of Original Medicare and offer a number of additional benefits.

Dialysis treatments and nephrologist care
Primary care doctor visits
Specialist visits
Hospital visits
Prescription drug coverage
Dental care
Vision exams and glasses
Health-related items and medications allowance
Transportation to medical appointments
Diabetic-related supplies and services

Fresenius Health Plans currently offers plans in select counties in Arizona, California, and North Carolina. Choose your state to see the exact coverage Fresenius Health Plans offers in your area.

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[micron]

The pamphlet describes it as "a medicare advantage plan for patients with ERSD"  So, it must be linked to medicare somehow, I'm don't know what advantage plans are though.

The monthly premium for medicare only patients is 27$, deductible/yr is 166 but max out of pocket is 6700 which seems very high.  I don't know how they can afford it either, so I was looking for some insurance experts.

for the curious, the site is esrdplan.com and looks like it's only available in 3 states right now.

[Simon Dog]

Medicare pays 80% of bills at the medicare rate, and the patient is responsible for the remaining 20%.   Medicare Advantage plans cover all or part of this 20%.

[Charlie B53]

This may have some possibility, but so far theirs are only very limited areas that this policy is available.   I do like that there is some Dental and Vision, but I wasn't able to find (yet) any specifics.


This got me to look into Part B coverage again as my Wife occasionally starts talking about retiring from the School Cafeteria.  Other times I overhear her telling her friends that she will NEVER stop working, it gets her out of the house (and away from ME!).

The Part B Plan F looks like a good plan except there is NO dental or vision.  Monthly cost in addition to the Medicare enrollment really isn't that bad considering the Plan covers most everything that Medicare does not.   I have to admit I only looked at one Plan F, the offering through AARP (United HealthCare) but I would imagine most all of the Companies coverage must be very nearly the same. With an annual deductible of ?? IIRC $166

[Charlie B53]

I downloaded and read through the coverage for Frenius for Arizona.   It pretty much parrots Medicare coverages AND lists our co-pays at 20% pretty much the same as Medicare.

Other than Dialysis coverage I fail to see advantage.

I do not know if they offer anything like Part B Plan F like many of the other Insurance Companies.


It is very difficult to select an insurance company without doing your homework.   You have GOT TO read the fine print, coverages, limitations, co=pays, and pharmacy coverages for EVERY company and every plan in order to make a better informed decision.   What they show you in the slick brochures and the TV Ads are NOT near enough and often may not be the coverage you need.

[Vt Big Rig]

It is very difficult to select an insurance company without doing your homework.   You have GOT TO read the fine print, coverages, limitations, co=pays, and pharmacy coverages for EVERY company and every plan in order to make a better informed decision.   What they show you in the slick brochures and the TV Ads are NOT near enough and often may not be the coverage you need.

A big AMEN to that ....... we are in the process of trying to determine coverage as both of us are quitting work, and we are moving out of state. We have spent more time on coverage than we have on buying a new house and selling the old one.

It is a chore!!