Ask Terry Questions Medicare or State HMO Insurance?

Medicare or State HMO Insurance?

By Terry Savage on October 25, 2015 | Insurance & Annuities

After working 20& yrs for State of Illinois, I am forced to retire at age 74. I have applied for Medicare B, but am confused. Should I keep my State HMO Insurance for free, but pay $79/mo for my wife, or apply for 1 of several
Medicare HMO Advantage plans for $0 per month

Terry Says:  Gosh, this is a tough question for me to answer, because I don’t quite know how your state insurance works.  I’m actually a bit surprised to find out that you can keep your state HMO for free.  And they let you keep your wife on the plan for $79?  Is this plan a supplement to Medicare Part B?

What you might want to do is go to and talk to them about what the state HMO covers vs a Medicare HMO Advantage plan that is available in your zipcode.   With a Medicare Advantage plan you each have one monthly payment that covers everything including prescription drugs, but you are limited to the doctors and hospitals in that plan.

I simply don’t know how to compare that to the coverage you receive from the state, which might cost less but include co-payments that could ultimately be more expensive.  And I don’t know if you would have prescription drug coverage from the state, or have to buy Part D drug insurance.

Does the HR department for the state offer to help you do the comparisons? That’s another good place to ask these questions about the state plan.  Let me list them again:

  1.  What is the all-in cost for you and your wife (or does she need her own health coverage)?
  2. Does the state plan have any co-payments or deductibles, and how do they compare to traditional Medicare or Medicare advantage?
  3. Does the state plan offer everything that Medicare A, B, and an “F” supplement, and Part D drug plan cover? Or what gaps would you have to pay for out of pocket if you take the state plan?

Sorry I don’t have the answers for you — but at least maybe now you have the right questions!



a personal
finance question