Why Medicare is Primary for Small Employers

Why Medicare is Primary for Small Employers

Turning 65 But Still Working; What To Do? In this day and age more eligible Medicare Beneficiaries are choosing to continue working and they are confused about what they should do when reaching age 65. Why Medicare is Primary for Small Employers In some cases, Medicare Beneficiaries can postpone their Medicare Part B and continue on their group coverage. Other times, these individuals will need to go ahead and pick up their Medicare Part B to stay on their employer’s group plan. If you find yourself in this situation, take heed, there are a few things you need to know in

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Do Not Pay Your Part B Deductible at Doctor Appointments

How do the Medicare Deductibles work? One of the most common misconceptions that Medicare Beneficiaries have relates to their deductible. Most people that are going into Medicare for the first time are accustomed to having group coverage, and they may incorrectly be under the impression that once they take Medicare they don’t have to pay anything. Do Not Pay Your Part B Deductible at Doctor Appointments All of us wish this was the way things work, unfortunately it is not. When starting Medicare it is important to know what costs you are responsible for are and how you pay those expenses. Medicare Part A (Hospital) With Medicare Part A, in 2018, you must meet a deductible of $1,340 for each occurrence into the hospital, once that is met the benefit period last 90 days. In other words if you go back to the hospital within 90 days for the same thing you will not have to pay the $1,340 again, but if you go in for another reason you could have to pay it again. If you are in the hospital for more than 90 days additional costs will occur. It is also worth a mention that when in the hospital certain services could be covered under Medicare Part B instead of A. This means you could have additional costs beyond the $1,340 for the stay. Medicare Part B (Doctors) Medicare Part B has a annual deductible of $183in 2018. Once you have satisfied that deductible you will then be responsible for 20 percent of all costs, and potentially excess charges in most states. What is an excess charge? When you go to a doctor that accepts Medicare, there are two designations that come up. A doctor that accepts Medicare assignment, and A doctor that accepts Medicare but does not accept Medicare assignment. When a doctor accepts Medicare assignment it means they agree to accept what Medicare pays as full payment; if a doctor does not accept Medicare assignment it means they are allowed to charge up to 15% more than the Medicare approved amounts. That 15% is called an excess charge. How do I know if my doctor imposes excess charges?  One of the easiest ways to find this out is simply ask, “Do you accept Medicare assignment?”, or “Do you charge excess charges?” Your doctor’s office will disclose to you if they do or do not accept Medicare assignment. You can also go to Medicare.gov and use the Physician lookup to look up your doctor and find out if they take Medicare assignment. Should I pay my deductible when I go to the doctor? This is a reoccurring question for Medicare Beneficiaries. It is a very important question to get the correct answer to, and here is how it works. When you go to the doctor you should show your Medicare card, if you have additional insurance like a Medicare Supplement you should show it as well. Upon conclusion of the doctor visit, the office staff will send the bill to Medicare. Once Medicare receives the bill they will determine if your deductible(s) has been met. If not, you will be sent a bill up to the amount of the deductible. If the bill is greater than the deductible, you may receive additional bills. Those bills will be for your 20% or excess charges. If you have secondary coverage such as a Medicare Supplement, some or all of those costs could be paid for by your supplement plan leaving you with little or nothing to pay out of pocket. If you have a Medicare Advantage Plan, the process will work a little differently and you have other concerns. A Medicare Advantage Plan essentially replaces your Original Medicare with a network based plan. When covered by a Medicare Advantage Plan it is common that you would have to pay at the doctors office prior to being seen. Some have out of network benefits. If your Medicare Advantage Plan has out of network benefits, it will also have a separate own set of co-pays, deductibles, and out of pocket costs. Most of the time your out of network responsibility will be double your in network amounts. What if I paid my doctor up front already? If you paid your doctor already for your deductible, it is possible Medicare will send you a bill for the deductible amount. It happens when Medicare receives an invoice from your doctor, Medicare automatically sends you a notice requesting payment for your deductible. If this happens you will need to pay that deductible to Medicare, and go back to your doctor and try to straighten it out with their billing department. Most medical provider billing departments  know that with Medicare Beneficiaries they should not collect the deductible or any funds up front. This can be a hassle. If you have a doctors office that tried to make you pay your Medicare deductible up front, you may want to consider if that doctor has your best interest in mind. What about the hospital deductible? When it comes to the hospital deductible, it should work the same way. Upon being discharged, the hospital should bill Medicare. After Medicare applies their billing process you will receive bills for your portion, whether it be just the deductible or additional amounts. Do Not Pay Your Part B Deductible at Doctor Appointments Do Not Pay Your Part B Deductible at Doctor Appointments Do Not Pay Your Part B Deductible at Doctor Appointments Do Not Pay Your Part B Deductible at Doctor Appointments Do Not Pay Your Part B Deductible at Doctor Appointments Do Not Pay Your Part B Deductible at Doctor Appointments Do Not Pay Your Part B Deductible at Doctor Appointments Do Not Pay Your Part B Deductible at Doctor Appointments

How do the Medicare Deductibles work? One of the most common misconceptions that Medicare Beneficiaries have relates to their deductible. Most people that are going into Medicare for the first time are accustomed to having group coverage, and they may incorrectly be under the impression that once they take Medicare they don’t have to pay anything. Do Not Pay Your Part B Deductible at Doctor Appointments All of us wish this was the way things work, unfortunately it is not. When starting Medicare it is important to know what costs you are responsible for are and how you pay those expenses.

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What you Need to Know about Open Enrollment fo Medicare

What you Need to Know about Open Enrollment fo Medicare

The Medicare Annual Election Period (AEP) begins October 15th and runs through December 7th each year. It’s also known as Medicare’s open enrollment. A time when Medicare Beneficiaries can re-evaluate their coverage and make changes. It’s also a good time for those who didn’t sign up for a Medicare plan when first eligible to go ahead and enroll. What you Need to Know about Open Enrollment fo Medicare Depending on the type of plan you have, you can make changes to your Medicare coverage during this time. Only under special circumstances that qualify as a Special Election Period, can Medicare Beneficiaries

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What Happens to Medicare Coverage When You Move

What Happens to Medicare Coverage When You Move

  When you change your residence, whether it be in the same city you are living, a different city or out of state, and you are on Medicare, you need to do the following: What Happens to Medicare Coverage When You Move The Social Security Administration handles Medicare enrollment. If you receive Social Security benefits, you can change your address online at ssa.gov, or by phone at 1-800-772-1213. If you have you Original Medicare, changing your address as noted above is all you need to do. However, if you have a Medicare Advantage Plan or Part D Prescription Drug Plan, or

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If you get cancer, what does medicare cover?

If you get Cancer what does Medicare Cover?

A cancer diagnosis after the age of 65 can be overwhelming, but with Medicare and the right supplemental coverage, paying for medical care doesn’t have to be. Understanding the facts and benefits of Medicare regarding cancer coverage will make going through the process of treatment, from oral medication to surgery, a little bit easier for patients and their loved ones. If you get Cancer what does Medicare Cover? Medicare does a very good job of covering cancer treatment for those 65 and over. The American Cancer Society reports that Medicare pays for nearly half of the $74 billion spent on cancer

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Our thoughts on how Medicare could be improved

Our thoughts on how Medicare could be improved

How could Medicare improve eldercare benefits?  Medicare, by itself, is very good coverage, often much better than what most people are accustomed to as they age into Medicare. However, there is certainly room for improvement. Our thoughts on how Medicare could be improved Some of the aspects of medical care that are not covered, such as dental, vision and hearing for example, have often been discussed as possibly being added in to basic Medicare’s coverage. That would certainly be an improvement to the coverage offered by “original” Medicare. Other changes that would potentially improve benefits offered by Medicare are reductions in

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Download this Medicare Education APP

Download this Medicare Education APP

The idea of an ALL VIDEO Medicare educational APP came to me on a beach in Ft Myers Florida. Download this Medicare Education APP  I was sitting there enjoying the sunshine and the beauty of the ocean and I noticed something.  Many of the people walking up and down the beach were older (yes) but all had smart devices in their hands. Download this Medicare Education APP  Smart phones and tablets were all around me on the beach.  They were in the hands of a generation of people that (I was told) had not embraced the use of such devices. My eyes

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What Medical Equipment is Covered by Medicare?

What Medical Equipment is Covered by Medicare?

  As you age, certain medical equipment may be necessary. If you use durable medical equipment (DME) and/or medical supplies which assist you in your daily functions, those items may be covered by Medicare Part B.  Be aware that Medicare covers the basic model of that equipment. If you want to add on expensive upgrades, you typically will have to pay for any extra charges. What Medical Equipment is Covered by Medicare? What Durable Medical Equipment (DME) is Covered by Medicare? Some DME items must be purchased and other items can be rented.  Generally, after 13 months of renting equipment, you

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How to Avoid Medicare Late Enrollment Penalties

How to Avoid Medicare Late Enrollment Penalties

One of the common problems new Medicare beneficiaries encounter is missing important Medicare enrollment deadlines and incurring the resulting penalties. How to Avoid Medicare Late Enrollment Penalties There are certain times that you are eligible to sign up for Medicare Part B, Part D, and Medigap plans. To avoid those potential late enrollment penalties, you should be aware of these deadlines and abide by them. Medicare Part B Enrollment Period and Penalties If you are already receiving Social Security at the time that you turn 65, you will be automatically enrolled into Medicare Parts A and B. You should receive

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