Home » Supplemental Plans
Tag:

Supplemental Plans

Close up of female doctor and senior man hands holding walking cane
Medicare Plans

Who Can You Trust to Help Make Your Medicare Decisions?

by My Senior Health Plan
written by My Senior Health Plan

The many choices and options related to Medicare Advantage and/or Supplement Plans are enough to overwhelm even the most educated among us. You want to make the right selections, but without the proper guidance and direction, these decisions are dizzying.

You’re aware of how easily you could get stuck with a plan you don’t need or want, but you’d probably rather endure a colonoscopy than spend countless hours researching different plans.

Yes, navigating the world of Medicare Advantage and Medicare Supplement Insurance is difficult. But it doesn’t have to be. My Senior Health Plan will help you find you the right coverage at the right price—the plan that truly fits your needs and budget.

Here’s why My Senior Health Plan is the right choice for your healthcare needs.

Understand your options

There are numerous Medicare Advantage and Medicare Supplement Plan options. Not all of these plans are created equal, and each one is designed to address a specific set of medical needs. So which one is right for you?

My Senior Health Plan prides itself on offering a comprehensive, personalized service that addresses these questions directly. Their representatives will work with you to determine what’s important to you and how that translates to a Medicare plan.

They take the time to not just listen but also understand where you’re coming from and why. With this information, they use their expertise to find the right options to satisfy your needs and budget. My Senior Health Plan takes the guesswork out of Medicare coverage by presenting plans that meet your coverage needs at a price you can afford.

Review your current plan

If you already have a Medicare plan in place, My Senior Health Plan will conduct a complimentary review of your coverage to ensure you’re protected. They take the time to get to know every one of their customers so they can offer the absolute right coverage options, no matter what your situation.

As they review your current coverage, they will provide insight on the right times to change your Medicare Advantage or Medicare Supplement Plans. Medicare has stringent rules on when beneficiaries can make changes to their plans, but with My Senior Health Plan, you don’t have to worry. They know when and how to make changes to your plan, and they’ll take care of the heavy lifting for you!

Save money on coverage

Understanding what coverage you need means also understanding your budget. If you’re on a fixed or low income, they’ll make sure you have an affordable plan with low out-of-pocket expenses.

My Senior Health Plan understands the budgetary constraints faced by most seniors. They don’t pressure their customers into buying coverage they can’t afford. They know there are plenty of options available to meet every seniors’ financial needs.

Check prescription coverage

For many seniors, prescription drugs are their biggest medical expense. They’ve got to have these costs covered, but few know how to find the right prescription drug coverage.

The Medicare professionals at My Senior Health Plan are well-versed in the prescription drug plans and will help you find a plan to suit your needs while keeping your out-of-pocket costs low.

Enjoy lifetime support

My Senior Health Plan is here for you, long after you’ve selected coverage. They provide personalized service to ensure their customers are happy and confident in their Medicare coverage selections.

They also understand how situations change and that when they do, needs change, too. An annual coverage review is standard at My Senior Health Plan. Every year, they’ll happily reevaluate your situation and coverage options to provide guidance on if and how you should change your Medicare Advantage or Medicare Supplement Plan.

Contact My Senior Health Plan today to learn more about their services and your coverage options.

0 comment
1 FacebookTwitterPinterestEmail
Medicare Plans

What are the different types of Medicare supplement plans?

by Kylie Johnson
written by Kylie Johnson

All Medicare supplement policies

Medicare supplement insurance, also known as Medigap, is designed to cover some or all of the costs a patient is responsible for before Medicare Parts A and B will pay anything, copays required by Medicare Parts A and B and amounts over the maximum that Medicare Parts A and B will cover. The different Medigap plans are standardized between companies, meaning consumers will receive the same coverage for Plan A (or whichever plan they select) regardless of which company they buy it from. There are 11 plans, each designated by a different letter, and each one covers different things. (Medigap plans are not labeled with letters in Massachusetts, Minnesota and Wisconsin, so-called waiver states.)

Plan A

Plan A covers additional days in the hospital after Medicare benefits are exceeded, copayments and coinsurance, hospice care and up to three pints of blood.

Plan B

Plan B covers everything that Plan A does and also covers the deductible required by Medicare Part A.

Plan C

Plan C covers everything that Plan B covers as well as the deductible required by Medicare Part B, 80 percent of medical care costs occurred when traveling abroad and the coinsurance for stays in skilled nursing facilities.

Plan D

Plan D is the same as Plan C, but it does not cover medical care costs occurred when traveling abroad.

Plan F

Plan F covers everything covered by Plan C and also covers any excess fees charged by a doctor or hospital that Medicare does not cover.

Plan F—High Deductible

The high deductible version of Plan F has the same coverage as the standard Plan F, but individuals must pay a high deductible, often over $2000, before the policy covers anything.

Plan G

Plan G covers everything the standard Plan F covers except that it does not cover the Medicare Part B deductible.

Plan K

Plan K covers additional days in the hospital after Medicare benefits are exceeded and 50 percent of the following: Part B coinsurance, up to three pints of blood, hospice care, coinsurance for skilled nursing facilities and the deductible for Part A.

Plan L

Plan L covers the same things as Plan K, but it pays 75 percent on the services where Plan K pays 50 percent.

Plan M

Plan M covers additional days in the hospital after Medicare benefits are exceeded, copayments and coinsurance, hospice care, skilled nursing facility coinsurance and up to three pints of blood. It also covers 50 percent of the Part A deductible and 80 percent of charges while traveling abroad.

Plan N

Plan N is identical to Plan M, except it fully covers the deductible for Part A and requires a small copay for office visits and trips to the emergency room.

Medicare SELECT

A type of Medigap policy which typically charges lower premiums so long as the policyholders uses approved networks of hospitals and doctors.

Who should consider purchasing Medicare Supplement Insurance?

Retirees

Anyone reaching retirement age should begin researching health insurance options for those 65 and over. Deciding on a plan before turning 65 may allow some consumers to get special discounts.

Seniors

Older seniors may wish to purchase Medicare supplement insurance if they’re concerned about paying for an unexpected medical need.

People with qualifying disabilities

Individuals with qualifying disabilities, usually those that make them eligible for social security disability, may be allowed to purchase Medicare supplement insurance before they turn 65.

Affinity Group Members

Affinity groups like AARP may offer members advantages if they buy Medigap through the organization.

0 comment
0 FacebookTwitterPinterestEmail
What you Need to Know about Open Enrollment fo Medicare
Medicare Plans

What you Need to Know about Open Enrollment fo Medicare

by Jagger Esch
written by Jagger Esch

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 make changes outside the Annual Enrollment Period. That’s why it’s imperative that you understand when you can make changes.
For example, with Medicare Advantage Plans (also known as Medicare Part C) the Annual Election Period is when you can sign up, change or disenroll from the plan. The AEP allows Medicare Beneficiaries with Medicare Parts A & B to switch to a Part C plan.
In addition, Medicare Beneficiaries that are currently enrolled in a Medicare Advantage Plan (Part C) can disenroll in the Advantage Plan and enroll in a Medigap Plan, also known as a Medicare Supplement Plan.
The effective date for coverage elected during the Annual Enrollment Period will be January 1st of the following year.

Provider Networks

Are you willing to change doctors to save money? If you are enrolling in a Medicare Advantage Plan, this will a topic on the table when you review your options. If you have any doctors that you are not willing to change, have that information handy.
It will help your agent research your options, and make sure the doctor you’d like to keep are in the preferred network of any Medicare Advantage Plan you are going to consider.

Prescription Drugs

Your pharmacy can provide you with a list of the drugs and doses you are currently prescribed. This list is convenient when reviewing your Part D, Prescription Drug coverage options. Whether you are enrolling in a Medicare Advantage Plan or a Medicare Supplement/ Medigap plan, you will need to know if you are getting enough prescription coverage.
Prescription drugs are categorized into different tiers, with copayments/ coinsurance depending on the tier they fall under. The same prescription may have different costs, depending on the Prescription Plan you purchase.
Your agent will ask you for a list of your prescription so they can review those options available and advise which one will best suit your needs.

How to evaluate your options

Confirm your eligibility to enroll

To sign up for a Medicare Advantage Plan or a Medicare Part D Prescription Drug Plan, you must be enrolled in Medicare Part A and Part B and live in the service area of the Medicare Advantage Plan.
If you have end stage renal disease (ESRD), there are a few exceptions, but typically you cannot enroll in a Medicare Advantage Plan. You should contact Medicare for resources and options available.

Review changes to your situation and decide if your current coverage still meets your needs

Before the Medicare Annual Election Periodbegins, review the coverage you have in place. Consider the health benefits your current policy offers and weigh it against the benefits you’ve utilized over the previous 12 months.
You will receive an Evidence of Coverage from your current insurance carrier every fall. Use this document to review against your expected needs for the upcoming calendar year. Of course, nothing takes the place of a licensed insurance agent that can help you review the many options available to minimize your medical expenses.
Verify that your Medicare Part D, Prescription Drug Coverage is considered creditable. That means the coverage is expect to pay at least as much as the standard Medicare Prescription Drug Plan. If you go for 63 or more consecutive days without creditable drug coverage, you may incur a Medicare Part D late enrollment penalty. That penalty never goes away.
If you already have a Medicare Advantage Plan (Part C) in place, you should check to see if your current plan offers dental and /or vision coverage. Usually, these ancillary benefits require a separate enrollment.
For most people, changes occur and our health coverage needs are no exception. It’s worth the time invested to make sure you have the coverage needed before it’s too late.

Be conscious of how enrolling in a Medicare plan may affect other insurance coverage

Coverage such as Tricare for Life or a Federal Employee benefits plan could be impacted if you choose to enroll in other Medicare Coverage. Before making any changes, be certain to speak to your licensed agent or benefits administrator to find out how your insurance works with Medicare.
There are some plans that require you to have Medicare to maintain eligibility, while others will cause you to irreversibly lose your coverage if you enroll into a Medicare Advantage or Prescription Drug Plan.
We should really stress that if you have a retiree benefit plan, please contact your benefits administrator to be sure you understand your obligations in maintaining that coverage. Most plans that are offered to retirees just can’t be beat, so exercise caution if or when you choose to review other options that may be available.

Consider the cost of your coverage

With Medicare Advantage Plans, your insurance company reviews the plan benefits and premiums they charge, every year. Adjustments are made as needed to keep the premium/ loss ratio within the regulatory requirements.
Just as the insurance companies review the policies every year, your licensed agent can shop around and help you compare prices for the best coverage that will meet your anticipated needs and budget for the upcoming year. It has nothing to do with loyalty and is strictly dollar driven. Take advantage of the knowledge agents have to offer. Remember, the agent works for you.
Be cognizant of total cost sharing expenses. A lower premium doesn’t necessarily mean you’ll save money if it’s offset by high deductibles or copayments.
Medigap Plan benefits do not change. Medigap or Medicare Supplement Plans are regulated by Medicare and the benefits do not change. These are the plans that are differentiated by letters, such as Medicare Supplement Plan F or G. It is of interest to note, there are at least ten different Medigap plans currently available.
Any rate increases must be submitted and approved by Medicare. With a Medigap plan, the coverage is the same for a Plan F no matter who underwrites the policy. Medigap Plans cost a little more in premium than an Advantage Plan, but leave the insured person with less out of pocket expenses when seeking medical treatment.

What Can You Do

Working through the intricacies of Medicare can be like navigating through murky water. Frankly, you never really know what’s below the surface. You need a trust licensed insurance agent. The agent works for you, as a matter of fact, the agent has a fiduciary responsibility to help you find the best plan to meet your needs and budget.
Contact your pharmacy and ask them to provide you a list of your medications and doses. Then make a list of the doctor’s you want to be in your network. Determine what benefits are “deal breakers” when you start looking over your coverage options this fall.
Gather your receipts from copayments and coinsurance that you’ve paid for the current 2017 year. Then seek out your agent to help you review the data and make an informed decision as to which coverages will best suit your needs in 2019.

What you Need to Know about Open Enrollment fo Medicare

What you Need to Know about Open Enrollment fo MedicareWhat you Need to Know about Open Enrollment fo Medicare What you Need to Know about Open Enrollment fo Medicare What you Need to Know about Open Enrollment fo Medicare What you Need to Know about Open Enrollment fo Medicare What you Need to Know about Open Enrollment fo Medicare What you Need to Know about Open Enrollment fo Medicare What you Need to Know about Open Enrollment fo MedicareWhat you Need to Know about Open Enrollment fo Medicare What you Need to Know about Open Enrollment fo Medicare
 

0 comment
0 FacebookTwitterPinterestEmail
What to do with the elimination of Medigap Plans C & F
Medigap

What to do with the elimination of Medigap Plans C & F

by Jagger Esch
written by Jagger Esch

For decades Medicare Supplement Plan F has been a top seller; it covers all the gaps in Medicare and leave beneficiaries with a $0 bill. With predictable healthcare costs, financial planning is easier. What to do with the elimination of Medigap Plans C & F
Plan C, like Plan F, is a very comprehensive plan. The only thing it doesn’t cover is the Part B Excess Charges. Plan C is not the same as Part C. Plan C is a Medicare Supplement plan and does not cover prescription drugs.

Why Plan C & F are Being Eliminated

Congress, wanting to cut spending, decided that by no longer allowing companies to cover the part B deductible, medical overuse could be prevented. Plan C & F are the only plans that cover the part B deductible. For 2018, the annual part B deductible is $183.
Cutting spending is not the only reason these plans are being phased out. The big issue Congress has been trying to avoid was, how to get doctors better paid for their Medicare services in the next few years. If the deductible is paid by the beneficiaries instead of the insurance companies, the doctors can be better paid.
Doctors that are not adequately paid are not going to want to work in the Medicare program, as you can imagine. Many health care providers made threats to quit the Medicare program if they were paid any less.
Congress created the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and signed it into legislation on April 16, 2015.
This bipartisan legislation created the Quality Payment Program which does several things:

  • Repeals the Sustainable Growth Rate
  • Changes how Medicare rewards clinicians for value instead of volume.
  • Arranges quality programs under the Merit Based Incentive Payments System.
  • Gives bonus’ for use of eligible alternative payment models.
  • MACRA is also requiring CMS to remove Social Security Numbers from all Medicare cards by April 2019.
  • Medicare Premiums for higher income individuals will also be increasing.

If you are going to be impacted by these changes, you have plenty of time to plan now to minimize any financial impact ahead.
This new legislation enacted by Congress should get doctors the fair payment they want for their Medicare services. The only difference is Plan F and C will be phased out and new enrollees will be responsible for the Part B deductible on Plan D or G.
Plan G is one of the top plans available to Medicare Beneficiaries. The savings usually makes it the most affordable plan for enrollees, depending on the state and enrollment type. The annual part B deductible is only $183, and sometimes a Plan F premium will be $200 more than a Plan G. Making plan G the more sensible plan anyways.
I don’t know if this is really going to cut the annual expenditure of Medicare, arguments on both sides of the spectrum have been given. nce 2020 comes we can all discover the real outcome.
If the beneficiaries are not experiencing higher than usual costs and doctors are paid fair compensation, then Congress found a great quid pro quo solution. If it doesn’t work in raising the pay for doctors, hopefully we will see more creative solutions.

MACRA and How It Impacts Providers

MACRA implements values-based initiatives aimed at improving care and access for Medicare and CHIP beneficiaries. The Quality Payment Program aims to transition the healthcare industry from fee-for-service to value-based care.
This means Medicare physicians, physician assistants, and nurses must participate in either a Merit-based Incentive Payment System (MIPs) or in Alternative Payment Models (APMs). The clinicians’ performance score will determine payment adjustment in later years. CMS will determine a positive, neutral or negative payment threshold.

Current Medicare Beneficiaries

If you are already enrolled in a Medicare Plan F or Plan C you should be “grandfathered” in to your plan and can keep your plan if you would like.
Some people are worried that the rates for Plan F and C will increase substantially, like in 2010 when plans H, I, and J were discontinued. The discontinuation of Plan F will be different in each state, some beneficiaries will still be able to change to other Plan F carriers in the future.
The states that follow the birthday rule or similar rule which lets them change Medicare Supplement companies during certain times of the year without going through any underwriting. This is the regulation in California, Connecticut, Missouri, New York and Oregon.
Only one Idaho has enacted legislation to be sure premium increases won’t affect Plan F beneficiaries specifically. The Idaho Department of insurance received misleading information from agents, telling people to switch plans now to avoid potential rate increases. Idaho Rule 18.01.54 protects Plan F policy holders from seeing a higher premium increase than other letter plan policy holders.

New to Medicare Enrollees

Congress believes that by implementing a mandatory deductible should make people think twice about visiting a doctor for a minor issue. Ideally this will mean fewer doctor visits, and lower Medicare spending.
Critics argue that by eliminating Plan F some people may choose to forego care altogether, resulting in even higher expenses later. If health conditions are not diagnosed early enough, Medicare could end up paying the price later.
The good news for Medicare beneficiaries is that the Part B deductible is not one of the biggest health care costs under Medicare. The Part B deductible for 2018 is only $183 for the year.
The Part A deductible is more than seven times the amount of the Part B deductible. In 2018 the Part A deductible costs $1,340 for each benefit period. Almost all standardized Medicare Supplement plans available in many of the states still cover at least 50% of the Medicare Part A deductible. Medicare Supplement Plan A is the exception, it does not cover the Part A deductible
For those new to Medicare, there are plans that are comprehensive and affordable; Plan G is one of them. You will be able to enroll in a plan G when you first become eligible for Medicare Part A and Part B.
Plan G covers everything Plan F covers, except for the Part B deductible. The doctor flexibility and $0 copayments give beneficiaries on this plan excellent coverage.
Plan N is another good option that is not getting discontinued. It is recommended that Medicare beneficiaries talk with an insurance agent about the plan that will be best suited for your individual healthcare and financial needs.

Things to Consider

The opponents of the legislation pointed out one brilliant thing; If someone has the money to purchase high-dollar coverage, they should be able to have that coverage. In theory, requiring beneficiaries to pay the Part B deductible should deter people from going to the doctor for minor problems.
Congress makes changes to the regulations on Medicare plans every so often. In 1990 they first made insurance companies standardized plan options for Medicare beneficiaries.
Then, in 2010 they removed some of the plan options like E, H I and J. The plans H, I and J were including prescription drug coverage; by eliminating that coverage option, congress was able to cut Medicare spending.
Congress can’t solve the Medicare-financing problem by borrowing funds. Debt in the Government is just a promise to raise taxes in the future. Younger workers will face massive tax increases if Congress does not cut Medicare spending.
With millions of people being affected by this change, at least Congress has given Medicare beneficiaries plenty of time to prepare. Legislation will always be changing and 2020 is still a few years away. What to do with the elimination of Medigap Plans C & F

What to do with the elimination of Medigap Plans C & F

What to do with the elimination of Medigap Plans C & F What to do with the elimination of Medigap Plans C & F What to do with the elimination of Medigap Plans C & F What to do with the elimination of Medigap Plans C & F What to do with the elimination of Medigap Plans C & F What to do with the elimination of Medigap Plans C & F What to do with the elimination of Medigap Plans C & F What to do with the elimination of Medigap Plans C & F

0 comment
0 FacebookTwitterPinterestEmail