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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.

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Health Insurance

How To Select A Medicare Supplement Company

by Kylie Johnson
written by Kylie Johnson

Plan Availability

Medicare supplement insurance plans are standardized by law and are named with letters. The standardization means that every company’s Plan A offers the same coverage, but not all companies sell every plan. And sometimes companies offer different plans in different states.

  • Plans by company: If you want to purchase coverage from a specific company, start by looking at the plans that company sells in your area.
  • Plans by type: If you are more concerned with the coverage provided than the company selling it, start by looking at plans and then determine which companies offer those plans in your area.
  • Plans by geography: Medigap policies are standardized in a different way in the so-called waiver states of Massachusetts, Minnesota and Wisconsin.

Price

Maximum out-of-pocket expenses and deductibles are standardized between companies. However, the monthly price may vary greatly between companies depending on your age, where you live, discounts and medical underwriting. To make sure a plan is financially beneficial, multiply the monthly premium by 12 and add any out-of-pocket cost you may need to spend. Weigh that cost against the chance you’ll spend more than that amount on healthcare if you do not have supplement insurance.

  • Monthly premium: Monthly premiums for the same policies are not standardized the way coverage is, so consumers should get multiple quotes before enrolling in any policy.
  • Discounts: Some companies offer discounts for paying your premium in full annually, for enrolling when you’re 64 or 65 and/or for having multiple policies with the same company. Consider getting quotes from companies you already have policies with, and ask the agent if discounts exist for current customers.

Customer service

Because coverage is the same regardless of which provider you select, a company’s customer service is an important factor to consider when selecting a new Medigap provider.

  • Available hours: Look at the hours when you can reach customer service representatives by phone. Make sure the contact information and hours for customer service representatives or agents, not just sales representatives, are listed.
  • In-person availability: If you would prefer to work with someone in person, ask about local agents. Some companies let you place a request for a local agent to contact you, so you only have to submit your information and then wait to be called.
  • Existing relationships: If you already have a policy with a company you like, you may wish to talk to the agent who manages your current insurance. They may be able to tell you about special discounts.

Reputation

A company’s reputation may help you choose between insurers with similarly priced plans.

  • Financial strength: Working with a financially stable company ensures that it will be able to pay for services long into the future , even if costs rise substantially or a disaster requires the company to pay for care for hundreds or thousands of policyholders. A.M. Best, Moody’s, Fitch and Standard & Poor’s are independent agencies that rate insurance companies’ financial stability. You can visit these agencies’ websites to see how they rate the financial stability of a specific company. Although many companies list a rating on their website, you can see the most reliable and recent rating on the independent agencies’ websites.
  • Years in business: The amount of time a company has been in business can indicate that they have reliable business practices and good customer service. You may also wish to compare how long a company has offered Medicare supplement insurance.
  • Recommendations: Ask friends and family members to tell you about their experiences with different insurance companies. Read online reviews to determine how the company deals with customers.

Extra features

Some companies offer additional features and benefits for policyholders. Be aware, these extra features are not a part of the insurance so they could be changed or eliminated at any time during the policy term.

  • Informational seminars: Some companies offer regular meetings and seminars to help customers understand insurance options and/or Medicare more generally. These seminars can help consumers make the best choice for their situation.
  • Informational guides: Some companies send customers free pamphlets and other informational materials. These guides give consumers some guidance so they can ask agents specific questions.
  • Healthcare perks: Some companies give customers free access to some healthcare services, like medical hotlines or preventative care discounts.

Other insurance offerings

Because companies may offer discounts for individuals who already own multiple policies with them, you may want to choose a company that sells several types of policies that interest you. A company’s other offerings may indicate how experienced they are in dealing with Medicare-related plans and/or people in your age group.

  • Auto/home insurance: Companies that have an extensive number of products for protecting your home or automobile will likely offer multiple policies that meet your needs, so a multiple-policy discount would be easy to qualify for.
  • Life insurance: Many companies that sell Medicare supplement insurance also offer life insurance policies. These companies might offer multiple policy discounts or might be accustomed to working with recent retirees.
  • Health insurance: Companies that offer health insurance may be better at helping individuals choose Medigap policies that meet their needs.

Buying periods

When is the best time to buy?

The best time to buy a Medigap policy is during the Medigap open enrollment period. The period begins on the first day of the month in which you turn 65 or older and enrolled in Medicare Part B. Buying within the enrollment window means:

  • Guaranteed issue: Insurance companies must sell you a policy.
  • Pre-Existing Coverage: Pre-existing health conditions are covered.
  • Can’t Be Charged More: Buying within the six-month window means people suffering from medical conditions can buy coverage for the same price as people without health issues.
  • Switching Medigap: You can switch Medigap policies, but you risk a penalty if you don’t switch during the open enrollment window. People switch because they want to cheaper Medigap policy, or because they need more benefits.

What if you buy outside of the enrollment period?

If you apply for Medigap coverage after your open enrollment period, there’s no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements, unless you’re eligible due to one of the situations below:

  • Disability: You’re under 65 and eligible for Medicare because of a disability or end-stage renal disease.
  • Pre-existing conditions: Coverage for the pre-existing condition can be excluded if the condition was treated or diagnosed within six months before the coverage starts under the Medigap policy. After the six-month period, the Medigap policy will cover the condition that was excluded.
  • Other insurance: If you have group health insurance through an employer or union, your Medigap open enrollment period will start when you sign up for Medicare Part B.
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Switching Medicare Supplement (Medigap) Plans
Medicare Plans

Switching Medicare Supplement (Medigap) Plans

by Garrett Ball
written by Garrett Ball

If you need to drop, change or enroll in a Medicare Supplement (Medigap) plan, you can do it at any time of the year. But before you make any changes, you need to consider whether you should make any changes or stay with whatever plan you currently have. Although you might be very satisfied with your Medicare Supplement plan now, it might not be suitable any longer because of your present needs or because of changes to the cost of your plan. As life events may have arisen, your current coverage could fall short of providing you with adequate coverage or may not meet all your needs for the duration of your life. You should consider very carefully the decision to change to another Medigap plan and/or company. Switching Medicare Supplement (Medigap) Plans
Some common reasons why you should consider switching Medigap plans, or switching from a Medicare Advantage plan to a Medigap plan are described below.

  • You are unhappy with your current Medigap policy because
  • the customer service being provided is substandard
  • your premiums have sky rocketed and you can no longer afford the increases
  • you want to change your level of coverage (i.e. Plan F to Plan G)
  • You have a Medicare Advantage Plan, but you are not happy with it because
  • the customer service being provided is substandard
  • your doctors are not in the Advantage plan network
  • you feel you just don’t have enough coverage and buying a Medigap policy would cover your healthcare more adequately
  • you fear that if you do acquire a major illness, you might be declined if you decide to switch at some time in the future, and you would rather change now.

What to consider when switching plans

When making that change to a Medigap plan, you should do a comparison of plans, i.e. which plans are available in your area and what benefits they offer (Plans F, G, N, etc). Medicare Supplement plans are standardized, however, they may vary widely in cost. You must get the same level of coverage no matter which company you buy your supplement from. In other words, one Medigap Plan G is the exact same as another Medigap Plan G. Your main goal is to find the best company at the lowest premium. Switching Medicare Supplement (Medigap) Plans
Note: If you are not satisfied with your Medicare Advantage plan, you have certain rights by federal law to buy a Medicare Supplement plan. You are entitled to these rights provided it is within 12 months of signing up for Original Medicare.

You cannot have both Medicare Advantage and Medigap, so you must be disenrolled from your Medicare Part C (Advantage) plan at the time a Medigap plan takes effect. You will need to contact your current plan and let them know that you want to go back to Original Medicare. Or you can disenroll from Medicare Advantage by signing up for a standalone Part D plan. For Medicare Advantage, the disenrollment process can only be done during certain times of the year or under special circumstances:

  • Annual Election Period (only for Part C and Part D): October 7 to December 15 each year. The change will take place the following January 1st. What changes can you make during the annual election period?
  • Annual Disenrollment Period (only for Part C and Part D): January 1 to February 14 each year. The change takes effect the 1st of the month following your request.

If you had a Medigap policy before you enrolled in a Medicare Advantage plan, you may be able to get the same policy back if it is still sold by that company. Otherwise you can buy another Medigap policy. Please note, that some states may provide additional special rights.

When is the best time to enroll in a Medigap Plan?

The best time for you to enroll in a Medigap plan is:

  • when you first turn 65. However, for you to be eligible, you must have already signed up for Medicare Part B. This is called the “Open Enrollment Period”. It is the 6-month period, which begins the 1st day of the month that you turn 65 and are in Medicare Part B. During this time, you have guaranteed issue rights. This means you cannot be declined in a Medicare Supplement plan because of your health. Even if you have health issues or pre-existing conditions, you are waived from answering any health questions, and must be offered the best available rate as anyone else who is in good health.
  • You are not limited to purchase a Medigap plan only during the open enrollment period or guaranteed issue rights. You are permitted to change it at any time since Medicare Supplement plans are not subject to the same guidelines as Medicare Advantage plans are. That said, you will, in most cases, have to undergo medical underwriting.

Whatever Medicare Supplement plan you switch to, make sure that you contact your current insurance company after you get approved by your new plan’s insurance company. This will prevent any duplication of coverage or any gap in coverage. You cannot have two Medigap plans at the same time. Switching Medicare Supplement (Medigap) Plans

Switching Medicare Supplement (Medigap) Plans

Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans Switching Medicare Supplement (Medigap) Plans

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Medicare Plans

Reinstating the Medicare Advantage “Open Enrollment Period”

by Jagger Esch
written by Jagger Esch

If you or a loved one receives Medicare coverage, you know how complicated and confusing enrollment periods can be. Enrollment periods are only confusing because the term “Open Enrollment Period” is used correctly and incorrectly to describe times when a plan change is possible

Reinstating “Open Enrollment Period”

The Medicare Advantage Open Enrollment Period was discontinued in 2010. In 2019, the OEP will make a return.

From 2011-2018 Medicare beneficiaries were given only the Medicare Advantage Disenrollment Period (MADP), during this time beneficiaries could disenroll from their Medicare Advantage plan and switch only to Original Medicare. Now all that is changing.

The Medicare OEP will begin on January 1st and end on March 31st. During this time Medicare beneficiaries can disenroll from a Medicare Advantage plan and enroll into another Medicare Advantage plan. You also have the option of switching back to Original Medicare, with or without Part D coverage.

It’s important for beneficiaries to know that they won’t be able to switch Part D prescription drug plans. If you are currently enrolled in a stand-alone Prescription Drug Plan you will need to change your policy during the Annual Enrollment Period from October 15 through December 7.

Medicare Supplement Open Enrollment Period

New terminology needs to be set up to make things easier for Medicare beneficiaries. It doesn’t need to be complicated, and it should be simplified.

The Medicare Supplement Open Enrollment Period is for Medicare beneficiaries that are new to Medicare Part B. This period lasts 6 months and begins on the first day of the month that you turn 65 or older and enrolled in Medicare Part B.

So, if you turn 65 on April 8 and don’t join Medicare until May 20, your Medicare Supplement Open Enrollment will start on June 1, which is the first day of the month in which you are both 65 and Enrolled in Medicare Part B.

Incorrectly Called “Open Enrollment Period”

The Annual Enrollment Period (AEP) happens every year from October 15 through December 7, this enrollment period is commonly called the Open Enrollment Period. It’s incorrect to refer to the AEP as the OEP, but people do.

When a Medicare beneficiary turns 65, they become eligible for the Initial Enrollment Period (IEP), this gives beneficiaries 7 months to enroll in a Medicare Advantage plan. IEP is commonly mistaken for an Open Enrollment Period. It’s clear that they are confusing the IEP with the Medicare Supplement Open Enrollment Period, while they are similar, they aren’t the same.

Other Coverage Changes in Medicare 2019

April of 2018, Medicare recipients will start to receive new Medicare ID cards that no longer have a Social Security number displayed on them. This is to help prevent fraud and identity theft among seniors. As required by the Medicare Access and CHIP Reauthorization Act (MACRA) all beneficiaries will have a new Medicare ID card by April 2019. The new cards will display a random ID number and you can shred the old card.

Then the Bipartisan Budget Act of 2018 (BBA 2018) will help close the donut hole one for brand-name drugs. This means that beneficiaries will only pay 25% of the cost of brand-name drugs. The cost of closing the donut hole for brand-name prescriptions is being shifted to the drug manufactures instead of insurance companies or beneficiaries.

So many good things are happening in 2019, it only makes sense that there is some less than desirable news. A new premium bracket for the highest-income Part B and Part D enrollees with go into effect. Under the BBA 2018 enrollees with an income of $500,000 or more ($750,000 for married couples) will pay a higher premium for Part B and Part D coverage.

Annually by September 30th, Medicare Advantage recipients will receive an Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing insurance carrier for their Medicare Advantage and Medicare Prescription drug plan providers.

CMS shares plan changes for the following year in October, several months before the new year. Medicare.gov is an awesome resource for Medicare beneficiaries, you can use it to compare plans, look up information and learn more about Medicare.

 

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Medicare Plans

Alternatives to 1st Dollar Coverage Plans

by Jagger Esch
written by Jagger Esch

We’ve lived our lives planning for our future and the future is now. Unfortunately, gone are 1stdollar coverage plans. Instead of paying a monthly premium that allowed us to close our wallet after writing that check we can expect to do a little more searching to find just the right plan. It’s back to the licensed insurance agent to review your needs and benefits against costs and risk.

If you aren’t familiar with 1stdollar coverage, we are referring to Medicare Supplement Plans F and C. Medicare Supplement Plans are sometimes referred to as Medigap Plans. Plan F covered everything not covered by Original Medicare. Plan C covered everything not covered by Original Medicare, except excess charges.

What Now

Nonetheless, there are great coverage options available to you. The most comprehensive Medigap Plans available for the 2020 year will be Plans G and N. Previously, these two plans were overlooked by many in favor of paying a higher premium and nothing more. Medicare Supplement Plans G and N will now be the sought-after coverage options.

Plan G

In 2019, the Medicare Part B deductible will be $185. For beneficiaries enrolled in a Medicare Supplement Plan G, that $185 deductible will be all they pay for covered services. Between Original Medicare and Medicare Supplement Plan G, everything else is paid for you.

This plan is like Medicare Supplement Plan F in that you can minimize your out of pocket risk. But by assuming the $185 deductible, you will save much more than $185 on an annual basis. Currently, the Plan G is the most popular plan.

The reason is that in most cases a Medicare Beneficiary will save considerably more every year by paying their Medicare Part B deductible out of pocket. In many cases, a Beneficiary can save $300 or more over the cost of the year, and that is even after the deductible is met. To Savy seniors, this plan has been the choice for several years now.

Plan G does cover any excess changes that could be imposed by a hospital or physician’s office. So, you are not giving up any peace of mind to save several hundred dollars. The protection is in this plan. You can find Medicare Plan G reviews here.

Plan N

Medicare Beneficiaries that want cost-effective coverage and are willing to use facilities and physicians that accepts Medicare assignment should consider Medicare Supplement Plan N. Plan N does not offer does not cover the $185 (2019) deductible or excess charges.

In addition, Plan N has small co-pays when seeing the doctor or going to the emergency room. The co-pay for a doctor visit, primary or specialist, is up to $20. The emergency room co-pay is up to $50.

The Plan N caters to seniors that do not go to the doctor often. Many times, the cost savings from the Plan N to the Plan G are significant as well. The only real gap in the Plan N is that it does not cover excess charges.

Most doctors do not charge them, but you will frequently see a cancer specialist, and specialty hospitals charging those charges. A Cancer policy can always be purchased, roughly $1 per day for about $10,000 in coverage, to help cover these charges if you were to be diagnosed with cancer. You can find Medicare Plan N reviews here.

Why the Sudden Change

The end of first dollar coverage plans has been several years in the making. Congress created the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and signed it into legislation on April 16, 2015.

There are several reasons for the birth of MACRA. People agree the single most important reason is to keep doctors on the Medicare program. Medicare Beneficiaries need a large pool of doctors from which to select the one that best fits their needs and personality.

It is important to mention that someone who is already enrolled in one of the plans being retired can keep it. It is even permitted to change to another carrier’s Plan F or C, depending on which plan they have currently. Provided they can medically qualify, up until 2020.

The last plan that was retired was the Plan J. The difference is when Plan J was retired, Medicare Beneficiaries were allowed a special enrollment period to change to the Plan F with no medical underwriting. This is not the case this time around.

If you want to know more about the elimination of Plans F or C, click here.

History has shown that members that elect to stay on retired plans will be subject to larger than usual rate increases. It may not occur right away but as people that are healthy leave those plans to more cost-effective alternatives and people that cannot medically change pass on, there are less people in the pool of that plan. In order to keep up with the increased claims of sicker people, the prices must increase more dramatically to cover the claims.

 

 

 

 

 

 

 

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MedicarePrescription Programs

6 Ways Seniors can Save on Prescription Drugs

by Guest Blogger
written by Guest Blogger

Prescription drug use is increasing across all groups of people. But seniors are the most like to use multiple medications at once. This phenomenon, called polypharmacy, sees some seniors saddled with ten or more prescriptions. As age increases, so does the number of pills consumed each day.

Whether or not polypharmacy is the best option medically, the financial burden is undeniable. Even with a Medicare Part D plan, prescription drugs costs stifle many seniors. This is especially true in the coverage gap, where patients are responsible for a larger percentage of drug costs. If you’re overwhelmed by the cost of medication or caring for a senior on a tight budget, try these 6 ways to save on prescription drugs.

  1. Try Generics

The average price difference between generic and brand-name drugs is between 80% and 85%. This represents a huge opportunity for cost savings, especially for people who take multiple medications.

Brand loyalty might be keeping you on a more expensive drug. But generic equivalents are subject to the same quality standards and contain the same active ingredients as brand-name medication. Unless your doctor has a specific medical reason for you a brand-name drug, ask for the generic.

  1. Switch to a Different Brand

Generic equivalents aren’t always available. But there are many different medications to treat common conditions. When your doctor prescribes something new or expensive, ask if a more economical option exists.

If you have Part D coverage, what you pay for a drug will depend on the plan’s formulary. This list puts medication in different categories and often changes from year to year. Request a copy of the formulary to help your doctor find the lowest price option for your condition.

  1. Preferred Pharmacies

If your Part D plan has preferred pharmacies, you should be using them whenever possible. They offer benefits like co-pay discounts, bulk ordering, or home delivery.

It’s especially important to shop around if you aren’t enrolled in prescription drug coverage. Prices can vary significantly between pharmacies. Call different retail chains and smaller independent stores to make sure you’re paying the lowest possible price.

 

  1. Change Medicare Plans

Enrolling in prescription drug coverage with Medicare can be overwhelming. Once you’ve selected a plan, it’s easy to stick with the status quo. But the plan that’s best for you will change as you age and your prescriptions increase.

Ask friends and family for advice or help researching new plans. You can also take advantage of resources like State Health Insurance Assistance Programs, where counselors are available to help find the right Medicare plan for you.

  1. State Pharmaceutical Assistance Programs

Medicare is a federal government program, but some states offer extra assistance to residents with a specific health condition or below a certain income. Check the Medicare website to see if you qualify for one of these programs.

  1. RxConnected Online Pharmacy

What if you take an expensive drug that isn’t covered by your Part D plan, or pay high out-of-pocket costs in the coverage gap? RxConnected.comis a Canadian prescription referral service that helps patients in the U.S. purchase lower-priced maintenance medications from licensed pharmacies in Canada and around the world. All you need is a valid prescription from your doctor. Placing an order online or over the phone is easy, and medication is delivered right to your door.

Ready to spend less money on prescriptions and less time at the pharmacy? Visit RxConnected.comto compare prices and find out just how much you could be saving.

Author Bio:

Katharine is a creative content writer who loves to tell stories. When she’s not busy writing, Katharine spends time hiking, cycling, and exploring beautiful British Columbia.

 

 

 

 

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Why Medicare is Primary for Small Employers
MedicareMedicare Plans

Why Medicare is Primary for Small Employers

by Jagger Esch
written by Jagger Esch

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 order to be certain you are making the right decision for yourself, and not subjecting yourself to a potential penalty.

Should You Enroll in Part B or Delay it?

The number of employees your company has in their workforce will be the determining factor. If your employer along with all of their subsidiaries (if any), has more than twenty employees then your employer’s group health plan will be primary and Medicare secondary.
Naturally, in this case you will not be required to start your Medicare Part B and you will not incur a penalty for delaying enrollment. You should, however, check with your employer’s benefits administrator before you elect to delaying your Medicare Part B enrollment.
You will want to ensure that your employer coverage is considered creditable for Medicare Part B and/or Part D. If it is not you will need to pick up Medicare Part B and/or Part D to avoid a penalty.
If your employer and any subsidiaries has 20 employees or less, Medicare Parts A and B will be your primary coverage. What this means for you is that if you delay enrollment into Medicare Part B you will receive a Part B penalty of up to 10 percent for every consecutive 12 month period you do not have creditable coverage.

Medicare is Primary Means What?

When Medicare is primary it means Medicare is the first to pay and your employer coverage will pay after Medicare pays its portion. You will be responsible for any amount not covered after Medicare pays their portion and your employer’s group plans pays their portion.
Just as an example, when you go to the doctor you will be subject to Medicare’s deductible and the 20% left over. Your employer plan make pay all or part of those costs.
Keep in mind the employer coverage you have after turning age 65 may not be the same coverage that you had prior to being 65. Check with the benefits administrator from your employer to discuss what changes will be occurring to your current employer sponsored health coverage.

Which is Better, Employer or Medicare Coverage?

One of the biggest concerns when investigating policy benefits should be prescription drug coverage. Normally, employer plans do not have a gap in prescription drug coverage.
However, nearly all Medicare Advantage Plans that contain prescription drug coverage and all Medicare Prescription Drug Plans include a coverage gap. You may have heard the term “donut hole” used to describe the prescription drug coverage gap that impacts Medicare Beneficiaries.
Due to the new Bipartisan Budget Act of 2018, the coverage gap is closing in 2019, for brand name drugs. Nevertheless, the cost of prescriptions drugs during what was previously known as the coverage gap, will still increase just not as drastic as before.
Before making a decision, review your medical and prescription drug options and evaluate the benefits and risks of each choice. This determination will require you to ponder and decide for yourself.
Everyone’s situation is a bit different, needs and budget will vary from person to person. Comparing employer coverage versus Medicare as primary, it is not possible to say one is better than the other.
The way Medicare Plans are rated in your state should be another factor in your deliberations. You’re in an “issue age” state in you’re a resident of Florida. The closer you are to age 65 when enrolling in a Medicare plan will ensure a lesser price on your supplement plan for the lifetime of that coverage. Most states are not “issue “age”.
It does not matter what age rating is used in your state of residency, chances are you will still receive annual rate increases.

What About My Situation?

If you work for a small company that has a group health plan, and your employer has less than 20 employees, Medicare will usually pay first. However, Medicare would usually pay second if both of these apply to your situation:

  • Your employer joins with other employers or employee organizations (like unions) to sponsor a group health plan(called a multi-employer plan)
  • Any of the other employers have 20 or more employees

Your employer’s group health plan could ask for an exception. Even if your employer has less than 20 employees, you’ll need to check with the employer’s benefits administrator to find out if Medicare pays first or second.

If the employer has more than 20 employees, the employer sponsored group health plan will usually pay first. Always confirm with the benefits administrator.

Employers that have 20 or more employees are required to offer current employees that are 65 and older the same health benefits that they were entitled to when they were under 65, with the same conditions.
If the group health plan offered coverage to significant others, they must offer the same coverage to significant others aged 65 and older that they offer to significant others under the age of 65.

What About Claims?

If the employer sponsored group health plandidn’t pay the full cost of your bill, your doctor or health care providershould forward the bill to Medicare for an additional (secondary) payment.
Medicare will pay based on what the group health plan paid already, and what the doctor or health care provider charged. You’ll be responsible for any additional costs not covered by Medicare or your employer sponsored group health plan.
Why Medicare is Primary for Small Employers Why Medicare is Primary for Small Employers Why Medicare is Primary for Small Employers Why Medicare is Primary for Small Employers Why Medicare is Primary for Small Employers Why Medicare is Primary for Small Employers Why Medicare is Primary for Small Employers Why Medicare is Primary for Small Employers Why Medicare is Primary for Small Employers

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How Seniors Can Keep Information Safe Online
Fraud & SecurityMoney

How Seniors Can Keep Information Safe Online

by Kimberly Johnson
written by Kimberly Johnson

What’s The Issue?

The Pew Research Center found that in a 2017 study that 67% of adults ages 65 and older say they go online. In a growing technological world, seniors are having to adapt more and more to living online. How Seniors Can Keep Information Safe Online
Unfortunately, since most of everyday life is spent online, the rise in online identity and financial theft has risen considerately. CNBC reported back in August that over $36 billion dollars has been stolen from seniors in online financial fraud schemes. That same report says that one in every 18 cognitively intact older adults falls prey to financial fraud or abuse in a given year.
These schemes are usually focused on seniors because many in the age group have a significant amount of money sitting in their bank accounts. The effects can be devastating, leaving them in a very vulnerable position with little time to make up for their losses.
There are multiple types of scams that target seniors, usually asking for personal information. some of these include:

● Medicare & health insurance scams
● Counterfeit prescription drugs
● Fraudulent anti-aging products
● Telemarketing & phone scams
● Internet fraud
● Investment schemes
● Homeowner & reverse mortgage scams
● Sweepstakes & lottery scams

How can seniors stay safe?

You can’t do everything offline. It’s easier to make purchases or transmit information over the Internet. Especially as seniors grow older, and may be limited physically, the Internet provides an additional option to them to complete tasks faster.
Keep some of these tips in mind while online:
1. Don’t share your personal information with unverified representatives.
Identity thieves often call and claim to be from an organization you trust. Some may say they’re representing a utility company, an administrator of a contest you’ve “won,” or even from your credit card company. Most of the time, these thieves are trying to trick you into giving them your credit card or Social Security number.
Don’t provide any personal information that can lead to your accounts being compromised. To check if the request is legitimate, contact the organization via its published phone number or any secure messaging system.
2. Never E-mail personal information
Just as you should never give personal information over the phone to someone you don’t know, make sure to do the same when receiving an email online. Criminals may email you pretending to be your bank, or bill collector from your health center.
Some email hackers employ search tools that scan for strings of numbers likely to be credit card accounts. Any time you send your card number in an email, it increases any risk of exposure.
3. Never post photos of your information
No matter what the reason, never send or post any pictures of your personal information online. Someone might ask for a picture of your credit card, Social Security card, or even insurance numbers. Any picture, even if you delete it, can live on forever through screenshots.
Some people think it may be safe to post a picture of their credit cards or bills by covering up half of the number. Sometimes, thieves have the ability to commit fraud even with part of the number, so why increase any risk?
4. Use a credit card for transactions
Debit cards and cash don’t offer any of the same fraud protections that credit cards do.
As you use credit cards, it’s the issuer’s money, and not yours on the line. It’s easier to get refunds in cases of credit card fraud. Almost all credit cards have fraud protection built in.
5. Manage your passwords and accounts carefully
As you make your passwords, make sure they’re unique and secure. Always change your passwords on a regular basis. If you’re using any computer accessible by others, be sure to log out of all websites after you finish a transaction.
Lastly, make sure a website has “https://” rather than just “http://” when submitting your credit card information online. The s stands for secure, and it means your information your submitting is encrypted.
By Jacob Lunduski
Jacob Lunduski is a Financial Industry Analyst that strives to connect with different communities to educate them on using credit with discipline. As a member of Credit Card Insider, he identifies the financial issues that different people face. He provides information and tips to ensure these people have a path to achieve financial success.

How Seniors Can Keep Information Safe Online

How Seniors Can Keep Information Safe Online How Seniors Can Keep Information Safe Online How Seniors Can Keep Information Safe Online How Seniors Can Keep Information Safe Online How Seniors Can Keep Information Safe Online How Seniors Can Keep Information Safe Online How Seniors Can Keep Information Safe Online How Seniors Can Keep Information Safe Online

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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
MedicareMedicare Plans

Do Not Pay Your Part B Deductible at Doctor Appointments

by Jagger Esch
written by Jagger Esch

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

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