Medicare Review Time Is Here

It’s that time of year again, and this doesn’t refer to Christmas, but instead Medicare plans.

Every year it’s a very wise move to review all Medicare plans in the family. Certainly this can be done at any time of the year, but it’s even more critical right now since it is open enrollment time until December 31st, 2009. This is when seniors have the option to change their existing Medicare Part D prescription plans and Medicare Part C Advantage plans.

When dealing with Medicare Advantage Plans, make it a point to speak to an expert health insurance broker, as there are a number of changes relating to the Medicare Advantage plans that will directly affect coverage. Currently, many seniors are now scrambling to find other health insurance coverage since Medicare Advantage has been cancelled out from under them.

The open enrollment period lasts six weeks and it’s a good time to evaluate the four parts of Medicare – Part A, Part B, Part C and Part D. Most of the seniors in Medicare have Part A and that provides them with hospitalization and rehab after they get out. Part B includes visits to the physician, some home care services and medical equipment. In some instances, seniors will also have an employer sponsored supplement or a private pay Medigap policy in addition to Parts A and B.

Most seniors are also very familiar with Part D, the fourth plan, because it covers drugs. Part C is the infamous Medicare Advantage program that came into being in 2003. Parts C and D were both created at the same time and actually Medicare Advantage was a dusted off and jacked up combination of the Medicare and Choice programs that had been in existence since 1997. With Medicare Advantage, seniors got the private insurance version of Parts A and B. If they signed on for Part C, then A and B no longer covered them. Now, Medicare coverage is run by private health insurance contracts with various insurance companies.

With all the changes to Medicare coming in 2010 and the cancellation of Medicare Advantage, it’s time to speak to a knowledgeable Medicare health insurance agent and find out what’s new for the future, who it will benefit, how it will benefit them, and how to get signed up.

To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Medicare Senior Power

If seniors banded together to make a difference in their health care costs, silver power would be a new word for the future of health care in America.

It’s a fact that most seniors have limited resources and need to watch their spending carefully. Nowhere is that more apparent than when it comes to health care needs. The way it works in the U.S. right now is that when a person turns 65, they become eligible for Medicare.

Medicare Part A is the hospital insurance portion and seniors get this free if the individual or spouse has 40 or more quarters of Medicare-covered employment. The rest of the medical insurance part, which is Medicare Part B, is for individuals who enroll at 65, and it’s fairly minimal; for example Medicare Part B was an average cost of $96.40 for 2009.

What these figures mean is that the cost for Medicare premiums is less than people were paying before they turned 65, and that is good news. The bad news is that Medicare does not cover all health care costs, which isn’t exactly new, but a lot of people forget this point.

Most seniors definitely need supplemental coverage to fill in the gaps for extra money they pay out for things not covered by Medicare. While that may sound depressing, there are 12 different Medicare supplement plans and so many Medicare insurers and HMOs to choose from, that not only is there a lot of variety and different prices, it’s sometimes tough to figure out which way to go. Just because something is good for one person, does not make it good for another.

Seniors can definitely control the costs of their health insurance coverage by keeping up-to-date on the latest information that relates to their plans and by making it a point to speak to an expert health insurance agent. They will do best by talking to an agent that sells what they need, not just someone who has many things they are able to sell.

It’s time consuming for seniors to find plans that suit their budgets, but this is definitely a doable proposition with the right health insurance agent that works with seniors one-on-one and finds them what suits their needs. If more seniors got together and became a powerful voice for Medicare insurance they could count on and afford, silver power would be a new word in health care circles when it came to Medicare.

To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Medical Homes Now in More States

Are medical homes a good idea and just what are they anyhow?

It appears that the current administration in Washington will be launching a 3-year medical home program that may be an option for qualified Medicare beneficiaries in states that are participating in this program. What it boils down to is those who do qualify will live in Medicare housing where they will be seen on a regular basis by primary care doctors and other health care providers. Those other providers would possibly include social workers, therapists and nurse practitioners.

This is initially a pilot program to see if all goes well and to assess if Medicare recipients do get a high level of care offered to them. Overall though, the main reason behind this pilot program is to ideally reduce costs. Evidently the new program will offer access to things like dietitians and physical therapists, something not usually covered by the “original” Medicare. So this program may just be a step in the right direction and be a benefit to Medicare recipients who need these kinds of specialized services.

What is happening right now is that if a senior is on Medicare and needs a service that isn’t covered under their plan, they have two choices – either pay for the service out-of-pocket or buy Medicare supplemental insurance. Generally speaking, it’s a smart move for seniors to have Medicare supplemental insurance so they are covered for things they may need. Buying this later often becomes more expensive.

To make this new program work, it seems that Medicare will be joining hands with Medicaid, state and federal health care programs, and private insurers in states that will offer the medical home program. For instance, Vermont already has a medical care home model in operation. By all reports, it seems to be doing what it was created to do, provide “uniform standards for advanced primary care.” It’s not just Vermont that has implemented this kind of a model either; so have Maine, Colorado and Massachusetts.

Never before has Medicare taken part in something this big and different. It breaks all the traditional rules and blazes some new trails. In addition to this it will be the first time that private insurance companies and primary care physicians will actually be on the same page when it comes to compensation. Of interest is that Vermont doctors get an extra patient bonus of $1.20 to $2.39 a patient, per month, to look after their care and get a further bonus if a patient’s health improves based on certain criteria.

If you’re making plans for the future, now is the time to call about making changes to your Medigap plans or improve your Medicare coverage. It is open enrollment until December 31, 2009.

Richard Cantu is with Medicare supplements resource, GoMedigap.com. To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Seniors Need to be Cautious About Medicare Ads

Despite what you may get in the mail, read everything you get with a grain of salt and lots of caution.
It’s that time of the year for seniors about to be eligible for Medicare. Your mailbox is going to be jam packed with ads about Medicare supplements and Medicare Part D drug coverage. Not that the information isn’t useful, but there is so much of it and it’s terribly confusing to boot. This is where you need to reach for the phone and call an expert Medicare insurance agent in your area and talk turkey about all the stuff you’ve been getting.

One thing you should definitely know right up front is that open enrollment for Medicare Part D started November 15th and runs right through to December 31st every year. You may or may not know this however, that Medicare supplements do not have an open enrollment period. The only open enrollment you make take advantage of is the one that relates to Medicare Part D drug coverage, period. The reason this is so important to know and remember is because a large portion of the senior population think open enrollment is for Medicare supplement plans. This is not the case.

This isn’t to say that you can’t attempt to make a change to your Medicare supplement at any time, but having said that, there are a lot of companies that will ask medical questions. The answers you give to those questions may either allow you to change plans or not, as the case may be.

Here is another area of confusion now, and likely in the foreseeable future, Medicare supplements are also called Medigap policies and they are identical by plan. So what that really means is that if you want to buy plan J from AARP, you will get precisely the same benefits with a plan J offered by American Progressive. In other words, it doesn’t matter where you buy the plan, it is the same plan.

The only thing that does tend to change is the premiums the various companies charge. Sure, you could shop for the cheapest deal, but you will want to know you are dealing with a company with a good reputation for honoring their claims. Just because the ads you get in your mailbox say company X is the biggest and best and is really aggressive about chasing your business, does not mean they “are” the best. So be wary.

The interesting thing here is that when you look in your stuffed mailbox, the ads you see are strictly regulated by the Center for Medicare Services. That may be all well and good, but that still does not help you sort out some very confusing and misleading ads. Remember this as well, that just because your banker or best friend has a plan that works for them, does not mean it is suited to your particular circumstances. Ask questions and don’t stop until you get answers that make sense, and get a plan based on your needs, health and budget.

Richard Cantu is with Medicare supplements resource, GoMedigap.com. To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Medicare Supplements and Guaranteed Issue

Federally mandated guaranteed issue periods allow people to enroll in Medicare supplement plans without being denied coverage.

If health problems exist and an individual has been unable to get Medicare supplement plans, there is hope in the form of guaranteed issue periods. These periods are federally mandated by the Centers for Medicare and Medicaid Services and apply to “all” Medicare enrollees. What this specifically means is that the guaranteed issue period lets people apply for a plan without being denied coverage, charging more for any health condition, and excluding any pre-existing conditions.

As a stand-alone product, Medicare pays for roughly 80% of most covered services. This would mean an individual or family would then be responsible for the other 20% of the expenses that are not covered. While this 20% might not sound like much, it definitely adds up if the hospital bill is for things like strokes, heart attacks or cancer. Basically any major medical event will run the meter up and leave many people in a desperate situation financially. For seniors on a limited budget, this is not good news. This is why seniors need to be supplementing Medicare with Medicare supplements. It’s essential.

One reason why it is essential for those over 65 to supplement their Medicare is the fact that anyone needing health insurance needs to consider the monthly premium rate. The coverage itself is standardized, so that means what someone pays for it is critical. Shopping around for better rates makes sense and in the meantime if the insurance company that sold the Medicare supplement plans goes under, those left in the dust are allowed to sign up for a new plan under the guaranteed issue period.

Consider any value added benefits and other possible discounts when sourcing Medicare health insurance. Not a lot of people realize that some insurance outfits offer additional benefits as an attractive value-added part of their plan. If a company offers something worthwhile and it would be used, then it might be the place to buy Medicare insurance.

Take into consideration that waiting might not be a smart idea when it comes to getting Medicare supplements simply because a person might not be able to qualify for it later. Private companies have control over who they accept onto their plans and while some have more lenient underwriting guidelines, they may deny coverage.

The bottom line is shop around, ask questions and read the fine print in any policy purchased. It only makes good sense to know what the policy covers and does not cover.

To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Medicare and Medicare Advantage Differences

Until 2010 when Medicare Advantage is discontinued, it pays to know the differences between Medicare supplement plans and Medicare Advantage.

It’s a fairly straightforward difference between Medicare and Medicare Advantage, and it basically boils down to the majority of an individual’s health care expenses is covered by Medicare. For example, Medicare part A will cover inpatient care at places like a hospice, skilled nursing facility or a hospital.

Medicare part B takes care of doctors and outpatient services, while part D handles prescription drugs. One thing to remember is that parts B and D mean paying a premium. While it looks like Medicare covers a whole lot, it doesn’t cover everything. This is where Medicare supplements or Medicare Advantage steps in if a person or family wants 100% of their health care covered.

If a person opts to buy Medicare supplements, they are purchasing a “gap” policy that fills in the holes in the original Medicare plan, usually referred to as a Medigap policy. With these particular policies, there are various levels of coverage in 12 different plans with alphabet designations A through L. Each one of these letters provides a different kind of supplemental health coverage and the prices are unique, based on the different levels.

Medigap health insurance is offered by private health insurance companies and there is a monthly premium to be paid. Usually the premium is dictated by the level of coverage, age of the insured and their zip code. As with many other things in life, these plans usually have a price increase yearly.

With the Medicare supplement policies there are usually open enrollment periods and a person is able to get guaranteed enrollment. If an application is not made during the open enrollment period, the usual health insurance underwriting routine applies.

Medicare supplements are additional coverage. Medicare Advantage is replacement coverage. To file a claim under a Medicare supplement policy, a person must file a claim with Medicare and the supplemental insurance company. In the case of Medicare Advantage, the claim is processed by the policy provider.

Medicare Advantage also currently provides many choices such as a PPO, FFS or HMO and right now plans are available to suit an individual’s personal preferences and what is still being marketed in the applicable zip code. All this will change when Medicare Advantage is no longer offered in 2010. Now is the time to speak to a local Medicare health insurance provider to find out what other alternatives will be available to replace Medicare Advantage.

To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Medicare Supplement Plans M and N Lower Premiums?

Is the news floating around in cyberspace true, that there will be lower premiums for Medicare supplement plans M and N?

For those of you that don’t know what Medicare supplementary plans are, they are meant to bridge the gap between the policy coverage of the original Medicare and the actual bill, when it arrives in the mail later.This “gapping” became necessary when it was discovered that the original Medicare plan didn’t pay for every medical service actually needed, and you were dealing with a medical disaster.

If you stop to think about that explanation, it will make a great deal of sense to find out that there is more than one “gap” between the original plan and your bill. In order to do something about that gap, you do need to have Medicare to begin with, and then supplement it with other plans to fill the gaps. This analogy is a bit like filling teeth in that the dentist takes the existing original tooth and fills in the gaps with supplemental material to make it whole again.

Notice the use of the term “gap” and it will come as no surprise that the plans to fill in the original Medicare are referred to as Medigap policies. Medigap policies are run by private insurance companies who sell them to the public for varying prices. While the plans themselves are standardized, meaning they are the same in every state, the prices tend to be different depending on what the insurance company wishes to charge for them.

Despite the fact that Medigap policies are controlled by private health insurance companies, they still must have common rules to be followed when it comes to actually selling the Medigap policies. First and foremost is there are only 12 standard policies running from plan A to L. Each of their policies has its own set of benefits as well.

What is often not clearly understood by many people is that most of the Medigap policies give consumers the basic benefits of plans A and B, and in addition to the basic benefits, they also have their own advantages.

The 12 plans (A-L) have been around since 1992, but now there may be two “new” plans introduced in June 2010, plans M and N. The main feature of these two plans will be that they are supposedly going to provide lower premium rates as an alternative to the existing Medicare Supplement plans. While it isn’t entirely clear what M and N may offer, it is predicted that they should sell well because of the lower premiums.
With any change in Medicare or Medicare supplements, make sure you take the time to read each policy you decide to buy so you “know” just precisely what health coverage you actually have.

Richard Cantu is with Medicare supplements resource, GoMedigap.com. To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.