There is a lot of debate regarding Medicare, Medicare supplement policies, and their funding. The Medicare program has been around since the 1960s, when President Lyndon B. Johnson signed it into law. At that time, only about one quarter of the American elderly population was covered by insurance. Currently, the elderly are the only age group that basically has universal coverage. Medicare supplement policies came about more recently than that. However, there is a lot of concern that the Medicare funds are running out, that Medicare supplement policies are not doing enough to help the elderly, and that there is not enough incoming money to continue to meet the program's financial needs.
Many people do benefit from Medicare, even though it does not cover 100% of all medical costs. Many people purchase Medicare supplement policies to help offset the costs that are not covered by traditional Medicare. These premiums will also go towards funding Medicare. To offset these gaps in coverage, many American older adults will also purchase Medicare supplement policies that will help them pay some additional costs. Other people get their Medicare benefits from Medicare Advantage Plans through a private health insurance company. This is another way the Medicare program is trying to share costs and risks, by allowing private health insurance companies to also offer Medicare benefits. The insurance carriers get paid from Medicare to offer benefits to older Medicare-eligible adults. A member who buys a Medicare Advantage Plan cannot also purchase a Medicare supplement policy because that would be considered being eligible to have double benefits for the same things. Medicare Advantage Plans include many of the benefits of a Medicare supplement policy.
Medicare supplement policies are regulated by the Centers for Medicare and Medicaid Services (CMS), and are identified at this time by the letters A through L. In the near future, new Medicare supplement policies M through P will be introduced. Some older Medicare Supplement policies will be discontinued soon. The availability of the different Medicare supplement policies is based on geographic location. You will need to submit your zip code and county in order to find out which Medicare supplement policies are available for you to purchase in your area.
The current crisis with Medicare funding is because the baby boomer generation is close to reaching the age of 65. All of these baby boomers have been working and paying taxes into FICA and Medicare and funding the Medicare program. When the baby boomers all hit the age of 65, there will be more people using the Medicare program than there will be people paying and funding the Medicare prog ram. This is where the crisis lies.
Although there is a lot of concern about Medicare funding, it has not been a top priority for the government. The current emphasis on health care reform has certainly touched on the Medicare funding problem. Attempts at making health insurance more affordable for more American citizens are supposed to help relieve some of the burden on Medicare. However, at this time, it is difficult to predict how that will all work out. Many conservative leaders predict some huge financial obstacles that Medicare must overcome in order to stay a viable program.
Medicare Supplement policies are purchased from a private health insurance company, but they are heavily regulated by the CMS to work with traditional Medicare Parts A and B policies.
Medicare Advantage Plans & Medicare Supplement Plans
Medicare Advantage Plans
Friday, September 30, 2011
Wednesday, September 28, 2011
Medicare only pays for 80 percent of a standardized amount for procedures
Many of those over 65 who saved for retirement have retained greater economic flexibility than those hit by layoffs while still trying to amass savings. That makes seniors a very desirable market for several industries. In fact, senior marketing is the fastest growing marketing segment today.
In sharp contrast, one of the biggest marketing failures that can have seriously harmful complications for those over 65 surrounds Medicare. With multiple parts, two deductibles, partial coverage (only 80 percent) for doctors' services, no coverage at times (such as when you travel outside of the U.S.) and no reconciliation when doctors charge above what Medicare will pay, Medicare is a maze of contradictions. How do seniors calculate and plan for their health care costs?
In truth, both people under and over age 65 find Medicare often to be obscure and some simply give up in confusion. It's a sad comment on the "information age" that we haven't explained Medicare's coverage in a way that allows many seniors to estimate their expected health care costs and plan accordingly.
Medicare Supplement Plans Help to Translate Medicare's Coverage
Private insurers marketing Medigap insurance must explain Medicare, at least in part, to show the need for their plans to protect seniors from all the health care charges that Medicare won't cover. For many, private insurance companies discuss Medicare in ways that are more direct and more comprehensible to give seniors a better overall understanding of where the holes in Medicare's coverage put them at risk. The risk is real because hefty doctor and hospital bills far too often devour retirement savings forcing seniors to reduce their standard of living. Health care costs may be the single biggest concern for many seniors because their need for health care grows as they age and because health care prices are spiraling out of control.
A Medicare Supplement Can Cut Seniors' Medical Bills down to Size
With existing Medicare benefits in jeopardy (Medicare was extended beyond it's predicted bust in just eight years), baby boomers and seniors are exploring alternatives, such as Medicare Advantage plans and Medicare Supplement plans.
In the face of the new health care laws, Advantage plans are beginning to lose their subsidies. It's expected that these plans will become increasingly expensive with the decline of government subsidies. Medigap insurance, often called Medicare supplement insurance, is a viable alternative. With 10 different plans, each one fills the gaps in Medicare in a slightly different way so seniors are free to choose only the benefits they need without paying for any extras. Medigap plans cover Medicare's Part A and Part B deductibles to make seeing the doctor and going to the hospital when you need more affordable. These plans can also cover Medicare's co-pays and co-insurance charges, and certain plans expand Medicare's coverage to services beyond Original Medicare, such as emergency medical care when you're out of the country.
Confusion over Medicare Has Left Seniors Unprepared for Health Care Debt
Although millions are now enrolled in Medicare in order to pay for their health care needs, many remain unprotected simply due to a lack of understanding about the intricacies of the Medicare system. One of the biggest misunderstandings involves the Medicare "pre-approved" amount. Medicare only pays for 80 percent of a standardized amount for procedures. That doesn't stop doctors from charging more; it just shifts the burden of payment onto the patient. Doctors can continue to charge their regular fee, Medicare can continue to pay its standard payment and it's up to you to make those ends meet. Getting the right information is crucial to getting the most out of Medicare, and Medicare supplement insurance is one key to bridging the gaps in Medicare coverage.Sunday, September 25, 2011
Will Medicare Advantage premiums be lower next year?
A recent announcement from the Centers for Medicare and Medicaid Services (CMS) indicated that, on average, Medicare Advantage premiums will be 1 percent lower next year. Plus the CMS expects that enrollment in Medicare Advantage plans will increase by 5 percent.
"These predictions are just further proof that many Americans find that the Medicare Advantage plan options are the right choice for them," suggests Alan Weinstock, insurance broker, at www.MedicareSupplementPlans.
Medicare Benefits for 2011
The good news is that the CMS said that the majority of Medicare beneficiaries will see little or no change in their 2011 benefits. In addition, there will be more drug plans offering coverage during the donut hole, that period in prescription drug coverage when there is a gap in coverage. And, consistent with the Affordable Care Act (ACA), beneficiaries in most Medicare Advantage plans and original Medicare will gain access to preventive benefits with no out of pocket costs.
The CMS further indicated that nearly the same percentage of Medicare beneficiaries with current access to Medicare Advantage plans will continue to have access in 2011. That number is 99.7 percent. And all Medicare beneficiaries will continue to have many prescription drug plans to choose from.
Medicare Resources for Seniors
It's important that all Medicare beneficiaries, especially those who are new to the program, get the information they need to make the right decisions about the type of coverage they want: Medicare Advantage or original Medicare with a Medigap plan.
One way to do this is to read the Welcome to Medicare brochure put out by the CMS. This booklet explains which health care services and supplies Medicare covers and how to get those benefits through regular Medicare Part A (hospital insurance) and Part B (medical insurance). In addition, Medicare and You 2011, the official Medicare handbook from the CMS, is due out in mid-October.
Seniors may also want to reach out to service organizations for assistance. Medicare beneficiaries who have questions about Medicare Advantage, original Medicare or how changes from the Affordable Care Act (ACA) might affect them, should consider contacting their state Senior Health Insurance Program (SHIP), a free statewide health insurance counseling service for Medicare beneficiaries and their caregivers.
And for Medicare beneficiaries who are considering Medigap insurance to help supplement their Medicare coverage, speaking to a reliable insurance broker like the brokers at http://www.
Wherever you turn for information, be sure to be proactive and investigate your options before you turn 65.
Thursday, September 22, 2011
Open enrollment period for 2011 Medicare Advantage plans
The open enrollment period for Medicare Advantage plans and prescription drug plans is from November 15 to December 7. You can find hundreds of different plans across the country, with different co-insurance, deductibles and premiums so procrastinators will be doing themselves a favor by shopping early.
Approximately 11.8 million Medicare beneficiaries were already enrolled in Medicare Advantage coverage plans as of September 30. That amounts to almost a quarter of all the people enrolled in Medicare.
How Do Medicare Advantage Plans Work?
These plans are from private insurance companies that provide insurance for seniors and certain people with disabilities. These plans are subsidized by the government and the plans typic ally compete with extras not available in Original Medicare, such as dental, hearing or vision coverage. With the subsidies, their premiums were lower than standard Part B Medicare premiums, but subsidies have come under scrutiny. The federal government has frozen subsidies during performance evaluations. Some plans may earn bonuses, but under-performing plans face a loss of subsidies and that may result in higher premiums.
Most Medicare Advantage plans include prescription drug coverage that is comparable to Medicare Part D. Advantage plans are also typically managed care plans, such as a health maintenance organization (HMO) or a preferred provider organization (PPO) plans. You typically have to choose a primary care physician and see that doctor for a referral before you can see a specialist.
Your access to doctors, hospitals or other medical providers may be restricted to the plan's provider network, too. A few insurers do have what are known as Private Fee-for-Service plans, which may let you to see any doctor or use any Medicare-approved hospital. Such plans may have co-pay charges for doctor visits, but you wouldn't be required to select a primary care physician or get a referral in order to see a specialist.
All Medicare Advantage plans provide all of your Part A and Part B Medicare coverage, including emergency and urgent care coverage. The plans don't cover hospice care because Original Medicare will provide that coverage even after you enroll in one of the Medicare Advantage plans.
How Do I Join One Of The Medicare Advantage Plans?
Generally, you can join a Medicare Advantage plan if you have Medicare Part A and Part B and you live in an area where there is an Advantage plan that accepts new members.
If you are switching to a dif ferent Advantage plan, all you have to do is join the new plan and you will automatically be disenrolled from your old plan. You will not have any lapse in your coverage.
As long as you are enrolled in any of the Medicare Advantage plans, you do not need to buy Medicare Supplement insurance. In fact, it is illegal for anyone to sell you any of the ten Medigap policies if you are in an Advantage plan. The benefits offered by Medigap policies are covered by Medicare Advantage plans and Medicare Supplemental insurance will not pay for your Advantage coverage plan co-insurance, co-pays or deductibles.
What Do Medicare Advantage Plans Cost?
These plans have been inexpensive or even free in certain cases. With the freeze on government subsidies, you may see higher premiums, co-insurance or co-pay charges or reduced benefits. Medicare Advantage coverage plans must continue to provide all of the benefits that are available through Original Medicare, though.
Medicare sets certain rules that all Medicare Advantage plans must follow, but these plans may include co-insurance charges on durable medical equipment like wheelchairs, add co-pay charges to see doctors, set an annual deductible you must meet before your prescriptions are covered or raise your premiums.
The only way to be sure you have the best Medicare supplement and are getting the most out of Medicare is to take a serious look at all of the Medicare Advantage plans and Medicare Supplement plans available in your area.
Approximately 11.8 million Medicare beneficiaries were already enrolled in Medicare Advantage coverage plans as of September 30. That amounts to almost a quarter of all the people enrolled in Medicare.
How Do Medicare Advantage Plans Work?
These plans are from private insurance companies that provide insurance for seniors and certain people with disabilities. These plans are subsidized by the government and the plans typic ally compete with extras not available in Original Medicare, such as dental, hearing or vision coverage. With the subsidies, their premiums were lower than standard Part B Medicare premiums, but subsidies have come under scrutiny. The federal government has frozen subsidies during performance evaluations. Some plans may earn bonuses, but under-performing plans face a loss of subsidies and that may result in higher premiums.
Most Medicare Advantage plans include prescription drug coverage that is comparable to Medicare Part D. Advantage plans are also typically managed care plans, such as a health maintenance organization (HMO) or a preferred provider organization (PPO) plans. You typically have to choose a primary care physician and see that doctor for a referral before you can see a specialist.
Your access to doctors, hospitals or other medical providers may be restricted to the plan's provider network, too. A few insurers do have what are known as Private Fee-for-Service plans, which may let you to see any doctor or use any Medicare-approved hospital. Such plans may have co-pay charges for doctor visits, but you wouldn't be required to select a primary care physician or get a referral in order to see a specialist.
All Medicare Advantage plans provide all of your Part A and Part B Medicare coverage, including emergency and urgent care coverage. The plans don't cover hospice care because Original Medicare will provide that coverage even after you enroll in one of the Medicare Advantage plans.
How Do I Join One Of The Medicare Advantage Plans?
Generally, you can join a Medicare Advantage plan if you have Medicare Part A and Part B and you live in an area where there is an Advantage plan that accepts new members.
If you are switching to a dif ferent Advantage plan, all you have to do is join the new plan and you will automatically be disenrolled from your old plan. You will not have any lapse in your coverage.
As long as you are enrolled in any of the Medicare Advantage plans, you do not need to buy Medicare Supplement insurance. In fact, it is illegal for anyone to sell you any of the ten Medigap policies if you are in an Advantage plan. The benefits offered by Medigap policies are covered by Medicare Advantage plans and Medicare Supplemental insurance will not pay for your Advantage coverage plan co-insurance, co-pays or deductibles.
What Do Medicare Advantage Plans Cost?
These plans have been inexpensive or even free in certain cases. With the freeze on government subsidies, you may see higher premiums, co-insurance or co-pay charges or reduced benefits. Medicare Advantage coverage plans must continue to provide all of the benefits that are available through Original Medicare, though.
Medicare sets certain rules that all Medicare Advantage plans must follow, but these plans may include co-insurance charges on durable medical equipment like wheelchairs, add co-pay charges to see doctors, set an annual deductible you must meet before your prescriptions are covered or raise your premiums.
The only way to be sure you have the best Medicare supplement and are getting the most out of Medicare is to take a serious look at all of the Medicare Advantage plans and Medicare Supplement plans available in your area.
Tuesday, September 20, 2011
How to get enrolled to the Medicare Supplement Plans
The Medicare Supplement Plans as we commonly know is the means to provide better help and support to meet with your need to pay off your medical bills. In fact the Medicare Supplement Plans are originally made for the purpose to provide some extra help to support the Medicare plans. In fact the point is that the Medicare plans does not cover up all the costs needed to pay off your medical bills and therefore there is the need of the Medicare Supplement Plans which along with providing their own set of benefits also covers up the gap left behind by the original Medicare plans. Besides that there are also some other things to consider as well. In fact when you are dealing with the Medicare supplement plans you need not worry about the company that you purchase the plan from. The point is that no matter the company you purchase the plan from you will get the same benefits for all the standard Medicare Supplement Plans.
These Medicare Supplement Plans were originally standardized in 1992 and since then there had been 12 Medicare Supplement Plans to be sold and administered by the private health insurance companies. In fact Medicare Supplement Plans are solely under the administration of the private health insurance companies. But the fact is that no single health insurance company has the power to bring in any changes in the standard Medicare Supplement Plans on their own. Therefore, while purchasing Medigap plans it is certain that you will get the same benefits and coverage for any particular plan irrespective of the company you are purchasing the plan from.
However, other than that it should also be kept in mind that there are also several other factors that should be kept in mind in this respect as well. In fact the point is that while making the choice of the Medicare Supplement Plans it is essential to go through the offer documents of all the Medicare Supplement Plans available so that you can make the proper choice meeting your respective needs. Other than that there are also some other things that should also be kept in mind as well. In fact the point is that it is always a better idea to seek the aid of some professional insurance advisor in this respect who can guide you best in order to make the proper choice of the Medicare supplement plan that can help you get better benefits from your Medicare plans.
There is also one more thing that should be kept in mind in this respect. In order to get enrolled to the Medicare Supplement Plans the most essential thing that is needed is to be a beneficiary of the Original Medicare plans first. The point is that as the Medicare Supplement Plans are only supplementary insurance plans to the original Medicare therefore it is essential that you get enrolled to the original Medicare plans first before you can get enrolled to the Medicare Original Medicare plans first. The point is that as the Medicare Supplement Plans are only supplementary insurance plans to the original Medicare therefore it is essential that you can get enrolled to the original Medicare plans before getting enrolled to the Medigap Insurance Plans. Other than that it is essential to note that there are also some other things to consider as well. In fact even if a person switches over to any other plan say for example the Medicare Advantage plans, he will no longer be able to avail the benefits of Medicare Supplement Plans unless he switches back to the original Medicare.
These Medicare Supplement Plans were originally standardized in 1992 and since then there had been 12 Medicare Supplement Plans to be sold and administered by the private health insurance companies. In fact Medicare Supplement Plans are solely under the administration of the private health insurance companies. But the fact is that no single health insurance company has the power to bring in any changes in the standard Medicare Supplement Plans on their own. Therefore, while purchasing Medigap plans it is certain that you will get the same benefits and coverage for any particular plan irrespective of the company you are purchasing the plan from.
However, other than that it should also be kept in mind that there are also several other factors that should be kept in mind in this respect as well. In fact the point is that while making the choice of the Medicare Supplement Plans it is essential to go through the offer documents of all the Medicare Supplement Plans available so that you can make the proper choice meeting your respective needs. Other than that there are also some other things that should also be kept in mind as well. In fact the point is that it is always a better idea to seek the aid of some professional insurance advisor in this respect who can guide you best in order to make the proper choice of the Medicare supplement plan that can help you get better benefits from your Medicare plans.
There is also one more thing that should be kept in mind in this respect. In order to get enrolled to the Medicare Supplement Plans the most essential thing that is needed is to be a beneficiary of the Original Medicare plans first. The point is that as the Medicare Supplement Plans are only supplementary insurance plans to the original Medicare therefore it is essential that you get enrolled to the original Medicare plans first before you can get enrolled to the Medicare Original Medicare plans first. The point is that as the Medicare Supplement Plans are only supplementary insurance plans to the original Medicare therefore it is essential that you can get enrolled to the original Medicare plans before getting enrolled to the Medigap Insurance Plans. Other than that it is essential to note that there are also some other things to consider as well. In fact even if a person switches over to any other plan say for example the Medicare Advantage plans, he will no longer be able to avail the benefits of Medicare Supplement Plans unless he switches back to the original Medicare.
Sunday, September 18, 2011
Medicare Advantage Private Fee-for-Service (PFFS) plans dropped by Health Insurance Carriers
Health insurance carriers are dropping their Medicare Advantage Private Fee-for-Service (PFFS) plans, according to recent announcements by some health insurance providers, including Coventry and WellCare. A PFFS is a Medicare Advantage (MA) plan that is available through a state licensed, risk-bearing entity, or a PFFS Medicare Advantage Organization (MAO).
As a result of PFFS coverage drops by Coventry and WellCare alone, more than 500,000 Medicare plan holders will have to find new coverage.
At this point, Medicare Advantage plans receive government subsidies so that they can offer beneficiaries more benefits than simple Medicare plans. Medicare Advantage plans are offered to Medicare-eligible individuals by private health insurers. However, analysts are expecting the reimbursement rates for these PFFS programs to fall by approximately 5%, making them less profitable for insurance carriers.
How PFFS Currently Work
PFFS are popular amongst consumer s because they allow Medicare beneficiaries to choose their own healthcare providers, rather than having to select their providers from a limited number of in-network of Medicare-approved providers. Beneficiaries can see any provider, as long as the provider agrees to charge based on the PFFS fee schedule. This fee schedule is the same as the Medicare schedule.
PFFS MAOs have yearly contracts with the Centers for Medicare and Medicaid Services to provide Medicare beneficiaries with their Medicare benefits as well as additional benefits that a company opts to provide. A PFFS provider pays for healthcare instead of Medicare when a beneficiary has such a plan.
The main benefit (which makes PFFS so popular) is that individuals who join PFFS MAOs are not required to use providers within a network and can, therefore, see any provider as long as the provider is able to receive payment from Medicare and the PFFS MAO.
More Changes to PFFS Plans
In addition to the decreased government reimbursement amount for PFFS plans, PFFS plans will be required to develop healthcare provider networks beginning in 2011. The change will force PFFS plan holders to select their healthcare providers from within the plan network, limiting their freedom to see providers that they prefer.
Experts predict that more healthcare insurance providers will follow Coventry and WellCare by dropping their PFFS plans in coming months. Individuals should contact their healthcare insurance providers if they are currently enrolled in a PFFS or are considering enrolling in a PFFS to get more information about how their provider will respond to the upcoming PFFS changes.
More Information About Medicare Advantage Plans
Medicare Advantage plans are specific types of Medicare plans that are in place to cover the cost of healthcare related expenses for Medicare participants. These plans are similar to traditional Medicare plans in that they provide financial support for individuals seeking medical or health-related services. However, Medicare Advantage plans generally have more benefits and lower copayments than other types of Medicare plans. In order to have a Medicare Advantage plan, Medicare participants need to have Medicare Part A and Medicare Part B plans.
One major difference between Medicare Advantage plans and other types of Medicare plans is that Medicare Advantage participants may need to see only doctors that are members of the Medicare Advantage provider plan. However, plans may allow participants to use a wide variety of services, including Medicare Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service providers, and Medicare Special Needs providers.
Medicare participants should be aware that Medigap policies do not provide gap coverage for individuals that participate in the Medicare Advantage program.
As a result of PFFS coverage drops by Coventry and WellCare alone, more than 500,000 Medicare plan holders will have to find new coverage.
At this point, Medicare Advantage plans receive government subsidies so that they can offer beneficiaries more benefits than simple Medicare plans. Medicare Advantage plans are offered to Medicare-eligible individuals by private health insurers. However, analysts are expecting the reimbursement rates for these PFFS programs to fall by approximately 5%, making them less profitable for insurance carriers.
How PFFS Currently Work
PFFS are popular amongst consumer s because they allow Medicare beneficiaries to choose their own healthcare providers, rather than having to select their providers from a limited number of in-network of Medicare-approved providers. Beneficiaries can see any provider, as long as the provider agrees to charge based on the PFFS fee schedule. This fee schedule is the same as the Medicare schedule.
PFFS MAOs have yearly contracts with the Centers for Medicare and Medicaid Services to provide Medicare beneficiaries with their Medicare benefits as well as additional benefits that a company opts to provide. A PFFS provider pays for healthcare instead of Medicare when a beneficiary has such a plan.
The main benefit (which makes PFFS so popular) is that individuals who join PFFS MAOs are not required to use providers within a network and can, therefore, see any provider as long as the provider is able to receive payment from Medicare and the PFFS MAO.
More Changes to PFFS Plans
In addition to the decreased government reimbursement amount for PFFS plans, PFFS plans will be required to develop healthcare provider networks beginning in 2011. The change will force PFFS plan holders to select their healthcare providers from within the plan network, limiting their freedom to see providers that they prefer.
Experts predict that more healthcare insurance providers will follow Coventry and WellCare by dropping their PFFS plans in coming months. Individuals should contact their healthcare insurance providers if they are currently enrolled in a PFFS or are considering enrolling in a PFFS to get more information about how their provider will respond to the upcoming PFFS changes.
More Information About Medicare Advantage Plans
Medicare Advantage plans are specific types of Medicare plans that are in place to cover the cost of healthcare related expenses for Medicare participants. These plans are similar to traditional Medicare plans in that they provide financial support for individuals seeking medical or health-related services. However, Medicare Advantage plans generally have more benefits and lower copayments than other types of Medicare plans. In order to have a Medicare Advantage plan, Medicare participants need to have Medicare Part A and Medicare Part B plans.
One major difference between Medicare Advantage plans and other types of Medicare plans is that Medicare Advantage participants may need to see only doctors that are members of the Medicare Advantage provider plan. However, plans may allow participants to use a wide variety of services, including Medicare Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service providers, and Medicare Special Needs providers.
Medicare participants should be aware that Medigap policies do not provide gap coverage for individuals that participate in the Medicare Advantage program.
Thursday, September 15, 2011
Medigap Options
Health care reform has sparked heavy debate regarding the appropriate supplement for Medicare. It is widely known that seniors ages 65 and above are eligible for government medical aid (Medicare) to assist in healthcare cost. Medicare covers a portion of senior's medical cost. Although government assistance is available, many seniors still lack ample funds to cover the holes in Medicare. Thus, seniors are left to decide whether to adopt a Medicare advantage plan or to simply adopt a supplement for Medicare.
Though this segment is dedicated to the appropriate supplement for Medicare it is prudent to explain differences in what Medicare advantage plans would provide as well. As stated above traditional Medicare covers certain medical needs for seniors. The government covers (by paying doctors and hospitals) certain senior medical needs based on a fee for service schedule.
There are options for seniors to be covered by an advantage plan with 0 out of pocket monthly . It goes without saying that where one medical plan may be ideal for an individual; the same medical plan may fall short of covering another individual's needs. Advantage plans are plans in which the government pays insurers a specific amount monthly for every Medicare member that they enroll (the plans cover hospitals and doctors as well).
Individuals covered under advantage plans are able to choose HMO plans which require advantage recipients to choose from a network of health care providers as well as PPO plans which allow for in network providers as well as out of network providers. It should be noted that individuals going outside of the network would likely have to pay additional fees. All advantage plans offer the same benefits (regardless of the insurer). However, the benefit to the Medicare Advantage plans is that they cover things such as hearing, vision and dental care whereas traditional Medicare plans do not. Medicare Advantage has become increasingly popular due to the advantages provided over and above traditional Medicare.
However, that is precisely the issue that critics raise. Advantage plans are said to "pay out" more than traditional Medicare plans. The congressional budget office has estimated that over 150 billion additional dollars has been spent in the last 10 years on advantage plans (that would not have been spent with standard Medicare). Ultimately, the additional expenditures mean more money spent by taxpayers. Which is why Medicare Advantage plans have been targeted by government and health care reform.
With Medicare Advantage plans being heavily scrutinized and funding likely to be cut at least to some extent, supplements are becoming more appealing. Where advantage plans offer 0 out of pocket, a supplement for Medicare would require some payment by the senior. Where advantage plans replace traditional Medicare, a supplement for Medicare is literally that€a supplement that covers certain holes left by traditional Medicare. Therefore, Medicare is considered the primary plan and a supplement for Medicare is considered secondary to the plan.
Medigap plans are also offered through private insurers at specific cost. Medicare supplement plans are also considered Medigap plans as they fill the gaps left by Medicare. Gaps such as Deductibles, Coinsurance and Co-pays can be filled with an appropriate supplement for Medicare. Any doctor that accepts Medicare should accept a supplement for Medicare. Medicare participants must be enrolled in Medicare part b in order to be eligible to buy a Medigap plan. Medicare part b covers things like doctor services, outpatient care, home health services as well as some preventative services.
There are several Medigap plans available and participants typically need not go through underwriting if they will attain the age of 65 within the next 6 months(and two months following their 65th birthday). Open enrollment occurs from November 15th through December 31st and this is the time that changes may be made by existing supplement users. Medigap options vary and are labeled A through L. Each plan offers different options to fill the holes left by traditional Medicare plans.
Core benefits include hospital coverage for specific periods during Medicare benefit period, approved hospital cost for co-payments during specific periods, skilled nursing coinsurance, doctor deductibles, foreign travel emergency coverage, at home recovery, drug benefit as well as preventative care. Benefits vary from plan to plan and may be viewed in the Medicare handbook.
Though this segment is dedicated to the appropriate supplement for Medicare it is prudent to explain differences in what Medicare advantage plans would provide as well. As stated above traditional Medicare covers certain medical needs for seniors. The government covers (by paying doctors and hospitals) certain senior medical needs based on a fee for service schedule.
There are options for seniors to be covered by an advantage plan with 0 out of pocket monthly . It goes without saying that where one medical plan may be ideal for an individual; the same medical plan may fall short of covering another individual's needs. Advantage plans are plans in which the government pays insurers a specific amount monthly for every Medicare member that they enroll (the plans cover hospitals and doctors as well).
Individuals covered under advantage plans are able to choose HMO plans which require advantage recipients to choose from a network of health care providers as well as PPO plans which allow for in network providers as well as out of network providers. It should be noted that individuals going outside of the network would likely have to pay additional fees. All advantage plans offer the same benefits (regardless of the insurer). However, the benefit to the Medicare Advantage plans is that they cover things such as hearing, vision and dental care whereas traditional Medicare plans do not. Medicare Advantage has become increasingly popular due to the advantages provided over and above traditional Medicare.
However, that is precisely the issue that critics raise. Advantage plans are said to "pay out" more than traditional Medicare plans. The congressional budget office has estimated that over 150 billion additional dollars has been spent in the last 10 years on advantage plans (that would not have been spent with standard Medicare). Ultimately, the additional expenditures mean more money spent by taxpayers. Which is why Medicare Advantage plans have been targeted by government and health care reform.
With Medicare Advantage plans being heavily scrutinized and funding likely to be cut at least to some extent, supplements are becoming more appealing. Where advantage plans offer 0 out of pocket, a supplement for Medicare would require some payment by the senior. Where advantage plans replace traditional Medicare, a supplement for Medicare is literally that€a supplement that covers certain holes left by traditional Medicare. Therefore, Medicare is considered the primary plan and a supplement for Medicare is considered secondary to the plan.
Medigap plans are also offered through private insurers at specific cost. Medicare supplement plans are also considered Medigap plans as they fill the gaps left by Medicare. Gaps such as Deductibles, Coinsurance and Co-pays can be filled with an appropriate supplement for Medicare. Any doctor that accepts Medicare should accept a supplement for Medicare. Medicare participants must be enrolled in Medicare part b in order to be eligible to buy a Medigap plan. Medicare part b covers things like doctor services, outpatient care, home health services as well as some preventative services.
There are several Medigap plans available and participants typically need not go through underwriting if they will attain the age of 65 within the next 6 months(and two months following their 65th birthday). Open enrollment occurs from November 15th through December 31st and this is the time that changes may be made by existing supplement users. Medigap options vary and are labeled A through L. Each plan offers different options to fill the holes left by traditional Medicare plans.
Core benefits include hospital coverage for specific periods during Medicare benefit period, approved hospital cost for co-payments during specific periods, skilled nursing coinsurance, doctor deductibles, foreign travel emergency coverage, at home recovery, drug benefit as well as preventative care. Benefits vary from plan to plan and may be viewed in the Medicare handbook.
Monday, September 12, 2011
Why purchasing Medicare supplement plan right when you turn 65 is a good idea
There are certain Medicare supplement policies, commonly referred to as Medigap, which are sold to Medicare beneficiaries who are already enrolled in Medicare or Medicare Advantage plans. These Medicare supplement plans help cover the "gap" or pay for expenses that Medicare does not include. Medicare supplement policies are private insurance plans that help pay expenses, such as deductibles, co-payments, or prescription drug costs.
Medicare beneficiaries can purchase Medigap, or Medicare supplement policies, on the open health insurance market. At this time, many seniors do not purchase Medicare supplement plans and only rely on Medicare or Medicare Advantage plans. The premium costs for Medicare supplement policies vary based on geography, type of plan, age and health condition. Therefore, purchasing Medicare supplement plan right when you turn 65 is probably a good idea, because th at is when you are the healthiest and youngest and eligible for Medigap coverage. If you purchase a Medicare supplement policy later on, you may have to pay a really high premium.
There are standardized Medicare supplement policies, which are government-regulated to include specific benefits so that individuals can compare the policies easily. However, each health insurance provider can set their own prices for their Medicare supplement policies. That is why it is important to do some comparison shopping between insurance providers.
Medicare beneficiaries can purchase Medigap, or Medicare supplement policies, on the open health insurance market. At this time, many seniors do not purchase Medicare supplement plans and only rely on Medicare or Medicare Advantage plans. The premium costs for Medicare supplement policies vary based on geography, type of plan, age and health condition. Therefore, purchasing Medicare supplement plan right when you turn 65 is probably a good idea, because th at is when you are the healthiest and youngest and eligible for Medigap coverage. If you purchase a Medicare supplement policy later on, you may have to pay a really high premium.
There are standardized Medicare supplement policies, which are government-regulated to include specific benefits so that individuals can compare the policies easily. However, each health insurance provider can set their own prices for their Medicare supplement policies. That is why it is important to do some comparison shopping between insurance providers.
Saturday, September 10, 2011
Benefits Of A Medicare Supplement Policy
There is a lot of debate regarding Medicare, Medicare supplement policies, and their funding. The Medicare program has been around since the 1960s, when President Lyndon B. Johnson signed it into law. At that time, only about one quarter of the American elderly population was covered by insurance.
Currently, the elderly are the only age group that basically has universal coverage. Medicare supplement policies came about more recently than that. However, there is a lot of concern that the Medicare funds are running out, that Medicare supplement policies are not doing enough to help the elderly, and that there is not enough incoming money to continue to meet the program's financial needs.
Many people do benefit from Medicare, even though it does not cover 100% of all medical costs. Many people purchase Medicare supplement policies to help offset the costs that are not covered by traditional Medicare. These premiums will also go towards funding Medicare. To offset these gaps in coverage, many American older adults will also purchase Medicare supplement policies that will help them pay some additional costs.
Other people get their Medicare benefits from Medicare Advantage Plans through a private health insurance company. This is another way the Medicare program is trying to share costs and risks, by allowing private health insurance companies to also offer Medicare benefits. The insurance carriers get paid from Medicare to offer benefits to older Medicare-eligible adults.
A member who buys a Medicare Advantage Plan cannot also purchase a Medicare supplement policy because that would be considered being eligible to have double benefits for the same things. Medicare Advantage Plans include many of the benefits of a Medicare supplement policy.
Currently, the elderly are the only age group that basically has universal coverage. Medicare supplement policies came about more recently than that. However, there is a lot of concern that the Medicare funds are running out, that Medicare supplement policies are not doing enough to help the elderly, and that there is not enough incoming money to continue to meet the program's financial needs.
Many people do benefit from Medicare, even though it does not cover 100% of all medical costs. Many people purchase Medicare supplement policies to help offset the costs that are not covered by traditional Medicare. These premiums will also go towards funding Medicare. To offset these gaps in coverage, many American older adults will also purchase Medicare supplement policies that will help them pay some additional costs.
Other people get their Medicare benefits from Medicare Advantage Plans through a private health insurance company. This is another way the Medicare program is trying to share costs and risks, by allowing private health insurance companies to also offer Medicare benefits. The insurance carriers get paid from Medicare to offer benefits to older Medicare-eligible adults.
A member who buys a Medicare Advantage Plan cannot also purchase a Medicare supplement policy because that would be considered being eligible to have double benefits for the same things. Medicare Advantage Plans include many of the benefits of a Medicare supplement policy.
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