Medicare Advantage & Medicare Supplement Info

Medicare Supplemental Insurance and Medicare Advantage Plans in Virginia

2012-01-31T02:20:00.000-08:00

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Arizona Medicare Advantage Plans or Medicare Supplemental Insurance – What Is The Difference?

2012-01-28T17:12:00.000-08:00

As traditional Medicare insurance has many gaps that are not covered, seniors in Arizona can’t speculate about their future and need protection for expenses that are not covered by Medicare.

There are two main options for additional coverage on top of traditional Medicare in Arizona: Medicare Supplemental Insurance plans and Arizona Medicare Advantage plans. So which option is best for you?

Medicare Supplemental Insurance (also called Medigap) is provided by private insurance companies, governed by Medicare. This means, each insurance provider that offers a specific plan (numbered from A to N) must offer the exact same plan benefits. However, the premiums for those plans may greatly vary from provider to provider. It pays for seniors on Medicare in Arizona to shop around before they select a plan.

While Medicare Supplement plans in general do have higher monthly premiums than Medicare Advantage plans, the coverage for doctor and hospital visits is more comprehensive and the insured has lower out of pocket costs. Medicare Supplement plans are designed to reduce your out of pocket costs for those health related expenses. Traditional Medicare will pay its share, and the supplemental insurance plan will pick up the remaining 20%.

As for Arizona Medicare Advantage plans, two different types are available – network-based HMO, PPO plans, where you have to use the services of health care providers that are members of the individual network, and non-network-based plans, so called fee for service plans (PFFS). Medicare Advantage plans are a privatized version of Medicare, so insurance providers that offer these plans can set their own plan benefits and premiums. Therefore, the benefits and premiums of Medicare Advantage plans in Arizona vary widely and it is imperative that you compare your options before you decide. Regardless of which type of plan or provider you choose, it is essential to consider the plan benefits based on your unique health and financial situation.

To help you select between Medicare Supplemental insurance and Medicare Advantage plans, you may want to ask yourself these 3 questions:

Can I manage to pay some out-of-pocket costs throughout the year? Supplements don’t have many, if any, out of pocket costs, but higher premiums, whereas Advantage plans work on a cost-sharing basisWould I rather have slightly higher, but fixed health care costs (Medicare Supplement), or variable cost-sharing based on your individual health during a given year (Medicare Advantage)?Is the security of staying within the government’s regulated Medicare plan important to me (Medicare Supplemental) or am I willing to give up that and go exclusively with a private insurance provider (Medicare Advantage)?

It is extremely essential for Arizona seniors on Medicare to know all their options and the details on Medicare Supplemental insurance and Arizona Medicare Advantage plans, so they can make the selection that is best for them. Visit www.medicare.gov for more information, or talk to your health insurance specialist.

More Medicare Info:

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Medicare Supplemental Insurance and Medicare Advantage Plans in Utah

2012-01-26T02:16:00.000-08:00

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Medicare Supplemental Insurance and Medicare Advantage Plans in Texas

2012-01-23T07:07:00.000-08:00

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Medicare Supplemental Insurance and Medicare Advantage Plans in South Dakota

2012-01-21T06:18:00.000-08:00

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Medicare Supplemental Insurance and Medicare Advantage Plans in Vermont

2012-01-18T05:13:00.000-08:00

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Medicare Supplemental Insurance and Medicare Advantage Plans in West Virginia

2012-01-15T12:22:00.000-08:00

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Medicare Supplemental Insurance and Medicare Advantage Plans in Wisconsin

2012-01-13T01:00:00.000-08:00

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Medicare Supplemental Insurance and Medicare Advantage Plans in Tennessee

2012-01-09T17:42:00.000-08:00

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Medicare Supplemental Insurance and Medicare Advantage Plans in Washington

2012-01-07T16:48:00.000-08:00

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Medicare Supplement Plans - How They Work

2012-01-04T12:10:00.000-08:00

Medicare Supplement plans are plans that are designed to fill in the "gaps" in "original" Medicare. "Original" Medicare includes Medicare Part A (hospital inpatient) and Part B (outpatient/doctor). These plans are consistent across companies - all companies are required to provide the same standardized benefits. This makes it very easy to understand the plans and how they work. Here are the top three things that you must know when looking at Medicare Supplement plans:

Medicare Supplement plans (also called Medigap) are Federally-standardized. The plans all provide equal coverage for "like" plans. What this means is that a Plan F with one company is the exact same as a Plan F with another company. Because of this, it is important to compare the plans on the basis of monthly premium and company rating or reputation. Price being equal, it is preferable to be with a company that has a long track record of involvement in the senior insurance marketplace and/or a high financial strength rating.
Medigap plans can be used at any doctor or hospital, nationwide, regardless of which company sells you the plan. Many types of insurance are network-based; however, this does not apply to Medicare Supplement plans. Even some types of Medicare plans - Medicare Advantage plans - are network-based in most cases. On the contrary, Medigap plans give you the flexibility of using the plan anywhere in the country that takes Medicare. This flexibility, particularly for someone that travels, is one of the many reasons that these plans have become increasingly popular as a way to supplement Medicare coverage.
Medigap plans all pay claims through the Medicare "crossover" system. There is no variation in how quickly or how efficiently one company pays claims versus another. While some companies may use the selling point of their timeliness in paying claims, this is not altogether accurate when it comes to this type of insurance. Because the plans are Federally-standardized and pay claims this "crossover" system, you can be assured that, regardless of the company, the claims are going to be paid in a timely manner and with minimal (usually no) involvement from the insured. Once you have a plan, you just need to present your plan identification card with your red, white and blue Medicare card when receiving services from a doctor or hospital.

Altogether, Medicare Supplement plans continue to be a viable option for those on Medicare, who wish to limit their exposure to out of pocket expenses. With only Medicare, you are subjected to paying approximately 20% of all medical costs. With a Medigap plan, however, you can greatly reduce or, with some plans, completely eliminate your out of pocket costs.

J. Garrett Ball is the owner of Secure Medicare Solutions, which administers http://medicare-supplement.us/. On the site, you can get information about Medicare Supplement plans and get Medigap quotes sent to you by email.

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Medicare Supplement Plans, The Easy Way

2011-12-29T00:07:00.000-08:00

So many of my clients have expressed their frustration and confusion when trying to sort through the masses of information around and about Medicare and Medicare Supplement Plans.

This article is not going to clear up all of that confusion. However you will find some very helpful information about accessing assistance in your quest for information and some hazards you will want to sidestep.

You do not have to "go it alone." There are many reputable insurance professionals that are ready and able to help you. How do you find a good one? Some questions you should ask to determine if you are dealing with one:

1)You will want to make sure that you are dealing with an independent agent or broker. This type of agent does not work for just one carrier. They are not limited to talking to you about just one company's options. The independent agent forms relationships with multiple carriers. This enables him/her to fit the solution to you rather than try to you into the limited options they have the ability to offer. There is the added worry that the agent will lose the connection with that one company and then no longer have the resources to provide service to you or your policy.

2)If your agent doesn't start out by finding out some key things about you and your lifestyle, he/she is just not doing a good job for you. Questions like: How much traveling to intend to do? How is your health? What is your budget? Are you comfortable with sharing some of the cost for your medical expenses or do you want total coverage? The answers to all of these questions are key if the agent is going to recommend the right plan for you.

3)Does the agent specialize in Medicare specifically? The world of insurance is extremely diverse. Look for an agent who specializes in Medicare. Someone who is up to date on the laws and the changes is going to be able to advise you. It is wise to avoid a "jack of all trades" when it comes to Medicare. There is a lot to know about any genre of insurance.You are better with someone focused on the segment that you are dealing with.

4)How long has the agent been in business? Each year thousands of people get into the insurance business. Each year the vast majority of those new agents leave the insurance business. Work with an agent who has established longevity in the industry and demonstrated a commitment to it. Avoid brand new agents. This will ensure that your agent will be there down the line for customer service.

5)Does the agent present the information in a way that is clear and understandable? This would seem almost too basic to mention, but it is key. A competent, caring agent should be able to clear up the confusion for you. If an agent does their job properly, you will feel confident that you understand your options and that you have made the right choice for your circumstances. Avoid agents that use "insurance speak" terms and phrases that only insurance people would know.

6)Ask yourself if it seems like the agent trying to help you or themselves. All insurance professionals are in business to make a living. It is the ethical insurance professionals who live by the fact that it is only by taking care of the customer, that you take care of yourself.

Help is available. Just take a deep breath, remember these points and you will find the right person to help you understand your Medicare and Medicare Supplement Plan options.

Let us help. Don't tackle medicare alone. For the latest information about Medicare or to compare medicare supplement plan options and rates in your area, call 888-347-5552 or visit http://www.medicarequote4u.com/.

Stephanie Coutavas is an Insurance Professional specializing in Senior Insurance Solutions and Medicare Insurance. Co-founder and Senior Broker at http://www.medicarequote4u.com/, Common Sense Insurance Solutions Group. Stephanie decided to specialize in Medicare because, "I saw the effects of the confusion and misinformation in the senior market. I really feel that with the proper,correct information, presented in an understandable way that our Seniors can position themselves for the future and achieve the peace of mind and security that they deserve at this exciting stage of life. We strive one client at a time to make sure that we address the individual and that they are better for having met us, regardless of whether they choose us as their broker."

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Medicare Supplement Plans: Purchase at the Annual Enrollment

2011-12-26T11:02:00.000-08:00

Medicare Supplement Plans are the most excellent kind of insurances for health available to adults over the age of sixty five.

People who buy these supplemental quotes can visit almost any specialist, hospital, or doctor, and often pay very less or nothing at all for these kinds of purchases. The only difficulty with Medicare Supplement Plans is the agencies that offer this kind of Medicare supplemental quotes have under-writing guidelines, which might make it difficult to qualify if you have preexisting circumstances. Using definite issue guide-lines to buy one of these plans might make a big difference in the worth of care you get and you're other expenses for physician and hospital services.

The most frequently used assured issue period is the period of preliminary enrollment, which starts on the first-day of the month where you are both registered in Medicare (Part B) and over the age of sixty five. This time extends for 6 months and you may register in any plan with any agency during this specific time without responding to any of the health queries. A lot of seniors buy Medicare (Plan F) in the initial registration period, however over the past few years a lot of people have been influenced to buy Medicare Advantage Plans that offer lower coverage.

The second most liked assured issue period happens when adults choose to work after their sixty fifth year of age. During this period they are frequently covered by company plans that offer higher coverage to normal Medicare. Though, when they finally leave when they retire their company plan, they have a sixty three day assured issue period where they might register in the insurance plan of their selection. This assured issue period in addition includes people who have left, although are still covered on their earlier companies plan.

Medicare Supplements Plans approximately always offer higher exposure to Medicare-Advantage-Plans, which is why a lot of people are opting to register in normal Medicare and buy supplemental-insurance. A lot of seniors over the years have received correspondences informing them of their coverage with the current benefit plan will be finished at the end of the current year. These insured adults have a special assured issue time frame, where they might register in any kind of plan with any agency without giving explanations to any of the health questions. People who have physical conditions and issues should utilize this period to buy a Medicare Supplemental quote.

The Author is a professional writer, presently writing for Medicare supplements and Medicare supplement insurance.

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Philadelphia Medicare Supplemental Insurance - Which One to Choose

2011-12-21T11:23:00.000-08:00

Medicare Insurance has never been this complicated! With so many changes in Healthcare Reform over the past 18 months, seniors today have to become experts to know which plan is best for them. Will it be around next year? Can I switch if I'm not happy with the benefits? These are all great questions to ask and better yet, know the answer to.

The safest way to go when it comes to your healthcare in your "golden years" is to protect yourself with a Medicare Supplement Plan. This means that the you will have Original Medicare, Parts A & B, as your primary medical insurance. A Medicare Supplement or Medigap plan will cover the cost that Medicare does not cover. This includes co-pays, co-insurance and other expenses.

Plan F of the Medicare Supplements has recently become the Cadillac choice for seniors today. Essentially it covers almost all of your potential out-of-pocket expenses that Medicare does not. Other plans such as Plan N or Plan G still leave some gaps that could potentially be devastating financially. For this reason the Plan F is your best choice when considering your options of a Medicare Supplement.

The greatest part is that the Plan F is the same no matter which carrier you decide to choose. In any city, county or state - the benefits remain the same! My advice is to shop around and make sure your getting the best price for the plan as each carrier sets their own price for their service. Some carriers even add Silver Sneakers or other health and wellness benefits that other do not, usually at no additional cost.

Now that you have your Supplement insurance squared away, make sure you also procure a Part D, better known as a Prescription Drug Plan. Neither Medicare nor your supplement plan will cover your monthly prescriptions and it is imperative that you seek the best plan for you based on your needs and budget. If you fail to do so, penalties may be imposed on you later and you will pay a higher rate for as long as you are on Medicare.

Lastly, a common misconception is that when you have a Plan F, regardless of your carrier, you are not bound by their network of providers. Remember, you have Original Medicare as your primary insurance and thus you can see any provider who accepts Medicare! Your supplement just covers the difference, so they don't care who you have as your Supplement carrier as long as they get paid.

For more information on Medicare Insurance please visit our website for updates, news, quotes and online applications.

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Senior Health - What You Should Know About Hospice

2011-12-18T23:41:00.000-08:00

Talking about hospice care is probably at the top of the list of the things you never ever want to speak about or even think about. However if you have a senior health plan called Medicare it is imperative that you understand your benefits. The same holds true if you love and care for someone who has Medicare. After all, you have been paying the health insurance premiums for years and you should know and understand the benefits. It is also important to know and understand the benefits so you and your family may make informed choices and decisions.

Hospice provides comfort and support for the terminally ill and for the families that care for their loved ones. A lot of times what happens is that an elderly person will be told that they have six months or less to live. Someone will probably suggest that the family "make arrangements". What does "make arrangements" in this case actually mean? It means that there is help available for your loved one at a very difficult time. It's called hospice and your senior health plan will cover almost all of the costs. Hospice is generally given in the home but may also be received at an inpatient hospice facility. Some large hospitals may also have special "hospice" wings.

After a person has been given over to hospice a specially trained medical team will take over providing all medical care. Services may include drugs, physical care, counseling, equipment and supplies for the terminal illness and related condition(s). Hospice care is given in two ninety day periods of care followed by an unlimited number of sixty-day periods. At the start of each period of care, the hospice medical director or doctor must re-certify that you're terminally ill.

If your health improves or you go into remission you have the right to stop hospice care at any time. You may return to the same senior health plan you had before you chose hospice, such as treatment to cure the terminal illness. If you are eligible you may go back to hospice care at any time. For more information always consult a licensed insurance agent that specializes in senior health plans.

Do you want to find quotes on a high deductible health plan, senior health plan or an individual family plan? Click here: Health Insurance Premiums View the original article here

Senior Health - Making Sure Seniors Are Protected

2011-12-15T21:48:00.000-08:00

Senior health is far more volatile than most of us would like to admit. Whether you are a senior citizen yourself or you have one you want to take care of, finding proper protection in old age is vitally important to the protection of life in general. The easiest way to get protection is to find a health insurance plan that will accommodate all of the senior's needs and more. The information below will show you how to go about doing that so you can make sure your health or the health of someone you love is protected at all times.

One of the first things you need to think about as a senior is what you will likely need the senior health insurance for. Some policyholders need their plans to cover doctor's visits extensively, emergencies, and others need to get good deals on prescription drugs. Assess your needs so that you may be able to find a policy that is most fitting for them. Chances are you will opt for some kind of Medicare plan. When you do, you can look into supplemental insurance plans to cover those special needs. You should be able to setup an affordable insurance plan that works for you.

When you have an idea of the kind of plan you want to get, the next thing you need to do is generate some quotes online so you can see how much money you may have to pay. Then you can get the policy right there so that you are protected as soon as possible. You can change supplement plans or even insurance companies if you find a better deal out there. Just make sure you check everything before you sign up so that you know you are getting the coverage you need.

Senior health may be a little more fragile than the health of younger generations, but that does not make it harder to insure. There are plenty of insurance providers out there that are willing to work with seniors, even those on a fixed budget. You should never assume that you are out of options for your insurance plan because there is always a new one out there to take into consideration. With a little bit of research, you should be able to find a plan that is tailor fit to your needs. You can reap the benefits of your protection after that.

Hass Mohammed is VP of Sales & Marketing at Insurance Medics. Insurance Medics is a national online insurance agency offering a vast array of insurance products from many different insurers.

To find a Health insurance broker or for more information on Health Insurance Plans, visit http://www.healthinsurancemedics.com/

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Senior Health - How The Donut Hole Works

2011-12-12T17:28:00.000-08:00

As a licensed insurance broker I find the prescription drug coverage difficult to understand. If it is confusing for me, I figured it must be even more confusing for those enrolled in a senior health plan. The prescription drug plan is Part D of the senior health plan called Medicare. Part D plans have a premium that must be paid monthly and most plans have a deductible that must be met before benefits begin.

Let's take a stroll through a scenario of prescription coverage for my friend Mr. Schultz. He has selected a plan with a $310.00 deductible. It works just like all high deductible health plan. Once you pay the deductible the insurance kicks in. Mr. Schultz takes four different drugs. Two are generic and two are brand name. He pays, or meets, the deductible in June. After that Mr. Schultz will pay a copayment and his plan will pay its share for each covered drug until the combined amount between what the insurance company pays and what Mr. Schultz pays reaches a total of $2,840.

Mr. Schultz is now in the hole of the donut! Most senior health plans refer to it as the coverage gap. In 2011, he will get a 50% discount of covered brand-name prescription drugs that counts as out-of-pocket spending. When Mr. Schultz has spent $4,550.00 total out of his own pocket his coverage gap will end. Now, Mr. Schultz will only pay a small copayment for each drug until the end of the year.

Searching for the right Senior Health plan can be confusing and tricky, so it's always best to speak to a licensed agent to assist you through the process.

Hass Mohammed is VP of Sales & Marketing at Insurance Medics. Insurance Medics is a national online insurance agency offering a vast array of insurance products from many different insurers.

To find a Health insurance broker or for more information on Health Insurance Plans, visit http://www.healthinsurancemedics.com/

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Supplemental Benefits

2011-12-10T04:23:00.000-08:00

Health insurance can be purchased on an individual basis, or through your employer. An insurance policy is, in fact, a contract. You agree to pay a premium, and the insurance company agrees to pay for certain medical losses. The one fact that most people don't realize is, the policy, as good as it is, may not be able to keep their finances from being challenged. Your policy may not pay enough.

A good way to keep up with medical expenses is with supplemental benefits. A supplement is something that fills in the gaps, and where the major health insurance leaves off, the supplemental benefits can take over.

People who have a vitamin deficiency take supplements, so why not supplement your health insurance and make sure you are completely covered. Supplemental benefits really do help financially, not to mention, relieve stress that comes with high medical expenses.

For major medical coverage most carriers pay between 70 to 90 percent of the allowed amount of the bill. This means the policy holder is responsible for the rest. Although it is true there is usually a limit each year on how much the member has to pay out of their own pocket, it can still be a staggering amount. A supplemental policy would really be beneficial in a situation like that.

Supplemental benefits come in different types of policies. Some of them pay medical services, and some of them send cash to you. This can be used to help with whatever expenses you need. If you were in the hospital and missed work, the money could be used as back wages, or for food.

Because supplemental benefits are varied, you should speak with an insurance representative who can help you choose the right one for you. An agent can save you hours of looking for the right policy, and an agent can recommend supplemental benefits that they know are reliable. Working with someone who knows every aspect of insurance and how it can help you is a great advantage.

Don't get caught holding a bag full of medical bills. Get supplemental benefits today and rest assured that you will have help when you need it.

Scott Swartzendruber has been helping businesses for 30 years with the proper communication and health care options for employees. To learn more on how Scott can help your company and held out all the health care changes visit http://www.healthcaresite.org/

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The Truth About Medicare SELECT - Can It Save You Money?

2011-12-07T01:41:00.000-08:00

If you took a poll and asked every American adult if they were interested in saving money on health insurance, what would the answer be?

An overwhelming: Yes!

As evidence of this, just take a look around. Every day healthcare is in the news.

-New legislation to help small businesses make healthcare more affordable.
-Newer high-deductible plans from insurance companies to help make premiums lower.
-Tax deferred plans for healthcare savings.

And...for those age 65 and over and enrolled in Medicare, saving some money on health insurance premiums whenever possible is a high priority.

Why is this?

Because, contrary to some popular beliefs, it DOES cost something to have Medicare. For instance, there are: Part A deductibles, Part B coinsurance, Part B premiums and more. The average senior healthcare consumer can expect to be out of pocket for many healthcare services.

One of the biggest out of pocket cost worries for Medicare beneficiaries is the Part B coinsurance. Original Medicare covers 80% of approved services for Part B. The rest is out of pocket.

That is...unless you have a Medicare Supplement - or Medigap - Plan.

Medigap plans cover most of the costs that Original Medicare makes you pay out of pocket otherwise.

But, there are many different Medigap plans out there. They are not all created equal. One Medigap Insurance plan option that could save you money is called Medicare SELECT.

What's the difference between a regular Medigap plan and Medicare SELECT?

With a regular Medigap plan, you can pretty much go to any healthcare provider that accepts Medicare. Medicare will pick up most of the tab and then your Medigap company will pay for the rest.

With a Medicare SELECT plan, you are given a list of providers you can use where your Medigap company will pay. Medicare will pay their portion no matter what as long as the provider accepts Medicare. But if you use an 'out of network' provider, your Medicare SELECT company will not pay.

Those Medicare enrollees that are used to being part of an HMO or PPO with their former insurance will be used to the 'in-network' versus 'out-of-network' provisions of this type of insurance.

So, what's the draw with Medicare SELECT?

Here are a couple to think about...

First of all, in many instances the premiums are less for a Medicare SELECT Medigap plan than for a regular Medigap Plan. This is where the cost savings can come into play. Premium differences range between companies. Talk to a trustworthy licensed Medigap agent for a detailed quote comparison.

Every little bit helps.

Secondly, you can typically chose any Medigap plan (A, B, C, D, F, G, K, L, M, N) that is available in your state for a Medicare SELECT plan.

Bottom line: Medicare Select policies are not available in all states. If you are OK with limited provider choices (check out the provider list ahead of time) then you should get a quote and at least compare your options. You might be able to save more money than you thought possible.

Adam J (A.J.) Davis is one of the nations leading experts in senior health insurance matters. He is an independent licensed agent in 12 states and founder of The Medigap Experts - an agency focused on saving money on health/dental/prescription drug insurance for those age 65 and over. He is the author of "How to Avoid 7 Critical Medigap Mistakes" - a consumer awareness guide. You can view this guide right now by visiting: http://www.themedigapexperts.com/

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The Finer Points of Medicare Eligibility

2011-12-04T00:49:00.000-08:00

Medicare is a government-run health insurance program that offers assistance with payment for hospital care (part A) and medical care (part B). Prescription drug coverage is also available through part D. Eligibility for medicare is based on disability or age.

The first criteria for medicare eligibility is that the applicant needs to be a citizen of the US, and they must have worked at least ten years for a job that paid into the Medicare system. This information should be readily available on your paycheck.

Eligibility extends to your spouse, meaning that if you are married to somebody who has worked for more than ten years, the eligibility extends to you as well. Additionally, you must be aged either 65, or you must have been diagnosed with a permanent disability or kidney failure.

Again, the two requirements for eligibility are that you paid into the Medicare system for at least ten years as a US citizen, and you are over 65 or have been diagnosed with a disability.

Medicare part A is the hospital insurance portion of medicare. Most people can receive part A coverage when they reach age 65. This benefit is offered without any monthly premiums being necessary. The general guidelines state that anybody who is eligible for social security is eligible for medicare part A. Some government jobs also provide medicare coverage.

Individuals under the age of 65 who have been receiving social security benefits for disability longer than 24 months are also eligible. Individuals who are going for dialysis are also covered.

Those who are eligible for part A are also eligible for part B. This is insurance that is used to cover the costs of doctor care, outpatient care, and other medical care that is not related to hospital care. Unlike part A, however, part B is not free. There is a monthly premium necessary. As of 2011, the premiums cost $96.40. For every year that part B is available but you choose not to enroll, your premium can be raised by 10%.

As with part B, anybody who is eligible for part A is also eligible for part D. Part D is used to help an individual pay for prescription drugs. Like part B, you will have to pay a premium to sign up for this plan, but unlike part B, you the plan is only provided by private health insurance companies. In addition to these plans, there are medicare supplemental insurance plans that offer additional coverage.

Peter Wendt is a writer and researcher living in Austin, Texas. He recommends you check out MedicareMall.com, a medicare supplement insurance company offering medigap insurance.

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Supplemental Benefits - Why You May Need Them

2011-12-02T00:17:00.000-08:00

Supplemental benefits are simply extra insurance benefits you can purchase that will fill the gap where your main insurance policy falls short. It doesn't matter how great an insurance policy you have because there will still be portions of the medical expenses that you will be responsible for. It can be very frustrating to pay premiums and then still be left holding the bag for high deductibles and co-insurance expenses. And, it would certainly be wonderful if all insurance policies paid 100%, but that is probably not going to happen. Finally people are getting the message that supplemental benefits can protect them from these medical expenses.

Today there are supplemental benefits plans, that don't cost an arm and a leg in premiums, that can help you with those left over medical bills. If you, are members of your family, receive medical care on a regular basis, or have a chronic illness, then a supplemental plan is something to think about. Supplemental plans come with different benefits, just as your health insurance plan does. You may want a plan that pays the medical providers direct, or you may opt for a plan that pays the lump sum cash directly to you. Many people prefer the cash-to-you policies because the cash can be used for lost wages, food, or whatever expenses you need.

Besides regular supplemental benefits, you can buy Cancer policies and Critical Care Insurance that covers diseases other than Cancer. On some supplemental policies, such as the Cancer policy, you need to have taken out the policy before you are diagnosed with the disease.

If your family has a history of Cancer, or any other debilitating disease, then maybe you should consider talking to a license insurance agent about setting up some Critical Care insurance now. Families that experience an illness of this nature are flooded with medical bills, and on top of fighting a dreaded disease, the stress can almost be too much. With a supplemental policy in place you can know that you will help in this time of need.

Sit down and take a good look at your health policy and you will see that there may be some areas where a good supplemental benefit plan could really be beneficial. Insurance is not always a bill that people like to pay, but when illness strikes, the relief you feel because you have insurance makes it all worth while.

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The Benefits of Medicare Supplemental Insurance

2011-11-30T00:49:00.000-08:00

It may appear a bit confusing when you see or hear two names mentioned, but Medicare supplemental insurance and Medigap insurance are the exact same thing. Both are actual insurance policies that help take care of the shortcomings of any co pays, deductibles or coinsurance gaps that original Medicare Plans A & B do not address. But when an annuitant of Medicare starts browsing for supplements they'll be happy to know that only those companies approved by the government can be providers. That's a good thing.

There are several key things to know about Medicare supplemental insurance before you start shopping for a policy.
#1) You must have Medicare Parts A & B.
#2) You will have to pay a monthly premium to the chosen insurance company for your policy.
#3) Your supplement or gap policy will only cover you, not your spouse. He or she will need to purchase their own.
#4) You will be required to purchase a supplement policy through a company approved in your state and on the government approval list.
#5) Typical supplement/gap policies will not cover drug benefits.
#6) You will be required to pay your Medicare Part B premium unless your state Medicaid pays it for you.

Because the insurance company approval list is a mile long, be wise in your selections and options. Various options have various costs. In other words, it is beneficial to shop around and keep an eye out for the best dollar rate for the coverage you choose. Your computer is the best way to find which company has the plan you need. You can talk to each company for valuable information or read the forms online. Additionally, you can deal directly with the chosen company and not through an agent.

On the other hand, if you are so inclined, try tossing your shopping list troubles to one agent and let him or her do the research. They may be able to find companies on the list you overlooked that could provide your medical needs for a lower cost. For additional help and to find answers to questions visit: http://www.medicare.gov/. They also provide updates on 2011 policy changes.

Hannah has a background in journalism and writes about Medicare Supplemental Insurance and Medigap

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The Benefits Of Owning A Medicare Supplement Insurance Plan

2011-11-26T23:28:00.000-08:00

The annual changes in the benefit structure in some Medicare Advantage plans can wreck havoc on your health care budget. Many have found their out of pocket expenses climbing while their benefits go downhill. On the other hand. Medicare Supplement Plans assist you in meeting your health care costs. Your Supplement Plan will automatically adapt to the changes in Medicare deductible and co-insurance from year to year.

Choose Your Doctors and Hospitals

You have complete freedom of choice for your doctors and hospitals when you have original Medicare along with a Medigap Insurance Plan. You do not have to deal with provider networks or get a referral if you need to see a specialist. Your are free to go to any provider, any time.

Other health plans may have local networks. Providers can leave and join the network. This could prevent you from receiving care from the people you've grown to know and trust.

Coverage is Guaranteed Renewable

MA Plans may revise their contract with the government every year. Every year plans are discontinued totally. Displaced members now must go through the process of finding another plan. Medicare Supplement Insurance Plans are guaranteed renewable. The only way that you can loose your plan is if you fail to pay the premium.

Any Provider or Hospital that Accepts Medicare Will Accept Your Medicare Supplement

All providers and hospitals that accept Medicare will also accept your Medicare Supplement Plan. This is not true with MA plans. A provider may choose not to participate in an MA Plan and even participating providers may choose not to accept new patients. Make sure to consult with your providers when you are considering a health plan.

Totally Portable Coverage

Original Medicare covers you anywhere in the country. Your Medicare Supplement covers you anywhere that Medicare does. In fact there are even some plans that will cover emergency medical expenses abroad. You can enjoy peace of mind while traveling and a change of venue does not require a change in insurance.

What About Guaranteed Issue?

There are circumstances that can afford you with guaranteed issue rights in regards to securing Medicare Supplement Coverage. This means that you can apply for any Medicare Supplement plan you wish and no health questions will be asked. You have this right when you are in your Open Enrollment Period, when you are first eligible for Medicare. There are other times as well,for instance, If you move out of your plan's coverage area or if the plan stops offering coverage in your area, if you are on a group retiree health plan and coverage is discontinued, and if you currently are enrolled in a Medicare Advantage Plan and it is your first time in an MA Plan and you choose to return to original Medicare. As long as you were in the MA Plan for less than a year. These are a few examples.

These are just a few of the advantages of choosing original Medicare along a Medicare Supplement Policy. Even if you have pre-existing health conditions, you may be able to qualify for a Medicare Supplement.

Get the info you need about any Medicare Supplement Insurance Plan Visit our website medicarequote4u.com for your free quote and up to date information about Medicare that you'll want to know.

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Why Is One Medicare Supplement Plan More Than Another? - Part 1

2011-11-24T00:21:00.000-08:00

With prices having the ability to vary by 100% between Medicare Supplement Companies the question is why? What factors are involved in determining the prices for standardized plans where the benefits have to by law be identical. Well here are some major factors.

In what region does a company decide to sell within?

Because every states regulations differ by so much you would imagine that it would be more expensive to sell in a certain state vs. another state. If a Company decides to sell in a state where regulations are very strict this could mean that higher rates will be passed onto consumers. In contrast if a Company decides to sell in a state where the regulations are lax than rates will dictate that.

Remember that just because a Provider does not sell in a certain state does not mean that you would not have coverage in that state. You will have coverage at every provider in the country that accepts Medicare. This means that if you happen to be in a state that does not have very strict regulations you might find yourself getting a much better premium.

If a Company chooses to accept more Guaranteed Issue clients they risk having higher health claims dues to more of there clients not going through a formal underwriting process. So Supplement Companies that offer coverage to large Groups would have a detrimental effect on rates for there clients.

When a Medigap provider offers their Plans to a Retiring Group, covering all retirees, they increase their risk due to the fact that they are required to offer Guaranteed Issue status to a larger group of people. This will inevitably increase the prices for all policy owners within that Company because of the added cost of not underwriting as many customers as possible under that company's umbrella.

Learn more about Medicare Supplements. Stop by Andrew Coutavas's site where you can find out all about medigap plans and what it can do for you.

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Your 2011 'Means Testing' Cost of Medicare Part B and Drug Premiums

2011-11-20T21:39:00.000-08:00

Your Medicare premiums now increase depending on your income. This is called 'Means Testing'. This article shows what the premiums are for 2011 for both your Part B and Drug Premiums.

Retirees have more medical expenses to deal with now. The Medicare Prescription Drug, Improvement and Modernization Act of 2003 changed how Part B premiums are calculated for some higher income beneficiaries.

The government pays a substantial portion-75 percent-of the costs for the vast majority of beneficiaries while the beneficiary pays the remaining 25 percent. The 'means testing' Act allows government's portion to be reduced for higher income beneficiaries who began paying a larger percentage of the Part B premiums back in 2007 according to their income. Each year, higher contributions are slated for 'higher income' beneficiaries.

-2011 premium update amounts:

The standard Part B premium for 2011 is $115.40 per person per month. That's for people with income (MAGI) below $85,000 for as a single filer or $170,000 for married couple filing. The amount paid per person for their Drug Prescription program depends on what the standard premium is for the drug program they chose.

For higher incomes, the premiums for both the Part B and the Drug program increases.

Individual filers with a MAGI above $85,000 up to $107,000 and Married couples with a MAGI above $170,000 up to $214,000 must increase their monthly per person Part B standard premium by $46.10 and their standard drug premium by $12.

Individual filers with a MAGI above $107,000 up to $160,000 and Married couples with a MAGI above $214,000 up to $320,000 must increase their monthly per person Part B standard premium by $115.30 and their standard drug premium by $31.10.

Individual filers with a MAGI above $160,000 up to $214,000 and Married couples with a MAGI above $320,000 up to $428,000 must increase their monthly per person Part B standard premium by $184.50 and their standard drug premium by $50.10.

Individual filers with a MAGI above $214,000 and Married couples with a MAGI above $428,000 must increase their monthly per person Part B standard premium by $253.70 and their standard drug premium by $69.10.

-What's Your Modified Adjusted Gross Income (MAGI):

Your Gross Income is the sum of all your income from taxable sources (gross income) less tax deductions that are allowable whether or not you itemize deductions on your tax return. Your taxable income includes salaries or other employment income, interest and dividends, and long- and short-term capital gains and losses and some retirement payments you get.

Your Adjusted Gross Income (AGI) is the result of subtracting adjustments (deductions) that include certain IRA deductions, moving expenses, and unreimbursed business expenses from your Gross Income. You figure it on the first page of the U.S. federal tax return.

Finally your Modified Adjusted Gross Income (MAGI) is calculated by adding back certain items to your Adjusted Gross Income. Some of these items most relevant to retirees are:

* Traditional IRA contributions that were deducted.

* Foreign income or housing costs excluded on Form 2555.

* Foreign housing deduction taken on Form 2555.

* Savings bond interest excluded on Form 8815.

-Disagreement in your case?

The IRS sends the Medicare Program your MAGI value. Call the IRS if you think it's wrong. If they determine you must pay a higher amount for your Medicare prescription drug coverage, but you don't have the co verager, call 1-800-MEDICARE.

Shane Flait helps you with your financial legal, tax, and retirement goals. Get his FREE report on Managing Your Retirement => http://www.easyretirementknowhow.com/FreeReportandSignUp.htm

Read his ebook: 'Wise Way to Financial Independence' => http://www.easyretirementknowhow.com/WiseWayGate.htm

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Senior Health Plan - 50,397 Reasons You Need One

2011-11-15T21:19:00.000-08:00

You have just turned 65 and signed up for Medicare or you already have Medicare and all your health care expenses are taken care of right? WRONG! Original Medicare has gaps in the coverage, thus the term "Medigap" which is used to refer to senior health plans. Medicare has deductibles, coinsurances and a set amount of lifetime reserve days. There are two different types of senior plans. One is a Medicare Supplement plan. These plans are standardized by the Federal Government. The other senior plan is called a Medicare Advantage Plan. In this article I will discuss the senior health plans called Arkansas Medicare Supplement Plans, Med Sups, or Medigap plans. They all refer to the same type of Medicare plans.

Just for fun let's add up all the deductibles or gaps in your Medicare policy. Part B has a deductible of $155.00. Part A for, for 2011, has a hospital deductible of $1100.00 for each 60 day hospital stay. It is possible to have almost six 60 day periods per year. There is also a skilled nursing facility deductible that must be met. Just those gaps alone come to $50,397 annually!

That figure does not reflect the 20% coinsurance for Part B that you would owe your doctor. So, you can see that without some type of senior plan your gold just got taken out of your golden years. Medicare plans also come in 11 different varieties. Not all plans are available in all areas. There is variety between the plans which enables almost every member to invest in a senior health plan, regardless of budget. So, how to figure which senior plan is the right one for you? Take a good look at your budget.

Once you figure out what would be affordable, the services of a licensed agent would probably be a great benefit in helping you to select the best senior health plan for you.

Do you want to find quotes on a high deductible health plan, senior health plan or an individual family plan? Click here: Health Insurance Premiums

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What Does Medicare Supplement Plan F Cost?

2011-11-13T12:03:00.000-08:00

Once people turn 65 and qualify for Medicare, they begin to consider Medicare supplement insurance plans or medigap plans, and the services these plans offers, and its cost. Medigap covers and pays for a portion of the total healthcare expenses that the actual Medicare plan doesn't. Like any other insurance plans and policies, deciding on which plan best suits your needs and situation can be difficult. There are several factors which have an effect on the supplement's monthly or yearly premium. Based on Weiss ratings, a reliable and independent strength ratings provider for banks and insurance companies, the most common medigap plan for 65 year old individuals and retirees which is Plan F, approximately costs $1,813.00 per year. For North Carolina Medicare plans, rates can be as low as $1,090 per year. That breaks down to about $90 per month. But you may ask what affects the rates for Plan F?

Medigap Insurance Policies: Ratings

Medigap insurance policies are rated in three different ways, issue-age rating, community rating and attained-age rating respectively.

Issue-age rating means that the Medigap cost is dependent on the age at the start insurance. The rate won't increase as the policy holder ages but it can possibly go up depending on factors like inflation and the economy. Community rating doesn't consider age but the insurance company still holds the right to make any adjustments on the cost due to claims over a period of time. Attained-age rating the cost of the policy is based on the age and start date of the senior.

Medigap Insurance Policies - Comparing Prices
Prices may vary depending on the insurance company selling the Medigap policy. When choosing the right policy there's two important things to consider. First is the coverage included in the quote comparison. The second important factor is rating structure; this is where monthly premiums are based. The medigap policy rate is better in non-smokers compared to smokers. It is also better for females and married individuals (due to partner discounts). In some instances, allowing bank drafts can offer additional savings.

Medigap Insurance Policies - Cost sharing with High Deductible Plan F
Some companies now offer the high deductible plan F. This cost sharing option makes a significant difference in the over-all insurance premium. These plans offer lower premium in exchange for the client taking more risk in potential out of pocket costs (high deductible). With high deductible plans, deductibles reset each year.

Medigap Insurance Policies - Medicare Open Enrollment Period When applying for a Medigap insurance policy for the first time, it should be done during the open-enrollment period which is the first 3 months before, the month of, and 3 months after your 65th birthday. The open-enrollment period guarantees the enrollment regardless of medical condition and health status. During this period your premium will not be affected by any health issues.

About the Author

Still unsure if a Medicare Supplement Plan F is best for you and what type of rating works? To learn more about what type of Plan F would be best for you, Heather B Williams recommends visiting http://www.mymedigapconsultant.com/.

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Understanding the Supplemental Insurance

2011-11-10T10:42:00.000-08:00

Life throws many unexpected curve balls. It is always a good idea to plan ahead so that when you are up to bat, you don't strike out. Even with a primary insurance, you can still wind up paying stacks of medical bills in the event of an illness or accident. Supplemental insurance is a good preventative measure against unexpected medical events.

Supplemental insurance is an optional insurance used to help cover the medical costs that a primary insurance may not. This is especially important in the elderly community. The elderly are more prone to illness and accidents, therefore requiring more medical attention. Medicare pays for a lot of medical expenses, but not all of it and a supplemental policy can help cover medical expenses.

There are several different types of covers that offer various benefits. One of the most common types is Medigap. Medigap can be sold by private insurance companies to people who are enrolled in Medicare. Just as the name sounds, Medigap is used in combination with Medicare to help fill in the gaps.

Apart from Medigap, there are many types of covers. Some of these include critical illness insurance, cancer insurance, disability, accidental death, and hospital indemnity. These policies may be available as an optional benefit from an employer, or can be purchased directly from the insurance company. The difference between the policies is the medical benefits received. For instance, an accidental death policy pays out in the event of an accidental death, just as the name states.

A lot of primary insurance policies do not cover the patient for preexisting medical conditions. Supplemental insurance plans may pay for these costs. This takes a lot of worry out of trying to get healthcare for a preexisting condition, especially with the elderly, who require good medical attention and a sound insurance plan. Unfortunately, supplemental insurance companies don't pay for preexisting condition prescription drugs. There are drug discount cards available to offset the costs of prescription drugs.

Supplemental insurance benefits are paid directly to the policy holder. A primary insurance policy pays the doctor or hospital. The payments do not have to be used for medical expenses. A lot of the time, payments are used to pay back the policy holder money they already put into medical expenses.

Supplemental insurance is usually much less expensive than a primary insurance. This is because supplemental insurance is only intended to cover the small portion of medical expenses that the policy holder's primary insurance doesn't pay. With a supplemental insurance only covering a small portion of the benefits, the premium is almost always substantially less than the primary.

In an economy where money is tight and every penny counts, it is important to have medical coverage to make out-of-pocket expenses minimal. Being vulnerable to illnesses and accidents can be scary, but with a supplemental insurance, there is no need to worry about the "what ifs" in life. Supplemental insurance is an affordable way to combat the overwhelmingly high costs of medical care.

Make an informed decision about the best life insurance quotes by visiting Comminsure Insurance. Also make sure to visit MetLife Life Insurance policy for your life insurance needs.

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Overview Of Medicare Supplemental Insurance

2011-11-05T16:36:00.000-07:00

The health of an individual is almost like the primary source of everything that he or she has. When your body is not functioning properly and you are suffering from various debilitating conditions, chances are you will not be able to carry out your work properly which will greatly affect your daily living. Because of this, it is a big must for you to get a partner which will be able to help you secure your health conditions. And one of these is the Medicare supplemental insurance (aka Medigap insurance).

A Quick Glimpse

Medicare supplemental insurance (aka Medigap insurance) is a kind of private insurance for health which is designed as a supplement for Original Medicare. It is the one which is responsible for the payment of the costs of healthcare which is not being covered by Medicare such as the deductibles and copayments. Medigap plans are also going to cover some of the services which are not being covered by the Original Medicare insurance. In case that you have decided to enroll in Medicare while having the Medigap policy, Medicare will still be paying its share of the amount that they have approved for the costs of the healthcare that they cover. For the meantime, your policy is in Medigap will also be paying its share.

Every Medicare supplement insurance plan (aka Medigap insurance) is also expected to adhere to both Federal and State laws that are designed to protect the holders like you and it should be evidently identified as the "Medicare Supplement Insurance." Insurance companies are only allowed to sell a plan that is standardized and identified with letters A to N. Every standardized and regulated policy must offer similar basic benefits, regardless of the insurance company selling it. Service and cost is the sole difference between the policies being sold by various insurance companies.

Buying Medicare Supplemental Insurance (aka Medigap Insurance)

As a whole, whenever you buy your Medigap policy, there is a minimum of two components in the policy, Medicare Part A, which is Hospital Insurance and the Medicare Part B, which is the Medical Insurance. If you decide to buy a medigap plan, you have to directly pay Medicare Part B's monthly premium to Medicare. Also, you have to pay another insurance premium to the corresponding company of private insurance which provides the Medicare supplemental insurance (aka Medigap insurance).

To clear some issues, Medigap policy does not have anything to do with the coverage that you can claim from your employer for this is not Medicare Part B, Medicare Advantage Plan and is not way connected to Medicaid. What is primarily does is to help you in closing the gaps with your deductibles in Medicare. There are also policies that are providing extra benefits not being within the bounds of Medicare like at home recovery, prescription drugs and routine checkups.

Getting your own Medicare supplemental insurance (aka Medigap insurance) is a good way of assuring that you will be able to properly look into your health for you to be assured that you will have no difficulties in the near future.

Learn more about medigap insurance and to find out how to get the lowest rates for the plan best suited for you take a look at http://www.mostmedicare.com/ and know your options. Check out mostmedicare's extended guide and obtain the plan befitting to your needs.

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Medigap Plan G - The Better Choice

2011-11-02T21:54:00.000-07:00

When a person first looks at the Medicare Supplement plans available they immediately zero in on plan F. This plan is the plan with all the boxes checked meaning it has the most complete coverage. Plan F is also the most popular plan available, but most popular does not always equate to the best deal.

If you take a look at the next plan down from F, plan G, you will see that it has almost the exact same coverage with the exception that G does not pay the Medicare part B deductible. The Medicare part B deductible for the year 2011 was $162. This is how much you will pay one time per year for out-of-pocket doctor's office charges.

So let's do some math. Once you have your Medigap quotes you will see that plan G's monthly premium is less expensive than plan F's. So subtract plan G's monthly premium from plan F's. Now multiply the answer that you get by twelve (the number of months you pay your premium per year). The answer that you get is how much more plan F costs to have than plan G per year. Now subtract the Medicare Part B yearly deductible from how much more it will cost to have plan F. This is how much you will save by having plan G.

For 2011, if the premium difference between plans F and G is greater than $13.50 per month, then Medigap plan G makes the most sense. Many people can save $100 - $300 per year even after having to pay out that $162 per year Medicare Part B deductible! Now if the savings is not that much and you simply don't want to fool with having to pay the part B deductible, then maybe Medigap plan G is not the best choice for you. But it is defiantly worth taking a look at.

Often insurance agents are reluctant to point out the possible savings available by purchasing a Medicare supplement plan G in lieu of plan F. This is because insurance agents make a little more when a person purchases plan F. A trustworthy independent insurance agent is always a huge asset when it comes to getting the best deal with Medicare Supplement Insurance. An independent agent does not work for a single insurance company. An independent agent licensed by your state and can sell you insurance from any insurance company in that state. This gives you the best opportunity to save.

Joel Moyer is an owner and independent agent for Centaur Medicare Solutions. Prior to being licensed as an insurance agent, Joel served in the US Army for over twenty years. His service included many places around the United States and countries including Iraq, Saudi Arabia, Egypt, and South Korea.

To learn more about Medicare, Medigap, Term life, or to purchase insurance please visit us at http://centaurmedicaresolutions.com/
To request Medigap quotes please visit http://centaurmedicaresolutions.com/get-quotes/medicare_supplement_quotes/

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Medigap Supplemental Insurance

2011-10-31T04:46:00.000-07:00

Are you starting medicare, as you can imagine there are many choices for you when it comes to coverage. With the large influx of people starting Medicare everyday, most are looking for a way to cover the gaps that are in Medicare like deductibles and co-insurance. It is easy to get overwhelmed with the choices that are in the market, we have found that Medicare Supplemental Ins plans have allowed people to cover these gaps in a cost effective way.

Medicare Part A- This is the portion of Medicare that you automatically receive from working 10 years or more at a job in the United States. Medicare Part A covers the hospital portion of any medically necessary situation. Medicare Part A has some large gaps in it however, as of 2011 there is a $1132 deductible associated with Medicare Part A, this deductible is a per benefit period deductible meaning that it needs to be paid for every separate accident or illness that may occur. If you have an accident or illness that you are going back into the hospital for within 60 day of the first occurrence of the accident or illness you will not have to pay the deductible twice, only if you are going outside of that 60 day window. I know that this may sound confusing but think of it like this the great majority of the time that you go into the hospital you will be responsible for a $1132 (2011) deductible. You will also be responsible for co-insurance or co-pays to the hospital that Medicare does not cover. This is one of the main reasons why we see so many people that are starting Medicare choose to have a Medigap type of plan. There is also another large gap in Medicare, this is Medicare Part B.

Medicare Part B- This is portion of Medicare has a cost associated with it, this cost has many factors, however we find the average cost is around $115.00 per month, having a Medigap plans will not pay this amount. Part B of Medicare is for your doctors and preventative care services. Medicare Part B has a $162 (2011) deductible. Unlike Part A of Medicare this is an annual deductible meaning that once the $162 deductible is paid all that you are responsible for is the 20% of expenses that are not covered by Part B of Medicare. Many people that are currently on medicare have chosen to have a Medicare plan to cover the above gaps.

Now its time to talk about these Supplements to Medicare. Things you need to remember about Medicare Supplement Plans are simple. They cover gaps that Medicare does not. However remember that there are many different plans, all of these plans cover different portions of the gaps in Medicare. Even the most affordable Medicare Supplement Plans will cover the Part A & B coverage gaps. If you spend a little bit more you will be able to cover the Part A deductible of $1132 per benefit period, and the Part B deductible of $162 annually. Covering these gaps can make a huge difference in out of pocket costs for Medical expenses. One of the most popular choices for a Medigap plan would be a Plan F. Having a Plan F will increase your coverage amounts to paying for additional nursing care, foreign travel and excess Part B charges. Having a Medicare Plan will drastically reduce your out of pocket expenses for medical care, also budgeting can be easier because you know that the amount of your monthly premium will typically be the limit of your costs.

I would imagine you see the benefit of having a Medicare Supplement Plan. It has certainly helped people maintain a budget and low out of pocket expenses. We definitely recommend them.

Want to find out more about, medicare supplement plans MedicareQuote4U.com for the knowledge you need about medicare and how to pay less for what you need.

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Supplement Insurance for Medicare

2011-10-28T05:46:00.000-07:00

In the American health care system, Medicare is a social insurance program that provides health insurance coverage to people over 65, and others who have a congenital physical disability. However, Medicare does not pay for all the costs associated with getting health services and supplies - there are copayments, deductibles, and coinsurance costs that are required to be paid by the patient or the insurance taker. Supplement insurance for Medicare is the type of insurance policy that pays for just such costs, the ones that are not covered by Medicare. Because they fill in the gaps between the cost of health care, and the total amount reimbursed by Medicare, supplemental health insurance is also called Medigap.

Benefits of Medicare Supplemental Insurance

There are many associated costs to using Medicare, including copayments, deductibles, and coinsurance costs. Medicare will also not cover many different types of costs associated with a visit to a hospital - these include travel, lodging, counseling, home recovery, and outpatient services, among others. Supplemental insurance plans will pay for these costs and more. It should be noted that supplement insurance is just that - a supplement to your Medicare insurance policy. It cannot be taken just by itself. However, it is a very useful policy to have because the extra costs associated with Medicare itself can come to thousands of dollars.

More specifically, Medigap insurance complements the coverage provided by Medicare Parts A and B. This includes hospitalization costs and payment of co-insurance. Medigap plans also provide insurance coverage for foreign travel, something that is not part of Medicare. It also covers the deductibles for both Plan A and B Medicare. For reference, Medicare Plan A covers in-patient hospital services, and Medicare Plan B covers medical expenses, outpatient services, and laboratory services.

Types of Medicare Supplement Insurance

Though Medigap is provided by private insurers, Medigap plans have been standardized by Centers for Medicare and Medicaid Services (CMS), which is a federal body. There are 10 plans named from A to N, with plans E, H, I, and J having been discontinued after May 31, 2010.

Aside from Medigap, there are other supplemental insurance policies that add benefits for other illnesses and diseases, which may not be covered by a regular plan. For example, if your normal insurance plan does not cover for critical insurance, you can take supplement insurance that cover for it. Other such plans include plans that cover, hospital indemnity or hospital confinement insurance and accidental death policies.

Selecting the right Medigap insurance plan will be one of the most important decisions you will make regarding your money and health, so you are advised to do the right research before you make your decision.

To know more about Medicare supplement insurance, and how to get the best quotes, visit nationalmedicaresupplements.com The site also has a toll free number to help you with any queries regarding Medicare supplemental insurance.

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Thing To Remember If You Are Purchasing A Medicare Supplement Or Turning 65

2011-10-25T20:56:00.000-07:00

After years of hard work you are finally eligible for Medicare. There is no shortage of information out there for you to decipher through. Make sure to review these points however.

Calls, emails, flyers. There is no shortage of information for you to look at or listen to but how do you make the best decision? Especially California Medicare plans can be a real maze with all of the plans to choose from like Medicare Advantage, Medigap, Part D, and Medicare Supplement.

Remember that Medicare Advantage and Medicare Supplements can vary in price. They also can differ in benefits. It does remind you of the adage "Pay me now or pay me later". Medicare Supplements are more money per month but less money usually in the long run.

You probably have some friends that are in the same age bracket as you. Sometimes you might think to yourself that if a plan works for them it will work for you. This is not the case. Advice on these very important financial matters should come from someone that understands all the factors involved.

Talk to a professional, a Financial Advisor or Insurance Agent that has the ability to offer all of the companies in your state can provide great information that can aid you in a educated decision. There are some factors that your Financial Advisor and/or Insurance Agent should be asking you about. They are the following:

Are you going to be living in the same area for a prolonged period of time?

Do you travel in the U.S. on a yearly basis?

Do you travel outside of U.S. on a yearly basis?

What is the monthly premium amount that works for you?

Does freedom of choice when it comes to providers matter to you?

With all of this information your Financial Advisor or Insurance Agent will be able to lead you in the right direction.

Want to find out more about Medicare Supplement, then visit Andrew Coutavas's site on how to choose the best Medicare Plan for your needs.

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Medicare Supplemental Insurance - How to Choose an Advisor?

2011-10-24T10:30:00.000-07:00

There are 10,000 baby boomers turning 65 every single day. If you are also turning 65 soon, you might feel a bit anxious. Not because you are turning 65 (after all, age 65 is the new 55). You are feeling overwhelmed due to the fact that your health insurance is probably changing and it's time to switch to a Medicare Plan. As the wise consumer that you are, you have started to do your research. Medicare and Medicare Supplemental options can be quite confusing. Then add all the mail that you've been receiving-those thick packets, the scary postcards and all those letters-you are even more confused, feel overwhelmed and you are now experiencing information overload. You have come to the realization that you want professional guidance concerning your options. But where to turn? If you follow these simple steps in seeking out an advisor, you will probably have a great experience with your Medicare Supplemental needs.

1. Stay Local. Do you really want to trust your Medicare Health Insurance with some calling center "agent," somewhere across the country or in another country altogether? If you stay local, that advisor should be willing to meet with you and review all your needs in person. Also, that advisor is well aware which plans work well in your area.

2. Expertise. There are many, many agents and brokers that sell insurance. Most of them are a jack of all trades, masters of none. Medicare and Medicare options are quite unique. Work with someone who specializes in Medicare Supplemental and Medicare Advantage plans and knows this field inside and out.

3. Professional. When you seek legal help, you talk to a person with JD on his/her business card. When you need tax help, you work with a CPA. Insurance advice should be no different. Work with a professional, who earned the designations Chartered Life Underwriter (CLU) and Chartered Financial Consultant (ChFC).

4. Broker. Never, ever work with an agent that only represents one company. That agent is working for that particular insurance company, not for you. You want an unbiased Medicare broker who handles many companies. Your advisor should work for you!

The internet is an amazing tool. Use it! When you are on the internet, you need to decide whether you simply want a quote, or whether you want a professional advisor assisting you. Either way, the premium you pay for the Medicare Supplement Insurance is exactly the same. Why not take advantage of the guidance of a local Medicare professional? The service, advice, and processing is going to make a world of difference. Follow the above steps when deciding on an Medicare advisor, and you will be in great shape!

Allen Heffler, CLU, ChFC is a licensed Insurance Agent located in Philadelphia, PA. He specializes in Philadelphia Medicare Supplement Insurance and can be reached via telephone- (215) 658-1555, email- heff@comcast.net or website http://www.mymedicareadvisor.com/

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Medicare Supplement Plans In Nevada, Colorado, and Utah

2011-10-23T04:27:00.000-07:00

When you compare these 3 states and the Medicare Supplement Plans they have to other states in the country you see a major trend. For the most part they are much less expensive when compared to other states that have large cities in them. As we know Colorado has Denver, Nevada has Reno and Las Vegas, and Utah has Salt Lake and some other medium size cities within. So why is there a big price difference between these states and others. We will talk about 2 reasons.

Typically the healthier the state the lower the rates. All of these states boast a very good health rating. When a Medicare Supplement Company has lower health claims they also have lower costs which they usually pass along to the consumer as lower rates for there plans. Actually these companies are able to look in years past to try to determine there future costs for claims, when they see that in years past claims costs have been comparably lower than other states they are able to keep prices lower because of that. These rocky mountain area states thus are benefiting from a healthy life style, All of these states have lots of outdoor activities which aide in preserving a great health rating.

Competition is also a large factor in rates, as you look across the country at rates you will notice an important trend. In states where there is only 1 or 2 companies that sell Medicare Supplement Plans we find that the rates are very high. In states like Nevada, Utah, and Colorado we find at least 5 companies that offer these types of plans. With that being said every company is vying for a position in the market. When you are dealing with a standardized plan having a position in the market has every thing to do with prices.

Standardized plans is of tremendous importance as to why competition is so important, think about it like this. If you went to a car dealership to purchase an automobile you would not pay $5000 more for the exact same car with the same options, that will get you to the same place. It just does not make sense. It is the same with Medicare Supplement Plans. Educated consumers know that these plans are essentially identical company to company which means that there is not much more to talk about than price.

Whether you are looking at Utah Medicare Supplement Plans, Nevada Medicare Supplement Plans or Colorado Medicare Supplement Plans, you are in a good position. Living where you live could save you thousands of dollars in your Medicare Career.

Looking to find the best deal on A MEDICARE PLAN, then visit http://www.medicarequote4u.com/ to find the best advice on a Medicare Plan for you.

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Your Medicare Supplement Plan - Have You Shopped Around Lately?

2011-10-23T02:14:00.000-07:00

It's funny. Think about how often we "shop around" when we are about to buy a product. Whether it's buying groceries, electronics, stuff for the home, staples - you name it - we always want to pay as little as possible. We want to make sure we're getting the lowest price, so we "shop around." If you are that kind of person (most of us are), you have to ask yourself this question - have you "shopped around" your Medicare Supplement Plan recently? Are you getting the best bang for the buck on your Medicare insurance? If you shop around correctly, you potentially could save a lot of money on your Medigap plan

It is important to understand psychologically why you might not have "shopped around" your Medicare Supplement Plan. First, Medigap plans for many seniors tend to be quite confusing, and people might not want to wade into those waters again. Second, we might be lazy. Your current plan is working well, so why bother? Third, Medicare Supplement shopping around is not as fun as going shopping for clothes or that big screen TV. Fourth, many people are under the wrong assumption that you can only change Medicare Supplement Plans during "Open Enrollment." Not true! You may be able to switch from one Medicare Supplement Plan to another at any time during the year. There is no Enrollment Period that you have to wait for. It is important to understand and then overcome these objections to shopping your Medicare Insurance, since you might be losing hundreds of dollars a year with an expensive plan.

How might you save all that money on your Medicare Supplement Insurance? It is significantly easier than you think! The important fact is that that Medicare plans are standardized. For your chosen plan, there is no difference in coverage between company to company! For example, if you have Medicare Supplement Plan F from one company, all other company's Plan F is identical to your current Plan F. No difference whatsoever in the benefits. If a doctor/medical provider/hospital accepts Medicare, they will accept all Medicare Supplement carriers.

The only difference is the price each Medicare insurance company charges you. The price difference can be substantial. I recently did a telephone review of a husband and wife's Medicare Plan. After a ten minute analysis, we were able to save this couple over $1,000 year on their premium, while keeping the same exact coverage! Thus, keep your Medicare insurance company "honest." Have a professional shop around for you to get the lowest cost plan available. You too, might be able to save hundreds of dollars a year, while maintaining the identical high quality Medicare coverage.

Allen Heffler, CLU, ChFC is a licensed Insurance Agent located in Philadelphia, PA. He specializes in Medicare Plans and can be reached via telephone- (215) 658-1555, email- heff@comcast.net or website http://www.mymedicareadvisor.com/

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What You Don't Know About Medigap - Medicare Supplement Plans Can Cost You

2011-10-20T09:06:00.000-07:00

As an Independent Broker who specializes in Senior Insurance and Medigap - Medicare Supplement Insurance, I see on a daily basis how important accurate information is. Making a sound decision is wholly dependent on acquiring knowledge about and understanding your options.

Many of my clients have told me that their search for information resulted in an avalanche of calls and emails from dozens of insurance agents leaving them frustrated and even more confused. This can become so overwhelming that they just give up, missing the opportunity to learn about an option that might better their situation and save them money.

Fact 1: There are marketing companies that will sell your information.

When you seek information online or fill in a form to win a prize you may be entering your personal information into a lead service. They will sell your information to numerous agents who contact with them to provide them with the names and contact information of people seeking information about Medigap- Medicare Supplement Plans. This is what starts the avalanche!

You can avoid this by always making sure that you are on a legitimate, licensed broker's website.There should be a toll free number for you to call and an email address for you contact them.

If you are required to give all of your personal information in order to receive a quote you may be in the wrong place.

Fact 2: Although the cost of your Medigap - Medicare Supplement Plan may vary from company to company, the benefits are exactly the same.

There are currently 10 standardized Medicare Supplement Plans. PLAN A, PLAN B, PLAN C, PLAN D, PLAN F, PLAN G, PLAN K, PLAN L, PLAN M and PLAN N. The benefits in each of these plans are approved by the Center for Medicare and Medicaid Services (CMS). All insurance companies who offer Medicare Supplement Insurance Plans must comply with the approved benefits for the supplement plans that they offer.

Even though the benefits in each of the different plans are the same no matter which company is offering the plan, there are big differences in the prices of the plans from company to company.

Knowing this fact and taking the time to compare prices may save you 30% or more on your Medicare Supplement. A few minutes really can save you money.

Fact 3: You are NOT locked into your Medigap - Medicare Supplement Plan until Open Enrollment.

Medicare Supplement Plans are not subject to any annual enrollment periods. You are free to change plans any time of the year.

Knowing this fact frees you to compare your plan options and switch to a different plan or company at any time. If you find that you can get the same plan for a better price from a different company, you can switch and start saving immediately.

Fact 4: You ARE locked into your Part D Prescription Plan until open enrollment.

Part D Medicare Prescription Plans (PDP) are Medicare Approved plans offered by private insurance companies.

They vary in terms of monthly premium, deductible, and co-pays. Each plan has a unique formulary. A formulary is a list of drugs that the plan covers and where the specific drug fall on the plans co-pay tiers.

We did a comparison of 27 different plans available in Florida. We used a sample drug list which contained 5 drugs, 4 generic and 1 named brand. The estimated annual drug cost ranged from $734 for the least out-of-pocket plan, to $2623 for the highest.

Being in the wrong PDP can really impact your bottom line.

Write a reminder on your calendar for October next year and take the time to make sure that you are in the right plan for your specific drugs during the Medicare Annual Enrollment Period. This is the only time of the year that you can change your PDP.

I hope that these 4 important facts about Medigap - Medicare Supplement Plans will help you keep more of your money in your pocket.

Stephanie Coutavas is an Insurance Professional specializing in Senior Insurance Solutions and Medicare Insurance. Co- founder and Senior Broker at MedicareQuote4U.com-Common Sense Insurance Solutions Group. Stephanie decided to specialize in Medicare because, "I saw the effects of the confusion and misinformation in the senior market. I really feel that with the proper,correct information, presented in an understandable way that our Seniors can position themselves for the future and achieve the peace of mind and security that they deserve at this exciting stage of life. We strive one client at a time to make sure that we address the individual and that they are better for having met us, regardless of whether they choose us as their broker."

Whether you are receiving Medicare Benefits before age 65, helping a parent or loved one or just not sure if there might be a better value for your health care $$$, we can help. Call us at 1-888-347-5552 to speak with a licensed Medicare Supplement Specialist or visit us at
http://www.medicarequote4u.com/. We are your Medicare Supplement experts and we are standing by to help.

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Medicare Open Enrollment 2011 for 2012

2011-10-18T15:31:00.000-07:00

Just a quick note that the Medicare Open Enrollment period has started! If you are on Medicare, during the Fall Open Enrollment period you can change how you receive your health coverage and add, change or drop drug coverage. You can make as many changes as you want. The last change that is made is the one that will take effect. Changes made during the Fall Open Enrollment take effect January 1.

For more info, visit Medicare Advantage Plans 2012

Medigap - Benefits of Using an Independent Agency

2011-10-18T01:52:00.000-07:00

As the Baby-Boomers turn 65 and start utilizing their Medicare benefits, many will have both the desire and the financial means to purchase some sort of additional insurance to fill in the gaps that Medicare leaves for the consumer to pay. This is where an independent agency is an extremely useful resource.

When people think about buying Medicare supplement insurance often the first thing that comes to mind are the big names: Anthem Medicare Preferred, Aetna, Blue Cross, Gerber, Mutual of Omaha, Sterling, etc. Some will spend hours calling or combing the internet trying to ring out the best deal for themselves. While this self-reliance and can-do attitude is noble, what if there is a very simple and easy way to ensure you get the lowest priced Medigap plan? This is where an independent agent comes in!

There are two types of insurance agents that you will meet when you wander through the woods of insurance shopping. The first and most prevalent is the captive agent. A captive agent is an agent that works for a particular insurance company and only sells insurance for that company. The reason they are so prevalent is because when an insurance agent starts off selling insurance they make very little money. Most agents cannot afford the cost of starting a small business, then going without a paycheck for many months. This means they have to sign with a big company that will sponsor them. The other type of insurance agent is an independent agent. This is an agent that is licensed in any particular state to sell insurance and can sell insurance from any company with which they have a contract. Most are contracted with several companies.

The benefit of using an independent agent is that they can compare the costs of all the insurance companies in your area and find you the lowest price. Also, your Medigap policy will not cost you any more if you use an independent agent. Many agents will even pay the mailing costs to process your application. Then in the future when your premiums rise, the independent agent can compare prices again to see if there is a better priced supplement plan for you.

Word of caution! Many seniors will go on the internet and start making quote requests on various web sites. This leads to them being bombarded with agents emailing them and calling them at all times of the day. It doesn't even matter if you are on a do not call list because you are granting permission to be called when you fill out the form. The reason for this happening is many of the internet sites that come up are there simply to collect people's information and then sell it to multiple agents and insurance companies. All Medicare Supplement plans are federally and state regulated, so there is no need to go through this hassle. The ABC plan of one company has the same exact coverage as the ABC plan of another. Also you cannot buy the plan of one company cheaper from one agent than you can another agent. The playing field is level.

So, save yourself a lot of hassle and time and find an independent agent from which to request your insurance quotes. To learn more about more about Medicare and Medicare supplement insurance from a licensed independent agency, visit us today at http://centaurmedicaresolutions.com/

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Part D Enrollment Period - Big Changes For 2012 Plans

2011-10-17T20:47:00.000-07:00

Almost everyone with Medicare or soon to be eligible for Medicare understands the value of joining a Medicare Part D Plan. The best time to join a Part D Plan is when you first become eligible for Medicare. By joining when you are first eligible you gain valuable coverage and avoid the Late Enrollment Penalty should you decide to enroll at a later date. But what if you want to join, switch or drop a Part D Plan? The Part D enrollment period, known as the Annual Enrollment Period gives you the opportunity.

When Medicare Part D Plans first became available in 2006 there were two distinct times to enroll or make changes. The Annual Enrollment Period (AEP) which originally ran from November 15 through December 31 and the Open Enrollment Period (OEP) which ran from January 1 through March 31.

During the AEP you could make changes with very little restriction. You could enroll in a stand-alone Part D Plan or for example if you live in California join a California Medicare Advantage Plan which included Part D coverage (MAPD). You could drop a plan or switch plans as you saw fit. You could even submit multiple applications with the last one received being the plan that you would ultimately join.

The OEP was little more restrictive. You could only make like-to-like plan changes with Part D being the determining factor. You were able to switch to another Part D Plan if you were currently enrolled in one. But were unable to enroll in a Medicare Rx Plan if you neglected to do so in the AEP. This enrollment period gave you the opportunity to make changes to your Part D coverage within the guidelines if you felt it was in your best interest.

People with Medicare liked the freedom afforded by these enrollment opportunities and insurance agents certainly liked being able to help a client who may have joined a plan that was less than beneficial for their circumstances. But the powers that be within the government felt that the Part D enrollment period needed fixing!

January 2011 saw the elimination of the Medicare Open Enrollment Period and the beginning of less choice for people with Medicare. Instead of the OEP a new dis-enrollment period was put in place. This period was only for people who enrolled in an Advantage Plan during the AEP who would like to drop that plan.

During the Annual Dis-enrollment Period which begins January 1 and ends February 14 you are able to drop your Medicare Advantage Plan and return to original Medicare. You can also purchase a different stand-alone Part D drug plan. If you choose, you can also purchase a Medicare supplement but may be subject to the insurance company's underwriting requirements. This does not allow you to switch a stand-alone Part D Plan. You are locked in.

Big changes are in store for Part D Plans with a January 2012 effective date. The Medicare Annual Enrollment Period has been changed. The Annual Enrollment Period for Part D and Medicare Advantage will now begin October 15 and end December 7. The extra week is nice but you better mark your calendar other wise you will be out of luck!

Plan sponsors should be releasing details of their Part D Plans and Medicare Advantage Plans earlier than in years past and information should also be posted on the Medicare website sooner as well. It is your responsibility to be proactive and research any plans you may be interested in prior to the Part D enrollment period end date of December 7.

Don't be one of the tens of thousands that will not get the word about these date changes. Be sure not to miss the opportunity to enroll in the Medicare Part D Plan of your choice.

David Forbes is President of Alliance Marketing Associates, Inc. David enables older adults to make informed decisions to protect their health and wealth. He also offers helpful advice on topics related to insurance for seniors, including information related to Medicare Part D Formularies

Sign up for your Free Mini-Course on Medicare Plans at http://affordablemedicareplan.com/humana-walmart-preferred-rx-plan-lowest-part-d-premium/.

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Medicare, Medigap, Medicare Advantage - Demystified

2011-10-17T10:06:00.001-07:00

If you are like many folks, you have struggled to understand your Medicare benefits. Parts, plans, deductibles, co-pays, co-insurance, Medicare supplement, PPO, HMO, POS, MAPD, language that seems to go in circles. You don't have to be a Medicare expert to understand your benefits and choices. The first step is to gain a clear understanding of some Medicare basics.

The Four Parts of Medicare.

Medicare consists of four parts. Each part is designated by a letter. A - D

Medicare Part A covers room and board and some other expenses in an inpatient situation. This can include a hospital, skilled nursing facility and hospice care. Medicare Part A has a deductible and co-insurances that you will be responsible for. Most people do not pay a premium for Part A.

Medicare Part B is the outpatient side of Medicare. This includes doctor visits, surgical services, physical therapy, speech therapy, durable medical equipment, home health care, outpatient testing and some drugs. Part B covers 80% of approved amounts for these expenses after you have met your annual deductible. Part B requires a monthly premium. Enrollment is optional. In most cases there is a late enrollment penalty that will be added to your premium if you delay enrollment in Part B unless you have other creditable coverage. There are limited enrollment periods every year when you are able to enroll in Part B.

Parts A & B are what is known as original Medicare. It was created in the 1965 with the first benefits paid in 1966 to help seniors with medical expenses. It is a government health plan. It covers most of your medical expenses. There are gaps in the coverage and most seniors cover all or some of the gaps with a Medicare Supplement insurance plan. Thus creating a situation where they can control and predict their medical expenses from month to month and year to year.

If you choose to stay with original Medicare you can use any doctor or hospital anywhere in the country as long as they accept Medicare.

Medicare Part C is Medicare Advantage. Since 1997 seniors have had the option to enroll in private Medicare Insurance. The Plan Provider is paid with your Part B premium and an additional amount from Medicare for each enrollee. These plans are required to cover at least what Part A & Part B cover. Some Medicare Advantage Plans, for example Anthem Medicare PPO include benefits not found in original Medicare like dental coverage, eye glasses and gym memberships. Some of the plans include prescription coverage. There are several types of Medicare Advantage Plans; HMO, PPO, PFFS, and POS. It is very important to remember that the coverage in a Medicare Advantage Plan is the same coverage as Medicare Part A and Part B. It is not the same as Part A and Part B with a supplement. All Advantage Plans will have out-of-pocket expenses in the form of co-pays for office visits, daily co-insurance for hospital stays etc. You are not permitted to add a supplement policy to your Advantage Plan to cover these costs. Regardless of the type of Advantage Plan that you choose, be aware that you will have to choose from providers who accept your specific plan or be ready to pay increased out-of-pocket expenses.

Medicare Part D is Medicare's prescription coverage. These plans are made available by private companies like Anthem Medicare plans. Medicare mandates and approves the plans that are offered. You will have a monthly premium for the Part D plan that you choose. You may choose to not enroll in a Part D plan but keep in mind that you will pay a late enrollment penalty when you do enroll. The fine will be based on the number of months from when you were eligible for Part D and the month you enrolled. Enrollment opportunities are limited to Medicare Enrollment Periods each year.

By taking a moment to understand what each Part of Medicare covers and knowing where you are exposed within the coverage of each you have provided yourself a solid position from which to plan a solution that works for your unique situation.

Stephanie Coutavas decided to specialize in Medicare because, "I saw the effects of the confusion and misinformation in the senior market. I really feel that with the proper information, presented in an understandable way that our Seniors can position themselves for the future and achieve the peace of mind and security that they deserve at this exciting stage of life. We strive one client at a time to make sure that we address the individual and that they are better for having met us, regardless of whether they choose us as their broker."

Whether you are receiving Medicare Benefits before age 65, helping a parent or loved one or just not sure if there might be a better value for your health care $$$, we can help. Call us at 1-888-347-5552 to speak with a licensed Medicare Supplement Specialist or visit us at http://www.medicarequote4u.com/. We are your Medicare Supplement Experts.

View the original article here

The twelve different types of Medicare Supplement policies

2011-10-05T09:48:00.000-07:00

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.
At this time, there are twelve different standardized Medigap or Medicare supplement policies. They are identified by the letters A through L. The federal and state government both regulates these Medicare supplement policies, in order to protect seniors. The first mandate is that all Medigap policies be clearly identified as "Medicare Supplement Insurance". The twelve different types of Medicare Supplement policies have a different set of basic benefits, plus possibly more additional benefits. In the next year or two, some additional Medicare supplement policies will be added. These will also be identified by letters.

In order to buy a Medicare supplement policy, you must already have Medicare Part A and Part B. You will continue to pay your premium for Part B, and then an additional premium for the Medicare supplement policy. Part A, as you are probably aware of, does not require an additional premium, as long as you paid into Medicare ta xes throughout your career life. Unlike traditional health insurance, each spouse must purchase their own Medicare supplement policy. One Medigap plan will not cover married spouses.

If you enroll in a Medicare Advantage plan, rather than the traditional Medicare, you are not eligible to also buy a Medigap policy. This is because the Medicare Advantage plans already have additional benefits, in addition to standard Medicare, and therefore a Medicare supplement insurance policy would be considered double benefits. You can get a lot of information about Medicare, Medicare Advantage plans, and Medicare Supplement insurance plans on the government's web site at Medicare.gov.

Remember that you can purchase Medigap or Medicare supplement insurance plans from the private health insurance market, and through a licensed insurance broker. A broker can help you find the right Medicare supplement insurance, and explain to you the difference between the twelve different Medigap policies available.

Medicare Many Advantage Plans have additional extra benefits

2011-10-02T06:45:00.000-07:00

You have known for a while that once you turn 65, you will be eligible for Medicare. As the time gets closer, you start paying more attention when people talk about Medicare options. You keep hearing about Medicare, Medicare Advantage Plans and Medicare supplement policies, and now you are confused as to which one you need, and which one you are eligible for, and which one you get for free. These are all good questions.

Traditional Medicare has been around since the 60s. It is a federal government insurance program. American workers who have paid FICA (Federal Insurance Contributions Act) or self-employed taxes have been contributing to the Medicare program already. These persons, once they reach the age of 65 and become Medicare eligible, will be permitted to enroll in what is referred to as traditional Medicare Part A, which are hospital benefits. Part A typically covers 80% of major medical hospital charges, after the deductible has been met. Members will no t have to pay premiums for Medicare Part A. However, members will have to meet their deductible, and then be responsible for 20% of the medical hospital charges.

That is when Medicare supplement policies come in. A Medicare supplement policy is designed to fill in the gap in traditional Medicare coverage. There are many different types of Medicare supplement policies. At this time they are identified by the letters A through L, although M through P will be introduced in the coming years. Each of these Medicare supplement policy has a different combination of benefits, included services, premiums, deductibles, etc. Therefore, it is important that consumers shop around carefully to find which Medicare supplement policy will best meet their needs. Many of these Medicare supplement policies will also help cover prescription costs, which is Part D of traditional Medicare.

Different from a Medicare Supplement policy is a Medicare Advantage Plan. A Medicare Advantage Plan is a policy that serves just like traditional Medicare Parts A and B, but is purchased from a private health insurance provider, not directly from Medicare. It does not merely cover the gap, like a Medicare supplement policy, but serves the same purpose as a traditional Medicare policy. However, Medicare Advantage Plans will have additional extra benefits to members. Their costs are somewhat higher, between $40 and $75 more per month, which is why they offer additional benefits.

Those individuals who purchase Medicare Advantage Plans are not permitted to also purchase a Medicare supplement policy. This is because the Medicare Advantage Plan already includes extra benefits, and will already be helping members pay things that traditional Medicare does not cover. Therefore, only those older adults who are enrolled in traditional Medicare Parts A and B will need to purchase a Medicare supplement policy to help them pay their medical expenses.

It is recommended that if you have a serious health problem, travel a lot, or split time between two homes, you are better off with traditional Medicare and a Medicare supplement policy. This is because there are no network restrictions with traditional Medicare, and the Medicare Supplement policy will help you pay off the deductible and coinsurance. Medicare Advantage Plans do require members to see in-network physicians.

Making health insurance more affordable for more American seniors

2011-09-30T10:42:00.000-07:00

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 only pays for 80 percent of a standardized amount for procedures

2011-09-28T04:36:00.000-07:00

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.

Will Medicare Advantage premiums be lower next year?

2011-09-25T00:33:00.000-07:00

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.com. "But whether Medicare beneficiaries choose a Medicare Advantage plan or go with original Medicare and add a Medicare supplement plan, it's important that they take time to compare the benefits of each based on their own personal needs."

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.MedicareSupplementPlans.com can be very helpful.

Wherever you turn for information, be sure to be proactive and investigate your options before you turn 65.

Open enrollment period for 2011 Medicare Advantage plans

2011-09-22T07:29:00.000-07:00

The open enrollment period for 2011 Medicare Advantage plans and prescription drug plans is from November 15 to December 31 in 2010. 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.

Starting in 2011, you will no longer have the traditional period from January 1 to March 31 to make additional changes once you're enrolled. That makes it even more important to compare all of your options thoroughly.

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.

How to get enrolled to the Medicare Supplement Plans

2011-09-20T08:26:00.000-07:00

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.

Medicare Advantage Private Fee-for-Service (PFFS) plans dropped by Health Insurance Carriers

2011-09-18T22:23:00.000-07:00

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.

Medigap Options

2011-09-15T00:20:00.000-07:00

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.

Why purchasing Medicare supplement plan right when you turn 65 is a good idea

2011-09-12T10:17:00.000-07:00

Benefits Of A Medicare Supplement Policy

2011-09-10T10:14:00.000-07:00

How to Select the Right Medicare Plan

2011-08-17T20:18:00.000-07:00

Just deciding which way to go when choosing from the combination of different types of healthcare coverage is confusing for many people eligible for Medicare. For most people, having choices is a very good thing. But what about when you have thousands of plans to choose from?

When it comes to Medicare, you have nothing but choices. Depending upon your circumstances, you may want to stay with traditional Medicare, or Medicare Parts A and B. If you choose this path, you'll probably want to get a Medicare Part D (prescription drug) plan, too, to ensure your medications are covered. Or, you might be more interested in a Medicare Advantage plan, which can combine traditional Medicare with drug coverage and other benefits. You also may be interested in even more coverage, such as that offered through a Medigap (supplemental) plan.

Fortunately, help is available. A Medicare advisor offers education on available Medicare programs, answers questions, and offers detailed plans of action to get the most out of your insurance choices. You also should know the basics beforehand.

Traditional Medicare

Medicare Parts A and B, also known as traditional or original Medicare, have been around since 1965. Medicare Part A is free to most people who've worked and paid Medicare taxes for at least 10 years and provides people with inpatient hospital coverage. Medicare Part B, which costs most people $96.40 in 2009, covers outpatient medical expenses.

People who have traditional Medicare can see any doctor they want in any facility they want without a referral, as long as that doctor or facility accepts Medicare patients. But traditional Medicare's benefits are limited.

Not only does traditional Medicare not cover most outpatient prescription drugs, if a beneficiary uses their coverage frequently enough, it can get very costly. That's why we also have Medicare Advantage and Medicare Part D plans available.

Medicare Advantage Plans

Medicare Advantage, also known as Medicare Part C, combines Medicare Parts A and B in one plan so you can get your Medicare Part A and Part B coverage in the same place. Medicare Advantage plans also often include prescription drug coverage and other benefits not commonly found under traditional Medicare, such as vision and dental services.

This program works just like private insurance - you have different types of plans to choose from depending upon what type of provider access you want (for example, health management organizations (HMO), preferred provider organizations (PPO) and more) and what health conditions or prescription drugs you take. You also can choose from a number of different levels of coverage. All Medicare Advantage plans must offer at least as much coverage as that offered under traditional Medicare. If they offer prescription drug coverage, that coverage must meet minimum Medicare Part D standards as well.

Medicare Part D

Medicare Part D is prescription drug coverage. Like Medicare Advantage, Part D is offered by private companies who are reimbursed for providing healthcare coverage. Also like Medicare Advantage, a minimum amount of coverage is required for a plan to qualify as a Part D plan and many different plans, some with different levels of coverage, are offered throughout the United States. Part D plans are best for people who use prescriptions, but don't need to see their doctors often.

Medigap Medigap, or Medicare supplemental plans, is sold by private companies to fill the "gaps" in traditional Medicare. This includes the cost of deductibles, co-payments and coinsurance. It also may cover other services that Medicare does not insure. In 2009, there are 12 Medigap plans - A through L.

Although Medigap may offer some additional coverage if an individual chooses to keep traditional Medicare, you can't buy a Medigap plan if you have Medicare Advantage. Because most Medicare Advantage plans offer better coverage and frequently more benefits than Medigap, having both is usually unnecessary. You can have both Medigap and Medicare Part D, but it may be more expensive to do this than simply purchasing a Medicare Advantage plan instead.

Comparing And Contrasting

It's no wonder that people are confused. There are thousands of plans available throughout the United States, and an average of 40 Medicare Advantage and Medicare Part D plans in any given area.

This is where a Medicare advisor can come in handy. With so many options in just one area, choosing a plan might feel like throwing darts at a board. Using a Medicare advisor can help you narrow down your choices so you know which combination of Medicare coverage will work best for you and which plans will give you the best and most affordable coverage for your needs.

Jim Allsup writes for Allsup, a provider of Social Security disability, Medicare and workers' compensation services, including Allsup Medicare Advisor, Medicare assistance services for people with disabilities and seniors.

Medicare Frequently Asked Questions

2011-08-16T18:24:00.000-07:00

Straight talk. Answers to 3 FAQ's about Medicare and Medicare Supplement Insurance. You don't need to be a Medicare expert or devote hours reading info and researching online to understand your Medicare and Medicare Supplement options.

Q: What is the difference between Original Medicare and Medicare Advantage (MA) Plans?

A: There are several key differences between Original Medicare and Medicare Advantage Plans. Original Medicare is your government Medicare. Medicare Advantage is private Medicare that takes the place of your government Medicare. You will have similar out-of-pocket expenses with an MA plan as you would with Original Medicare alone.

It is important to understand that in general an MA plan is the same coverage as Original Medicare. You may get some extra benefits such as dental or eyeglasses, and some of the plans include drug coverage as well, but the base coverage will be the same as original Medicare.It is not the same as Medicare plus a Medigap or Supplement Plan. You can not get a supplement plan to cover your out-of-pocket expenses when you are enrolled in an MA plan.

Q: What are my potential out-of-pocket expenses with my Medicare coverage?

A: Medicare itself is great coverage but there are some gaps in the coverage that many beneficiaries fill with a Medicare Supplement policy.

Medicare Part A covers hospital room and board, short-term skilled nursing care and hospice care.

There is a deductible for Part A. Currently the deductible is $1132.00. This means that you will pay the first $1132.00 before Medicare benefits are paid. This is not an annual deductible. It is a benefit period deductible. A benefit period starts the day you are admitted to the hospital and ends 60 days after you are released. It is possible that you could encounter the Part A deductible more than once in a year. After the deductible is met Medicare covers 100% semi-private room and board for 60 days. From day 61-90 the is a daily co-insurance of $283 per day. After 90 days Medicare provides coverage for an additional 60 lifetime reserve days with you paying a daily co-pay of $566.

Skilled nursing facility following a hospital stay of at least 3 days is covered by Medicare at 100% for the first 20 days. Days 21-100 have a $141.50 co-pay per day.

Hospice is covered by Medicare with very limited co-pays.

The deductibles and co-insurances increase from year to year.

Your exposure on the A side of Medicare are your deductible, and the various co-insurances mentioned above.In addition, Medicare doesn't cover the first 3 pints of blood.

Medicare Part B covers medical expenses in or out of the hospital such as doctor visits, inpatient and outpatient medical and surgical services and supplies.Diagnostic testing, speech and physical therapy, and durable medical equipment are Part B expenses.

There is a calendar year deductible for Part B. This year the deductible is $162.00. After you have met your deductible medicare covers 80% of approved amounts for covered services.

Your exposure on the B side of Medicare includes the deductible and 20% of approved amounts for covered services and any Part B excess charges. Part B excess charges are charges for covered services that exceed Medicare approved amounts.

Q: How can I limit my exposure and cover the gaps in my Medicare coverage.

A: You can supplement your Medicare coverage with a Medigap insurance policy.

There are 10 Medicare supplement policies that are approved by Medicare. All of the supplements have the same basic benefits.

Medicare supplement basic benefits for Medicare Part A cover all of your hospital co-insurances and will extend your covered days beyond Medicare coverage for and additional 365 days. The Part A deductible and skilled nursing co-insurance coverage are optional benefits.

Your supplement will automatically adjust to the changes in Medicare deductibles and co-pays from year to year.

Under Medicare Part B, Medicare Supplement basic benefits will cover your 20% co-insurance.

You can choose a supplement plan that includes optional benefits such as Part B deductible, Part B excess, and foreign travel emergency coverage.

Seek the guidance of a broker who specializes in Medicare to help you determine which of the 10 Medicare Supplement Plans best suits your needs.

Whether you are receiving Medicare Benefits before age 65, helping a parent or loved one or just not sure if there might be a better value for your health care $$$, we can help. Call us at 1-888-347-5552 to speak with a licensed Medicare Supplement Specialist or visit us at http://www.medicarequote4u.com. We are your Medicare Supplement experts and we are standing by to help.

Supplement For Medicare

2011-08-15T09:08:00.000-07:00

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. You may also view supplement for Medicare options by searching Medicare resources at the Texas low cost health insurance site.

http://www.texaslowcosthealthinsurance.com, Medicare resources

Medicare and Medicare Advantage Update 2010

2011-08-14T14:04:00.000-07:00

Q. What are the changes to Medicare in 2010?

A. Medicare is made up of three parts: Hospital Insurance (Part A), Medical Insurance (Part B), and Drug (RX) Insurance (Part D). Part A Deductible for 2010 is $1,100 for a hospital stay of 1 - 60 days, $275 per day for 61-90 days, and $550 day for 91-150 days of a hospital stay (lifetime reserve days). After 150 days, you pay all costs for the hospital. Part A also includes Skilled nursing facility and some home health care but not long term care. Skilled nursing facilities is subject to a $137.50 per day co-insurance for days 21-100. Part B covers Medicare eligible physician services, outpatient hospital services and certain home health services and durable medical equipment. You pay 20% of the Medicare-approved amount after you meet the $155 deductible.

Part D coverage is for both short and long-term prescription needs not given in the hospital, coverage for both brand name and generic drugs and can differ dramatically from one company to the other. Part D is not deducted from your Social Security check.

Q. Can you explain the difference between a Deductible, co-pay(ment) and out of pocket.

A. The deductible is the amount you must pay for health care before Medicare begins to pay. These amounts can change every year. A co-payment is a partial cost you will spend to see the doctor. These can be zero or more. These are out of pocket which are costs that you must pay on your own because they are not covered by Medicare.

Q. What are the differences in HMO, PPO, PFFS, SNP and MSA plans?

A. Health Maintenance Organizations (HMO)- Just like the private sector, HMO is a group of doctors, hospitals and other care providers that agree to give health care to Medicare beneficiaries for a set amount of money from Medicare every month. You get your care from the provider in the plan.

Preferred Provider Organization (PPO)- Doctors, hospitals and providers that belong to the network and with most PPO plans, you can use doctors, hospitals and providers outside the network for an additional cost.

Private Fee for Service (PFFS)- These are sometimes referred to as regional PFFS since the doctor or hospital accepts payments from the insurance plan rather than Medicare. The Insurance plan decides how much it will pay and what you pay for the services you get. You may pay more or less for Medicare covered benefits.

Special Needs Plan (SNP) - A type of plan for people with chronic illnesses or conditions with special needs.

Medical Savings Plans (MSA) - A type of savings plan for those people who do not go to the doctor often but need a savings plan to pay some of the costs of the deductibles and co-payments.

Q. My Doctor takes Blue Cross but he does not take Medicare Advantage Blue Cross. What does that mean?

A. Medicare Advantage plans are a hybrid of coverage offered from an insurance company. When you are eligible for Medicare at age 65, you select Part C--Medical Insurance offered by a company. You still pay your premiums out of your social security check for Part B but the government pays the insurance company to administrate the benefits. These Medicare Advantage Plans appear to have many benefits and include Drug coverage (Part D). Medicare Advantage plans are the best of both worlds but they have some drawbacks. If your doctor is not a Medicare Advantage plan doctor, you will pay additional costs to see him/her but with most plans you can see another doctor (usually not available with HMO plan). You will be subject to separate deductibles and separate co-payments and often need a referral for approval before you can get care from the specialist. If you do not get a referral, the plan may not pay for your care.

Q. Since Medicare Advantage provides all Medicare health care through that plan, what if I don't like it? I have heard Doctors payments will be cut and the company I sign up with may stop insuring them. What protection do I have?

A. Since Medicare is a government provided plan for those 65 and older, you have many options for coverage. Every November 15 through December 31 you can switch from one Medicare Option to another--you can enroll in any Medicare Advantage or Part D at this time. This is called the Annual Enrollment Period. (AEP) Your new coverage would begin on January 1. From January 1 to March 31 Medicare members can make ONE plan change to a like kind. For example, you can change to another MA plan. The member CANNOT change Part D coverage during this time unless they have it with the plan they are leaving. This is called Open Enrollment Period (OEP). During Special Enrollment Period (SEP), members must enroll within 63 days of a special event. This is if you move outside the service area, move into or out of a long term care facility, loose credible prescription drug coverage, return to the US from another country or get assistance from the state in which you live, loose coverage under an employer or union either voluntarily or involuntarily.

Q. What other benefits do I get with a Medicare Advantage Plan?

A. You may get extra benefits by selecting a Medicare Advantage Plan. These may include vision, hearing, dental and/or health and wellness program including membership to a specific gym. Because you do not need to buy a Medigap or Medicare Supplement policy, the premium are supplemented by the government and are less expensive than a traditional supplemental plan.

Q. I hear there are many gaps in the Part D (Drug) coverage and I take 5 prescriptions a day. How do I get most of my drugs covered?

A. Every insurance company that offers Part D coverage has a written list of drugs. These include generic and brand name drugs. (Check the web sites or ask your agent for a printed formulary drug book.) Your plan may have several tiers and your co-payment amount depends on which "TIER" your drug is listed. Not all brand names will be covered and these can be very expensive if you have a high copayment or it is not listed. Always ask your doctor whether the drugs prescribed are available as generic. Be sure to ask your doctor whether you can split a high-dose version of the prescribed drugs as

they are often the same price as low-dose version or go to http://www.medicare.gov/MPDPF/Public/Include/DataSection/Questions/MPDPFIntro.asp?version=default&browser=IE%7C7%7CWinXP&language=English&defaultstatus=0&pagelist=Home&ViewType=Public&PDPYear=2010&MAPDYear=2010&MPDPF%5FMPPF%5FIntegrate=N to compare drug plans in California.

Q. I like what I see--a policy issued by a leading insurance company that does not cost me the same as a Medigap or Medicare Supplement. Why should I buy a Medicare Supplement instead of a Medicare Advantage Policy?

A. That is a good question. If you can afford the individual premiums for a Medicare Supplement with a separate part D, you should do that. You can choose you own doctor as long as that doctor takes Medicare patients. Today many plans are a hybrid and some cost ZERO monthly premium and include a RX plans are also a PPO so people have the freedom of a PPO. As Seniors age, options and benefits become very important and we are here to help you decide which plan is best for you. Be confident in your Medicare Choices.

For the past 30 years, Karen Adams has been an independent insurance agent working primarily in Southern California. She has help hundreds of clients find the right insurance program to meet their needs. Rapidly approaching age 65, she decided to become as knowledgeable as possible about Medicare solutions. "I have written articles about Medicare Supplements and have insured clients who have reached Medicare age. Most Medicare Supplements (MS) are about the same and as long as a doctor takes Medicare he/she must accept the supplement their patient uses (not an HMO plan). Therefore, the advantage from one company over another is how easy they make their payment process, how patient orientated the company is, how large their network of Doctors and the premium they charge for the plan," says Karen. "Then came highly government regulated Medicare Advantage (MA) plans and the ball game changed. Now there is ZERO premiums with Drug coverage. What cost from $200 to $300 a month in premium in a supplement with a prescription drug card now appears to be free. What's that all about? Karen can help you untangle the web of MEDICARE insurance. Call her today or go to http://adamsinsuranceagency.com/ for your personalized quote.

9 Questions to Ask When Evaluating Your Medicare Plan

2011-08-13T23:30:00.000-07:00

More than 45 million Americans are currently enrolled in Medicare and many of them are paying for a plan that is either too expensive or doesn't have the coverage they need. Each year, Medicare provides a window of opportunity for enrollees to reevaluate their healthcare coverage and to make any necessary changes or adjustments to their coverage. Each year that enrollment period starts on Nov. 15 and ends Dec. 31.

It is crucial that Medicare enrollees use this time to evaluate their coverage to ensure they are getting what they need at a price they can afford. Many people avoid this crucial step, fearing they will be unable to understand the legal and insurance industry jargon. Medicare plan selection services are available for these people. A Medicare plan selection service helps people find the best and most affordable Medicare plan based on their specific needs and circumstances. This service will help you evaluate your healthcare needs using expert knowledge of recent program changes and criteria that include the following 9 questions.

Do I need Medicare if I have private healthcare insurance?

You will use the same factors of cost and coverage when comparing private health insurance with Medicare. It is important that you speak with your private plan administrator before making any changes.
Should I use Traditional Medicare or a Medicare Advantage Plan?

A Medicare Advantage plan (Part C) is ideal if you require frequent doctor visits and take prescription drugs. If your current medical condition only requires that you make routine medical visits and take few or no prescriptions, traditional Medicare (Parts A and B) with a prescription drug plan (Part D) may be a better choice.

Does my current plan cover prescription drugs?

Traditional Medicare (Parts A and B) generally does not cover medications unless they're administered in a doctor's office or a hospital. If you require regular prescription medications, you will need to purchase a Part D plan for that coverage. If, however, you are enrolled in a Medicare Advantage plan, you may already receive prescription drug coverage.

How do I know if my prescription drugs are covered?

Every plan that offers prescription drug coverage has a list of covered medications called a formulary. This list can change each year, which makes it crucial that you or a professional Medicare plan selection service evaluate your coverage during the annual enrollment period. Failure to do so may cost you thousands of dollars in uncovered prescription medications.

What about gaps in coverage between different prescription medication plans?

For many individuals-whether in a Medicare Advantage plan with prescription drug coverage or a stand-alone prescription drug plan-there is a gap in coverage once they reach a certain out-of-pocket threshold. This is referred to as the donut hole.

A Medicare Advantage plan that offers prescription drug coverage provides a combination of services found in Parts A, B and D-your hospital, medical and prescription drug coverage. As far as traditional Medicare is concerned, the Part D coverage is separate-it can even have a separate deductible. So the rules Part D follows (including the donut hole) may be slightly different from the medical portion (Part B) of coverage.

For example, after your plan has paid a certain amount for your prescriptions, you will have to pay the full cost, up to $3,453.75 in 2009, before the plan will pay for your prescription costs again. That cost is prohibitive for many people on Medicare and makes the annual evaluation of your coverage much more important.

Can I keep seeing the same doctors?

Most doctors, hospitals, physical therapists and other healthcare providers accept traditional Medicare, which will allow you to continue seeing the same doctors if you choose to stick with traditional Medicare and a Part D plan. But, as with any other insurance, Medicare Advantage plans have a network of providers. If a doctor is outside that network, you may have to pay more. Before you join a Medicare plan, particularly a Medicare Advantage plan, you should determine if the doctors you see are part of that plan's network.

Will the plan cover dental and vision services?

Traditional Medicare does not cover dental, vision or health and wellness programs, but some Medicare Advantage plans do. To receive this type of coverage, you must evaluate the available Medicare Advantage plans for your needed dental and vision services. Again, the use of a Medicare plan selection service will provide further assurance that you will get the coverage you need.

How much is it going to cost me?

Traditional Medicare premiums are relatively inexpensive, but your deductibles and copayments or coinsurance costs may be higher than what you would pay with a Medicare Advantage plan. Medicare Advantage plans may offer zero-dollar premiums and low copays. Some plans may even put a cap on total out-of-pocket costs. Your Medicare plan selection service can give you specific dollar amount and coverage information.

Will I be covered when traveling?

Traditional Medicare provides coverage throughout most of the country. Some Medicare Advantage plans are restricted to certain areas, but many offer out-of-network coverage in the event of an emergency while traveling. If you travel frequently or reside in different areas depending upon the time of year, it is important to find a Medicare Advantage plan that will provide coverage in both areas.

How do I know if I need a supplemental plan?

Traditional Medicare (Parts A and B) may not provide all of the coverage you require. Before paying for a supplemental plan, it is important to determine if you qualify for the Qualified Medicare Beneficiary program, have adequate coverage through an employer, or if you are already enrolled in a Medicare Advantage plan.

With medical costs skyrocketing and your own healthcare needs changing, it is imperative that you take advantage of the upcoming annual enrollment period offered by Medicare to determine whether you are receiving the coverage best suited to your needs and budget. This process is made easier with the professional expertise of independent Medicare plan selection services. Their knowledge and experience will ensure that you get exactly what you need at a price you can afford.

Jim Allsup writes for Allsup, a provider of Social Security disability and Medicare services, including Allsup Medicare Advisor, a Medicare plan selection service for people with disabilities and seniors.

Will Health Care Reform Kill Medicare Advantage?

2011-08-11T23:26:00.000-07:00

It has been six months since the highly contested Patient Protection and Affordable Care Act, also called health care reform, became law. Polls show that people remain worried about how the law will affect their health care. There is a lot of talk about big cuts in Medicare, and seniors are worried their coverage will be reduced or that their doctors will no longer accept Medicare. Should they be worried?

The worst news is for people who love their Medicare Advantage plans. This program pays private insurance companies to enroll seniors in managed-care networks. Many plans offer more benefits than "plain" Medicare, such as dental and vision coverage and health club memberships.

The problem with Medicare Advantage is that taxpayer's aren't getting their money's worth from the program. Much of the recent increases in Medicare costs can be traced to overpayments to insurance companies offering the subsidized plans.You've heard that Medicare is going broke? Well, Medicare Advantage is a big reason for that.

A Medicare Advantage benefit costs the government 14 percent more than exactly the same benefit offered through regular Medicare. In some parts of the country, the difference is as high as 20 percent. That extra money is being eaten up in marketing and administrative costs, and in profits to the insurance companies.

According to the U.S. Department of Health and Human Services, all Medicare beneficiaries, including those enrolled in regular Medicare, are paying for these overpayments through higher premiums. HHS says that this year these subsidies are adding about $3.60 per month to premiums.

But there is no proof that the program is providing better health care than regular Medicare; just that it's more expensive. And for this reason, most of the cuts to Medicare provided in the health care reform law are cuts to Medicare Advantage, not regular Medicare.

These cuts won't go into effect all at once. In 2011, the subsidy going to private insurance companies will be frozen at 2010 levels. After that, the payments will be reduced an average of 12% per year, until costs are more in line with the cost of regular Medicare. Beginning in 2014, the private insurers offering Medicare Advantage plans must maintain a "medical loss ratio" of at least 85%, which is a fancy way of saying that 85 percent of the subsidies and premiums they receive must be paid out in benefits. On the other hand, companies that meet certain benchmarks for quality of service are eligible for a bonus.

Bottom line: according to the Congressional Budget Office, by 2019 the private insurance companies offering these plans will receive $136 billion less than they would have received at the current level of subsidy.

Naturally, the private insurance companies do not like this one bit, and they say they will drop out of the program if these cuts aren't repealed. And when those Medicare Advantage taxpayer subsidies stop being a cash cow for those companies, they might very well drop out of the program. Companies that stay in the program probably will eliminate some of the extra benefits that make Medicare Advantage popular.

Some seniors will be unhappy about this, but it's important for them to understand why it is happening -- Medicare Advantage as it is has been dragging the entire Medicare program closer and closer to bankruptcy.

Before the Medicare program began in 1965, only 56 percent of people over age 65 had any health insurance. Today, without Medicare, the percentage of seniors with health insurance would be very tiny, indeed. It's a sad fact that in our autumn years, nearly all of us will suffer increasing problems with our health. Some ailments -- arthritis, heart disease -- are common, and some are rare, such as mesothelioma cancer, rarely diagnosed before the patient is 50. Either way, senior health care is expensive, and private insurance companies don't want seniors as customers -- unless taxpayers are supplying the profits.

In 2009, while health care reform was being hotly debated in Congress and town hall meetings all over America, some insurance companies deliberately misinformed their customers about what the bill would do to their Medicare Advantage Plans. One major Medicare Advantage provider sent out a letter to its Medicare Advantage customers claiming that Congress and President Obama would cut "important benefits and services" provided by Medicare.

Remember the stories about silver-haired grandmothers marching in protests with signs saying "Keep Government Out of My Medicare"? People laughed at them, but it's possible those were misinformed Medicare Advantage customers.

But the Patient Protection and Affordable Care Act is not cutting any benefit from Medicare. In fact, it is adding a few new benefits. Beginning this week, Medicare patients will not have to pay a co-payment to the doctor for preventive care or for an annual checkup. The health care reform law also will gradually close the infamous "doughnut hole," the gap in Medicare Part D prescription drug coverage that costs some Medicare patients thousands of dollars every year.

Last year, the trustees of the Medicare program announced that by 2017, the part of Medicare that pays hospital bills would be out of money, and Medicare would have to stop paying those bills. This year, the same trustees said the hospital fund should be good until 2029, thanks mostly to the health care reform bill. This tells us the struggle to save the program isn't over, but we're moving in the right direction.

As we get closer to the November midterm elections, watch out for politicians citing the cuts to Medicare Advantage as a reason to repeal the health care reform bill. Without those cuts, Medicare itself is in grave danger.

Barbara O'Brien is a concerned citizen who writes the popular political blog, The Mahablog.

Medicare Supplemental Policies

2010-11-18T18:11:00.000-08:00

Medicare supplement plans are also known as "Medigap insurance". It is private health insurance, which is designed to supplement the original Medicare plan.

In basic format, Medicare is a coverage plan that usually only covers up to 80% of all aspects of medical care for those that have this form of health coverage. The remainder of expenses are often required to be paid out of pocket from those that do not have any other type of coverage. This remaining 20% could be rather costly depending upon the types of health conditions and needs that are present with anyone under this type of plan.

Recently, there has been an increased awareness placed upon the costs that are out of pocket form those under this plan. With such, an increased focus on supplement insurance has been something that many people have been paying attention to. Understanding what this is and how to select the best provider could save a great deal of money.

There are actually a dozen forms of Medicare supplement insurance that exist today which all offer varying degrees of coverage options and protection. Basically, they are labeled A through L and all have varied costs and levels of coverage. Also, there are various co payment levels within these policies.

For those that wish to pay lower premiums, the Medicare Select plan is best for them. There are much lower premiums and co payments required and provide which are more suited for those with a lower budget. With this plan, there are very specific lists of doctors and specialists that are covered with this plan which could be rather restrictive.

One of the incredible benefits of this type of insurance is that it is very heavily regulated. Basically, this means that any level of protection purchased is the same across the spectrum of companies that offer them. Thus, shopping around is truly not very difficult to do at all.

When purchasing Medicare Supplement insurance, it is usually best to do so within the first six months of receiving Medicare. This is often because companies are unable to deny coverage based upon pre existing conditions.

What Is Medicare Part D?

2010-11-17T14:07:00.000-08:00

Medicare Part D is the prescription drug coverage under the Medicare program. This medicare plan can be somewhat complicated. The best source of accurate information about the Medicare "part d" plan is the official government Medicare web site. Medicare, like many government programs, may seem complicated at first but if you take your time you will be able to understand what is going on. Part D is particularly a little bit quirky.

Part D must be purchased from private insurance companies and health maintenance organizations. Coverage in Part D is voluntary. There are many rules regarding when you can sign up for Part D. You might have to pay a fine if you do not enroll in the right time period.

Congress and President Obama passed significant health care reform on March 23, 2010. The law is called The Patient Protection and Affordable Care Act. Health care reform attempted to address the problem with the so called "doughnut hole". The doughnut hole was a major flaw in this Gov't program.

Part D will pay 75% of prescription drugs after a deductible is met up to a certain limit. When the limit is reach the patient has to pay one hundred per cent for prescription drugs until another limit is reached. At this point medicare will pay for ninety-five per cent of drugs. These terms are done on an annual basis. Each year the patient is obligated to pay the deductible and the limits are reset.

There are many decisions a senior citizen must make regarding prescript drug insurance protection. There are many options to consider when deciding what type of prescription coverage you need. You must analyze your particular situation and making an informed assessment.

Because of the importance of these decisions, it is suggested that the senior citizen consult with a professional. Your CPA, insurance agent or other trusted professional may give you the financial guidance to assist you in making wise informed decisions. It is your responsibility to educate yourself about Medicare. The more you understand how these important federal programs work the better off you will be.

Social Security and Medicare are wonderful programs that are managed by our federal government. The success of these programs demonstrate that our federal government can have a positive effect on our lives. Although there are problems with Medicare, over time these problems will be addressed. Medicare Part D will be an important program that is helping millions of lives.

How Medicare Part D Helps You Pay For Your Mediation

2010-11-16T18:04:00.000-08:00

The prescription drug plan sponsored by Medicare is called Medicare Part D. This plan helps senior citizens pay for their medication. There are strict rules stipulating when a senior can enroll in Part D. If you enroll late you may have to pay fine or late fee. You can read about Part D on the official government Medicare web site. Some people find the Part D drug prescription program difficult to understand. Medicare Part D is an important issue that senior citizens ought to be knowledgeable about.

Medicare part d insurance can only be bought from an insurance company or an health maintenance organization. Participation in Part D is strictly voluntary. There are many decisions to make in selecting a part d policy.

In March 23 of 2010, The Patient Protection and Affordable Care Act was enacted into law after a lengthy debate. This health care reform legislation takes some step to alleviate the problem of the Part D "doughnut hole". The doughnut hole is a major problem with the Part D prescription plan under Medicare.

After paying a $310 deductible, Part D coverage will pay 75% of prescription drugs until the total cost of prescription drugs reaches $2,830. At this point, you must pay 100% of the costs until your total cost out of pocket reaches $4,550. This period is called the doughnut hole. After $4,550 out-of-pocket expenses medicare will pay for 95% of the cost of your expenses. This is all done on an annual basis. Every year the deductible and your out-of-pocket total starts back at zero.

Selecting a Part D plan is a major decision a senior citizen must make. There are many aspects to consider with several options to be weighed when selecting any plan under Medicare. This is not a decision to be taken lightly, a health care expert is advised

Many experts recommend using a financial planner or some other qualified professional to help you choose a good Part D plan. You might want to talk to the health care providers you are currently using. If you have Medicare supplemental insurance, the company that sold you that plan may have a Part D plan that will coordinate with your current coverage.

Medicare, Medicare Part D and Social Security are excellent programs sponsored by the federal government. The success and popularity of these great programs are one example of the positive effect that democratic government can have on people's lives. No program is perfect but Medicare is always being improved and should serve our seniors well into the future.

Best Medicare Options 2011

2010-11-15T12:09:00.000-08:00

Attention Medicare recipients, are you searching for the best option for 2011? Well, then Medicare Supplemental Insurance is the ideal solution. But what has made Medicare supplemental insurance, an inevitable thing of 2011? Of course, I can give solid answers for your question. Lots of debates and discussions are going on about the new health care reform bill because it is found that this new healthcare bill has failed to meet the needs and expectations of senior citizens (65 years and above). Now you might have understood why people are in a hurry to enroll their names in Medical supplemental insurance plans. The proven success and good history of records it holds are the other reasons that make Medicare supplemental insurance simply the best.

For people who are hearing this idea for the first time, here are some basic facts for your better understanding. Medicare insurance is designed to cover about 80% of the hospital expenses like hospitalizations, consultations and diagnosis tests.

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It is a federal health insurance program for people 65 and older and also for people under 65 with some disabilities and suffering from the end stage renal disease called Lou Gehrig. The Medicare supplemental insurance can be called as an amended plan as it fills the gaps and cons of the basic Medicare insurance plans. There are 12 existing Medicare supplemental plans labeled from A to L, also termed as Medigap. Each package has distinct coverage and features although all must cover the basic and specific Medicare benefits.

As said before, plans are labeled A through L and offer different benefits, at varying prices, that fill particular gaps in regular Medicare coverage. Medicare Supplemental Insurance Plans K and L are similar to Plans A through J but have lower monthly premiums for higher out of pocket costs. All these plans are standardized by Medicare, which shows the equality among all the insurance companies in offering the services. Medicare Supplement Plan F will remain as the preferable choice, but Medicare Supplement Plan N can also be a great option for people who like Medicare Advantage plans and are in good health. Plan N brand new as of June 1, 2010 and will likely be very popular in 2011 as thousands of people are expected to make a shift from the Medicare advantage program back to original Medicare.

Find a company that specializes in Medicare plans to help you with these questions like Medicare insurance Phoenix. A broker is usually the best bet since they can sort down information for all of the companies and you can compare all insurance from one source. It sure to save your time and beats the alternative of contacting each individual company one at a time.

Author Description :

Timothy Terkander covers the healthcare industry. Specializing in Medicare insurance Phoenix and Medicare supplemental insurance for Phoenix area residents.

Article Source: http://business.ezinemark.com/medicare-changes-for-2011-31861de4e3b.html

Bipartisan Deficit Commision Unlikely To Make Big Medicare Changes

2010-11-14T02:36:00.000-08:00

Topics: Health Costs, Medicare

Oct 01, 2010

National Journal: "For all of the attention surrounding President Obama's bipartisan commission on deficit reduction, the country's biggest cost centers — health care in general and Medicare specifically — will likely remain unscathed when the panel offers its recommendations in December. The reason is simple: When congressional Democrats crafted the health care reform package, which became law a little more than six months ago, they did so by squeezing Medicare as much as they could politically … The Democrats' nifty feat of taking out more than $500 billion from Medicare, mostly by reducing provider payments and changing how the system pays private health insurance companies, has handcuffed the Republican budget hawks who serve on the panel. The cuts have left them nibbling around the edges in an attempt to reduce the nation's $2.5 trillion health care tab" (DoBias, 10/2). This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from more than 300 news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

View the original article here

9 Questions to Ask When Evaluating Your Medicare Plan

2010-11-13T01:06:00.000-08:00

Do I need Medicare if I have private healthcare insurance?

Does my current plan cover prescription drugs?

How do I know if my prescription drugs are covered?

What about gaps in coverage between different prescription medication plans?

Can I keep seeing the same doctors?

Will the plan cover dental and vision services?

How much is it going to cost me?

Will I be covered when traveling?

How do I know if I need a supplemental plan?

Medicare Supplement Plans And Open Enrollment

2010-11-12T18:09:00.000-08:00

Medicare Supplement Insurance plan is used to assist with health care charges that are not covered by the original Medicare program. The coverage cost varies quite a little as the different companies demand a variety of monthly premiums. This insurance helps as well with copayments and deductible sums. Consumers who are registered for a Medicare Edge Plan cannot put it to use. All Medicare product policies must be plainly identified accordingly. These policies must have similar or even identical benefits.

Rewards like long term care, spectacles, dental health, and so forth - are not covered simply by these policies. The insurance policy companies may decide which types of plans they sell yet state laws have an effect on the policies that you can get. Sometimes, insurance companies need to sell you a coverage regardless of virtually any health problems you might have especially if you decide to make application during enrollment.

At times apart from open enrollment, the coverage policy company will not issue you a coverage if you have preexisting conditions. Because many individuals have medical concerns, the best occasion to get a policy will be during open application..

Open enrollment can last for six months and also starts on the very first day of the particular month that you reach your 65th birthday and are registered for Part-B Medicare. They will make you hold out to start the coverage for any previous conditions however you will find numerous ways to cut short or avoid the holding out period. Also remember, if it is a site covered by Medicare health insurance, they will nonetheless cover the expenses, even when your personal charges are not covered by your other policy.

It is quite crucial to understand just how open enrollment operates. During open application, the insurance business must sell you a policy at a similar price as healthy folks even if you have got health issues. Acquire help from a coverage specialist, if needed and this important opportunity should not be missed. If you delay until your open application is over, the coverage policy firm does not have to offer you a coverage if you are ill.

There are certain circumstances when insurance firms must offer you insurance coverage by law, although you may have health issues. Typically, if you have some other insurance coverage which you lose for a reason, it is possible to still get a coverage with existing conditions. This example is called a certain issued right.

Attention should be given when choosing the coverage that is right for you. There are numerous issues to look at. What forms of benefits do you need? Simply how much do you want to devote to your premium?

How Medicare is Failing Diabetic Americans

2010-11-12T02:00:00.000-08:00

Bill was 67-year old real estate agent. He was semi-retired. He like showing houses because he had lived in the same small town his whole life. People trusted him. But one day he got a diabetic foot infection. He called his primary care doctor and was referred to a podiatrist. But the podiatrist didn't have any more "Medicare appointment slots" available until the end of the month. While waiting for the appointment, the infection got worse. So instead of high quality care, Bill got an amputation. Now he sits in a wheelchair, wishing he could sell houses.

Retired Americans often view Health Care paid for by Medicare as one of the few perks of retiring. After a lifetime of working hard, raising children, and paying into the System, Medicare is one of the few reliable ways to get a return. But unfortunately for those who are diabetic, Medicare can be bad for your health. It's just math; not enough money equals not enough high quality medical care.

The recent attempted resurrection of President Obama's Health Care reform efforts speak to the broken system. The fact is that Medicare is an expensive program. Since 2002, Medicare has been short of money. There is only just so much money to go around. All of the federal mandates that have been written into law to save money are simply killing diabetics. As long as you understand why, you'll be able to get quality care even if you do have Medicare.

1. Difficult to Find a Medicare Doctor.

Since 1986 Medicare has set all doctor fees. Doctors don't decide how much they get paid, Medicare decides. Adjusted for inflation, over the last eight years, Medicare Has reduced fees about 20% every year. On March 1, 2010 doctors took another hit when Congress let another 21.2% reduction in doctor pay take effect. Imagine if at your job every year you get 20% less pay instead of a raise. How long would it take you to look for another job? Obviously your doctor can't just switch careers, but he can stop taking Medicare.

In some places this means less doctors are available to accept new patients. If you live in San Francisco, the cost of living may be twice that in rural Ohio. But incredibly, doctors seeing patients in San Francisco get paid comparable fees by Medicare. So your doctor has to either learn to live poor or see twice as many patients.

2. Doctors Who Accept Medicare are Swamped.

In 2008, the president of the American Medical Association (AMA) was testifying in front of Congress about declining care for Medicare patients and the problem of Medicare cuts. The AMA President informed congress that the vast majority of doctors in the United States would simply opt-out of Medicare and stop providing care for Medicare patients. Senator Stark replied that since Medicare started reducing payments to doctors many years ago, doctor's have simply seen more and more patients each year to make up for the lost revenue.

But it is now clear that doctor's can't keep seeing more and more patients. Sixty patients in a day is just plain bad medicine. Seven minutes of time in a room with a patient is not enough time to understand blood sugar readings, sugar pills, insulin shots, hypertension, peripheral vascular disease and explain diabetic foot care. It just isn't enough time to practice good medicine. Too many patients and not enough time is a prescription for a diabetic disaster.

3. Less Pay for Medicare Diabetes Doctors.

Many people don't think pay should have anything to do with the quality of the care. But the reality is, it just comes down to math. If your doctor accepts Medicare, but has to see 60 patients a day, you won't get much time. I actually have a doctor friend who says, "I just tell Medicare patients they get two problems to talk about during a visit. Just two," she said holding up two fingers.

But what if you have high blood pressure, diabetes, and you also have a little sore on your foot? If you can only talk about two problems, you'll ignore the diabetic foot ulcer. And if that diabetic foot sore turns in to a diabetic foot infection, you just might wind up with an amputation.

When you are allowed the time you need to talk to your doctor, you would and should talk about all of your health concerns. This of course is the way medicine used to be. The fact that most patients don't know is that your doctor is obligated ethically and in many cases legally to hear about all of your health problems that need to be treated. So if you doctor says, "We'll have to discuss that next time," just insist that he hear you out.

4. Medicare is Decreasing Services.

If you have diabetes you will be sent to a lot of different specialists. Studies have shown that having diabetes make you four times more likely to have a heart attack. You are also way more likely to develop kidney trouble, blindness, or diabetic foot infections that lead to amputation. To make sure everything is working right, your primary care doctor will likely send you for "consultations" with other diabetes specialists like podiatrists, cardiologists, opthalmologists and nephrologists.

A consult is a visit to a specialist requested specifically by your primary care doctor. The problem is that Medicare simply stopped paying "consult codes" this year. So don't expect a specialist to take any extra time explaining your health problems to you or your primary care doctor. And don't be surprised if these specialists don't work you into their schedules very quickly. They simply are making money like the once were.

Once upon a time, house calls were common, but now very few doctors who accept Medicare can afford to make house calls. There is just no way they can take the time to drive from house to house with the low rates medicare pays. This is obviously a big problem for an elderly diabetic who may have poor eyesight or an open wound on the foot. If you can't see because of your blindness and aren't supposed to walk on the foot with an open sore, how can you easily get to the doctor's office?

5. No Diabetes Prevention.

It is simply a fact that the problems related to poorly managed diabetes are preventable. Blindness, kidney failure, and diabetic leg amputations are all preventable. Doctors fully understand how elevated blood sugar levels damage the eyes, kidneys and feet. Doctors also fully understand how preventative care can prevent this damage. But Medicare won't pay for intensive diabetic foot monitoring programs. It has been shown that close monitoring of diabetic foot skin temperatures can prevent diabetic foot sores. But this sort of close monitoring by a diabetic foot expert isn't a service that Medicare will pay for. As a result, it is a service that isn't offered to you by your doctor.

So now that you know the Top 5 Reasons Medicare is bad for your diabetes, what can you do about it? First keep in mind that most doctors decided to become doctors because they really and truly want to help people stay healthy and happy. Remember that your doctor is on your team. But feel free to remind him or her that you need help, even if it might take a little extra time. In most cases your doctor will listen.

You've got to ask tons of questions. Take a list of questions so that you can stay on track and get all of your concerns dealt with in a short doctor visit. Ask your doctor about performs house calls. If not, find one that does. Even if you have to pay for it, having a doctor come to your home is an amazing convenience. Make sure you ask your doctor about any new treatments that are available, but not covered by Medicare. If you don't ask, many docs will simply not take the time to offer all available treatments if they aren't covered.

Diabetes is a serious disease. Many patients with diabetes will die from health complications directly attributable to poorly controlled blood sugar. Given that most of these problems can be managed and prevented, you owe it to yourself to insist on the very best care from your doctor.

Dr. Christopher Segler is a podiatrist in the San Francisco Bay Area. He offers House Calls for diabetic foot exams, Diabetic Foot Emergencies, and Diabetic Foot Wound Treatment. Serving San Francisco, Marin, Palo Alto, and Walnut Creek. You can learn more about house calls as solution to foot pain at San Francisco Podiatrist housecalls or visit the best info on San Francisco Podiatry.

Will Health Care Reform Kill Medicare Advantage?

2010-11-11T03:20:00.000-08:00

Barbara O'Brien is a concerned citizen who writes the popular political blog, The Mahablog.

Medicare Advantage Plans - Advantages to Seniors

2010-11-10T02:25:00.000-08:00

Some Medicare Advantage Plans have gotten a bad rap lately, but that may have been because of the overzealous marketing efforts of a few people, rather than the actual plans. All Medicare Advantage plans must be approved by the Center for Medicare and Medicaid (CMS). They must provide services that are equal to, or better than, services provided by the traditional Medicare Part A and Part B. Of course, the point of these plans is to provide services that will provide advantages over Part A and Part B!

What is the Problem With Medicare Advantage?

The recent flak over Medicare Advantage Plans is over the type of plan called PFFS (Private Fee For Service). These plans allowed access to "any doc", or the enrolled person's choice of Medicare care. The problem there was that the doctor or other medical provider had to accept and bill to the plan. Since some of the plans were very new, medical providers like doctors, hospitals, and therapists did not have the plans yet. This caused problems because the enrolled people needed to file the bill with the insurance companies instead of having the medical provider do it. Indeed, this did cause problems for many Medicare recipients.

What about other Medicare Advantage Plans?

Medicare Health Maintenance Organizations (HMO) and Medicare Preferred Provider Organizations (PPO) have been around a long time. Both of these types of Medicare Advantage plans use networks of doctors and other medical providers that have already agreed to participate in the plans. As long as plan members use their identification card, they are not experiencing a lot of billing problems. In general Medicare PPO and HMO members are expressing great satisfaction with their health plans.

A combination of private competition and federal incentives allow private plans to offer health plans that do deliver quality health care and save Medicare recipients money. The networks, once thought to be restrictive, actually ensure that medical providers understand and agree to the system so that system works more smoothly. These plans usually include the Part D or prescription part of Medicare too!

Who is Happiest With Medicare Advantage Plans?

Medicare Advantage plans appeal to people with moderate incomes. Medicare supplements can be a burden for seniors and disabled people on fixed incomes. However, many seniors with larger incomes also participate in Medicare Advantage plans because they come from the same companies that used to carry their old group or individual health plans, and they are comfortable with the medical providers in the network!

Medicare Advantage plans also provide satisfaction to those with specialized or chronic needs. Plans are available that address chronic conditions such as diabetes or heart problems, or those in nursing homes. Some plans even address the needs of caregivers!

You have choices about how to get the most out of your Medicare benefits!

M Katz is a licensed Texas insurance agent, who has been certified to work with many Medicare Advanage Plans. In her experience, the vast majority of her clients who chose Medicare Advantage plans or Medicare Supplements with traditional Medicare were satisfied because they chose the right plan for their own needs.

We have helped thousands of seniors and disabled people make the most of their Medicare benefits. If have questions about Medicare Benefits, consult with the Medicare Health Plan Experts at Trusted Senior Specialists Medicare Plans!

http://www.MedicareTxRX.com -- Medicare Plans in Texas!

The Medicare Factor in Long Term Care Planning

2010-11-09T02:11:00.000-08:00

Medicare and Health Insurance History in the United States With a vision to provide a universal health plan, such as Medicare, the United States does not truly have a national health care plan. Even though universal health care, another name for national health care plans, has its conception in the 20th century, the United States has shied away from its inception. In fact, the United States is one of the few industrialized countries that do not offer true, government provided universal health care.

The first private health insurance programs created nation wide was the Blue Cross plans. Originally paid by individuals on prepaid bases for certain hospitals, this was later changed to include any sponsored hospital. The individual would provide a monthly payment that ensured he was cared for a specified number of days.

The Blue Shield plan was another plan created during the 1940s. It allowed the prepayment for doctor services. The plan’s creation provided an alternative to a national health care plan. The Blue Shield and Blue Cross plans eventually merged, forming what we call today Blue Cross Blue Shield.

There are varying reasons that a national health care insurance plan has not taken hold in the United States. As the American Medical Association has opposed the establishment of a national plan, the employer sponsored insurance plan has added the catalyst to not create a national plan. Since the employers can write off the plans provided to their employees, Congress has not received any push to change the concept of employer-sponsored plans.

The closest conception of universal health care the United States institutionalized is Medicare. Medicare was created in 1965.

Then Came Medicare

So how did Medicare take hold? Though it is not a true national health care plan for everyone, only for those over 65, it is because of President Lyndon B. Johnson and a majority of Democrats in both houses of Congress that the plan came into existence.

Attempting to provide a plan comparable to the private sector, the creation of Medicare part A came about. By mimicking the current plans, Medicare part A provided a determined amount of hospital care. Any more care beyond what the plan stated was to be paid by the patient.

The disadvantage to a plan such as this is the increasing expense of hospital care. The costs paid by the insured are now at a level to completely destroy financially that individual. In other words, as expenses have increased with hospital care, Medicare Part A has not kept pace. Therefore, any difference in cost is paid for by the patient.

This realization gave way to catastrophic plans. These plans allow the insured to pay for some of the upfront costs up to a predetermined out-of-pocket limit. Once that is reached, the insurance pays 100% of the cost. Unfortunately, Medicare has not evolved into this type of arrangement.

As such, we are beginning to see the bankruptcy of the plan, as well as the bankruptcy of the insured attempting to cover their part of the insurance plan.

Medicare part B evolved into a plan to encourage doctors to be paid by the federal government with the attempt to not institute price controls by the same. Under the original intent, Medicare part B paid for 80% of a doctor’s services while the patient paid the other 20%, and any fees above the reasonable costs.

However, the plan has degenerated into a government price control plan, where the government dictates to doctors what they will be paid for services the doctors provide.

Medicare Eligibility

Medicare enrollment takes place only one time during the year. The time frame usually is between October and December of the year prior to its activation for an individual. To learn more of the enrollment process for Medicare, read this publication: http://www.medicare.gov/Default.asp .

Most individuals understand that to enroll one must be age 65 years or older. However, most may not know that they also must be eligible for receiving Social Security or Railroad retirement. Furthermore, the individual does not need to be receiving either one of the retirement payouts, but one must be eligible to receive them.

In short, you can receive Medicare without receiving Social Security or Railroad Retirement income. You probably know someone who has decided to continue working. As such, they have delayed their receipt of government retirement payouts. However, to ensure a medical benefits plan, they have signed up for Medicare.

When you sign up for Social Security or Railroad retirement at age 65, or decide to receive payments at 65, you are automatically enrolled in Medicare Part A and Part B.

If an individual under 65 is disabled, and has applied for and receives Social Security disability for two years will receive Medicare. Furthermore, if a person of any age with end-stage renal disease may also receive Medicare.

Anyone born after 1938 will not receive their full retirement benefits from Social Security until the age of 67. Due to this, most individuals may decide to continue working. As such they will not apply for Social Security at the age of 65, thus not automatically receiving Medicare Part A.

Or, if the person is under a group plan, he or she may be forced into enrollment in Medicare at the age of 65. The person will not lose their group coverage, but it will be shared with Medicare.

I Have A Group Plan

Returning to the previous situation where an individual continues to work, or not retire, and not having a group plan, he or she may not receive a reminder to sign up for Medicare Part A. Fortunately, there will not be any penalties. However, he or she will only be allowed to sign up during a specified period during the year.

As for Medicare Part B, there is a penalty. You must sign up for Medicare Part B either three months before or after your 65th birthday. Otherwise, a penalty will be assessed against the premiums. However, if a person is covered under equivalent group coverage or is on Medicaid, the penalty is waived.

Though Medicare Part A is paid via payroll deductions and there is not cost when implemented, this is not the case with Medicare Part B. Medicare Part B is a cost-sharing plan.

The premiums for Medicare Part B are $88.50 (for year 2006). However, these premiums increase every year as the cost of medical services increase. Beginning in 2007, for those individuals in high-income brackets, they will pay a higher premium as a percentage for Medicare Part B.

The increases are phased in over a five-year period. The increases are scheduled as such:

income of: $80,000 -$100,000: 65% subsidy
income of: $100,000-$150,000: 50% subsidy
income of: $150,000-$200,000: 35% subsidy
income above: $200,000: 20% subsidy
If you are married, the incomes are twice what are depicted. However, for both individuals and married couples, the income ranges increase annually based on the Consumer Price Index (CPI).

I’m Not Eligible for Social Security

What about those individuals who are not eligible for Social Security and their spouse is not eligible either? That person can still get Medicare but will pay a premium, which may be equivalent to the Medicare Part A premium.

Eligibility for Social Security requires at least 10 years, or 40 quarters, under the system or paying into the system.

You do not have to participate in the Medicare program. However, if a person does not participate in Part A, they are not allowed to participate in Part B. If the person, though, must pay premiums for Part A, they can elect not to, and instead purchase Part B. It also works the other way. If you do not desire to participate in Part B, you do not have to.

To sign up for Part B, it must be done so during the first three months before the month of an individual’s 65th birthday, or three months after. This equates to seven months to sign up (3 months before and after, and the individual’s birthday month).

If an individual does not sign up for Medicare Part B during the initial period, they are penalized. The penalty is 10% for each full 12-month period the individual does not sign up. A person can sign up for Part B between January 1 and March 31 if they do not sign up during their initial enrollment period – the seven months mentioned earlier.

Can I Afford Not To Have Medicare Part B?

But what of the individual who cannot afford the premiums for Medicare Part B? Most individuals who are affected in this manner may be able to receive assistance through Medicaid or a state’s Medicare Savings Program. Normally, someone must meet the state’s requirement of limited income and resources. The plan will pay for Medicare premiums and possibly Medicare deductibles and coinsurance.

A situation which may help with understanding may include a person who receives Medicare Part A (which the Medicare Savings Program might pay the premium) and

He or she has resources equal to or less than $4,000; a couple would be $6,000. The resources may include monies in checking or savings account, stocks or bonds.

He or she has a monthly income of less than $1,068; a couple would be $1,426 (as of 2005; Alaska and Hawaii have higher limits).

If you are an individual that is 65 or older and still working with a group insurance plan, there are solutions to Medicare Part B. Most individuals under this scenario will continue with their group plan and use Medicare Part A as their secondary, or supplemental, insurance. However, they may not need the Part B.

But what if they do need Part B? As mentioned earlier, would they not be penalized if they signed up later? There are special rules for someone under a group insurance plan that allows them to sign up for Part B without a penalty.

If an individual is retired but has continued with a group plan under an agreement with the company, there are waivers to allow for coverage of Part B. However, the waiver only takes effect if the person loses their group coverage in the future.

If you are one of the aforementioned individuals who need to take advantage of these waivers for Medicare Part B, then you will need to apply during the Special Enrollment Period.

Study Up So You Don’t Have To Pay Up

Make sure you go to the Medicare link (http://www.medicare.gov/Default.asp) and read what you are entitled to. I don’t like that word, entitlement, but you have paid for Medicare so use it. Just don’t abuse it. Make it part of your Long Term Care Planning so you can make it through your golden years.

T. Sydney Shinn Home Health Care Solutions [http://www.home-health-care-solutions.com]

A developer of technical health care solutions, a Crown Ministries budget counselor, and a family man, Mr. Shinn understands the challenges of today's families. After taking care of his own father for five years, he created Home Health Care Solutions to to provide the material that families need to make informed decisions on home care options.

Wonder if a loved one will be able to continue to live in their home as they mature? Discover information for families and seniors about in home care giving, in home care services, mental and hospice care, legal and financial planning to ensure that the elder family member is able to live in their home forever. The site provides guidance in preparing the retiree, family, caregiver and senior family member.

The New Medicare Prescription Drug Plan Pitfalls

2010-11-08T05:01:00.000-08:00

Coverage for the New Medicare Prescription Drug Plan begins on January 1, 2006. Many seniors are feeling confused and concerned about this plan. Here are some of the pitfalls associated with this plan that Medicare eligible individuals will want to be aware of.

1. To join the Medicare Prescription Drug Plan (Medicare Part D) you must choose one Prescription Drug Plan from dozens of plans that are available (there are up to 50 plans in some states). Once you have chosen a plan you are "locked-in" until the enrollment period the following year.

2. Prescription Drug Plan (PDP) providers can change the particulars of their plans at any time with a short warning period for plan enrollees. These changes can include changes to which drugs are covered under the plan, which pharmacies are in the plans network, the charges associated with being a part of the plan and any other detail of the plan. These changes are at the discretion of the plan administrator and can be implemented at any time.

3. For 2006, once you have used $2250 worth of medications, you are 100% responsible for paying for the full amount of the drug until you reach the $5100 Catastrophic coverage limit. This range between $2250 and $5100 where you have to pay for 100% of your drug expenditures is known as the "donut hole".

4. At its greatest level of savings Medicare provides a 49% savings. This is only 7% better than the average savings experienced with a licensed Canadian pharmacy. This greatest savings occurs when people spend exactly $2250 on medication in one year (if you spend more or less than that the savings go down). That means that the greatest savings anyone on Medicare can experience above a Canadian pharmacy's average savings is $157.50 annually (7% of $2250) or $13.13 a month. Is $13 a month worth the risk of being "locked-in" to paying monthly premiums for a plan that can be switched on you at any time. (Note: Some people can save more than 49% if they spend well over $7100 per year. This is in the catastrophic coverage range).

5. If you do not sign up with at Medicare Prescription Drug Plan before May 15th, 2006 then you will be penalized with a cumulative 1% increase to your premiums for every month that you do not enroll in a plan after that date. This penalty is the governments way of forcing people, who do not really need a drug plan, into joining a plan and thus "subsidizing" the Medicare program. 1% of the average plan is 32 cents. So for every month after March 15th, 2006 that people are not in a plan, 32 cents will be added to your monthly premium or basically $1 for every 3 months you do not join. This penalty is however applied to your premium for all future monthly premiums. What many seniors groups are advocating is for people to wait until the May 15th, 2006 deadline and then join the cheapest possible plan (approx. $10 monthly premium) and still order medicines from a licensed Canadian pharmacy like Universal Drugstore.

6. Average monthly premiums, the annual deductible and the Out-Of-Pocket expenditure limits are expected to increase substantially every year. This means you will be required to spend more and more money every year that you are part of the Medicare prescription plan.

7. Unless you are spending more than $800 on medications in 2006 there is no real savings with the Medicare Prescription Drug Plan. This required minimum amount of expenditure to experience savings will increase every year as the annual deductible, the monthly premiums and the Out-Of-Pocket expenditure limits are also increased every year.

8. It will be extremely time consuming and difficult to decipher myriad plans available in each state (all providing different coverage) and to try and figure out which plan is best for you personally. This will be twice as hard for a couple as the prescription drugs used by each person in the couple will be different and therefore they may require different plans. Even once a plan is chosen, there is still the risk of having the plan changed once you have made your decision and you are "locked-in".

9. Drug companies stand to make a ton of money off of the Medicare program. That is why they spent millions of dollars lobbying to get the legislation passed to make Medicare Part D a reality. It is also why Senator Bill Tauzin, a major advocate and motivating force behind getting the Medicare Prescription Drug Plan passed, is now a $2 million a year executive in Big Pharma's trade organization. On Sept. 5, 2003, Sen. John R. McCain (R-Ariz.) told the New York Times, "There's no doubt in my mind that the drug industry got everything it wanted and more," he said. "It perhaps should be called the 'Leave-No-Lobbyist-Behind Bill.' "

10. Plan providers have the ability to negotiate better drug pricing with the drug companies but they do not have to pass the savings on to the consumer or the government.

11. If you join a Medicare Prescription Drug Plan (PDP) at any time after Dec 31, 2005 your coverage is not available to you until the first day of the following month.

12. Action is required to enroll in Medicare Part D (the Prescription Drug Plan part) unlike Medicare parts A and B which are automatic. You are not simply enrolled in the best plan for you. You have to wade through piles of information to decide what is best for you.

13. It is very difficult for persons who qualify for Medicare Part D to be sure if their drugs will be covered under their plans formulary (which can change at any time anyways.) A formulary is a list of drugs covered under particular drug plan.

14. You may not qualify for Medicare Prescription Drug Benefits if your annual income is too high or if you own too many assets.

15. Different plans will have different monthly premiums. The plan you need may have a really high monthly premium. $32.20 is simply the "predicted" average monthly premium.

16. Will your plan cover temporary-use medications (such as antibiotics or heartburn medications) or only chronic medications (such as drugs used for diabetes or heart conditions)?

17. Plans with lower monthly premiums may have higher deductibles and co-pays.

18. Payments for drugs which are not on your plans formulary are not counted towards your Out-Of-Pocket expenditure limit.

19. Payments made by insurance plans do not count towards your Out-Of-Pocket expenditure limit

20. Is your regular pharmacy included in your plans network of pharmacies? Like many people you have most likely come to rely on a pharmacist that knows you and your medical conditions well. However, you may be forced to go to another pharmacy if your pharmacy is not included in your plans network of pharmacies.

21. How many days of medicine can you get at one time? Do you need to keep going back to the pharmacy every month or can you get 90 days?

22. Will your drug be covered by your plan the next time you go into your pharmacy?

23. Does your plan require step-up therapy or prior authorization? Step-up therapy means using drugs in a series of stages or steps in order to treat your condition. For example if you have GERD your plan may not cover Nexium unless you have previously tried ranitidine (Zantac) and/or omeprazole (Prilosec) first. Prior Authorization means that for certain drugs, your plan will not cover the drug without first reviewing your medical and drug history to determine if your treatment steps have been appropriate.

24. The Prescription Drug Plan providers stand to make a ton of money from the Medicare program (drug companies stand to make the biggest windfall).

25. Net cost to the government for Medicare Prescription Drug Benefits is estimated to go from $37.4 Billion in 2006 to $109.2 Billion in 2015 (estimate by Health and Human Services department). However, much higher estimates of the costs of Medicare Part D can also be found from non-government resources. Two years ago Congress reluctantly approved for the plan at a cost of no more than $395 billion dollars over 10 years. A few months later the cost ballooned to $534 billion and earlier this year it shot to $795 billion. Big Pharma is the biggest recipients of the increased dollars added to the costs of this program.

26. Plan may force you to use generics when you are used brand name medications and may not be able to tolerate generic versions.

27. The appeals process for some plans is very confusing and convoluted. (You can appeal to your plan if your drug is not covered.)

28. Many of the big pharmaceutical companies are now making anyone eligible for Medicare Part D, ineligible for their assistance programs. These companies are effectively forcing seniors into a "voluntary" program that may not be right for them. The AstraZeneca Foundation was the first to take such steps.

29. Many people are finding it difficult to obtain accurate, updated lists of what medications each plan will cover.

30. Medicare's own hotline can only answer general questions. For more specific questions you must contact each individual insurance provider.

31. Many people have waited 30 minutes or more when calling the Medicare hotline to get information that they need.

32. Rep. Dan Burton (R-Ind.) in a 60 Minutes segment televised March 14, 2004 said, "Seniors, when they find out what's in that bill, are going to be very angry. The problem is, they're not going to find out about it until after this next election."

Jeremy Cockerill is a licensed Canadian pharmacist who owns and operates htttp://www.UniversalDrugstore.com/ , one of the top Canadian mail-order pharmacies. Mr. Cockerill graduated from the Faculty of Pharmacy at the University of Manitoba with Honors in 1998. Mr. Cockerill recently won the 2005 Manager of the Year award from the Manitoba Customer Contact Association. Mr. Cockerill has been studying the new Medicare Prescription Drug plan since early 2005.

Supplement For Medicare

2010-11-07T19:25:00.000-08:00

http://www.texaslowcosthealthinsurance.com, Medicare resources

What is a Medicare Supplement?

2010-11-06T11:54:00.000-07:00

A Medicare Supplement (also called "Medigap Insurance") policy is private health insurance specifically designed to supplement the Original Medicare Plan. This means it helps pay some of the health care costs ("gaps") that the Original Medicare Plan doesn't cover (like coinsurance and deductibles). Medicare Supplement policies may also cover certain things that Medicare doesn't cover. If you are in the Original Medicare Plan and you buy a supplement policy, then both plans will pay their share of the Medicare-approved amount for covered health care costs. Medicare Supplement policies are sold by private insurance companies.

A supplement policy is not a "Medicare Advantage" (like an HMO or PPO) because it's not a way to get Medicare benefits. Insurance companies can sell you only a "standardized" Medicare Supplement policy. Standardized supplement policies are identified by letters (A through L). In some states, like Texas or Louisiana, you may be able to buy another type of Medicare Supplement policy called Medicare SELECT. Each type of supplement policy offers the same basic benefits, no matter which insurance company sells it. Usually the only difference between policies sold by different insurance companies is the cost. Medicare Supplement policies must follow Federal and state laws. These laws are designed to protect you.

What Medigap Policies Do Not Cover

Medicare Supplement policies do not cover long-term care (like care in a nursing home), vision or dental care, hearing aids, eyeglasses, and private-duty nursing. Any new supplement policy is guaranteed renewable. This means the insurance company cannot cancel your policy as long as you pay the premium. Although some policies sold in the past covered prescription drugs, no new Medicare Supplement policies are allowed to include prescription drug coverage. If you want prescription drug coverage, you may want to join a Medicare Prescription Drug Plan (Part D) offered by private companies approved by Medicare.

When is the Best Time to buy a Medicare Supplement?

The best time to buy a supplement policy is during your open enrollment period. This period lasts for 6 months and begins on the first day of the month in which you are both age 65 or older and enrolled in Medicare Part B. During this period, an insurance company can't use medical underwriting. This means it can't refuse to sell you any supplement policy it sells, make you wait for coverage to start, or charge you more for a policy because of your health problems. If you buy a supplement policy when you have a guaranteed issue right, the insurance company can't use a pre-existing condition waiting period at all.

Note: You can send in your application for a Supplement policy before your open enrollment period starts. This may be important if you currently have coverage that will end when you turn age 65. This will allow you to have continuous coverage. It is very important to understand your open enrollment period. During this period you can buy any supplement policy the company sells. If you apply for coverage outside of your open enrollment period, there is no guarantee that an insurance company will sell you a policy. After your open enrollment period ends, insurance companies are allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the policy.

Comparing Medicare Supplement costs

The cost of supplement policies can vary widely. There can be big differences in the premiums that different insurance companies charge for exactly the same coverage. As you shop for a policy, be sure you are comparing the same type of Supplement policy.

What is Medicare SELECT?

There is another type of supplement policy called Medicare SELECT that is sold in some states, including Texas and Louisiana. Medicare SELECT can be any of the standardized Supplement Plans A through L, however, you must use specific hospitals and, in some cases, specific doctors to get your full insurance benefits (except in an emergency). Medicare SELECT policies generally cost less than other Medicare Supplement policies, however, if you don't use a Medicare SELECT hospital or doctor for non-emergency services, you will have to pay some or all of what Medicare doesn't pay. Medicare will pay its share of approved charges no matter which hospital or doctor you choose.

What is The Best Way to Find the Correct Medicare Supplement? The best way to find the best policy for your particular situation is to consult a professional who specializes in Medicare Supplements.

David Hecker is a Licensed Insurance Agent based in Longview TX. He specializes in Medicare Products. He is licensed in Texas, Louisiana and Arkansas. He can be reached at (903) 918-9091. E-mail: dhecker@cablelynx.com or on the web at: http://www.tx-medicaresupplement.com To receive your "Free" e-mail newsletter about Medicare Supplements, send an e-mail request to: dhecker@cablelynx.com

Top Carriers Dropping Medicare Advantage Private Fee-for-Service Plans

2010-11-06T05:54:00.000-07:00

Top 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 beneficiaries will have to find new coverage.

Currently, 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 five percent, making them less profitable for insurance carriers.

How PFFS Currently Work

PFFS are popular amongst consumers 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. Essentially, the 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 beneficiaries 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, the Advantage plans generally have more benefits and lower copayments than many other types of Medicare plans. In order to have a 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 also be aware that Medigap policies do not provide gap coverage for individuals that participate in the Medicare Advantage program.

By Wiley Long - President, MedigapAdvisors.com - The nation's leading independent agency specializing in Medigap coverage. Our professional medigap advisors will help you choose the best plan.

What Medicare Does and Does Not Pay in 2010

2010-11-05T23:43:00.000-07:00

A summary of seniors medicare benefits for 2010:

Considering the fact that most seniors live on a very tight budget, what medicare will and will not pay for medical cost is a major concern for most seniors. Unfortunately, the government is on a yearly basis increasing the medicare premiums and reducing the benefits medicare will pay. This brief article will outline in general the present state of medicare and what medicare will and will not pay in 2010. The article will also discuss briefly the various alternatives available to seniors to fill in the gaps on what medicare does not pay and expects the senior to pay out of pocket.

Medicare Abc's: 2010

Medicare has four areas of coverage: ABCD

Medicare Part A: Hospital Expenses.. If a senior is in the hospital for 24 hours medicare will pay for all hospital cost for the first 60 days after a $1100 deductible. ( note, this deductible is reinstated every 60 days for subsequent admissions or possibly six times a year).

61-90 days- The senior has to pay $275 per day

91-150 days- The senior pays $550 per day

After 150 days- The senior pays 100%

Medicare Part B: Doctor's cost( visits-surgery), including lab test, xrays,etc.

If already enrolled in Part B, the monthly cost for Part B is $96.40, usually deducted from your social security check. If a new enrollee in 2010 the cost is $110 per month..And increases if your income exceeds $82,000

Under part B medicare will pay only 80% of the cost and the senior pays the additional 20%.

Part C: Under Part C the senior can enroll with one of many carriers that will help fill in the gaps where medicare does not pay. It is called Medicare C Advantage Plan. The premiums are relatively low or nothing. However, under a Med C you can expect deductibles, co-pays, waiting periods,etc. Also Med C plans are run like group health plans where the carrier dictates the doctors, the place, the time etc of your medical care much like PPO's and HMO'S.

Part D: Prescription coverage. Briefly, the premium for Part D coverage is relatively inexpensive. However, unless you are taking some very expensive drugs, many national drugs stores offer very inexpensive drug programs to seniors.

Supplemental Coverage: A number of private carriers offer Medicare supplemental coverage. Supplemental meaning coverage that fills in the gaps that Medicare does not pay under Part A and Part B above. In others words, supplemental payments for the co-pays and deductibles previously discussed regarding Part A and Part B that the senior has to pay out of pocket.

Supplemental Coverage VS Part C coverage. As previously stated, Part C coverage by a private carrier is administered much like group health with co-pays, deductibles and a selection of their doctors. Supplemental plans vary in coverage and the yearly supplement premium is based on the degree of coverage.Ther are supplemental plans that pay all of the cost medicare does not pay under Part A and B to plans that may have a $2000 yearly deductible. The advantage of the supplemental plans is that you have control over which doctors you go to,anytime and anywhere. Of course the less you have to pay for coverage of the un-paid medicare cost the more your supplemental premiums will cost. Keep in mind that regardless of the cost for supplemental coverage, the premiums are far less than traditional non-medicare major medical coverage, and with better benefits.

Also, regardless of your pre-existing medical conditions most people have the opportunity to qualify for medicare supplements, so if you are turning 65 be sure to discuss the various supplemental medicare plans available and enroll when the pre-existing conditions are not a factor.

Obviously, this has been a very general overview of Medicare 2010, but hopefully outlines the medicare coverage and supplemental coverages available. And keep in mind that medical coverage is so critical to any senior that it is imperative to consult with an insurance professional in your state to know what alternatives are best for you.

If you have any questions about this issue please contact me at my website and I will direct you to an insurance professional in your area. Hopefuly this brief summary has been helpful and beneficial.

David Burlison, JD and licensed insurance producer in the state of Tennessee
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Coverage Options For Medicare Eligible Individuals

2010-11-05T03:36:00.000-07:00

People with Medicare can obtain their medical care through original Medicare or the Medicare Advantage Program (Part C). Medicare Advantage Plans consist of HMO, PPO, Private Fee for Service Plans and Special Needs Plans. Of the more than 10 million individuals enrolled in Medicare Advantage Plans, the majority are enrolled in HMO's (Health Maintenance Organizations) which have been available since the 1980's.

To help your parents (or you) make an informed decision, they need to understand how these plans work, and then decide which plan is right for them. The following is a brief description of each of the plan types.

Original Medicare

If an individual elects to go with traditional fee for service Medicare, they can generally use any doctor or hospital that accepts Medicare assignment anywhere within the United States. However, Medicare does have deductibles, copays and cost sharing requirements that can play havoc with budgets. To help pay these additional out of pocket expenses, many individuals purchase Medigap or Medicare supplement policies.

Medicare Advantage Plans (Part C)

If you opt to go with a Medicare Advantage Plan, you actually trade your traditional Medicare benefits for these plans. Many of the Medicare Advantage Plans are offered to eligible individuals at little or no cost other than continued payment of their Part B monthly premiums.

Medicare HMO's (Health Maintenance Organizations)

These plans cover the same physician and hospital costs as traditional Medicare, but usually with lower out of pocket costs. HMO's are attractive to Medicare eligible individuals because they often provide extra benefits like eyeglasses, hearing aids, and dental benefits which are not covered by traditional Medicare.

Individuals considering a Medicare HMO should be aware that they can only receive medical services from providers who are part of the HMO's network of contracted providers. The HMO usually requires that an individual joining their plan select a primary care physician from those who participate in their network. This primary care physician would then be responsible for all medical care including referrals to a specialist and admittance to a hospital. The HMO will not pay for unauthorized visits to specialists nor non-emergency care received outside the HMO's service area or visits to non-network physicians.

Medicare PPO's (Preferred Provider Organizations)

These plans are private healthcare plans like HMO's. However, PPO's and HMO's do differ into two very important areas. First, Medicare PPO's do cover eligible medical care services obtained from doctors and hospitals outside the PPO network. And, second, Medicare PPO's do not usually require that you obtain an authorization before seeking care from a specialist.

Regional PPO's are available in many areas of the country. These plans serve large geographic areas and must offer the same premium costs and plan benefits to all individuals residing in these areas. Medicare PPO's cover the same types of medical expenses that traditional Medicare does. In addition, Medicare PPO's commonly include a prescription drug benefit. Unlike traditional Medicare, Medicare PPO's have an annual out of pocket limit for benefits covered under Parts A and B of Medicare. The out of pocket limit caps the amount an individual can spend on covered medical expenses in a calendar year. As with any PPO program, when an individual uses a non-contracted provider for covered services, they will pay more out of their pocket.

Private Fee for Service (PFFS) plans

These plans are available to Medicare beneficiaries in exchange for their traditional Medicare Benefits. PFFS don't have a formal network of doctors and hospitals to choose from and not all doctors or hospitals are willing to provide medical services to participants in these types of plans. If an individual is considering enrollment, it is wise to check with their doctor and local hospitals to make sure that they will accept the plan's payment for services before enrolling. Also, the enrollee should thoroughly understand the benefits of a fee for service plan because the fee for service plans decide how much they will pay for Medicare covered services and may charge a higher cost sharing percentage than traditional Medicare. Private fee for service plans may include a prescription drug benefit. If they do not, the enrollee is free to join a Medicare stand alone prescription drug plan.

Special Needs Plans (SNP)

These plans are private plans that provide benefits to Medicare beneficiaries, including prescription drug coverage, who need additional help paying for their medical benefits. These would include individuals who qualify for both Medicare and Medicaid (MediCal in California), those residing in long term care facilities, and those with chronic or disabling medical conditions.

Medicare Prescription Drug Plans (Part D)

Prescription drug plans are available to all Medicare eligible persons regardless of medical history or income levels. When a person first qualifies for Medicare, their initial enrollment period begins three months before their 65th birthday, includes their birth month, and ends three months after their birth month. Otherwise, the annual open enrollment period for prescription drug plans runs from November 15th thru December 31st, with the coverage commencing on the following January 1st.

Medicare drug plans are designed to reduce drug costs for enrollees and protect against catastrophic drug costs. However, there is a monthly cost for these plans. In addition to a monthly premium, the covered individual is required to pay a percentage of the cost of the medications (or a copay) and Medicare pays part of the cost. Costs for a plan will vary depending on the medications taken and the type of plan selected. At a minimum, the plans available must provide a "standard" level of coverage.

For 2010, a standard prescription drug plan will have the following costs:

? A monthly premium which varies from approximately $24 per month to in excess of $100 depending upon the plan selected and medications taken.

? An annual deductible equal to the first $310 worth of prescription drugs.

After the annual deductible has been satisfied, the insured will pay the following amounts for the remainder of 2010:

? 25% of the cost for covered medications from $310 up to $2830 in charges, (the plan pays the other 75% of these costs); then

? 100% of the next $3842.50 in total drug charges (often called the donut hole or coverage gap); then

? After exceeding the annual of pocket limit of $4550, 5% of your drug costs or a copay of $2.50 or $6.30, whichever is greater for the rest of the current calendar year.

This describes a "Standard Plan." Many of the prescription drug vendors do offer better benefit plans which forego the plan deductible and substitute copays instead of the 25% coinsurance. Generic medications are available for substantially less than brand names with these plans.

There is a penalty of 1% per month, using the average national premium, for non-enrollment/late enrollment, which is assessed for as long as they remain enrolled in the plan.

This has been just a brief overview of the benefits available to Medicare eligible individuals. For more detailed information, please consult the Medicare handbook, Medicare & You. The handbook is available by contacting Medicare at 1-800-MEDICARE or visiting the Medicare website at http://www.medicare.gov.

In addition, a copy is available at our website- http://www.waldenbrokers.com. Should you or your parents need assistance in selecting a Medicare plan, please feel free to contact us at 818-597-2890.

Edward Walden, CLU, RHU, REBC

New Medicare Reporting Requirements and How it Affects Plaintiffs Attorneys

2010-11-04T03:36:00.000-07:00

New Medicare Law and how it affects the Plaintiffs Bar

If you primarily practice personal injury law then you need to be aware of the new Medicare reporting law otherwise you and your client will not see the money from your recent settlements.

The Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) has now gone into effect as of January 1, 2010 and has brought with it new issues for Plaintiffs and their attorneys. It is important to be aware of these changes as they can now seriously delay your settlements.

The amendments, codified at 42 U.S.C. ? 1395 y(b)(8), now require liability insurers (which are defined to include self-insured entities) to report payments related to bodily injuries incurred by Medicare beneficiaries. It also requires that the Medicare beneficiary or "other party," defined by the regulations as including the entity making the payment, must reimburse Medicare within 60 days of the payment or be subjected to a $1,000 a day fine along with interest. The regulations further provide that if Medicare is not reimbursed within 60 days the primary payer must reimburse Medicare even though it has already reimbursed the beneficiary or other party.

This means that an insurance company settling a claim may be liable for paying the Medicare lien, even after paying the plaintiff, if the Plaintiff does not reimburse Medicare within 60 days of the date of payment. So now more than ever insurance company adjusters and their attorneys are making sure that Plaintiff's attorneys are resolving Medicare liens before they will issue payment of any settlement check.

If you have dealt with Medicare in the past you know the problems inherent in notifying them of your claim and trying to resolve your client's lien. If you have not dealt with Medicare before you need to seriously consider co-counseling with an attorney experienced in the area.

Whenever Medicare provides a lien they simply provide a search from the date of the accident through the date of the request. This means that the lien will include charges that are not related to your client's accident that you will have to dispute. Unfortunately, Medicare will not provide your final lien amount until 10 days after they are notified that the case has settled. Further problems arise because it takes Medicare in excess of 45 days to evaluate and remove unrelated charges from their lien so even if a plaintiff's attorney puts Medicare on notice at the inception of a claim and provides the information necessary for Medicare's contractors to evaluate the claim, the contractor will not issue a final demand letter setting forth Medicare's entitlement until notified of the settlement. This means that your client's lien amount can change at any time and you will have to pay Medicare whatever they are claiming or your client will be responsible for late fees and fines. Medicare's position is that it should receive its full demand entitlement pending resolution of such issues.

This is now causing insurance companies to be directly involved in the Plaintiff's negotiations with Medicare. Insurance companies and their attorneys will now want to include Medicare on any settlement checks as an essential element of any proposed settlement despite the fact that there is nothing in the current statute or implementing regulations requiring that payment be directed to Medicare or CMS.

So how do we avoid this?

Make sure to put Medicare on notice at the inception of a claim and negotiate their lien before settling your case. This is the only way to avoid significant delays at the end of the case when the Plaintiff is waiting on their money. If you do not know how to handle a Medicare lien then be sure to review my pamphlet "How to handle a Medicare lien" available on my website.

Then try to have the insurance company agree to a hold harmless and release providing indemnification from any claims by Medicare including fines and/or interest.

If they will not agree then as a last resort negotiate with the adjuster or attorney to enter into an enforceable Settlement Agreement, which would be reported to Medicare, but deferring the actual payment of the settlement funds until such time as you have obtained a final demand letter from Medicare setting forth Medicare's entitlement. Separate checks can then be issued to Medicare on the one hand, and the plaintiff and plaintiff's attorney on the other.

Christopher Wigand is a trial attorney and partner with Winston & Clark, P.A. in Plantation, Florida. The majority of his practice involves handling cases for other attorneys who do not litigate. Mr. Wigand has devoted his career to helping injured individuals and families. He is always available to discuss a co-counsel arrangement or for direct client referrals. For more information on contacting Mr. Wigand please see his website at http://www.christopherwigandlaw.com.

Medicare Supplements and Medicare Advantage Plans Are Not the Same Thing

2010-11-03T14:20:00.000-07:00

Medicare Advantage Plans, are health plans from insurance companies that have a contract with CMS (Center for Medicare and Medicaid). Individuals who have Medicare Part A and B are eligible to choose a Medicare Advantage plan. Specialized plans exist for people with certain health conditions, but beyond that the general plans are not allowed to decline based on health except for very specific reasons.

When an individual is enrolled in the plan they do not lose their Medicare. They are entitled to cancel their Medicare Advantage plan, and the next month, they can go back to original Medicare. While enrolled in Medicare Advantage, they will have to use the insurance card provided by the Medicare Advantage plan instead of their Medicare card.

These plans may cost the participants nothing, or very little, though many still require the Part B participation amount. A Medicare Advantage plan is not free however. The plans receive a contribution from CMS every month, instead of having that tax money go to original Medicare. That is how the bulk of the plan is paid for, from tax money.

Traditionally, Medicare Advantage Plans were thought of as HMO plans were an insured person had to use the plan hospitals, doctors, and other medical providers to be covered. Many Medicare Advantage Plans are HMO plans. However, PPO Medicare Advantage plans also exist. Fee for Service Medicare Advantage Plans, or plans that will cover any medical providers who accept the insurance, are being marketed aggressively these days.

Your own medical needs and preferences will determine which plan will work out well for you. If your current medical providers contract with the plan's HMO, then you may be very satisfied with comprehensive coverage with very little extra payments. If you like more choice, and area doctors will accept a Free For Service plan then you might consider an "Any Doctor" plan. Be aware that not all doctors work with the Fee For Service plans, even though the insurance company claims it will work with any doctor! A great compromise is provided by PPO plans. You get the greatest coverage at the lowest price inside the network, but will still be covered by other medical providers.

Most, but not all, Medicare Advantage plans also contain Part D, or prescription drug coverage. Medicare Advantage plans may have very low, or no, premium for the insured people beyond their normal Part B premium. Some plans even refund the Part B premium. Also, Medicare Advantage Plans are not allowed to do a lot of risk selection based upon health, so they may be a good choice for less healthy applicants.

A traditional Medicare Supplement is very different from Medicare Advantage. With Medicare Supplements you still use your original Medicare Card, and add your Medicare Supplement health card. These plans are also provided by insurance companies, but they simply supplement the coverage gaps and deductibles not provided by original Medicare Part A and Part B.

If you have Medicare Part A and Part B, your Medicare supplement plan will pay the portion of your medical bill that Medicare will not pay. Of course, Medicare supplement plans differ, and so you need to be aware of exactly which portions a Medicare Supplement plan will pay before you sign up. For instance, Medicare may be 80% of your hospital bill, and your supplement will pick up the other 20%.

Medicare supplements come with premiums, and also may exclude unhealthy individuals. However, they generally provide the broadest access to health care.

Choosing a Medicare health plan can be one of the most important decisions a Medicare beneficiary will make. Let us help you find the right plan to fit your needs, lifestyle, and budget.

Compare Supplemental Medicare Health plans with simple online zip code searches

Medicare Part What?

2010-11-02T19:56:00.000-07:00

Are you confused by Medicare? If you are, you are not alone. When you first begin to learn about Medicare, you are confronted with a whole new set of information. There is Medicare Part A, Part B, Part C, Part D.

If that were not confusing enough, you can add Medicare Supplement insurance to your new knowledge base, and you have a whole new set of Parts (or at least plans). Medigap Plan A, Plan B, Plan C, all the way through Plan L. Now, in 2010, that whole structure is changing yet again.

An then, to add insult to injury, even if you learned how to decipher all of these Medicare Part something or others, you still need to have a basic knowledge of health insurance terms. Deductibles, co-insurnace, co-pays, etc. ad nauseam.

The truth is, if you are like most people newly qualifying for Medicare, you don't care about becoming an expert in Medicare, but you would like to know at least a little about the system that will cover you, perhaps for the rest of your life.

Following is a very simple primer, in which I give you everything you need to know and probably care to know.

Medicare Part A

Part A is the Medicare Part that pays for in-patient hospital expenses. The way I like to remember it is that it pays your expenses (A)fter you get (A)dmitted.

Medicare Part B

Part B is the Part of Medicare that pays for most out-patient expenses like visits to your doctor. The way I like to remember it is that it pays for your expenses (B)efore you get admitted to a hospital.

Medicare Part C

Part C is that Part of Medicare that insurance companies to manage your health care (instead of Original Medicare). You probably know someone who accesses their Medicare benefits via an HMO, or network. That person is most likely participating in a Medicare Advantage Plan (which is another word for Part C).

Medicare Part D

Part D is the Part of Medicare that provides insurance plans for your prescription medicines. This one is easy to remember also. Part D stands for (D)rugs.

I should note that you can't access Parts C & D directly from Medicare. As of this writing, you have to participate in these parts through a privately contracted insurance company.

For example, both Company ABC and Company XYZ offer Medicare Advantage Plans (Part C). You have to enroll with those companies to participate. Every company that offers these plans, is highly regulated and works closely with Medicare.

The same goes for Part D. Both Company ABC and Company XYZ offer Prescription Drug Plans. You have to get your drug coverage through a company that sells one of the plans.

Speaking of plans, what about all of those Medigap Plans? A,B,C,D,E, Etc.?

A Medicare Supplement Plan is also known as a Medigap Plan, because it "fills in the gaps" left by Original Medicare. Remember all of those insurance terms? Deductibles, Co-insurance, etc. These plans (also available only through private insurance companies) pay for some or all of your share of the cost. The plan letter, like "A" or "F" simply have to do with the level of coverage you desire.

So that is all for this primer. I have a 4 year old, and if he walks in any time soon, I am sure I will be tempted to sing that tune... "Now I said my ABC's, won't you sing along with me?"

Get help now with the Medicare Part that is confusing to you. Go now to: MedicareNational.com

At MedicareNational.com, our goal is to help you feel secure, save money and get the plan that is right for you. We Make Medicare... Easy!

A Guide to Medicare Coverage

2010-11-01T05:15:00.000-07:00

Signed into law by then-President Lyndon B. Johnson on July 30, 1965, Medicare coverage began as a social insurance program for American citizens age 65 or older. Today Medicare also covers citizens who may not be 65 years old but demonstrate need. Those suffering with Lou Gehrig's Disease, in need of a kidney transplant or have been receiving Social Security benefits for at least 24 months are all examples of people who qualify for Medicare.

Originally, Medicare coverage applied only to Hospital Insurance (known as Part A) and Medical Insurance (Part B). Former President Harry S. Truman was the first recipient of an official Medicare card, which then rarely entitled the holder to prescription drug coverage. As of early 2006, more comprehensive drug coverage was provided.

Medicare Part A

Part A of Medicare is Hospital Insurance, which will cover hospital stays, nursing home or assisted-living home care for a period of time. To receive the benefits of Medicare Part A, there are four main criteria that must be met, the first of which addresses only hospital visits:

The hospital stay must be a minimum of three days and three midnights, not including the day you are discharged
A nursing-home stay is covered only if the problem is diagnosed during the hospital visit outlined above. For example, if a respiratory issue sent you to the hospital, Medicare would cover a nursing home stay to help rehabilitate your lungs.
If you don't need rehabilitation at a nursing home but have an ailment that requires constant medical assistance or supervision, the stay would be covered.
Those caring for you at the nursing home have to be skilled. Part A of Medicare does not cover long-term, unskilled or custodial care.
Regarding nursing-home stays, Medicare will only cover 100 days per ailment. The first 20 days are paid for by Medicare in full; the next 80 days require a copayment of $128 per day (as of 2008). Whenever you go 60 days without using Medicare to help pay for a nursing home stay, the 100-day clock is reset and you qualify for a new 100 day period.

Medicare Part B

Part B of Medicare deals with Medical Insurance. This section covers most outpatient services and medically necessary products that Part A leaves untouched. Everything from doctor's visits to immnuosuppressive drugs for organ-transplant recipients are covered by Part B, including limited ambulance transportation.

In addition to outpatient doctor's services and treatments like chemotherapy, Part B helps you to pay for durable medical equipment (DME). Examples of DME include mobility scooters, prosthetic limbs, canes and oxygen.

Medicare Part C

Part C of Medicare deals with Medicare Advantage plans. After the Balanced Budget Act of 1997 passed, Medicare recipients were given the choice to either keep their original Medicare plan (Parts A and B) or receive their benefits through a private health insurance plan. After the Medicare Prescription Drug, Improvement and Modernization Act was enacted in 2003, those using private health insurance through Part C became known as Medicare Advantage (MA) recipients.

If you choose Medicare Advantage, Medicare will pay a set amount each month toward private health insurance. You're required to pay any additional premiums, and in many cases you'll have to pay a fixed copayment amount (usually around $10 or $20) each time you see a doctor. By law, the private insurance company you choose must offer a benefit package that is at least as good as the one provided by Medicare Parts A and B.

Medicare Part D

Medicare Part D provides coverage for prescription drug plans and went into effect at the beginning of 2006. If you use Medicare Part A or B, you are eligible for Part D. If you're using an MA Plan, you can adjust your benefits to take advantage of Part D, in which case the overall plan becomes an MA-PD.

To get Medicare Part D, you need to enroll in a Prescription Drug Plan (PDP) or change your MA coverage to MA-PD. Costs and benefits vary between the different plans, and medications that you need may not be covered by all plans. Some drugs, such as cough suppressants, benzodiazepines and barbiturates, aren't covered at all.

To get the best Medicare Part D coverage at the best price, you should compile a list of your prescriptions and talk to your pharmacist, MA provider or a Medicare representative. You can get a head start by visiting http://formularyfinder.medicare.gov/formularyfinder/selectstate.asp, which provides a list of Medicare Part D options by state when you provide your prescriptions.

Costs

Each year that you work, 2.9% of your wages are taxed under the Federal Insurance Contributions Act (FICA) and applied to your future Medicaid coverage. This 2.9% is split between employers and employees. Those who are self-employed have to pay the full 2.9% on their own. There is no limit to the amount of your wages that must be paid to FICA tax.

Once you're eligible for Medicare, it works like private health insurance. Your care provider bills Medicare for expenses, and you make up any differences that aren't covered.

Medicare coverage is limited, and while it can provide some protection for routine expenses or a minor injury, such as a broken leg, it's not a solution for long-term care needs. For this reason, it's a good idea to look into supplemental coverage, known as Medigap, to cover additional costs. While the monthly premiums for Medigap insurance can be high, they're still far lower than the medical bills that pile up in the event of a catastrophic illness or if you need long-term care.

For more information on medicare, visit the career and money section of Life123.com.

Medicare Health Plan Options

2010-10-31T08:54:00.000-07:00

If you or someone you know is about to go on Medicare, you should know that you'll be able to choose how you receive your Medicare benefits including your prescription drug coverage. This brief article will explain some of the more popular options as well as give you specific phone numbers to call with you Medicare questions. Medicare health insurance is currently for people who are age 65 or older, under age 65 with certain disabilities, and at any age living with End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure requiring dialysis or a kidney transplant.

While Medicare covers a lot of different health care services and supplies, it does not cover all of the costs associated with your health care. There are "gaps" associated with Medicare that require the beneficiary to pay out of their pocket. These Medicare costs include coinsurance, copayments and deductibles. Depending on the Medicare health plan you choose, you'll have varying degrees of costs.

Medicare Health Plan Options

Original Medicare is managed by the Federal Government and provides Part A and Part B health coverage. Original Medicare pays for many of the health care services and costs associated with normal services and supplies. Original Medicare does not pay for all of your health care costs. It is important that you understand your coinsurance, copayments and deductible. These are called out-of-pocket costs, or also known as cost-sharing.

Many Medicare beneficiaries choose to buy a Medicare Supplement policy (a.k.a. Medigap Policy) to help fill these out-of-pocket costs. Before you can buy a Medicare Supplement policy, you'll generally have to have both Part A and Part B. A Medicare Supplement policy can only generally help you if you have Original Medicare. If enrolled in Original Medicare and you would like to have prescription drug coverage, you'll need to buy a seperate policy to cover your prescription drugs. These are simply called Medicare Prescription Drug Plans.

Medicare Advantage Plans are known as Part C. They are health plans that are similar to traditional HMO or PPO insurance plans. These plans are another way to get your Medicare benefits. These are plans that are approved by Medicare, but run by private insurance companies. You'll find that your out-of-pocket costs may be different in a Medicare Advantage Plan. Check to find out what your coinsurance, copayments and deductibles will be for any Medicare Advantage Plan by using the online comparison tool found at Medicare.gov.

Medicare Prescription Drug Coverage is also called Part D. Prescription drug coverage is available for everyone with Medicare. These prescription drug plans are run by private insurance companies and approved by Medicare. There is a separate premium associated with Part D plans. You have to enroll in the plan and pay the premiums to get Part D prescription drug coverage.

In the next article we'll explore Medicare Supplement insurance policies. These plans are specifically designed to cover the gaps in Original Medicare.

Michael D Coday II is a licensed insurance agent in Texas. He offers free medicare supplement quotes for Texas residents at his website. Find him online now: http://www.medigapmedicareinsurance.com

Understanding Medicare - Comparing Medicare Part B and Part D

2010-10-30T18:11:00.000-07:00

More than 40 million Americans are enrolled in the Medicare program, but not all of those Medicare beneficiaries have identical Medicare plans. Medicare programs can be designed to suit the particular needs of each Medicare beneficiary, which means that Medicare beneficiaries need to take time to understand the differences between major Medicare options so that they can ensure they select their best plans for their needs.

Medicare Part B and Medicare Part D are popular Medicare options that beneficiaries can select. However, unlike some other Medicare plans, Medicare Plan B and Plan D can be combined together. Here is a basic overview of the major differences between Medicare Plan B and Medicare Plan D that every Medicare beneficiary needs to be aware of:

Coverage differences

Medicare Part B is the Medical coverage plan. Part B will cover the cost of doctor visits, home health care, and lab tests. Additionally, some medications and medical equipment is covered under Medicare Part B, including items such as diabetic test strips and wheelchairs.

Medicare Part D is the medications coverage plan. Part D pays for many medications that a Medicare subscriber takes on a regular basis. These medications may include drugs for diabetes, heart disease, and asthma. Additionally, some short-term medications may also be taken, such as an antibiotic.

Types of medications generally covered by each plan

Medicare Part B and Part D cover different types of medications, in many cases. Part B may cover the following types of medications:

- Allergy injections

- Blood products, such as plasma protein

- Hemophilia drugs

- Flu vaccines (when the vaccine is provided according to state law)

- Intra-articular injections, which may include Orthovisc, Synvisc, and Carticel

- IV flushes, including Heparin and Saline solutions

- Pneumonia vaccines ordered by a doctor

Part B may also cover a vaccine if the vaccine is required as a result of an injury. For example, if a Medicare Part B subscriber steps on a nail, the subscriber may be covered for a tetanus shot. Part B will cover inhaled nebulizer medications for beneficiaries who are not in a long-term care facility.

Part B will also cover immunosuppressive medications after a transplant as well as oral anticancer medications, Hepatitis B vaccines for high-risk individuals, oral anti-emetic medications used to treat nausea within 48 hours of chemotherapy that is related to cancer chemotherapy, total parenteral nutrition medications used to treat permanent dysfunction of the digestive tract, injectable medications administered at home that require an infusion pump, and more.

Medicare Part D may cover the following types of medications:

- Any medicine regularly taken by a Medicare beneficiary for chronic conditions.

- Medications subscribed for short-term medical conditions

Medicare Part D may cover a vaccine if the vaccine is prescribed by a doctor for reasons unrelated to injury. Part D will cover inhaled nebulizer medications for beneficiaries who are in a long-term care facility.

Part D will also cover immunosuppressive medications after a transplant as well as oral anticancer medications required for reasons other than cancer treatment, Hepatitis B vaccines, oral anti-emetic medications used to treat nausea that is related to cancer chemotherapy - after 48 hours of the chemotherapy or for other reasons, total parenteral nutrition medications required for reasons other than permanent dysfunction of the digestive tract, injectable medications not administered at home that do not require an infusion pump, and more.

Medicare beneficiaries should speak with a healthcare advisor for more information about what specific medications and treatments are covered by Medicare Part B and Medicare Part D. In many cases, Medicare beneficiaries can save money and ensure greater coverage by enrolling in Medicare Supplemental insurance policies or by adjusting their current Medicare policies to better suit their specific healthcare needs and budgets.

By Wiley Long - President, MedigapAdvisors.com - The nation's leading independent agency specializing in Medigap coverage. Our professional medigap advisors will help you choose the best Medigap plan for your needs.

How to Select the Right Medicare Plan

2010-10-29T19:15:00.000-07:00

Traditional Medicare

Medicare Advantage Plans

Medicare Part D

Comparing And Contrasting

It's no wonder that people are confused. There are thousands of plans available throughout the United States, and an average of 40 Medicare Advantage and Medicare Part D plans in any given area.