Medicare Advantage Plans & Medicare Supplement Plans

Medicare Advantage Plans & Medicare Supplement Plans
Medicare Advantage Plans
Showing posts with label Medicare Rx. Show all posts
Showing posts with label Medicare Rx. Show all posts

Wednesday, October 5, 2011

The twelve different types of Medicare Supplement policies

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.

Saturday, November 6, 2010

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

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.

Friday, October 29, 2010

How to Select the Right Medicare Plan


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.


Tuesday, October 26, 2010

SSDI & Medicare - A Beginner's Guide


Figuring out how the Social Security Disability Insurance (SSDI) and Medicare programs are related can be confusing to anyone who isn't currently enrolled in these programs. This article provides basic information on SSDI and Medicare eligibility and benefits. In addition, this guide will show you how to apply for and receive the right benefits for your situation.

Defining the Programs

SSDI is a payroll tax-funded, federal insurance program that was established in 1954. A portion of the FICA taxes taken out of your paycheck are set aside for this disability insurance program, which provides monthly income to people who are unable to work due to a severe disability.

Medicare is another federal insurance program, but is health insurance instead of disability insurance. It is available to all individuals age 65 and older as well as those who have been receiving SSDI cash benefits for 24 months. The program is made up of many parts - Medicare Part A consists of hospital benefits; Medicare Part B is medical benefits; Medicare Part C (Medicare Advantage) provides extra coverage and is provided by private insurance companies; and Medicare Part D is voluntary prescription drug coverage.

Determining Eligibility - How to See if You Are Entitled to Benefits

Eligibility for each program depends on several factors. For SSDI, there are three general qualifying criteria: 1) you must have worked and paid into the program (through your payroll taxes) for five of the last 10 years, 2) you also must have been disabled before reaching the full retirement age of 65-67, and 3) you must meet Social Security's definition of "disability." The Social Security Administration (SSA) has a process to determine who's eligible for benefits. By evaluating your income, limits of your disability, past job history and more, the SSA determines whether or not you're qualified to receive disability insurance.

There are several ways people can become eligible for Medicare. Anyone who turns 65 is automatically eligible for benefits. If you get Social Security retirement benefits or receive benefits from the Railroad Retirement Board (RRB), you will be considered eligible as well. Additionally, if you're awarded SSDI benefits for something other than Lou Gehrig's disease (ALS), you will become eligible for coverage 24 months after the date of entitlement to cash benefits. If you are awarded SSDI and have ALS, you will automatically be eligible for Medicare once you begin receiving SSDI benefits, and if you have kidney failure, you'll be able to enroll in Medicare three months after starting dialysis.

Specific Benefits You Can Receive

Social Security Disability Insurance allows you to receive a regular monthly income, results in eligibility for Medicare benefits (as explained earlier), and allows possible extension of your COBRA benefits, protects your retirement and long-term disability benefits, plus allows for dependent benefits and return-to-work incentives.

Medicare has many parts to cover specific healthcare costs. Medicare Part A covers inpatient care in hospitals and provides patients with a stay in a semi-private room, complete with meals, general nursing, and drugs. Part A also covers the cost of a blood transfusion if the hospital must purchase blood for you, up to 100 days per each benefit period in a skilled nursing facility, and hospice care for those with a life expectancy of six months or less due to a terminal illness. Part A coverage costs nothing, except for your deductibles or copayments, and coverage gaps must be paid by you or covered by other insurance.

Medicare Part B covers doctors' visits and services, outpatient care, rehabilitative care under a physical therapist, occupational therapist, or speech-language pathologist, and some preventative services like flu shots and mammograms. The monthly cost (or premium) for Part B coverage is tied to your annual income and adjusted each year. Most will pay the standard Part B premium of $96.40 per month in 2009 (if your annual income is not more than $85,000 as a single taxpayer or $170,000 if filing a joint tax return).

Medicare Advantage (Part C) plans at a minimum cover everything offered by traditional Medicare (Parts A and B). They also may offer additional benefits not covered by traditional Medicare like dental care, vision screening, prescription drugs and other services that would otherwise need to be provided under a supplemental insurance policy (Medigap).

Your out-of-pocket costs are likely to be less with a Medicare Advantage plan than if you use traditional Medicare and a Medigap policy. Everyone in a Medicare Advantage plan pays at least the same monthly premium as those enrolled in Medicare Part B. Your premiums may cost more depending on the benefits provided by the plan.

Medicare Part D (prescription drug coverage) provides brand-name and generic prescription drug coverage. These plans are provided by private companies that are approved by Medicare. Part D coverage is optional and available to those enrolled in traditional Medicare (Parts A and B) or Medicare Advantage plans that don't offer prescription drug coverage. Costs, extra benefits and details vary by plan.

Work With a SSDI & Medicare Advisor Service to Maximize Your Benefits

Don't stay confused trying to figure out the complex rules of these programs on your own - let those who understand it best help you maximize your benefits. Medicare & SSDI programs can be confusing with all of the different program requirements and eligibility criterion. Working with an SSDI expert and Medicare Advisor Service can help you determine the best coverage for your specific needs to ensure you get all of the benefits you are entitled to receive.








Jim Allsup writes for Allsup, a nationwide provider of Social Security Disability, Medicare and workers' compensation services for individuals, employers and insurance carriers. Allsup provides a Medicare Advisor service to help you select the Medicare plans that are right for you.


Sunday, October 24, 2010

Medicare Coverage For Home Care and Skilled Nursing Care


One of the biggest myths about Medicare is that it pays for long-term care. It doesn't. Medicare covers only limited periods of inpatient care in a skilled nursing facility, and skilled nursing care and therapy at home, under strict guidelines. Still, Medicare's coverage of these services can be vital if the person you're caring for has just been hospitalized or has otherwise suffered a serious medical event. Medicare can pay for costly short-term, intensive rehabilitation, which in turn can give you a chance to arrange for longer-term care if it's needed.Medicare coverage of inpatient care in a skilled nursing facility is a standard part of Medicare Part A. Someone already enrolled in Part A doesn't have to do any special paperwork to receive nursing-facility coverage.Skilled care at home can be covered by either Medicare Part A or Medicare Part B, under slightly different rules. Persons enrolled in either Part A or Part B can receive coverage for skilled home care without any additional Medicare enrollment.

"Nursing home" or "nursing facility" can refer to different levels of inpatient care in different types of places, including rest homes, nursing homes, board-and-care homes, assisted-living facilities, congregate living homes, and sheltered care homes. All of these provide what is called custodial care, which is long-term residence and nonmedical assistance with the activities of daily living -- such as bathing, eating, walking, and dressing -- for people who don't have acute medical conditions but who are no longer able to care for themselves completely. This type of custodial long-term care is not covered by Medicare.At the other end of the spectrum is a much higher level of inpatient medical care, referred to as skilled nursing or rehabilitation care. Under certain circumstances, Medicare Part A covers this skilled care for a limited time while a patient is recovering from a serious illness, condition, or injury. This care is usually provided in the nursing-facility wing of a hospital, in a separate skilled nursing facility, or in the skilled nursing part of a "multilevel" nursing or rehabilitation facility.

In order for someone to receive Medicare Part A coverage for inpatient nursing-facility care, a number of different conditions have to be met:



Prior hospital stay: A patient's stay in a nursing or rehabilitation facility has to begin within 30 days of an inpatient hospital stay of at least three days.


Need for daily skilled nursing or rehabilitation: Medicare covers an inpatient nursing-facility stay only if the person needs, and his or her physician prescribes, daily skilled nursing care or physical rehabilitation. For someone who needs skilled care but doesn't need it every day, Medicare will not cover an inpatient stay; instead, Medicare might cover home care.

Medicare-approved facility: For Medicare to cover inpatient skilled nursing or rehabilitation care, the care must be received in a facility that Medicare has certified for that purpose.

Improving condition: Medicare covers inpatient skilled nursing care only as long as the patient's condition is improving. Once Medicare, the patient's doctor, and the facility have determined that his or her condition has stabilized, Medicare will no longer cover inpatient care.

If, and as long as, a patient meets the qualifying conditions described above, Medicare will pay a limited amount for inpatient nursing-facility care.For the first 20 days in the facility, Medicare pays all covered charges -- excluding only items like a telephone or television or a private room if not medically necessary.For days 21 to 100 in a nursing facility during any one benefit period, Medicare no longer pays any of the cost.

If a patient needs skilled nursing or rehabilitation care at home, either Medicare Part A (following a minimum three-day hospital stay) or Part B (no hospital-stay requirement) can cover it. The care may be provided in the patient's home or anywhere else he or she stays. If a patient meets the requirements to qualify for home care (see "How does someone qualify for Medicare coverage of at-home care?" below), Medicare can cover skilled nursing care and physical and speech therapy as needed while the patient recovers from an illness, condition, or injury. Medicare also covers needed medical supplies and equipment.Medicare doesn't generally cover nonmedical at-home care and assistance, including meals and housekeeping. However, if a patient is getting Medicare coverage for skilled nursing or therapy at home, Medicare generallys pays for limited visits by an aide from a home care agency to help him or her with personal care. If Medicare covers skilled care for the patient, it can also cover the services of an occupational therapist to help him or her relearn how to accomplish daily personal care and household tasks safely.

For Medicare Part A or Part B to cover a patient's at-home care, several conditions have to be met:



Need for part-time skilled care: The patient must have a medical need for, and his or her doctor must prescribe, skilled nursing care or rehabilitative physical or speech therapy. The care must be needed part-time only, to help recover from a specific illness, injury, or acute condition. If, instead, the patient needs care because of a long-term condition or general frailty, Medicare will not cover it. Nor will Medicare cover full-time or daily care.

Confinement to home: Medicare covers at-home care only if and for as long as the patient is "confined to home." This means that he or she is unable to leave home without difficulty and with the assistance of another person or a medical device such as a wheelchair. However, it doesn't necessarily mean bedridden.

Recovery period: At-home care is covered only while the patient is actively recovering, which means while his or her condition is improving. Once a patient's condition has stabilized, as determined by his or her physician, the home care agency, and Medicare, coverage ends.

Medicare-approved agency: Medicare only covers home care provided by a Medicare-certified home healthcare agency. Unfortunately, this leaves out registry nurses, private therapists, and independent caregivers.

If a patient qualifies for coverage of at-home care, Medicare pays the full amount of the home care agency's charges, except for the rental cost of durable medical equipment such as a wheelchair or hospital bed (for which Medicare pays 80 percent). Sometimes, a patient's medigap insurance policy will pick up this extra 20 percent; otherwise, patients have to pay for it personally. The home care agency is not allowed to bill patients for any amount above the Medicare-approved charges.Medicare doesn't put any specific limit on the number of home care visits it will cover, nor on the total number of days patients can be served by the home healthcare agency. But coverage will continue only as long as they meet all of the qualifying conditions for coverage. A patient's condition and needs are regularly evaluated by the agency and by Medicare itself to determine how long the agency's care is medically needed and thus how long Medicare will keep paying.

If the person you're caring for is in the hospital and you're looking for answers about follow-up nursing-facility or home care, contact the hospital's discharge planner, who arranges both of these types of care, or the hospital ombudsman, who is trained in Medicare issues and helps patients understand them.Even if he or she isn't currently in the hospital, you can get information about nursing-facility and home care coverage directly from Medicare's website or by calling (800) 633-4227. If he or she has been referred to a particular nursing facility or home care agency, the intake administrator for that service can also help with Medicare-related questions or problems.








http://www.caring.com/articles/medicare-home-care

[http://www.caring.com/articles/medicare-coverage-for-skilled-nursing]


Wednesday, September 1, 2010

Medicare Part D Drug Coverage Explained For the Newbie

Medicare Part D provides some coverage for the cost of prescription medication on behalf of eligible dependents enrolled into the program. A familiarity of the basic concept will help make an educated and intelligent decision before purchasing the benefit which is after all offered through private insurance carriers. This article was created for those considering coverage and is intended to provide a conceptually easy way of understanding exactly what it can do for you.

Who is eligible.

If you are entitled to Medicare Part A or are enrolled in Medicare Part B, you may join a Medicare Part D prescription drug plan. Participation is voluntary for most people. However, if you receive benefits through Medicaid you are automatically enrolled in a Part D plan in order to continue receiving prescription coverage.

Who Administers The Program?

Medicare operates the overall program, but you must choose one of the specific Part D drug plans offered by private insurance companies in your state. It is ultimately your decision to enroll directly with the carrier.

What Is The Cost For Participation?

Most people pay a monthly premium to the insurer. Premium dollar amounts may range $0.00 through $50.00 per month depending on the plans available within your geographic area and also on the particular level of benefits chosen.

What Is The Coverage?

All plans cover some, but not all, prescription drugs in every category of medication. Each plan has its formulary list in which consist of the specific prescriptions covered. The plan will pay its share only for drugs listed and purchased from a pharmacy or other distributor that participates in that plan.

How Much Is The Reimbursement or The Amount The Plan Pays?

For Basic Part D coverage there are four payment allocations which comprise of deductibles, partial coverage, coverage gaps, and catastrophic coverage.

Deductible: You pay for the first $295.00 per year of the total cost of your drugs. A few high premium plans waive this deductible.

Partial Coverage: Once your total yearly drug expenses reaches $295.00 and before it reaches $2,700.00, the plan pays 75% or you pay 25% of your drug cost. Your portion comes in the form of a copayment for each prescription. Your copayment may be higher for brand name drugs, or less for generics, depending on your plan.

Coverage Gap: more commonly referred to as "The Doughnut Hole". Once your total yearly drug expenses reaches the threshold of it's maximum allowable which is $2,700.00, you must pay the entire amount of your drug cost. Your plan generally pays no part of your prescription drug cost within this doughnut hole, although a few high premium plans may pay some portion of your cost.

Choosing The Right Plan.

Not all plans are alike, and choosing the best plan for you involves several steps. You must get the most comprehensive possible coverage of the drugs you take, with fewest restrictions on availability. You must also accomplish this means with the lowest overall out of pocket cost to you. This does not necessarily mean the lowest premiums or deductibles. Choosing the right plan can be a difficult and cumbersome endeavor, if you need assistance in this regard, please visit our website at http://www.health-insurance-buyer.com and leave your contact information so one of our licensed insurance agents can help you with a no hassle quote and free consultation.

Carlos Diez is a senior benefits consultant for Health Insurance Buyer a referral service that refers consumers to the insurance carriers that can best fit their wants and needs. He holds life, health, and annuity licenses in 48 states and is appointed with over 88 carriers. For contact information please reach him at http://www.health-insurance-buyer.com/

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Monday, August 9, 2010

Medicaid and Medicare Beneficiaries Advantage Plan Options

If you are enrolled in both Medicaid and Medicare, you are considered to be a dual eligible individual. Your health benefits are coordinated between Medicare and your State's Medicaid program. It is important to know that, as a dual eligible individual, you have some choice when deciding on a Medicare Plan.

There are Special Needs Medicare Plans available for certain categories of individuals, including those that have both Medicaid and Medicare. A special Needs Medicare Plan is a type of Medicare Advantage Plan that is offered by a private insurance company. Insurance companies that offer Medicare Advantage Plans contract with and are approved by CMS (Centers for Medicare and Medicaid Services) to administer your Medicare Plan.

There are three types of Special Needs Plans (SNP)

Dual eligible Special Needs Plans for those with both Medicaid and MedicareChronic Illness Special Needs Plans for those with qualifying chronic illnesses.Institutional Special Needs Plans for those confined to a nursing home.

Part D Medicare Drug Plans are included in all Special Needs Plans. If you are dual eligible and have both Medicaid and Medicare, your co-payments will be subsidized and the Medicare Drug Plans generally will not require a monthly premium. In general, if you are enrolled in both Medicaid and Medicare, you will not pay a premium for your Special Needs Medicare Advantage Plan.

But if you have both Medicaid and Medicare, and Medicaid only allows for partial benefits, you may want to discuss your Medicaid status with your insurance agent to make sure a special Needs Plan is right for you.

The benefits of choosing a Dual Eligible Special Needs Plan

If you have both Medicaid and Medicare, a SNP may allow you more benefits than what you would otherwise have. Many include dental, vision, gym memberships, as well as transportation benefits to and from medical appointments.SNPs for those with both Medicaid and Medicare are generally network-based plans and may afford you some provider options that you otherwise may not have available.If you qualify, you are not subject to the enrollment periods that limit most people who would like to enroll in or change Medicare Plans.Part D drug plans are included in the SNP and you will only have to interact with one customer service department, should it be required.

Medicare Advantage Plans generally offer benefits beyond what original Medicare offers. As a dual eligible individual, you have the right to explore your options. Enrolling in a Special Needs Plan for people with both Medicaid and Medicare may give you more freedom of choice and some benefits you would otherwise not have available.

David Forbes is President of Alliance Marketing Associates, Inc. David offers helpful advice on topics related to insurance for seniors, including finding an affordable Medicare Plan.

Sign up for your Free Mini-Course on Medicare Plans at http://www.affordablemedicareplan.com/

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