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.

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

There are certain Medicare supplement policies, commonly referred to as Medigap, which are sold to Medicare beneficiaries who are already enrolled in Medicare or Medicare Advantage plans. These Medicare supplement plans help cover the "gap" or pay for expenses that Medicare does not include. Medicare supplement policies are private insurance plans that help pay expenses, such as deductibles, co-payments, or prescription drug costs.

Medicare beneficiaries can purchase Medigap, or Medicare supplement policies, on the open health insurance market. At this time, many seniors do not purchase Medicare supplement plans and only rely on Medicare or Medicare Advantage plans. The premium costs for Medicare supplement policies vary based on geography, type of plan, age and health condition. Therefore, purchasing Medicare supplement plan right when you turn 65 is probably a good idea, because th at is when you are the healthiest and youngest and eligible for Medigap coverage. If you purchase a Medicare supplement policy later on, you may have to pay a really high premium.

There are standardized Medicare supplement policies, which are government-regulated to include specific benefits so that individuals can compare the policies easily. However, each health insurance provider can set their own prices for their Medicare supplement policies. That is why it is important to do some comparison shopping between insurance providers.

Medicare Supplemental Policies

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.

How Medicare Part D Helps You Pay For Your Mediation

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.

Medicare Supplement Plans And Open Enrollment

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?

Medicare Part D Prescription Drug Plans

Medicare Part D: What is it?

Medicare's prescription drug program was created as a result of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA). Although the Act was written into law in 2003, Medicare eligible individuals did not start enrollment into these plans until January 1, 2006. This plan is commonly referred as PDP (Prescription Drug Plan) or simply Part D.

Part D is available to everyone who has Medicare regardless of income or health history. Private insurance companies provide the coverage. The enrollees select a plan from those available in their geographic region and pay the insurer a monthly premium for the coverage. Even though enrollment is voluntary there is a penalty for late enrollment which will be discussed a bit later in this article.

You can elect to enroll in a Medicare Prescription Drug plan in one of two ways:

(1) Stand along prescription drug plans (PDP); or

(2) Medicare Advantage Prescription plans (MA-PD).

The first type of plan covers prescription drug benefits only. These plans were designed for people who choose to stay with traditional fee for service Medicare and need the prescription drug coverage along with a Medicare supplement to round out their medical coverage. Most States have several carriers who offer this coverage on a free standing basis. The plans do vary in areas of monthly premiums, deductibles, copays, formularies, and other cost sharing arrangements.

Medicare Advantage plans, the second broad category of prescription drug plans, not only cover medications but also Medicare approved medical services. These plans are available through private insurers and include HMO, PPO, and Private-Fee-for-Service programs. In the case of Medicare Advantage Plans, the Medicare beneficiary has actually "traded" their traditional Medicare benefits for a Medicare Advantage program. Medicare Advantage plans sometimes provide enrollees wish additional benefits. However, there are frequently restrictions on the doctors and hospitals that they may use for covered medical services.

Enrolling in a Plan

Generally speaking, an individual may enroll in a Prescription Drug Plan during their initial open enrollment period when they first qualify for Medicare Part B. For someone turning age 65, this would be the three months prior to their birthday month, the month of their birthday, and the three months following their birthday month. After, their initial enrollment period (IEP), there is an annual open enrollment period (AEP) when they can change plans. Historically, the annual open enrollment period commences on November 15th and closes on December 31st with enrollments effective the following January 1st. There are other special enrollment periods available to medicare beneficiaries such as when they relocate or leave employer sponsored plans.

For the 2011 plan year, the annual open enrollment period will commence a bit earlier and end prior to the holidays to avoid confusion over deadlines in past years.

The "Standard" Prescription Drug Plan

All of the insurers that participate in the PDP program must offer at least the Standard plan of coverage. Monthly premiums will vary from State to State. However, the average premium for 2010 is expected to be $46.58. The plan deductible for 2010 is $310.

After you pay the yearly deductible, you pay the following amounts for the remainder of 2010,

- 25% of the cost of drugs after the $310 annual deductible until total charges reach $2830

(the plan pays the other 75% of charges); then

- 100% of the next $3610 in total drug charges (often called the donut hole or coverage

gap); then

- 5% of your drug charges or a copay of $2.50 for generic medications or $6.30 whichever is lesser; for the rest of the calendar year after you have spent a total of $4550 out of pocket.

Even though, at a minimum, an insurer must provide a Standard plan, they are permitted to offer plans that do differ in benefits. These other plans usually do away with the deductibles and impose fixed dollar copays for covered medications instead percentage copays. Some of these other plans even cover generic mediations in the "donut hole."

The Late Enrollment Penalty

If you do not have "creditable coverage" from another source, such as an employer plan or the Veterans Administration, and do not sign up for a Medicare prescription drug plan when first eligible, you will, in all likelihood, be charged a penalty for late enrollment. The penalty is based on the number of months that have elapsed since you were first eligible to enroll and when you finally do enroll. A penalty of 1% per month will be levied and that penalty will last for as long as your remain enrolled in a plan. The penalty is based on the average cost of a plan in the year that you finally enroll. For example, if 50 months have elapsed since you were eligible to enroll and the national average cost for a plan in that year was $50, the cost for your plan would be $75- (1.50 times $50). Again, this penalty would be assessed each year into the future for as long as you remain enrolled in a plan.

Financial Help for Those of Modest Means

The Social Security Administration has a program available for those with qualifying incomes called Extra Help. Extra Help can save qualifying individuals as much as $3900 per year. Extra Help can assist with premiums, paying deductibles and copays associated with a Medicare prescription drug plan. To qualify for Extra Help, an individual must be enrolled in a Part D prescription drug plan and for 2010; resouces must be limited to $12,510 for an individual or $25,010 for a married couple. Resources would include things like bank accounts, stocks, bonds, and mutual funds. Houses, cars, life insurance cash values, and money received from relatives or others to pay household expenses do not count as resources. Some individuals with higher annual income may qualify for the Extra Help program. To inquire if you qualify, you can contact the Social Security Administration at 800-772-1213 or visit your local Social Security office.

Using Information Sources To Choose a Plan

There are a number of useful sources to help you learn about the PDP plans available to and help you compare so that you can select the plan that works best for you.

Medicare's Medicare & You 2010 Handbook available at http://www.medicare.gov is an excellent source of information. The handbook lists plans in your area and basic information about cost and plans benefits.

State Health Insurance Assistance Programs and Community Organizations quite are excellent places to find help.

Also, do not forgot your local Medicare certified health insurance agent. Should you or your parents need assistance in selecting a Medicare prescription drug plan, please feel free to contact us at 818-597-2890.

Edward Walden, CLU, RHU, REBC

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]

Medicare and Medicare Insurance - A Beginner's Guide to Understanding the Parts of Medicare

Turning 65 or going on Medicare for the first time can be an overwhelming experience in one's life. Coupled with that, most make an attempt, sometimes futile, to understand the complex world of Medicare and Medicare insurance. This article is to serve as a primer of the "parts" of Medicare, of which there are currently four, and what they do.

Part A

Part A is the part of Medicare that everyone gets from paying into the social security system during their working life (as long as they meet the minimum work amount requirements). The primary thing that it covers as inpatient hospital care, and you will sometimes here it referred to as the "hospital" part of Medicare. However, it does also cover skilled nursing facility care, home health care and hospice facility care.

Part B

Medicare Part B is optional - most people who have employer coverage that works with Medicare coverage do not necessarily need Part B until or unless their employer coverage ends. Medicare Part B has a monthly premium associated with it, that is typically paid out of one's social security check.

Part B covers "services" primarily, and it is sometimes called the "doctor's office" part of Medicare. Some of the primary things that it covers include doctor's services, diagnostic tests, outpatient services and physical therapy and some preventive-type screenings.

Part C

Part C is the portion of Medicare that was created in the last 10 years. It is sometimes referred to as "privatized Medicare", but is primarily known as Medicare Advantage. In Part C, a private insurer that has a contract with the government takes over management of all of your Medicare benefits. Your benefits are all provided through this private insurer - you pay premiums directly to this company and they pay claims on your behalf.

This is an optional part of Medicare. You still have to pay the Part B premium and you do not altogether "lose" Part A and Part B, but Part C does provide your benefits in place of A & B. Also, you can not have (or do not need) a Medicare Supplement plan and Part C - most elect to either have one or the other. Supplements pay AFTER Medicare pays; Medicare Advantage pays INSTEAD of Medicare.

Part D

Part D is the part of Medicare that you may hear about the most. This is the portion of the Medicare program that covers prescription drugs. It is offered through private companies, which must be certified and approved by the Centers for Medicare & Medicaid Services on an annual basis to offer this prescription coverage (Part D).

You pay premiums directly to the private companies, although most offer the ability to deduct it automatically from your Social Security check. This is an optional part of Medicare - not everyone signs up for it when they are first eligible or at all.

Secure Medicare Solutions is a leading, independent resource for South Carolina Medicare Supplement insurance and South Carolina Medicare Insurance. Our web site contains a bevy of resources for those Turning 65, including information about South Carolina Medicare Supplements.

Medicare Complete - Is it a Medicare Supplement Or Medicare Advantage Plan?

If you watch TV, you probably have seen one or more advertisements for Medicare plans. Many of these plans are offered by United Health Care. They offer Medicare supplements, also known as Medigap, and Medicare Advantage Plans. But which type of plan is Medicare Complete?

Many people refer to all Medicare plans offered by private insurance companies as supplements. But this is not the case. Medicare supplements and Medicare Advantage Plans are two distinct types of plans. This misunderstanding leaves people confused about Medicare Complete. Before we unravel the mystery of Medicare Complete, let's take a look at the difference between a supplement and an Advantage plan.

Medicare supplement - A supplement or Medigap insurance is an insurance policy that is offered by a private insurance company to fill the gaps left by Medicare. When Medicare was enacted in 1966, it was not meant to be totally comprehensive coverage. The beneficiary is responsible for a certain level of cost sharing. In general terms, the beneficiary is responsible for a hospital deductible, co-pays after extended hospital stays and 20% of outpatient expenses.

Medicare Advantage Plan - An Advantage Plan is also offered by a private insurance company, but instead of filling the gaps left by Medicare, the Advantage Plan is another way to receive your Medicare benefits. Insurance companies contract with and are approved by CMS (Centers for Medicare and Medicaid Services) to administer your Medicare. Plans are required to meet certain criteria, and in many cases offer benefits beyond conventional Medicare. You may still have cost sharing, but it is in the form of deductibles, co-pays and co-insurance. Plans typically include a maximum out-of-pocket expense. Advantage Plans often include Part D prescription drug coverage.

Setting the record straight. Medicare Complete is a Medicare Advantage Plan. Offered in some service areas as a PPO and offered in others as a HMO, Medicare Complete does not fill the gaps left by Medicare, but rather is an Advantage Plan with predetermined out-of-pockets costs. Unlike a standardized supplement, Medicare Complete may have varying levels of coverage and benefits depending on the plan's service area. You may have a regional PPO plan available in your County, while someone in a neighboring County may have Medicare Complete available as a HMO plan.

If you are looking for a plan that includes Part D drug coverage and a low monthly cost, then you may want to take a look at Medicare Complete when you are comparing Medicare Advantage Plans. If on the other hand, you don't mind a higher monthly premium and are looking for a plan that will fill the gaps left by Medicare, you may want to consider a Medicare supplement.

Determining if Medicare Complete is right for you.

Here are some things to consider when determining whether Medicare Complete is the best plan for your needs.

Is the plan affordable? This means affordable, not only as far as any premium that may be required (there may not be one!), but also the amount of cost sharing that may be required to use the plan.
Do you feel comfortable with the plan's provider network? In many service areas Medicare Complete has a strong network, but you need to investigate this for yourself.
Does the plan offer as many extra benefits as other Advantage Plans that may be available to you? Many plans offer dental, vision, hearing and in many cases the Silver Sneakers program.
Do you feel that the maximum amount out-of-pocket that you could incur is reasonable compared to paying a higher monthly premium for a supplement? If the maximum annual amount is high and you have several costly health conditions, you may want to consider whether a supplement would be a better option.

Choosing a Medicare Advantage Plan is an important decision, but armed with the right information, it does not need to be overwhelming. Now that you know that Medicare Complete is an Advantage Plan, it is up to you to do your homework and determine if the plan is right for you.

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/

Medicare Supplement Insurance Helps With Expenses Not Covered by Medicare

Just when you are ready to relax and enjoy retirement, you realize that medical insurance has become even more complicated. You're presented with Medicare Advantage Insurance, Medicare Supplement Insurance (also called Medigap Insurance), and Medicare Part A, B, and D. What's it all mean?

Let's Start at the Beginning

Medicare is divided into four parts. Part A deals with home health care, hospice, hospital, and skilled nursing care. Part B handles doctors' services, other medical services, and supplies not covered by Part A. Part C allows you to receive Medicare benefits through private health insurance (Medicare Advantage Insurance) in place of Parts A and B. Part D provides prescription drug coverage.

What Is Medicare Advantage Insurance?

With a Medicare Advantage Plan, generally all of your Medicare-covered health care is provided through that plan, which can include prescription drug coverage. These plans may offer more benefits, and lower co-payments than Medicare Part A and B.

Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), private Fee-for-Service Plans, and Medicare Special Needs Plans.

Private Fee-For-Service plans are offered by state-licensed risk-bearing entities with yearly contracts to provide Medicare benefits. They may also offer additional benefits, and do not usually require you to use a network of providers.

Special Needs Plans focus on certain vulnerable groups, such as those who are institutionalized, are dual-eligible, and/or have severe or disabling chronic conditions.

What Are HMOs?

Doctors, hospitals, and insurers participate in HMOs, which provide medical treatment on a prepaid basis. HMO members pay a fixed monthly fee regardless of how much care is needed in a given month. Most HMOs provide a wide variety of services, but members must usually obtain medical treatment from in-network facilities and physicians.

With HMOs, you must see a primary care physician before you can see a specialist. Rather than paying a percentage of the bill every time you receive medical care, you pay a fixed monthly fee, and HMOs often have nominal co-payments rather than deductibles. HMOs generally do not limit lifetime benefits, but will not pay for non-emergency care from a non-HMO physician.

What Are PPOs?

PPOs are made up of doctors and/or hospitals that provide medical services only to a specific group or association at discounted rates. PPO members pay for services as they are rendered, and are generally reimbursed for treatment costs minus co-payment percentages. Physicians may submit bills directly to insurance companies so members pay only a co-payment.

PPO members are not required to seek care from PPO physicians, but members may receive 90-percent reimbursement for in-network care as opposed to 60 percent for non-network treatment. PPOs may also require a deductible. You may have to fill out paperwork for reimbursement, and most PPOs have larger co-payments than HMOs.

You must have Medicare Part A and B to join a Medicare Advantage Plan. You will have to pay a monthly Part B premium, and may also have a monthly premium for the Medicare Advantage Plan for the extra benefits it offers.

When you join a Medicare Advantage Plan, your Medicare Supplement Insurance or Medigap Insurance will not pay co-payments, deductibles, or other cost sharing under your Medicare Health Plan.

What Is Medigap Insurance?

If you do not have a Medicare Advantage Plan, Medigap Insurance can cover expenses that Medicare does not cover. When you have Medicare and a Medigap policy, both pay their share of covered health care costs.

Medigap policies must have standardized benefits, but costs can vary. You may be able to choose up to 12 different Medigap policies (Plans A through L), which have different sets of basic and extra benefits. The benefits of any Medigap Plan (A through L) are the same for every insurance company, and companies choose which policies to offer.

Generally, you must have Medicare Part A and B to buy Medigap Insurance. You will pay a monthly Part B premium, and a premium for the Medigap policy. Medigap Insurance will not cover your spouse, so you both need separate policies.

With some basic insight into how Medicare works, you can select the Medicare Advantage Insurance or Medicare Supplement Insurance that best fits your needs. If you have questions, expert advisors are available online to answer questions, and explain terms. These types of plans can make your retirement more secure so take advantage of sources that can answer your questions before you need Medicare.

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.

Medicare Disability Benefits Are More Comprehensive When You Enroll in a Medicare Advantage Plan

Medicare benefits are available for people under 65 due to a disability or ESRD (end stage renal disease). If you or someone you know is eligible for Medicare benefits due to a disability, you will have the same benefits as a Medicare beneficiary who is over 65. That is the good news. The bad news is, you may not have as many options for supplemental coverage as the person over 65.

Generally, when you turn 65 and enroll in Medicare, you have three options.

Enroll in Medicare and pay out-of-pocket for the portion of charges that Medicare does not cover.
Purchase a Medicare supplement (Medigap policy) during your open enrollment period.
Enroll in a Medicare Advantage plan that may even include the Part D Medicare drug coverage.

If you are receiving Medicare disability benefits, you can choose the first option and pay the out-of-pocket charges that Medicare does not cover. This will include a hospital deductible, hospital co-pays for extended stays and 20% of the charges for outpatient services. This can be a slippery slope. You are more than likely on a fixed income of SSI and the gaps in Medicare can be unpredictable and potentially financially devastating. Due to the nature of your Medicare eligibility, a qualifying disability, your health care costs may be higher than someone becoming eligible due to turning 65.

The second option, purchasing a Medicare supplement, may not even be available to you. Federal law does not currently require insurance companies to sell you a Medicare supplement if you are younger than 65. Although, some States require companies to do so, it generally means that you will pay a much higher premium than someone who is 65.

A Medicare Advantage plan is available to all beneficiaries, including those receiving Medicare disability benefits. If you have both parts A and B of Medicare, live in the plans service area and do not have ESRD, you are allowed to enroll in a Medicare Advantage plan.

These are the benefits of an Advantage plan for those receiving Medicare disability benefits.

An Advantage plan offers the certainty of fixed costs, including; co-pays, co-insurance and deductibles. The uncertainty of outpatient costs (20%) are eliminated with co-pays and co-insurance.
The premium (if required) is usually a fraction of the premium for a Medicare supplement.
The Part D Medicare drug plan is often included.
Advantage plans often include benefits beyond what Medicare includes. Extras can include dental, vision, hearing, gym memberships, discounts on alternative health services and transportation to and from medical appointments.
A Special Needs Plan may be available for qualifying chronic conditions. These plans include a comprehensive level of managed care related to your health condition.

An Advantage plan can give you a more comprehensive health plan than Medicare alone while costing considerably less than a Medicare supplement. When you compare the choices available to you, it is easy to see that a Medicare Advantage plan has a great deal to offer you if you are receiving Medicare disability benefits.

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/

Senate Republicans Examining Health Reform's Effect On Medicare Advantage

Topics: Delivery of Care, Medicare, Politics, Health Reform

Sep 27, 2010

The Hill: "A quartet of Senate Republicans is calling on Medicare's top accountant to release the numbers behind his analysis of health reform's impact on the Medicare Advantage (MA) program. The lawmakers ... say the steep cuts to MA under the new reform law will cause many plans to fold, while many others will be forced to drop benefits to remain profitable. In April, Richard Foster, chief actuary at the Centers for Medicare and Medicaid Services (CMS), issued a report that largely supported those claims.  … The letter [to Foster] arrived just a few days after the Obama administration announced that enrollment in MA plans is projected to jump 5 percent next year, while average premiums will fall by 1 percent. Those figures, CMS officials said, belie the charges that the new law will cut benefits and hike costs" (Lillis, 9/27). 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.

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Turning 65 - What About Medicare?

Once a person reaches the age of availability for medicare they have many questions surrounding what it covers and even more questions about medicare supplement insurance. This is insurance provided by private companies, for a fee, that allows for gap coverage. It is a way to supplement medicare and prepare for the unexpected. The cost for medical care is high, and when something unforeseen happens, the need for gap insurance becomes critical. No one should take the chance.

Once retirement age arrives, there is no excuse for not being prepared. Of course the recent economic downturn has hurt many retirement funds, and some people never saved properly to begin with. Still, medical expenses continue to eat a huge portion of the retired person's budget, and when an emergency arrives the importance for supplemental insurance is easy to see.

It is not a concern for whether or not to invest in supplemental insurance. It is a matter of which plan to use. The good news is that here are any number of plans available. The benefits vary and the price follows as expected. Those looking to make a purchase must make certain they are well aware of their many options before making the very critical decision of which plan to pursue.

There are ten standard plans for medicare supplement insurance, also knows as Medigap insurance. Some are more expensive than others, and some are not available in certain states. Where there are unavailable plans in some states, a plan that similarly matches is generally offered. This means that even in those states an equivalent level of benefits can be obtained for a similar price.

One thing of importance to note is that the benefit these plans offer are the same from one company to the next, however the premiums are frequently very different. Understand that paying more does not equal more benefits for a given plan. Even the process of making a claim is the same. There will surely be salespeople who indicate otherwise, however the law overrides their sales pitch ever time.

On the first of January of each year, adjustments are made to the price of the premium as a result of inflation. Because the benefits through a supplemental plan follow those of medicare, the premiums for the supplemental plane will increase for this reason every year.

Prices for these plans are set in three ways. One is called attained age. In this price plan, premiums will increase due to inflation as well annually every 1, 3, or 5 years. Still, this is often the least expensive option. The next is issue age. Cost here is based on a persons age when they sign up. There are no increases in premiums other than the annual inflation adjustment. Finally, community-rated plans offer premium prices based on geographic location.

So there are many options to chose from when one reaches the age of Medicare. It is important to understand all the benefits, the rules for the state you are in, and that paying a higher premium does not include better benefits. Take the time to become well versed in your options and chose the plan that is most suited to your personal needs. If you are looking for more information on Medicare, visit this Medicare blog.

Facts About Medicare Supplement Insurance

Medicare supplement insurance is a highly recommended purchase for most seniors but some of the details surrounding it are confusing. If you are acting on the basis of incorrect information it could hurt you down the road, so be armed with the most important things you need to know about it before you make a purchase.

Insurance plans like these also go by the name Medigap because they aim to take care of the things Medicare does not cover. Hence, they bridge the gaps. You will pay an additional amount to get this type of policy on top of your Medicare premiums. Also, you must first have Medicare Parts A & B before you can purchase a supplemental policy.

Keep in mind that your Medigap policy does not cover your spouse. If you both need coverage, you will have to buy two separate policies. This confuses some people because traditional insurance often does cover spouses.

Government regulations have made the twelve plans offered as Medicare gap coverage standardized. What this means is that while there is a choice between 12 different plans, the plan you choose will be the same no matter which company you buy it from. Any company that tells you their plan A offers more benefits than their competitor's plan A is lying.

It pays to check with a lot of different companies before committing to any individual plan. This is because not all companies carry all 12 plans, so an insurance agent may be steering his or her customers towards one of the plans that company offers when a different plan might be preferable for you.

You may not realize it but current law states that anyone can get prescription plan coverage through Medicare. This was not always true in the past, but because it is now, you cannot get prescription coverage from Medigap because there is not a gap. If you do not have prescription coverage through Medicare their website will tell you what you need to do to fix this problem.

Also, beware of anyone who tries to sell you additional Medicare supplement insurance if you already have this type of policy in place. US law states that it is an offense to try to sell additional policies of this type, as the plans offer a wide range of benefit options and as long as you choose the right plan, a second plan would be totally unnecessary.

View the original article here