Medicare Supplement Insurance Helps to Make Sense of Medicare

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.

By Wiley Long - President, MedigapAdvisors.com - The nation's leading independent agency specializing in Medicare Supplemental Insurance. Our professional MediGap advisors look forward to the opportunity to help you get the best insurance for your Medicare needs.

The Medicare System and Senior Citizens

Medicare benefits are, inevitably, something we must all become familiar with as we get closer to retirement age. However, what exactly is medicare? When did it begin? And what is its purpose? Here is a brief outline of the federal government's medicare program, including its history and the rationale for its existence.

Medicare came into existence in 1965. It was created as one of the component parts of then-President Lyndon B. Johnson's "Great Society" initiative. The principal purpose of medicare was to provide a system of healthcare for elderly U.S. citizens, i.e. individuals who were sixty-five years of age or older.

However, medicare benefits are not simply for the elderly. Medicare is also availabe to individuals who are younger than sixty-five and who are disabled.

Qualifying for medicaid benefits on the basis of disability status, of course, requires that a person file an application, or initial claim, for title II benefits with the social security administration. Title II benefits are mandated under title 2 of the social security act and title II benefits are commonly referred to as social security disability benefits, or SSD.

Individuals who are approved for social security disability benefits are eligible to receive medicare benefits two years after their date of entitlement has been established and, no doubt, this provides for a healthcare safety net for disabled citizens who must subsist on a relatively small monthly disability benefit.

Who is eligible for medicare? Fortunately, unlike supplemental security income and medicaid benefits, medicare is not considered a needs-based program. In other words, younger individuals who are disabled and individuals who are of retirement-age may be eligible without regard to their income.

Until recently, medicare benefit coverage was thought of primarily in terms of hospital insurance and medical insurance. Medicare part A covers hospital visits and nursing home stays, while medicare part B pays for outpatient care and services, including doctor's visits, xrays, and lab reports. However, the medicare program was recently restructured to include a prescription drug benefit. This is known as medicare part D.

Medicare part D went into effect on January 1st, 2006, as part of the Medicare, Prescription Drug Improvement and Modernization Act. Medicare Part D is available to any individual who is eligible to receive medicare part A and medicare part B benefits. The intent of medicare part D is to guarantee prescription drug coverage for medicare beneficiaries. However, the federal government does not actually provide this coverage. Prescription drug coverage under medicare part D is provided by independent drug plans that are actually operated by private health insurers, though, legally, such plans are regulated by the federal government, i.e. the medicare program.

Are medicare benefits free? No, medicare part B requires the payment of a monthly premium which, for 2006, was $88.50. However, for those individuals who might have difficulty paying this premium, an assistance program is available to qualified individuals to pay part B premiums. This program is known as MQB, or medicaid for qualified (medicare) beneficiaries. Like other types of medicaid, this particular medicaid program is needs-based and serves no other purpose than to pay a medicare recipient's monthly medicare insurance premium.

The Medicare program may well be the most transformational program to arise as a result of Lyndon Johnson's Great Society initiative, and its effect, in many ways, may be as profound as the creation of the social security program under President Franklin D. Roosevelt. Recent estimates hold that medicare accounts for more than a tenth of all federal spending and approximately one-third of healthcare spending.

The author of this article is Tim Moore, who, in addition to being a former food stamp caseworker, medicaid caseworker and AFDC caseworker, is a former disability claims examiner. He publishes a blog on the disability process which is titled the Social Security Disability and SSI blog

New Medicare Supplement Plans Are Available Now

Medicare does not cover all health costs. There are gaps in the coverage. Some or all of these gaps can be filled by additional insurance purchased from private insurance companies. These plans are known as Medicare Supplement Insurance Plans or Medigap Plans. There are currently twelve plans available, identified by letters A through L.

Since Medicare Supplements are standardized by government regulations, all Medicare Supplement insurance companies are regulated as to what provisions and what policies they can offer. That does nott mean the prices are the same. There can be a big difference in premium costs for the same plan, depending on which insurance company you choose.

First, a little background information:

The Medicare Prescription Drug Improvement and Modernization Act of 2003 (also called the Medicare Modernization Act) was signed into law In December of 2003. Prior to this Act, Medicare did not provide for outpatient prescription drug benefits. This Act created Medicare Part D, to give access to prescription drug insurance coverage for those eligible for Medicare Part A or who were enrolled in Medicare Part B. This coverage began on January 1, 2006 and is administered by private health plans.

The Medicare Modernization Act (MMA) also encouraged the National Association of Insurance Commissioners (NAIC) to modernize the Medicare supplemental insurance marketplace. NAIC developed a revised Medigap Plan model.

On July 15, 2008, Congress enacted the Medicare Improvements for Patients and Providers Act (MIPPA) that authorized the states to put the NAIC's changes into effect. Congress felt that Medigap insurance had not kept up with some of the changes in Medicare, so the 2010 Medicare Supplement changes are, in effect, an effort to modernize the Medigap Insurance market by dropping some coverage options and adding others.

Summary of changes for 2010 Medigap plans purchased on or after June 1, 2010:

? Preventative Care will be dropped from all 2010 Medicare Supplement plans

? At-Home Recovery benefit will be dropped from all 2010 Medicare Supplement plans

? Medigap Plans E, H, I and J will no longer be available for new sales

? Two new Medigap Plans -Supplement Plan M and Supplement Plan N will be available in June 2010

? Plan G will be modified to increase excess charges from 80% to 100%

? A New Hospice Benefit will be added to all plans

? Insurance carriers will be allowed to offer plans that include New or Innovative Benefits, such as hearing aid benefits or eye wear. They may not include outpatient prescription drug benefits.

Current underwriting guidelines for these new 2010 Modernized Plans allow the application dates to be written 60 days prior to the effective date of coverage. This means that the new Plan M and Plan N can be acquired now.

The new Medicare Supplement Plan M will be standardized as is all the current plans available.

This plan uses what is known in the insurance industry as cost-sharing in an effort to reduce monthly premium costs. You would see a slightly lowered premium, but would split the cost of Medicare Part A deductible ($1,100 in 2010) with the insurance company. This means that your Part A deductible would be $550.

Medicare Supplement Plan M does not cover any of the Medicare Part B deductible. Once you meet this Part B deductible ($155 in 2010) you would not have any co-pay for doctor visits. We think this will in effect reduce this plans monthly premiums by 15% compared to the popular existing Medicare supplement Plan F premiums.

Medicare Supplement Plan M does cover the basic Core Benefits including full coverage for the Part A daily inpatient hospital coinsurance charges, all costs of hospital care after the Medicare benefit is used up, Part B coinsurance charges, the first three pints of blood, and now the Part A hospice coinsurance charges for palliative drugs and has the foreign travel emergency benefits. Hospice care is included (as it is in all Medicare Supplement Plans for 2010).

Take a close look at Plan N. From what I have learned so far, it looks to become one of the most popular plans because of its affordability. Plan N also uses cost-sharing in an effort to reduce monthly premium costs. In order to lower the monthly premium costs, unlike Plan M, Supplement Plan N uses co-pays. Co-payments for doctor visits are $20 and $50 for emergency visits. Currently the co-pay system is set to go into effect after the Medicare Part B deductible is met.

Look for Plan N as a cost effective alternative to Medicare Advantage Plans. It offers a better solution than Medicare Advantage because Plan N has no network restrictions and much lower out-of-pocket liabilities to the client.

Medicare Supplement Plan N has 100% coverage for the Part A inpatient deductible. It does not cover the Part B deductible. Insurance companies are estimating this will in effect reduce this plans monthly premiums by 30% - 35% compared to the popular existing Medicare supplement Plan F premiums.

Medicare Supplement Plan N does cover the basic Core Benefits including full coverage for the Part A daily inpatient hospital coinsurance charges, all costs of hospital care after the Medicare benefit is used up, Part B coinsurance charges, the first three pints of blood, and now the Part A hospice coinsurance charges for palliative drugs and has the foreign travel emergency benefits. Hospice care is included (as it is in all Medicare Supplement Plans for 2010).

It's almost impossible to call all the insurance companies that offer Medicare Supplement Plans in your state to find the best prices on premiums. Your best bet is to contact a company that can find the best prices among all the insurance companies that service your area. One such source would be http://www.medigap4seniors.com

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/

Prescription Drug Coverage With Supplemental Medicare Insurance and Medicare Advantage Plans

If you are about to turn 65, you have probably been studying up on how Medicare works and the various plans it offers. Because some of the plans are similar, the differences between them are often blurred, leaving potential beneficiaries confused about what plan is right for them.

Medicare Part C, known as a Medicare Advantage Plan, is one of the four basic parts of the Medicare system. It allows users of the original Medicare Parts A and B to get coverage from a government approved private insurance company of their choice. Medicare Advantage Plans include plans like Health Maintenance Organization Plans (HMO) and Preferred Provider Organization Plans (PPO). The biggest weakness the original Medicare plans have is that they do not cover the cost of prescription drugs. If you want additional coverage, you have a few options.

Medicare Part D is available to anyone with original Medicare (Parts A and B), and can help cover the costs of prescription drugs. You must get this coverage through a private insurance company approved by Medicare. If you have a Medigap policy, the same as supplemental Medicare insurance, it may already cover the costs of drugs. But if it does not, you are allowed to get a Medicare Prescription Drug Plan as part of Medicare Part D, but must alert your insurance company if you do so. Not all supplemental Medicare plans will cover drug costs, so it is important to make sure the plan you choose offers this benefit. If it does not, just remember that you can still get drug coverage through a Medicare Plan.

If you are not going to utilize Medicare Part D, or get supplemental Medicare insurance, consider Medicare Part C - the Medicare Advantage Plan. These plans, provided by private insurance companies, may offer prescription drug coverage at an additional cost. If you have one of these plans, you will not need supplemental Medicare insurance at all; it is simply an alternative. Make sure to check your coverage history from past employers; you might have additional coverage choices if your former or current employer provided you with prescription coverage.

Make sure not to buy a supplemental Medicare plan if you already have a Medicare Advantage Plan. Doing this is illegal, unless you are completely dropping your Medigap plan and returning to original Medicare. Be very careful before ever dropping your supplemental Medicare insurance, because it is possible that you may not be able get it back in the future. Discuss the issue with your State Health Insurance Assistance Program and your insurance company before ever making a decision that could affect your long-term health coverage.

Getting prescription drug coverage is an important element in any health coverage plan, and only gets more important as you get older. You should seriously consider getting a plan that helps cover the costs of prescriptions, as you never know what types of health issues you may have in the future. Whether you choose to get supplemental Medicare insurance or a Medicare Advantage Plan, having some kind of drug coverage will have you prepared for any twists or turns life may bring.

Richardt Insurance has over 35 years of experience helping seniors find the best supplemental Medicare insurance and prescription drug coverage that is available in their state.

Medicare Open Enrollment is Coming So Get Ready!

Are You Ready For Medicare Open Enrollment?

When Medicare Open Enrollment rolls around, it is time to consider your health and prescription plans for next year. According to the US Center for Medicare and Medicaid, Medicare Open Enrollment is from November 15th to December 31 this year. Even if you are content with your current Medicare health and prescription benefits, you want to make sure that the plan will be very similar next year. Because plans do change, and the period after Medicare Open Enrollment is when those changes will show up.

How To Prepare For Medicare Open Enrollment

The Medicare websites gives some great tips to evaluate your current Medicare health and prescription plans, and they are pretty simple.

Gather Information About Your Health Needs. This includes your current prescription list, your medical providers, and any notices you have received from Medicare, Social Security, and any private health or prescription insurance companies about changes to your plan.
Compare plans in your local area for cost, coverage, and customer service. You can do research by using the Medicare website, contacting a local insurance agent who is a specialist on various Medicare Health and Prescription Plans, and also by asking people you know and trust about their experiences.
Decide if you would like to keep your current coverage or make a change.
If you decide to consult an insurance agent, look for a Medicare specialist who is appointed and certified with multiple area plans. If you find an agent who only represents one company they may be less motivated to give you a balanced view. Of course, you may end up purchasing from one company, but it would be best to do your shopping with a consultant who is not motivated to only push one plan.

Understand the differences between Medicare Advantage Plans and Medicare Supplements. This subject still causes confusion. And no, there is no one right answer for everybody. Some people feel as if Medicare Advantage plans are only for seniors with moderate to low incomes, but some individuals with very high incomes are very satisfied with Medicare Advantage. On the other hand, some people, especially those who do not live where a doctor network is convenient, may be happier with a very flexible plan like some Medicare Supplements, even though they cost more. Of course, on still another hand, some Medicare Advantage plans will work with any doctor who accepts the plan, so they can be very flexible too!

I do not mean to be confusing here, but I do mean to illustrate that the variety of Medicare Health and Prescription plan choices makes choice complex. If you have questions, do not hesitate to consult Medicare or a private Medicare Specialist. An insurance agent who specializes in Medicare health plans should not charge you anything. They earn a living with commissions from the various companies when they do sell a plan. If you can find an agent who is appointed and certified with all, or most, of the local plans, they will not be motivated by that commission to select one plan over another. They should be motivated to find the best plan for you, and keep you as a valuable client!

Do you need to find a Medicare Health Plan?

It only takes a moment to Compare Medicare Health Plans. Our forms are simple and free, and they will show you the options in your local area.

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