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Guide for Federal Retirees and Medicare Part B

by Jagger Esch
written by Jagger Esch

Medicare Part B covers physician and outpatient services. Part B can include ambulance services and durable medical equipment as well as laboratory tests and x-rays.

While most seniors get Medicare Part A “premium free”, most seniors pay a monthly premium for Medicare Part B. Generally, Part B premiums are taken out of your monthly Social Security check or a retirement check.

To Take Part B or Not to Take Part B, that is the Question

If you don’t take Part B when you are first eligible there is a 10% penalty on the current year premium added for each year you delay enrollment. You will need to pay this penalty for as long as you have Medicare.

You won’t owe a late enrollment penalty if you qualify for a Special Enrollment Period (SEP). This allows you to enroll in Medicare Part B and enroll through an SEP if you have health coverage based on current employment (yours or a spouse’s).

It’s important to know that not all coverage qualifies you for an SEP. The following types of coverage won’t qualify you for creditable coverage based on current employment and wouldn’t exempt you from paying the Part B penalty if you delay enrollment:

    1. COBRA
    2. TRICARE and Medicare– (unless you, your spouse, or dependent child are an active-duty member.) If you’re Medicare-eligible, you must be enrolled in Part B to continue receiving TRICARE benefits.
    3. Veterans’ benefits
    4. Retiree benefits

If you have coverage through a current employer (yours or a spouse’s) you may decide that you don’t need extra coverage. There is no penalty for delaying Part B enrollment if you or your spouse have other coverage based on current employment.

You can sign up for Part B through an SEP anytime that you’re still covered by the group plan or in the eight months after your employment or group coverage ends.

If you’re an active duty service member, you may delay enrollment, keep TRICARE and sign up for Part B during an SEP without paying a late enrollment penalty.

If you are 65 or over and still employed by the federal government or are a 65-year-old retiree that has health care coverage through your new employer or you are covered under a working spouse exemption, you can delay applying for Part B without penalty and that makes sense for many.

You can delay taking Part B without penalty if you switch FEHB coverage to a federally employed spouse to keep the benefit premiums non-taxable and delay without penalty for the 65-year-old retiree’s Part B enrollment. Unfortunately, retiree’s FEHB premiums are considered taxable income unlike active federal employees.

Many retirees work at another job after they leave the federal service. Federal retirees can also delay taking Part B without penalty if they are covered under a working spouse exemption or if they are working for other employers that provide primary healthcare coverage where the FEHB becomes secondary.

You must evaluate your costs to see if accepting insurance from your new employer would reduce your costs. If you start your own business or work for another company that doesn’t provide primary health insurance, you will be assessed a penalty if you don’t take Medicare B at age 65.

Part B Premium Determination

Medicare Part B premiums are determined by your Modified Adjusted Gross Income (MAGI). The higher your income, the higher your Part B premium. For many beneficiaries, the government pays a large portion of the Part B premium, about 75 percent, and the beneficiary pays the remaining 25 percent.

If you’re a high-income beneficiary, you’ll pay a larger percentage of the total cost of Part B based on the income you report to the Internal Revenue Service (IRS). If you have a high income and are considering not enrolling in Part B because you think it will save you money, this isn’t the case.

When you postpone enrolling in Part B, you’ll be subject to a late enrollment penalty that will increase your Part B premium the entire time you have Medicare Part B.

If you’re unsure about whether you should enroll into Medicare Part B, talking to your benefits coordinator at the place where you work can help you determine the best decision for you.

 

 

 

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Medigap

Guide to Medicare Supplemental Insurance (Medigap)

by Carol Marak
written by Carol Marak

Medicare Supplement Insurance, also known as Medigap, is a private insurance policy that helps pay some of the health care costs that Original Medicare doesn’t cover, like copayments, co-insurance, and deductibles. Some Medigap policies offer coverage for services that the Original Medicare does not cover. Examples are the medical care when you travel outside the U.S or visit a doctor who does not accept Medicare, and charges an “excess charge.”

Medicare Supplement Insurance policies only work if you enroll in the Original Medicare Plan. You must have Medicare Part A and Part B but won’t pay any benefits if you’re in a Medicare HMO or another type of Medicare Plus plan.

First, Let’s Explain Medicare

Original Medicare is fee-for-service coverage under which the government pays the insured’s health care providers directly for the Part A and Part B benefits.

Medicare Supplement policies can minimize Medicare co-payments and deductibles for covered services, but do not offer expanded coverage of long-term care services or prescription drugs.

Medicare Part A covers hospital insurance and for most people it is free. You might be required to pay for Medicare Part A if you were self-employed or didn’t contribute to Medicare when you were younger. If you or your spouse paid Medicare taxes for less than ten years total, you would have to pay a monthly fee for Part A coverage.

Medicare Part B is not free. You have to pay a monthly Medicare premium, which comes out of your social security check. Medicare Part B (Medical Insurance) helps cover:

  • Services delivered by doctors and other health care providers,
  • Outpatient care,
  • Home health care,
  • Durable medical equipment,
  • Some preventive services like Pap tests, flu shots, and screening mammograms.

7 MUST KNOW FACTS about Medicare Supplemental Insurance (Medigap) Policies

  • If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
  • You pay the private insurance company a monthly premium for your Medigap policy also to the monthly Part B premium that you pay to Medicare.
  • A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.
  • You can buy a Medigap policy from any insurance company that’s licensed by the state.
  • Any standardized Medigap policy guarantees renewable even if you have health problems. Therefore, the insurance company can’t cancel your Medigap policy as long as you pay the premium.
  • Some Medigap policies sold in the past cover prescription drugs, but Medigap policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
  • It’s illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.(Source: Medicare.gov)

 

Medigap policies don’t cover:

  1. Long-term care,
    Vision or dental care,
    Hearing aids,
    Eyeglasses,
    Private duty nursing like medical and non-medical care

 

Long-term supports and services provided at home, in the community, in an assisted living, or in a nursing home. Individuals may need long-term supports and services at any age. Medicare and most health insurance do not pay for long-term care.

Medicare Supplemental Insurance Plan Details

Medicare Supplement Insurance offers twelve (12) plans. These programs must follow Federal and State laws. Each plan has different benefits. The twelve labeled A – N, lists below. The percentage shows how much each plan covers. The co-insurance is active after reaching the deductible. This PDF offers a quick look at the standardized Medigap Plans A through N and their benefits. Note: Plans E, H, I, and J are no longer for sale, but you can keep these programs if you already have one.

  • Plans A through N, (with the exceptions of E, H, I, and J which are no longer for sale) pay 100% on Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits.
  • Plans A through N pay 100% on Medicare Part B Coinsurance or Copayment with the exceptions of Plan K pays 50%, and Plan L pays 75%.
  • Plans A through N pay 100% of Blood (First 3 Pints) with the exceptions of Plan K pays 50%, and Plan L pays 75%.
  • Plans A through N pay 100% of Part A Hospice Care Coinsurance or Copayment with the exceptions of Plan K pays 50% and Plan L pays 75%.
  • Plans C through N pay 100% of Skilled Nursing Facility Care Coinsurance with the exceptions of Plan K pays 50%, and Plan L pays 75%. Medicare Part A (Hospital Insurance) covers skilled nursing care in a skilled nursing facility under certain conditions for a limited time.
  • Plans B through N pay 100% of Medicare Part A Deductible with the exceptions of Plan K pays 50%; Plan L pays 75%, and Plan M pays 50%.
  • Plans C and F pay 100% of Medicare Part B Deductible with no other exceptions.
  • Plans F and G only pay 100% of Medicare Part B Excess Charges as it relates to Medicare medical services. If you are on Medicare and go to a doctor who does not accept Medicare assignment (receive full payment by Medicare), s/he’s allowed to have an “excess charge”. This excess charge would be an amount above and beyond what Medicare approves for a particular procedure/doctor office visit.
  • Plans C through G, M and N, pay 100% of Foreign Travel Emergency (Up to Plan Limits).
  • Other Medigap Plans information to know:
  • Plan F offers a high-deductible policy plan. If you choose the high-deductible option, you pay for Medicare-covered costs up to the deductible amount of $2,110 in 2013 before your Medigap plan pays anything.
  • Plans K and L, after paying out-of-pocket limit ($4,800 for K and $2,400 for L) and the Part B deductible ($147 in 2013), the Medigap plan pays 100% of covered services for the rest of the calendar year.
  • Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

7 Things that Medicare and Medigap do Not Cover but You May Need

  • Long-term care such as assisted living (for recovery purposes)
  • Dental and eye care
  • Dentures
  • Hearing aids and exams
  • Cosmetic surgery
  • Acupuncture
  • Routine foot care

8 Insurance Plans that are not Medigap

  • Medicare Advantage Plans (like a HMO, PPO, or Private Fee-for-Service Plan)
  • Medicare Prescription Drug Plans
  • Medicaid
  • Employer or union plans, including the Federal Employees Health Benefits Program
  • TRICARE
  • Veterans’ benefits
  • Long-term care insurance policies
  • Indian Health Service, Tribal, and Urban Indian Health plans

COMPARE THE COSTS of Medigap Plans

Insurance companies may charge different premiums for the same policy. As you shop for a policy, be sure you’re comparing the same policy (for example, compare Plan A from one company with Plan A from another company).

In some states, you are able to buy another type of Medigap policy called Medicare SELECT. (If you buy a Medigap SELECT policy, you have rights to change your mind within 12 months and switch to a standard Medigap policy. A great resource is the 2013 Guide to Choosing a Medigap Policy.

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Medicare Plans

Medicare OEP 2020: How Mrs. Jones Made Changes to Her Medicare Advantage Plan

by My Senior Health Plan
written by My Senior Health Plan

The new year is upon us and so is Medicare Open Enrollment Period (OEP) 2020. Yes, just when Annual Enrollment Period 2020 has finished, it’s time for OEP 2020! We know the Medicare system can be difficult, so today we’re going to follow Mrs. Jones through the Medicare Open Enrollment Period.

Mrs. Jones is a little confused since the Medicare rules can be complicated. But we’re here to help!

What is Medicare Open Enrollment Period?

Mrs. Jones wasn’t happy with the Medicare Advantage Plan she chose in the fall during AEP, and she’s been waiting for January 1st so she can make a change to her Medicare coverage. She has until March 31st, and she’s allowed to make just one change to her plan.

During the Medicare Open Enrollment Period, she:

CAN switch from one Medicare Advantage plan to another Medicare Advantage Plan

CAN disenroll from a Medicare Advantage Plan and return to Original Medicare (with or without a Part D drug plan).

But Mrs. Jones:

CAN’T switch from Original Medicare to a Medicare Advantage Plan

CAN’T add or switch a Medicare Prescription Drug Plan (if enrolled in Original Medicare).

If Mrs. Jones was in the first three months of her Initial Enrollment Period, she would also be able to:

Change to another Medicare Advantage Plan (with or without drug coverage)

Or go back to Original Medicare (with or without a drug plan).

What kinds of changes can be made during OEP?

Mrs. Jones changed her Medicare Advantage Plan during AEP. That plan became active on January 1st. But just a month after her new plan began, she realized that plan doesn’t cover her prescription drug needs.

Fortunately for Mrs. Jones, she can make a change because it’s Open Enrollment Period. She’s choosing to switch from the Medicare Advantage Plan she chose during AEP to another Medicare Advantage Plan that covers her prescription drug needs. This is a one-time change for Mrs. Jones that will go into effect on March 1st.

But what if her new Part D plan begins, and she finds she doesn’t need the coverage? Unfortunately, she’ll have to wait until AEP on October 15th to make additional changes.

But she may qualify to change her coverage during a Special Election Period (SEP). Here’s how.

What is a SEP?

A Special Election Period is a time when you can make changes to your Medicare Advantage and prescription drug coverage outside the typical AEP and OEP periods.

SEPs are granted for many different circumstances. A few of these are:

  1. A change of address that impacts your coverage
  2. Residency in an area affected by a FEMA-sanctioned emergency or natural disaster during a previous enrollment period (either for the beneficiary or caregiver)
  3. Moving into or out of an institution.

 

Also, if you lost your previous insurance, whether it’s Medicaid or employer-provided, you may be eligible to enroll in Medicare Advantage during an SEP.

Medicare is complicated, but MySeniorHealthPlan.com is here to help you confidently navigate your health insurance decisions.

If you have questions or need to talk to a licensed Medicare specialist, visit our website or call (877) 255-6273. You’ll be able to talk to a knowledgeable member of our team who will help you find the right plan for you.

 

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Medicare Plans

How to Enroll in Medicare if You’re Working Past 65

by My Senior Health Plan
written by My Senior Health Plan

For decades, the gold standard for retirement age was 65. But in the last several years, we’ve seen the retirement age inch up with many folks working past 65. Now, 20 percent of Americans age 65 and older are participating in the workforce—the highest rate in nearly six decades.

Some of this is due to the U.S. government formally changing the Social Security retirement age. Since 1983, the retirement age, previously set at 65 has slowly inched toward 67, with the current age set at 66 and eight months.

But there’s more going on here. Not only are we living longer, but also the cost of living is exponentially higher than 10 or 20 years ago. Unfortunately, many of us weren’t able to adequately plan for retirement.

What is fortunate is that no matter your employment status, you can still enroll in your Medicare benefit at age 65. Here’s how.

What if you have employer-provided health benefits?

When you turn 65, even if you’re working, you gain access to what’s called the Initial Enrollment Period (IEP). If you have employer-provided healthcare, you can still apply for Medicare Part A.

You may be wondering why this is necessary. If you require medical care not covered by your employer-provided plan, your Medicare Part A plan will pick up where your primary coverage leaves off. Part A Medicare benefit is premium-free, so you stand nothing to lose financially by enrolling.

If you have a spouse who isn’t working, is over 65 and covered by your private insurance, the same principles apply.

But do stay on top of enrolling, because Medicare won’t remind you to sign up unless you currently get Social Security or Railroad Retirement Board benefits. Also, in order to take advantage of Medicare, you or your spouse must have worked and paid Medicare taxes for at least 10 years of your lives.

What if you’re working past 65 and losing your employer-provided health benefits?

When you decide to retire, you’ll need to make changes to your (and your spouse’s, if applicable) Medicare coverage. You probably already have Part A at this point, but you need to get supplemental coverage to make up for what used to be covered by your employer-provided health insurance.

If you’re beyond your IEP and are losing your employer-provided insurance outside of another enrollment period, like OEP or AEP, you’ll be eligible for a Special Enrollment Period (SEP). SEPs enable beneficiaries with extenuating circumstances to enroll in Medicare programs outside the typical enrollment periods.

The SEP for Parts A and B will last for eight months beginning the month after you lose your private health insurance benefits. The SEP for Parts C and D will last for two months beginning the month after you lose your private health insurance benefits. So, if you retire in March 2020, you’ll have between the months of April and November 2020 to enroll in Medicare Parts A and B and April and May to enroll in Medicare Parts C and D, if needed. Confused? Don’t worry, MySeniorHealthPlan.com is here to help.

What about Medicare Part B and D?

You may be aware of penalties for late enrollment in Medicare Part B and/or D. Since you’re covered by employer-provided health insurance during your IEP, you may be eligible for a Special Enrollment Period (SEP) to delay enrolling in Parts B and D.

You’ll have to consult with your employer to confirm eligibility.

With any health insurance decision, particularly those related to Medicare, we recommend you work with your employer’s plan administrator to understand what coverage you have, what coverage you need and how those options will change upon retirement.

If you need help or have questions about Medicare when working past 65, visit our website or call (877) 255-6273. You’ll talk to a knowledgeable member of our team who will help you navigate the Medicare system and find your best coverage options.

You may also seek assistance from Medicare by calling (800) MEDICARE (1-800-633-4227).

 

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Medicare Plans

How to Avoid Medicare Late Penalties

by Jagger Esch
written by Jagger Esch

While there are many benefits to having Traditional Medicare, the few disadvantages come in the form of late penalties.

Traditional Medicare consists of two parts, Medicare Part A and Medicare Part B. Part A benefits are your hospital benefits and covers any treatment given during hospitalization.

Part B consists of coverage for doctor’s office visits, diagnostic testing, lab work, outpatient surgeries, and ER visits.

Prescription drug coverage is not available on Medicare Part A or Medicare Part B. There is Medicare Part D, which is stand-alone insurance that provides prescription medication coverage.

And while Medicare covers most everything, there’s still out of pocket costs like deductibles, copayments, coinsurance, and other medical expenses.

How to Avoid Medicare Part A Late Penalty Fees

Most seniors are automatically enrolled for Traditional Medicare Part A by the time they turn 65 years of age. If you or your spouse worked for ten or more years, you’ve paid into Medicare and are then enrolled without charge.

If you haven’t previously worked or haven’t fulfilled the required amount of time to become eligible, you may still enroll; however, there may be a premium to pay.

For those not automatically enrolled in Medicare Part A, there’s a timeframe called the Initial Enrollment Period (IEP). The IEP starts the three months leading up to your 65th birthday and then lasts through the three months following your birthday month.

Failing to enroll during this period will result in the Medicare Part A penalty. The Medicare Part A penalty adds an extra 10% to the Part A premiums.

Each year gone without Part A benefits is multiplied by two and then added onto the premium costs. Depending on how long gone without enrollment, will determine the penalty fees as well as how long they will be charged.

How to Avoid Medicare Part B Late Penalty Fees

With Medicare Part B, enrollment is standard, and the Initial Enrollment Period is the same as enrollment for Medicare Part A.

As of 2018, The Centers for Medicare and Medicaid Services (CMS) set the Part B premium as $134.00. This can increase, however, based on income and decrease if ones on Social Security or disabled.

While the IEP’s are the same with both Medicare Part A and Medicare Part B, the penalty is different. The Medicare Part B penalty increases your monthly premium by 10% for every year gone without Part B benefits.

Unlike Medicare Part A’s penalty, with the Medicare Part B penalty, the extra premium charge is paid for the duration of time the Part B benefits are carried.

How to Avoid Medicare Part D Late Penalty Fees

With Medicare Part D, the various private health insurance carriers in your area offer the Prescription Drug Plans (PDP).

As of 2018, the Medicare Part D premium averages around $34.00; however, plan pricing can differ because of location and plan.

Just like with Traditional Medicare, the IEP is effective for the seven months surrounding your 65th birthday. Medicare Part D for prescription drug coverage is optional; however, there is a Part D penalty for not enrolling in the Initial Enrollment Period.

After 63 consecutive days or more having gone without Medicare Part D results in the penalty.

You will be penalized unless you have any of the following:

  • A Medicare PDP
  • A Medicare Advantage Plan or Medicare Part C Plan offering prescription benefits
  • Creditable coverage through employmentor the union with benefits offers at least, if not more, of Medicare’s standard prescription drug coverage.
  • Any other Prescription Drug Plan offered by a different Medicare Plan

 

The Part D penalty is calculated by adding 1% for each month without prescription drug coverage. Once this is determined, the penalty is then rounded to the nearest $.10 and then added onto the monthly premium.

The Part D penalty is permanent and must be paid while prescription drug coverage is active.

Another downside, the penalty may increase every time there’s an increase in the national base beneficiary premium.

Medicare Late Enrollment Exceptions

For Medicare Part A and Medicare Part B, penalty exceptions are possible if you or a spouse carry qualifying health insurance from another source.

Although there are Special Enrollment Periods (SEP) available when an individual loses health insurance from a union or group health plan, they have 8 months to enroll for Traditional Medicare benefits.

If the Medicare beneficiary enrolls during the SEP, no penalties will be enforced.

There is also a late enrollment exception with Medicare Part D. Medicare Part D offers the Extra Help program which subsidizes prescription drug costs for individuals with low income.

This Extra Help Program helps on expenses associated with deductibles, premiums, copays, and coinsurance.

With the Extra Help program, there are no late penalty fees. Another benefit with the Extra Help program is there is no Part D coverage gap which is also known as the. “donut hole”.

Additional Medicare Help

With all the penalties tied to late enrollment, it’s easy to see how quickly the out of pocket expenses can add up.

Most seniors are on a fixed income, you’ll want to enroll in Medicare as soon as possible to avoid any late penalty fees associated with the three parts offered by Medicare.

There are several options in which additional assistance can be provided for seniors carrying Medicare benefits. Opting for a Medicare Advantage Plan or subsidizing with a Medicare Supplement Plan will save you money and provide benefits.

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Medicare Plans

Are You Ready for Medicare Open Enrollment?

by Carol Marak
written by Carol Marak

It’s Medicare open enrollment period starting October 15 and through December 7, 2019. Your chance to change coverage (Medicare plans) if you want.

Medicare Part C plans, known as Medicare Advantage plans are private health insurance plans, mainly HMOs and PPOs, for people enrolled in Medicare. If you enroll in a Medicare Advantage plan, you still have Medicare, but you get all of your Medicare-covered benefits through a private plan.

Most Medicare Advantage plans also cover prescription drugs and may cover other services, like vision, dental, and hearing. If you have Part A and Part B and are covered under the Original Medicare program, then you do not need to sign up for a Medicare Advantage plan during Open Enrollment unless you want to get your Medicare benefits through a private plan.

Medicare Advantage plans restrict the health care providers that enrollees see (provider networks) whereas beneficiaries in the Original Medicare may see any doctor that accepts Medicare, without needing prior authorization or a referral from their primary care doctor.

Start Your Research

Now is the time to research and make preliminary calls to get an idea of what changes (if any) need to be made to your Medicare coverage. Gathering information now will prevent you from making knee-jerk decisions at the end of enrollment. Here are six steps to take:

  • Become familiar with each part of Medicare, Part A, Part B, Part C, and Part D. This glossary explains terms in the Medicare program, https://www.medicare.gov/glossary/.
  • If you have a Medicare Advantage Plan (Part C), are you happy with it? Be sure to read all mail from the carrier which arrives in September and October. Look for any changes to monthly premiums, deductibles, copays and provider groups.
  • If you have a Medicare Supplemental Insurance policy (Medigap), check for any changes or monthly premium increases. Some beneficiaries switch from Medigap to a Part C (Medicare Advantage Plan) at this time of year.
  • If you’ve spent a lot of money out-of-pocket on hospital visits and doctor’s appointments because you don’t have a Supplemental insurance plan or Medicare Advantage Plan, add up expenses to know if a more coverage would help save money. Or check with Medicaid, a state Medicare Savings Program, the “Extra Help” program, or the local State Health Insurance Assistance Program (SHIP).
  • Get up-to-date information on your health status. Is your annual visit with the primary care physician coming up? Will you need to see a specialist? Make a list of all your prescription medications. If any are brand name, ask the pharmacist if there are generic equivalent. If not, ask your insurance plan Part C or Part D for an exception if the expensive brand-name medication isn’t part of the drug formulary.
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Medicare Plans

When Does Medicare Annual Enrollment Period End? Soon!

by My Senior Health Plan
written by My Senior Health Plan

If you need to make changes to your Medicare coverage for the upcoming year, mark your calendar for December 6th! It’s when the 2020 Medicare Annual Enrollment Period (AEP) will end.

After that date, you will not be able to make changes to your existing Medicare coverage until next October.

In case you’ve been thinking about making changes to your existing Medicare plan, now is the time to take action!

Book your appointment as soon as possible

While December 6th may seem a ways off, November is a busy month for everyone, including your plan providers.

Additionally, Thanksgiving falls on the 28th of this year, a little over a week before the end of AEP.

If we factor in weekends, the available time for getting an appointment and processing your application starts to narrow.

Get in early to get the one-on-one attention you deserve

During AEP, your carrier’s calendar fills up fast and they get strapped for time. Each application is time-intensive, requiring much more than a simple phone call or filling out a form.

During your scheduled appointment, your plan specialist will discuss your existing benefits and any Medicare changes that may affect your plan. For instance, this year, some beneficiaries may not qualify for Medicare Plan F.

Once you and your plan specialist have worked out what you need, they’ll submit any plan changes. The insurance carrier must then approve the application.

If any adjustments need to be made, your plan specialist will let you know, discuss your options, and resubmit your application.

The AEP application process—from your consultation to plan approval—must be completed by December 6th.

How to prepare for your Medicare plan call

Once you have a scheduled appointment with your plan provider, take some time to prepare for your AEP appointment.

After all, Medicare can get complicated. That includes understanding plan changes you can make during AEP 2020.

Here are some questions to consider:

Have you had the same plan for two or more years?

It’s easy to get comfortable with an existing plan. Maybe you receive the Annual Notice of Change letter each year and figure you don’t need to make any changes.

However, your health needs may have changed—or improved. Maybe you no longer take medication because your health improved. By revisiting your prescription drug plan, you may be able to adjust your benefits and save some money on coverage costs.

Were you happy with your coverage last year?

If you made changes to your plan last AEP or started receiving Medicare benefits for the first time, you may want to assess how well your insurance plan held up.

Did you have enough coverage? Are you comfortable paying the same deductibles for another twelve months? Were there any surprises? Make a note of your experiences and share them with your plan specialist.

Are there additional services or medications you may need this year?

Maybe you and your medical provider are monitoring a health condition. Now is an excellent time to talk to your physician about a timeline for treating it.

If you decide to take action this year, you will want to make sure you have the right coverage.

Also, if you wish to make changes to your Medicare benefits, make sure your healthcare provider will accept your new plan.

Taking charge of your healthcare

If you’ve decided your Medicare benefits are working well for you, that’s great! However, should you want to make any changes to your existing coverage, you must make an appointment with your plan specialist as soon as possible.

The MySeniorHealthPlan.com team can answer all your questions and guide you through the process. Call today toll free: 877.255.6273

 

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Medicare Plans

Medicare Open Enrollment 2019: What You Should Know

by Guest Blogger
written by Guest Blogger

What: Medicare Annual Enrollment Period (AEP)
Also known as the Annual Election Period or Medicare Open Enrollment

When: October 15 through December 7, 2019

Medicare beneficiaries have one guaranteed chance to make changes to their Medicare enrollment each year — the Medicare Annual Enrollment Period from October 15th through December 7th. During this period, you can:

  • Enroll in a Medicare Advantage Plan
  • Enroll in a Part D Prescription Drug Plan
  • Drop a Part C or D Plan

Understanding the Medicare Parts

Original Medicare — Parts A & B

Original Medicare, the coverage offered by the federal government, includes coverage for some hospital services, as well as preventative and medically necessary care. It does not include coverage for prescription drugs, vision, dental, and a number of other categories. You only have to enroll in this coverage once, when you are initially eligible by turning 65or through having a disability, end-stage renal disease, or ALS.

Medicare Advantage — Part C

Medicare Advantage Plansare offered by private insurance companies that are contracted with the federal government. These plans include the same coverage as Original Medicare, and many plans also offer additional benefits like vision, dental, hearing, fitness, and wellness. Some also offer prescription drug coverage, which is critical for many people.

Prescription Drug Plans — Part D

Individuals who are enrolled in just Original Medicare or a Part C plan without prescription drug coverage may also enroll in a Part D plan, which offers only prescription drug coverage.

Changing Plans During AEP

The Medicare Annual Enrollment Periodis a great time to find out what new Medicare plans or benefits might be offered in your area. If you’re covered by Original Medicare only, you may be able to gain benefits like vision, dental, hearing, fitness, and prescription drug coverage by enrolling in a Medicare Advantage Plan. Some of those plans may be available with $0 premiums, copays, and deductibles, making it possible to get more benefits at no additional cost.

If you’re already enrolled in a Medicare Advantage Plan, the Annual Enrollment Period is an opportunity to find out what other Medicare Advantage Plans are available in your area. Plan benefits change each year, so there may be a plan that’s now better suited to you.

New Medicare Advantage Benefits in 2020

Due to updated regulations in 2019 from the Centers for Medicare and Medicaid Services (CMS), insurance providers can now offer a wider range of benefits with Medicare Advantage plans in 2020, including things like:

  • Home helpers/in-home support
  • Transportation
  • Meal delivery
  • Safety/assistive devices
  • Day center visits
  • Fitness membership

 

Several of these additions improve coverage for long-term care and at-home support, which have long been areas where there was little or no Medicare coverage. Review the Medicare Advantage plans in your area to discover if these benefits are available for you.

AEP and Dual Eligibility

Some Medicare beneficiaries are also eligible for Medicaid through their states. These individuals are considered dual eligible and may be qualified for additional assistance with Medicare costs, such as premiums and prescription drugs.

Individuals who are dual eligible can also enroll in Medicare Advantage plans called Special Needs Plans (SNPs). If you are uncertain about your Medicaid eligibility, the Annual Enrollment Period is a good time to look at Medicaid information in your state and make sure you’re not missing out on benefits or assistance you could be receiving.

Medicare Annual Enrollment Period Resources

Medicare AEP Toolkit

You can learn more about this enrollment period with easyMedicare.com’s Annual Enrollment Period Toolkit. This convenient online resource includes information on how to prepare for AEP, a guide to this enrollment period, and answers to frequently asked questions.

Online Enrollment Portal

You can easily enroll in a Medicare Advantage plan during the Annual Enrollment Period using the Medicare Online Enrollment Portal. Use your zip code to search for plans in your area, choose plans to compare side-by-side, and then follow the guided process to enroll in the plan of your choice.

The portal includes plans from a number of top carriers, like Humana, United Healthcare (UHC), and WellCare. It is available 24/7 — no waiting on hold or trying to schedule a callback from an agent. The site is designed with high-contrast adjustable text for your ease of use. It is also equipped with SSL encryption to protect your personal information.

Summary

The Medicare Annual Enrollment Period occurs October 15 through December 7. This enrollment period is critical to your healthcare coverage for 2020 and you may be able to save money, receive additional assistance, or gain new benefits by enrolling in a Medicare Advantage plan during this time. The Medicare AEP Toolkit is a resource for additional information about taking advantage of this enrollment period. You can easily enroll in a Medicare Advantage plan through the Medicare Online Enrollment Portal.

By the easyMedicare.com Team

easyMedicare.com is an independent digital insurance marketplace providing individuals the ability to purchase Medicare insurance from the comfort of their homes. The company has proudly served tens of thousands of people across the United States.

 

 

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Medicare Plans

Alternatives to 1st Dollar Coverage Plans

by Jagger Esch
written by Jagger Esch

We’ve lived our lives planning for our future and the future is now. Unfortunately, gone are 1stdollar coverage plans. Instead of paying a monthly premium that allowed us to close our wallet after writing that check we can expect to do a little more searching to find just the right plan. It’s back to the licensed insurance agent to review your needs and benefits against costs and risk.

If you aren’t familiar with 1stdollar coverage, we are referring to Medicare Supplement Plans F and C. Medicare Supplement Plans are sometimes referred to as Medigap Plans. Plan F covered everything not covered by Original Medicare. Plan C covered everything not covered by Original Medicare, except excess charges.

What Now

Nonetheless, there are great coverage options available to you. The most comprehensive Medigap Plans available for the 2020 year will be Plans G and N. Previously, these two plans were overlooked by many in favor of paying a higher premium and nothing more. Medicare Supplement Plans G and N will now be the sought-after coverage options.

Plan G

In 2019, the Medicare Part B deductible will be $185. For beneficiaries enrolled in a Medicare Supplement Plan G, that $185 deductible will be all they pay for covered services. Between Original Medicare and Medicare Supplement Plan G, everything else is paid for you.

This plan is like Medicare Supplement Plan F in that you can minimize your out of pocket risk. But by assuming the $185 deductible, you will save much more than $185 on an annual basis. Currently, the Plan G is the most popular plan.

The reason is that in most cases a Medicare Beneficiary will save considerably more every year by paying their Medicare Part B deductible out of pocket. In many cases, a Beneficiary can save $300 or more over the cost of the year, and that is even after the deductible is met. To Savy seniors, this plan has been the choice for several years now.

Plan G does cover any excess changes that could be imposed by a hospital or physician’s office. So, you are not giving up any peace of mind to save several hundred dollars. The protection is in this plan. You can find Medicare Plan G reviews here.

Plan N

Medicare Beneficiaries that want cost-effective coverage and are willing to use facilities and physicians that accepts Medicare assignment should consider Medicare Supplement Plan N. Plan N does not offer does not cover the $185 (2019) deductible or excess charges.

In addition, Plan N has small co-pays when seeing the doctor or going to the emergency room. The co-pay for a doctor visit, primary or specialist, is up to $20. The emergency room co-pay is up to $50.

The Plan N caters to seniors that do not go to the doctor often. Many times, the cost savings from the Plan N to the Plan G are significant as well. The only real gap in the Plan N is that it does not cover excess charges.

Most doctors do not charge them, but you will frequently see a cancer specialist, and specialty hospitals charging those charges. A Cancer policy can always be purchased, roughly $1 per day for about $10,000 in coverage, to help cover these charges if you were to be diagnosed with cancer. You can find Medicare Plan N reviews here.

Why the Sudden Change

The end of first dollar coverage plans has been several years in the making. Congress created the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and signed it into legislation on April 16, 2015.

There are several reasons for the birth of MACRA. People agree the single most important reason is to keep doctors on the Medicare program. Medicare Beneficiaries need a large pool of doctors from which to select the one that best fits their needs and personality.

It is important to mention that someone who is already enrolled in one of the plans being retired can keep it. It is even permitted to change to another carrier’s Plan F or C, depending on which plan they have currently. Provided they can medically qualify, up until 2020.

The last plan that was retired was the Plan J. The difference is when Plan J was retired, Medicare Beneficiaries were allowed a special enrollment period to change to the Plan F with no medical underwriting. This is not the case this time around.

If you want to know more about the elimination of Plans F or C, click here.

History has shown that members that elect to stay on retired plans will be subject to larger than usual rate increases. It may not occur right away but as people that are healthy leave those plans to more cost-effective alternatives and people that cannot medically change pass on, there are less people in the pool of that plan. In order to keep up with the increased claims of sicker people, the prices must increase more dramatically to cover the claims.

 

 

 

 

 

 

 

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