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Medicare 101
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Medicare 101

by Jagger Esch
written by Jagger Esch

While most individuals embrace the aging process, Medicare is excellent coverage that many seniors look forward to obtaining. Medicare has been providing health insurance coverage since 1965 for individuals 65 and older as well as certain disabled Americans.

Over 15% of the country is currently enrolled in Medicare today and that’s a definite bonus after having worked for most of our lives. Being on Medicare means having Hospital and outpatient coverage for many services.

Although, many seniors are unaware of the coverage they have and what expenses they’re responsible for paying. Having a Medicare Supplement could help you plan your health care expenses better.

Traditional Medicare Benefits

Medicare consists of two main parts:

  • Part A (Hospitalization)
  • Part B (Outpatient and DME supplies)

 

Medicare Part A is typically premium-free and provides coverage for your hospitalizations and skilled nursing facility stays. Additionally, Part A benefits provide coverage for home health and hospice care.

Part B premiums are ever-changing, typically they go up annually based on inflation. However, the government takes into consideration individual incomes, paid taxes and annual expenses. Many people with Part B don’t pay the full Part B premium.

Extra Help is available to those that qualify.

Part B benefits cover your outpatient costs for doctors’ visits, lab work, diagnostic testing, physical therapy, and outpatient surgeries.

Regardless of whether Medicare Part A or Medicare Part B is being used, each plan only covers at 80%. The remaining 20% leftover is the Medicare beneficiary’s responsibility to pay.

Both Plan policies only take effect after the Part A and Part B deductibles have been met. Each year the deductible cost changes so you can log onto Medicare.gov to see the exact rate for each deductible.

How to Qualify for Medicare

To become eligible for Traditional Medicare benefits, individuals must be at least 65 years of age.

When enrolling in Traditional Medicare you have a seven-month Open Enrollment Period (OEP). The OEP begins the three months leading up to your 65thbirthday, continues through your birthday month, and the remaining three months after turning 65.

Failing to enroll for Medicare Part A or Medicare Part B during the Open Enrollment Period can result in penalty fees.

Medicare Part A Penalty:

If you have Part A premium, an extra 10% is added for each year gone without Part A benefits. Based on how long one goes without Part A benefits will determine the number of penalty fees.

Medicare Part B Penalty:

With the Medicare Part B penalty, the monthly premium is increased an extra 10% for every year without Part B benefits. With the Part B penalty, the increased premium rates are paid for the entirety of having part B benefits.

Medicare is also available for certain individuals with end-stage renal failure and certain other disabilities. For those individuals who also receive social security benefits or certain Railroad Retirement Benefits, you’re automatically eligible and enrolled in Medicare Parts A and Part B after two years.

Part C Medicare Advantage Plans

Medicare Advantage Plans are provided by private insurance companies within your area. Premiums are based on the individual plans offered.

Part C Plans are oftentimes referred to as Medicare Supplement Plans as their benefits will take over coverage for that of Traditional Medicare Part A and Part B.

Oftentimes, Medicare Advantage Plans come with cheaper premium costs. So, those living on a fixed income find the sound of these policies appealing.

However, with the cheaper premium prices come at a price.

Medicare Advantage shortcomings include:

  • Restrictions
  • Referral requirements to see a specialist
  • Coverage limitations
  • Limited doctor, pharmacy and hospital networks
  • Limited coverage areas.

 

What seems like being more valuable, can end up costing more for the individual when it comes to their out of pocket cost. Coinsurance, deductibles and copayments are commonly discussed when you enroll in these plans.

Medicare Part D

Traditional Medicare offers no insurance benefits for prescription medications. With medications, especially brand name, the out of pocket costs at the pharmacy can be downright astronomical!

By obtaining a Medicare Part D Plan, AKA, a Medicare Prescription Drug Plan (PDP), you can get those medically necessary prescriptions at a lower price. In some cases, you can get them at no cost whatsoever.

Offered by the individual health insurance companies, you can pick the best Part D Plan to suit your prescription medication needs. Depending on the policy will depend on your premium prices.

Another bonus of enrolling in a Medicare Part D Plan is you will avoid the penalty fees.

Like the penalty fees of Original Medicare, failing to enroll during your 7-month initial enrollment period will result in an increase in the Part D premium charge.

Depending on how long one went without drug coverage will determine the additional premium fees each month.

Medicare Supplement Plans

There are also Medicare Supplement Plans, that like Advantage Plans, are purchasable through your local private insurance carriers.

With Medigap Plans, they work alongside the already excellent Traditional Medicare benefits. These plans provide extra coverage for those items not originally covered by straight Medicare.

Pending on which Plan is chosen, items like deductibles, coinsurance, copayments and other items not covered by Medicare can cost less for the beneficiary. In some cases, there are plans that offer complete coverage.

There are ten letter plans available to choose from and depending on your individual healthcare needs will depend on which plan best suits you.

For example:

Plan F

This plan provides 100% coverage of both your Medicare Part A and Medicare Part B deductibles.

It has the added benefit of paying for:

  • Medicare Part B’s copayments
  • Foreign travel emergency coverage
  • The remaining 20% coinsurance for your Part A and Part B fees

 

While Plan F is the most popular due to the great additional benefits, it also comes with a higher premium price tag.

High Deductible Plan F

There is also a Medicare Supplement Plan F High Deductible version that provides the exact same benefits, just with a deductible. The added bonus of this specific plan is there is a lower monthly premium so it’s cheaper for those on fixed incomes.

Plan G

This plan is another great Supplement Plan that’s also comparable to Plan F, however, there is no Medicare Part B deductible coverage.

Many times, the savings in Plan F premiums is more than the Part B deductible, meaning you get comprehensive coverage at a great price. Besides, Plan G typically has lower annual rate increases when compared to other plans.

Plan N

With this specific policy, it’s considered, “cost-sharing”. While the Medicare Part A deductible is completely covered, the beneficiary will be required to pay a small copayment for ER and doctor’s office visits.

It’s important to research all Medicare plans available, prior to picking your “perfect” plan. What works for one individual, may not work for another.

There’s plenty of information available regarding not only Traditional Medicare benefits, but also Medicare Advantage as well as Medicare Supplement Plans.

Medicare low Income Plans

While Medicare offers good healthcare coverage, those living on a fixed income may find it hard to afford monthly premiums, deductibles, coinsurance and copayments.

Even with lower premiums associated with Medicare Advantage plans or more coverage with Medicare Supplement Plans, the out of pocket costs can still be quite burdensome.

Those still struggling with healthcare costs there are Medicare Savings Programs that you may qualify for, applying is highly recommended when you meet the income requirements.

Additionally, each individual state has their own State Health Insurance Program, also known as SHIP. SHIP can provide financial assistance and relieve some of the stress associated with out of pocket costs for health insurance.

Changes in Medicare as of 2020

In the upcoming years there’s always the chance of change when it comes to not only premium and deductible prices, but also changes in policies.

The most major upcoming change will be the doing away with First-dollar coverage plans. What this means is that any of the Medicare Supplement Plans that leave a Medicare beneficiary without any out of pocket costs, will no longer be available.

This affects the 3 major first-dollar coverage Supplement Plans:

  • Medicare Supplement Plan C
  • Medigap F
  • High Deductible F policy

 

This change in 2020 is mainly due to congress feeling as though Medicare beneficiaries who have no deductibles or out of pocket costs, will then no longer overuse healthcare services they don’t necessarily need.

This upcoming change will only affect those eligible for Medicare benefits after 2020. Luckily for those who currently carry or are eligible prior to 2020, will be, “grandfathered in.” This means you may still reap the benefits of those first-dollar plans!

There will be other options available for those looking to enroll after 2020. You can still enroll in Medicare Supplement Plans with just some slight changes and a small overall increase in your out of pocket costs.

Getting good health insurance to converge should be simple. Traditional Medicare benefits, a Supplemental insurance plan as well as a Prescription Drug Plan can provide individuals with optimal healthcare coverage.

Medicare is readily available, easy to obtain and most providers take the insurance. Regardless of what you may have heard about Medicare in the past, take action and enroll in Medicare as soon as you become eligible.

The sooner you do the sooner you too can start benefiting from our government appointed healthcare!

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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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MedicarePrescription Programs

6 Ways Seniors can Save on Prescription Drugs

by Guest Blogger
written by Guest Blogger

Prescription drug use is increasing across all groups of people. But seniors are the most like to use multiple medications at once. This phenomenon, called polypharmacy, sees some seniors saddled with ten or more prescriptions. As age increases, so does the number of pills consumed each day.

Whether or not polypharmacy is the best option medically, the financial burden is undeniable. Even with a Medicare Part D plan, prescription drugs costs stifle many seniors. This is especially true in the coverage gap, where patients are responsible for a larger percentage of drug costs. If you’re overwhelmed by the cost of medication or caring for a senior on a tight budget, try these 6 ways to save on prescription drugs.

  1. Try Generics

The average price difference between generic and brand-name drugs is between 80% and 85%. This represents a huge opportunity for cost savings, especially for people who take multiple medications.

Brand loyalty might be keeping you on a more expensive drug. But generic equivalents are subject to the same quality standards and contain the same active ingredients as brand-name medication. Unless your doctor has a specific medical reason for you a brand-name drug, ask for the generic.

  1. Switch to a Different Brand

Generic equivalents aren’t always available. But there are many different medications to treat common conditions. When your doctor prescribes something new or expensive, ask if a more economical option exists.

If you have Part D coverage, what you pay for a drug will depend on the plan’s formulary. This list puts medication in different categories and often changes from year to year. Request a copy of the formulary to help your doctor find the lowest price option for your condition.

  1. Preferred Pharmacies

If your Part D plan has preferred pharmacies, you should be using them whenever possible. They offer benefits like co-pay discounts, bulk ordering, or home delivery.

It’s especially important to shop around if you aren’t enrolled in prescription drug coverage. Prices can vary significantly between pharmacies. Call different retail chains and smaller independent stores to make sure you’re paying the lowest possible price.

 

  1. Change Medicare Plans

Enrolling in prescription drug coverage with Medicare can be overwhelming. Once you’ve selected a plan, it’s easy to stick with the status quo. But the plan that’s best for you will change as you age and your prescriptions increase.

Ask friends and family for advice or help researching new plans. You can also take advantage of resources like State Health Insurance Assistance Programs, where counselors are available to help find the right Medicare plan for you.

  1. State Pharmaceutical Assistance Programs

Medicare is a federal government program, but some states offer extra assistance to residents with a specific health condition or below a certain income. Check the Medicare website to see if you qualify for one of these programs.

  1. RxConnected Online Pharmacy

What if you take an expensive drug that isn’t covered by your Part D plan, or pay high out-of-pocket costs in the coverage gap? RxConnected.comis a Canadian prescription referral service that helps patients in the U.S. purchase lower-priced maintenance medications from licensed pharmacies in Canada and around the world. All you need is a valid prescription from your doctor. Placing an order online or over the phone is easy, and medication is delivered right to your door.

Ready to spend less money on prescriptions and less time at the pharmacy? Visit RxConnected.comto compare prices and find out just how much you could be saving.

Author Bio:

Katharine is a creative content writer who loves to tell stories. When she’s not busy writing, Katharine spends time hiking, cycling, and exploring beautiful British Columbia.

 

 

 

 

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If you get Cancer what does Medicare Cover?
Medicare Plans

If you get cancer, what does medicare cover?

by Jagger Esch
written by Jagger Esch

A cancer diagnosis after the age of 65 can be overwhelming, but with Medicare and the right supplemental coverage, paying for medical care doesn’t have to be. Understanding the facts and benefits of Medicare regarding cancer coverage will make going through the process of treatment, from oral medication to surgery, a little bit easier for patients and their loved ones. If you get Cancer what does Medicare Cover?
Medicare does a very good job of covering cancer treatment for those 65 and over. The American Cancer Society reports that Medicare pays for nearly half of the $74 billion spent on cancer treatment each year.
Medicare covers most of the expenses involved with cancer treatment, and a Medigap plan can cover the rest.

What Does Medicare Part A Cover?

Medicare Part A covers hospital stays for cancer treatment. There is a deductible of $1340 (2018) that must be met before coverage begins. That expense can be covered by a Medigap plan, which is a supplemental insurance policy that pays for expenses that Medicare does not. A Medigap plan can greatly reduce the cost of cancer treatment for Medicare recipients.
Medicare Part A also pays for the full cost of skilled nursing facility care for 20 days after cancer surgery. This amount can also be increased with a Medigap plan. Those who don’t have money to pay such expensive medical bill may consider medical loans for bad credit. Low rates and easy repayments!
Skilled nursing care is vital to the successful recovery of patients who have cancer surgery, as it allows for time to heal while being expertly cared for by professionals, as opposed to returning home and having loved ones caring for patients. The idea of more time away from home may not be appealing, but in the long run the extra time in qualified hands will benefit not only the patient but their family members as well.
If hospice care is needed, Medicare Part A will cover it.

What Does Medicare Part B Cover?

Medicare Part B covers 80% of the cost of doctor’s office visits and treatments onsite, including cancer screenings, chemotherapy and radiation administered in the doctor’s office, tests and other outpatient care. A Medigap plan will pay for the other 20% of expenses for doctor’s office visits and treatments.
Part B covers some of the cost of medication for cancer treatment. Part B will pay for 80 percent of the cost of intravenous cancer treatment and intravenous anti-nausea drugs. If your doctor decides to treat your nausea with oral medication instead, it will cover 80% of those medications as long as they are taken within 48 hours of the cancer treatment. A Medigap plan will take care of the 20% of medication costs not covered by Part B.

What Does Medicare Part D Cover?

Medicare Part D, the prescription drug coverage plan, covers cancer prevention medications, anti-nausea drugs in pill form, and any injections that you give yourself during your cancer treatment. The cost of cancer drugs, from chemotherapy to immunotherapy, can be extremely high. Medicare Part D is essential to keeping those costs at a minimum for the patient.

What Does a Medicare Advantage Plan Cover?

Medicare Advantage plans, offered by private, Medicare-approved insurance companies, include all your Medicare Part A and Part B benefits. Medicare Advantage plans often include extra benefits, such as prescription drug coverage that are useful for a patient undergoing cancer treatment.
The downsides of a Medicare Advantage plan for cancer treatment is that patients may need referrals and will be limited as to which doctor they can choose to see based on who is in their plan. This can both slow down the process for getting treatment and prevent patients from seeing doctors who may be experts in treating their form of cancer.

Additional Things to Know About Medicare and Cancer

Medicare is invested in screening and prevention of cancer. Medicare members can and should take advantage of:

  • Mammograms every year for women over 40, including 3D mammograms in some states.
  • Pap smears and pelvic exams to screen for cervical and vaginal cancer, once every 24 months, or annually for women who are at increased risk.
  • Colorectal cancer screenings. A colonoscopy every 10 years is recommended for anyone over 50. Those with a higher risk can be screened more frequently under Medicare plans.
  • Annual lung cancer screenings for smokers or former smokers aged 55-77, if their physicians request the procedure.
  • Prostate cancer screening annually for men over 50. One in seven men is diagnosed with prostate cancer, but only one in 41 will die from it, due to early screening and intervention.
  • Although hair loss is a problematic side effect of some cancer treatments, Medicare does not cover the cost of wigs.
  • Medicare Parts A and B cover cancer treatment no matter how old you are.

Be prepared if you are diagnosed with cancer by understanding the coverage you have under Medicare and Medicare Advantage plans. Consider a Medigap plan to cover the costs that Medicare does not pay for. Get the care and treatment that is available to you through Medicare to stay healthy and get well.

If you get Cancer what does Medicare Cover?

If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover?If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover? If you get Cancer what does Medicare Cover?

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