The ability of a spouse of a Medicare beneficiary to enroll in Medicare depends on age. If a spouse of a Medicare beneficiary is over the age of 65, then they can enroll in a Medicare plan. The situation changes for spouses who are below the age of 65.
If for example, a spouse is 62 and their partner is 65 with Medicare, then the younger spouse cannot enroll in plans during open enrollment. Even though a spouse has Medicare, the younger one does not qualify for Medicare until they turn 65.
So, if the younger souse does not have health insurance now, it may be worthwhile to explore other options to obtain it. Check health insurance plans available for purchase through the official insurance Marketplace. If your joint income is less than $66,000, then the younger spouse might qualify for premium tax credits. If your joint income is below $22,700, then the younger spouse may be eligible for Medicaid if you live in a state with an expanded Medicaid program.
Talk to a knowledgeable insurance agent if you have any concerns or questions about open enrollment or the available insurance options for you and your family.
Posted on Friday, December 28th, 2018. Filed under
Medicare.
Remember that Medicare plans are not Marketplace plans and are not sold through the state or federal Marketplace websites. So, you can compare and review your considered choices on the Medicare Plan Finder. The plan finder allows users compare to Medicare plan options, including Medicare Part D plans, Medigap supplemental policies and Medicare Advantage plans.
If you would rather speak directly to an insurance agent, then call 1-800-MEDICARE (1-800-633-4227). Another alternative is to reach out and connect with the State Health Insurance Assistance Program (SHIP) located in your state. SHIP are able to assist you by offering personalized, local counseling to get you the right insurance for your family.
If you do not know the SHIP phone number in your state, then call 877-839-2675 and ask for your state SHIP phone number. Choosing the right health insurance plan is easy once you find out what you need to know from an insurance agent or SHIP. Always remember, that Medicare and Medicare Advantage representatives are there to help you make choices that suit your budget and lifestyle.
Posted on Thursday, December 27th, 2018. Filed under
Medicare.
In 2019 there will be two different open enrollment dates for Medicare and Medicare Advantage. The usual Medicare open enrollment runs from October 15 through to December 7 every year. In 2019, however, Medicare Advantage will get its own open enrollment period which will begin January 1 and end March 31. Those already in an Advantage plan have a chance to swap plans to a different one or drop Medicare Advantage and go back to original Medicare.
There are a number of beneficiaries that may find that option attractive in addition to the fact that 2019 Medicare Advantage plans are offering lifestyle support services including home safety fixtures, home meal delivery and transportation from home to medical appointments and back. Always double check your insurance policy to check if you qualify for what is being offered in 2019. If for any reason something does not make sense or feel right, contact an experienced Medicare Advantage insurance agent.
Posted on Friday, December 21st, 2018. Filed under
Medicare.
Medicare Advantage is popular, just about one third of all beneficiaries are enrolled in it nationally. That means roughly 20 million seniors are enjoying the benefits of Medicare Advantage, which is offering more plans every year.
Medicare Advantage is the equivalent of Medicare Part C. Medicare Advantage plans are offered by private insurers as an alternative to traditional Medicare. Medicare Advantage includes, PPOs and HMOs and covers the same health care services as Medicare Part C. Vision, dental and hearing coverage options in Medicare Advantage plans are often more affordable. This is what beneficiaries love.
The good news do not stop there for beneficiaries. More changes are coming in 2019. Beginning in January, there are going to be extra options that range from adult day-care programs, home health aides to assist with daily living tasks and safety features such as a wheelchair ramps. The new enhancements are intended to help people “age in place.”
While the enhancements are being added they are not going to be available to everyone across the board. The new, added benefits must be prescribed/ordered by a licensed provider for a patients who have specific health care needs that require them. Put another way, Medicare Advantage subscribers cannot decide to get a grab bar for the bathroom just because they would like one. They must have a specific need that mandates a grab bar, such as a high risk of falling or mobility problems.
As with any other change to a Medicare Advantage plan, it is best to ask an insurance agent what would work for your circumstances. It is confusing to figure out what you are able to apply for and what you are not. With 10,000 people turning 65 each day, the number of Medicare Advantage beneficiaries is rising. Know what works for you.
Posted on Tuesday, December 18th, 2018. Filed under
Medicare.
Sixty million new Medicare cards are in the mail to U.S. beneficiaries.
The new cards, issued by the Centers for Medicare and Medicaid Services, are intended to curtail identity theft. It is anticipated that the new cards will significantly reduce, but not likely fully eliminate, senior identify theft.
The old Medicare cards listed a recipient’s Social Security Number (SSN) and their signature. What is more, the SSN on the old cards functioned also as a Health Insurance claim Number (HICN). Because of this, fraud and identity theft was common. The new card was created to curb senior identity theft and fraud. The new Medicare cards, as mandated by a Congress issued deadline, should be delivered to all recipients by April 2019.
What Seniors Need to Know About the New Medicare Cards
The most important point to note about the new cards is that they are being mailed out in waves to all recipients across the country. That means that if you live in California and do not get your card when your relative in New York did, wait for it to show up. It is on its way. The wave mailings started in the spring of 2018 and since that time 15 states have been covered. Next on the list are South Carolina, North Carolina, Florida, Georgia and Alabama.
Did not get your card even after the mailing for your state is designated as being complete? Not a problem. Go to your “MyMedicare” account and check to see if your card was mailed. There are instances where cards have not been mailed to addresses that were not clear or Medicare felt were not trustworthy. Beneficiaries only need to contact Medicare and offer updated information to ensure they receive a card. Once you do receive your new card shred your old one to guard against identity theft.
The new card does not change your benefits. They stay the same. For example, if you are in a Medicare Advantage Plan or Medicare Drug Plan, keep using that plan’s ID card. The new card is still very recognizable — red, white and blue, with black print — but the design is different.
These new credit-card sized Medicare cards have a Medicare Beneficiary Identifier (MBI) consisting of 11 numbers and letters. The cards use numbers 0 through to 9 and all letters except—S, L, O, I, B and Z—which will never be used on the new cards. The Social Security number is not listed the new cards.
New Medicare Cards Mean New Scams
Seniors need to stay aware of scams and con artists trying to obtain their personal information for illegal uses. Two scams in particular are of concern: callers stating they are Medicare representatives calling to verify a recipient’s SSN or stating the new card needs to be paid for. The second popular scam tries to tell beneficiaries that there is a balance on their current Medicare card and they want to refund that money into their bank account, once the target gives them bank account details.
Even with the new changes to Medicare cards, scammers have been known to be extra vigilant and creative in finding ways to con people out of their personal information. It is best, despite receiving a new card, to be extra cautious about how it is used. Be safe. Be alert. Be aware. Protect your identity.
Posted on Tuesday, December 4th, 2018. Filed under
Medicare.
Good news for seniors who wish to stay in their home and community instead of going to a senior care facility. A new program offered by Medicare — Medicare PACE — will allow seniors to receive health care from the comfort of their homes and communities. This program is not available in all states.
Medicare PACE stands for Program of All-Inclusive Care for the Elderly. Currently roughly 40,000 seniors participate in Medicare PACE and receive in-home care. The program is optional but is turning out to be a really good support for elderly Americans in need of social services and more inclusive, personal, in-depth medical care.
The Medicare PACE program is designed to allow seniors to continue to live at home and in their communities instead of senior facilities. Seniors may qualify be eligible for the PACE program if they are in need of nursing home-level care, are able to live safely in the community, are 55 or older and are living in a PACE service area.
Those participating in the program have a medical team dedicated to them and their health care needs. Each team features a primary care doctor, occupational therapist, recreational therapist, nurse, social worker, physical therapist, activity coordinator, home care liaison, dietician and various other medical professionals.
With a team working with you, you get personalized, one-to-one care. You may need use a PACE-preferred doctor, but that is to your advantage as the physicians are trained in a multi-disciplinary approach to senior care. There is no deductible/co-payment for medications, services or care approved by your health care team. It is covered under the program for eligible beneficiaries.
What does PACE cover? Currently, it covers a wide variety of services that may change over time or be added to as it grows. The services covered include:
- Physical therapy
- Occupational/recreational therapy
- Laboratory
- X-ray services
- Home/Hospital care
- Emergency services
- Meals
- Medical specialty services
- Nursing home care
- Adult day primary care
- Mental health services
- Dentistry
- Prescription drugs (partially covered under program)
It is important to note that you may choose to get your medications through the PACE program and can still enroll in Medicare Part D. However, if you do enroll in a prescription drug plan, you are disenrolled from PACE.
What do you pay for PACE? If you have or qualify for Medicaid, you do not pay the premium for long-term care. However, if you do not qualify for Medicaid but have Medicare, you do pay the monthly premium and a premium for prescription drug coverage.
Posted on Friday, November 30th, 2018. Filed under
Medicare.
Recently Washington, D.C. hinted that changes to Medicare are coming. Medicare is the federal health program for people 65 and older.
Medicare Advantage plans are becoming made available through private health insurers and include Medicare Part A, for hospital/catastrophic care, and Part B, doctor visits/routine medical care. They can address dental and vision insurance and prescription drug coverage. Currently, one in three Medicare beneficiaries out of a total of 19 million seniors has a Medicare Advantage plan. Between 2016 and 2017 enrollment in Medicare increased by approximately 1.4 million people.
The Chronic Care Act, one of the most welcome new acts affecting medical care for seniors, will boosts Medicare Advantage plans by adding more benefit flexibility for non-medical coverage — meaning items such as wheelchair ramps or grab bars for the bathroom. The act also makes more telehealth services available for seniors with Medicare Advantage.
Following the footsteps of the Chronic Care Act, the Centers for Medicare and Medicaid Services (CMS) announced the expansion of the definition of “health-related” supplemental benefits in Medicare Advantage to include compensation for physical impairments, reduce avoidable ER visits and reduce the impact of health conditions or injuries. That means the supplemental benefits in Medicare Advantage would include “additional service that increase health and improve quality of life.”
This is exciting news as it means Medicare Advantage would be able to offer services such as aides to help with daily living activities; home modifications; and home delivered, medically appropriate meals that are currently limited to a small number of conditions. Aging at home is something that a great number of seniors would prefer as opposed to living in a nursing home facility. Aging at home also means lower costs for Medicare and Medicaid. Medicare Advantage plans have 77 percent enrollment in the 65 to 84 age group compared to 71 percent for original Medicare.
Currently, Congress and the Trump administration support Medicare Advantage. With such support it appears that healthcare for seniors is not going anywhere.
According to a Congressional Budget Office study, 41 percent of Medicare enrollees are expected to choose Medicare Advantage by 2027 — a figure that looks like it may keep growing.
Posted on Tuesday, November 27th, 2018. Filed under
Medicare.
If you do not enroll in certain Medicare programs/plans when you are first eligible during the Medicare Initial Enrolment Period (IEP), you could increase your premiums. There are late-enrollment penalties for Medicare Part A, Part B and Part D plans.
The IEP begins three months before you turn 65 and lasts seven months in total.
The vast majority of Medicare beneficiaries automatically receive Part A premium-free provided they have worked for at least ten years and have paid Medicare taxes. If you already get Railroad Retirement benefits or Social Security, you are auto-enrolled in Medicare Part A.
Not qualified? Then you are not enrolled and may end up paying a 10 percent higher monthly premium if you do not enroll during the IEP period. You would also be paying this increased premium for twice the number of years that you could have had Part A but were not enrolled. As an example, the Part A premium can be as high as $422, without the penalty, in 2018.
Part B may also come with a late enrolment penalty if you do not enroll when you are first eligible. That may send your monthly premium up 10 percent for each year you were without Part B after your IEP closed. This penalty may be with you for the remainder of the time you are enrolled in Medicare.
Part D may have a penalty as well if you go 63 or more consecutive days without a creditable drug plan after you IEP closes.
It is definitely confusing trying to keep track of all the ins and outs and if you need more information before you make Medicare choices, contact a knowledgeable health insurance agent. They are your best friends when it comes to helping you choose what you need and what suits your lifestyle.
Posted on Friday, November 23rd, 2018. Filed under
Medicare.
You may find yourself wondering if you qualify for both the Medicare and Medicaid programs. If you are a senior with medical needs and are living on a small income, you may qualify.
Qualifying for both Medicare and Medicaid is called dual eligibility. Those that are eligible for both programs are usually low-income adults over the age of 65, or a low-income individual with a disability. This dual eligibility can be quite confusing and for that reason, the Centers for Medicare & Medicaid Services (CMS) try to ensure that each program works with the other efficiently and effectively.
CMS offers an extensive collection of resources for those searching for information on how to co-ordinate their benefits. You can find that collection here.
If you still have more questions about your eligibility contact an insurance agent. They are trained in helping individuals like you.
Posted on Wednesday, November 21st, 2018. Filed under
Medicare.
Right now it is more important than ever to understand the differences between Medicare and Medicaid. Under the new administration, things are changing so rapidly, it is hard to keep track. It may be necessary for you speak to an insurance agent to understand what are the changes may affect you.
Medicare is a federal program for all seniors 65 years of age or over. Medicaid is jointly funded at federal and state levels and is usually intended to serve lower income individuals and families.
To find out what program is right for you, you will need to speak to a highly trained health insurance agent who knows the industry, as well as their products. An insurance agent can help you choose what best suits your needs. While it is confusing, with the help of a qualified insurance agent, the choices are much easier to understand.
Posted on Tuesday, November 13th, 2018. Filed under
Medicare.
