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Open Enrollment Period for Medicare and What to Consider

Did you know there was a special enrollment period for senior citizens from January 1 until the end of March? It is supposed to be the same for next year, so mark it on your calendars.

The most important thing to remember about this special three-month period is that it offers beneficiaries a window during which they can switch some of their Medicare arrangements. During this time, it is not a bad idea for seniors to consider their options regarding their Medicare plans. This is even more crucial if you are soon to be turning 65.

Around enrollment time, solicitations for Medicare Advantage come flying into mailboxes with light speed, each offering something special, unique. All the information is intended to inform readers that if they have a Medicare Advantage plan, they can switch to another Medicare Advantage plan or drop a plan, return to the Original Medicare and buy a Part D stand-alone drug benefit. There seems to be quite a bit of flexibility for seniors looking to make changes in their Medicare plans.

A word of caution, along with all the things that seniors can do, beware there is one thing you cannot do, and that is if you happen to have traditional Medicare partnered with a stand-alone drug plan, you cannot switch to a new drug benefit that may save you money on prescriptions. That may only be accomplished during open enrollment in the fall. So, the special enrollment period is actually a second chance for seniors to save on drug costs – one of the most sought after benefits in this age of expensive pharmaceuticals.

Remember though, if you choose to divest yourself of a Medicare Advantage policy and cut over to traditional Medicare, you might find it difficult to buy a Medigap policy to plug the holes. In fact, there are only four states that offer guaranteed issue Medigap insurance, even if beneficiaries have pre-existing conditions – Maine, New York, Massachusetts and Connecticut. This may not be possible in other locations.

The little known trick to getting good drug benefits that actually saves money is to shop ahead of needing a drug plan benefit and find out which one can save the most. If you research that information before you hit the next special enrollment period, you could end up saving upon switching plans. Research and asking a lot of questions are two of the most important things seniors need to do when it is time for special enrollment.

Posted on Friday, May 17th, 2019. Filed under Medicare.

Medicare Policy Non-Renewal Notices Can Be Confusing and End in Cancellation

Due to the confusing nature of letters and notifications from insurers about changes to Medicare, often, Medicare Advantage beneficiaries end up not renewing their contracts. Moreover, what happens if a Medicare Advantage plan was not renewed by the insurer and the beneficiary did not understand that?

While this situation can be confusing, the beneficiary does have a special enrollment period available to make changes to their Medicare coverage. Most years, that special enrollment lasts until February 28. If the beneficiary opts to remain in the Original Medicare, they would typically enroll in a Medicare Part D drug plan and a Medigap plan. Most insurers advise Medicare beneficiaries when they discontinue coverage that the insured has a “guaranteed issue right” for Medigap plans.

The beneficiary would also be well advised to consider a Medicare Part D drug plan to handle the cost of prescription drugs. There are numerous Part D options that can be compared by using the Find Health and Drug Plan tool at www.medicare.gov. In the alternative it is always easy to call 1-800-MEDICARE to get assistance in comparing costs and coverage options.

What if the beneficiary wants to choose another Medicare Advantage plan? It is a good idea to figure out precisely how the plan is to be used before making any calls or doing research. Some Medicare Advantage plans have hearing, vision and dental services, services that a beneficiary may not need. Or they may wish to choose a plan that offers all three. Again, beneficiaries have the option of going online to see what kinds of Medicare Advantage plans are available for 2019 and use Find Health and Drug Plan tool at www.medicare.gov.

It is worth noting that Medicare Advantage plans usually have a contracted network of hospitals and physicians and also have out-of-pocket expenses that the beneficiary is responsible to pay. It is worth asking for a summary of benefits for any chosen option in order to compare various alternatives.

Medicare is changing but it is not clear yet how. That leaves beneficiaries struggling to make the best available choices open to them at the time they come up for enrolment or when they first become eligible for Medicare. The one thing to know with certainty is that whatever is purchased now is likely to be portable later and that in buying the best option(s) now is likely to mean cost savings in the long run. Always know that if you are having trouble figuring out what your best Medicare options are, you can always call a knowledgeable insurance agent who can help you make an informed choice.

Posted on Tuesday, April 2nd, 2019. Filed under Medicare.

Medicare Advantage, Medigap Beneficiaries Lose Fitness Program Built into Health Insurance

A fitness program once embedded into Medicare Advantage is no longer available. The loss of this program concerns many seniors who used it to stay fit and healthy, allowing them to age in place.

UnitedHealthcare ceased offering the program as of January 1, 2019, upsetting over 2 million beneficiaries using it. That said they also replaced it with their own fitness program that may be more innovative and flexible.

According to UnitedHealthcare, people enrolled in Medicare Advantage plans with the company can now take advantage of “Renew Active.” The main reason the company opted to bring in their own health/fitness program is that they are able to offer more customized programs based on what members want. UnitedHealthcare’s program offers wellness coaches, incentive programs for achieving walking goals and even online exercises. Taken as a whole or in part, the new approach hopes to help seniors improve the quality of their life and health.

Renew Active comes at zero additional cost to those enrolled in eligible UnitedHealthcare Medicare Advantage plans and it offers access to over more than 6,000 fitness locations locally, regionally and nationally for “no” additional cost.

Perhaps the most unique option about Renew Active is that seniors have the choice of an in-person fitness orientation plus the benefit of a standard membership at participating fitness locations. This opens the door to the ability to be able to use more amenities, a wider range of fitness equipment and also be able to get into group exercise classes.

It is good news for seniors wishing to stay fit and active that Renew Active does not cost them extra at a time in their life when finances are typically sparse. With the wide range of fitness choices now offered, seniors are likely to find that they have access to just about any program that they are interested in.

Posted on Wednesday, February 13th, 2019. Filed under Medicare.

Five Medicare Changes for 2019 You Should Know About

You likely knew it was going to happen at some point, and it did. Medicare changes in 2019 are coming your way.

Medicare is set to expand its scope of coverage and many beneficiaries may find this attractive, but as always, they should check each option that interests them before making a decision. For 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. In some instances, seniors who need a hand with daily living activities may find the cost of a home health aid is covered. Again, always double check what you read about new services offered in order to understand whether or not they apply to you.

Do not like what you chose in terms of Medicare options and plans? This is new option may be for you. For 2019, you have the option to try an Advantage plan for up to three months and switch to another, or back to original Medicare, if you do not like your coverage.

This year you should be aware that Part B premiums are going up. They were $134/month in 2018 and are going up $1.50/month to $135.50. However, those with higher incomes may pay quite a bit more for Medicare Part B.

Along with the fact that Medicare Part B premiums are going up, Medicare deductibles are also going up. The Medicare Part B deductible will be $2.00 higher than in 2018 and cost $185. You should also note that the Medicare Part A inpatient deductible for being admitted to hospital goes up to $1,364; an increase of $24.00 over 2018.

Do you struggle with mobility issues? Then this new service may be appealing. Older Americans with mobility issues sometimes put off going to see a doctor because it is too much trouble. Medicare has been offering a telehealth videoconferencing program to connect patients and doctors, but for 2019 these services are expanding to those receiving stroke treatment or end-stage renal disease.

And last, but not least, Medicare Advantage is going to have a new open enrollment period. In 2019 Medicare Advantage gets its own open enrollment period to 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. This open enrollment period is different from Medicare’s regular open enrollment that runs October 15 to December 7 each year.

Also, eligible Americans who prefer coverage under Medicare (Parts A, B, D) can choose between the original Medicare or Medicare Advantage with cost effective bundles (including prescriptions vision, dental, hearing that Medicare does not offer).

Be informed. These are your Medicare choices.

Posted on Tuesday, January 15th, 2019. Filed under Medicare.

Where do you find Medicare options and review them?

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.

Open enrollment for Medicare is going to be different in 2019

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 Changes Coming in 2019

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.

More and Better Medicare Advantage Plans on the Horizon

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.

The skinny on Medicare

Medicare, the federal program, offers health insurance to adults 65-years-old and older. With this program, most people who paid Medicare taxes while working for at least 10 years, are automatically enrolled when they turn 65. If you have not worked for 10 years, then you could possibly be eligible for Medicare through your spouse.

Medicare offers health coverage for basic needs and breaks down into Parts A through Part D. Hospital insurance is Part A and means you are covered for stays in hospitals and for medically necessary needs while there. Part B handles outpatient needs, such as doctor visits. Part C, also known as Medicare Advantage, allows those enrolled to get all the benefits of Parts A and B (there are some limitations). Part D handles prescription drugs.

If you do not know what you need to suit your lifestyle, ask your health insurance agent or broker. They are trained to know every detail you could possibly want to know.

Posted on Tuesday, October 16th, 2018. Filed under Medicare.

Choosing Between Original Medicare and Medicare Advantage

When enrolling in Medicare insurance it is important to do it on time. The enrollment period is individually based. Open-enrollment occurs three months prior and three months after an individual’s 65 birthday. If you miss the enrollment deadline you could end up paying higher premiums.

The first decision to make when enrolling in Medicare whether to choose Original Medicare or Medicare Advantage. Original Medicare, which is Part A and Part B, covers hospital expenses, some non-hospital costs including supplies, outpatient care and certain kinds of medical appointments. Medicare plans are offered by the federal government and permit beneficiaries to use any health care professional that accepts Medicare.

On the other hand, Medical Advantage offers beneficiaries a variety of health insurance plans from private insurance companies, which are typically PPOs, HMOs and EPOs. Most of these offerings charge a monthly premium in addition to the basic Part B premium. These plans may also a greater range of coverage choices.

There is no right or wrong when choosing the plan that best suits you and your circumstances. However, it is important that you make the right choice that suits you when you enroll, otherwise you stand to lose access to some options once open enrollment ceases. During open enrollment for Medicare Advantage, plans offered are not allowed to decline health insurance coverage. If you miss open enrollment health insurance providers could decline to issue health insurance to you.

For those choosing to go with Original Medicare, they might want to consider basic coverage with a Medigap plan. These plans are sold by private insurance companies and offer coverage for health care expenditures that do not fall under Part A or Part B. Once the decision is made to purchase a Medigap plan, you need to consider which type to get. There are 10 different standardized options (the same coverage is available no matter where you live or who is selling it).

The vast majority of beneficiaries new to Medicare choose Medicare Part D, which offers prescription drug coverage. However, this is optional, depending on what other Medicare plans you have selected. Original Medicare and Medigap do not offer prescription drug coverage, so it is recommended to choose Part D.

There are some Medicare Advantage plans offering drug coverage as a component of the basic plan but you need to ask about it during enrollment. If your Medicare Advantage plan does have good drug coverage, then you could skip Part D.

In general, always ask questions when making health care insurance choices because if you do not you may find that you are not covered for a certain procedure.

Posted on Monday, October 16th, 2017. Filed under Medicare.
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