Need Health Insurance?

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.

What questions to ask when searching for a Medicare supplement plan for you and your family

There are a number of ways to save on Medicare supplements, but you definitely need to ask the right questions when shopping for what you need. To be fully informed it is best to allow at least an hour talking to a knowledgeable agent. Keep in mind that some agents only represent/sell for just one company, but others may represent multiple users, which expands your options exponentially.

What questions to ask when speaking to an insurance agent? Here is a list of some of the first questions to ask:

• Are there any value added programs that would be of benefit to me?
• Are there any value added programs that would be of benefit to me and to my spouse?
• What types of value added programs are there?
• What insurance companies offer them?

Furthermore, for couples, ask about household discounts whether both individuals are on Medicare yet or not. Also, ask about current rates, and do not forget to inquire about the company’s history of rate increases.

Of course these are not the only questions you want to ask. You need to be curious about what is definitely covered in your policy and what is not included. You do not want to be in a situation where you need immediate medical attention and surgery, but find out later the surgery was not covered for some reason stated in your policy.

It cannot be emphasized enough, but make sure to read your policy. If you know what it says, you will be able to ask questions and make informed decisions about your insurance policy.

Age-related hearing loss and how Medigap plans can offer relief

As seniors grow older, some things do not function as well as they once did. Maybe your loved one is not as sharp as they used to be or they may suffer a partial or total hearing loss. In fact, according to the National Institute on Deafness and Other Communication Disorders (NIDCD) one in three people, in the United States, between the ages of 65 and 74 will experience hearing loss.

Age-related hearing loss occurs gradually, most often in both ears. The treatment for hearing loss will depend on the severity of the condition. However, there are several devices that can help seniors hear better. Hearing aids, are electronic devices that can help amplify the sounds entering the ears.

While hearing aids are necessary medical device, they are not cheap. The cost of hearing aids can go up to as much as $2,000 per aid. That adds up to $4,000 for both ears, if that is what is required. In addition, there is also the cost for the hearing exams and batteries. These expenses can add up quickly and Medicare may not cover them all.

However, some Medigap policies include free hearing screenings and discounts from 20 to 40 percent on hearing aids and free batteries for a year. Asking about added benefit, and others like it, can prove helpful when you are looking to buy health insurance.

Although Medicare supplement plans are uniform in what they cover, their pricing does vary from agency to agency and location to location. For help in choosing the appropriate Medigap policy with the best benefits speak to an experienced Medicare insurance agent.

Many Medicare supplement plans may include no cost benefits

When making choices on Medicare and Medigap policies keep in mind that your decisions will have various effects on your finances. Often, Medicare and Medigap will cost you more than expected. To ensure that your premiums cost less, do your research on the numerous plans and their costs.

For instance, if you are looking to save money on a Medigap policy, then you want to stay alert for value added benefits. Value added benefits, in a Medigap policy, could include free access to various fitness facilities, hearing aids, eye exams and eye wear. Free services, like these, could save thousands of dollars a year. Such savings are important for seniors often struggling to get by on a limited income.

Many seniors miss out on these extra benefits. However, to find out about value added benefits ask what benefits are included with your policy. Do not assume that all Medigap policies have the same benefits or have any extra benefits at all, because they may not.

Remember to make it a point to find out what your Medigap policy covers. Additionally, find out what other benefits may be included that can save you money.

How to choose a Medicare supplement plan

There are a number of health decisions that need to be made when you turn 65. It is important to not wait until the last minute to decide what policies you want. Waiting too long can result in you not receiving the coverage you need because you had to make a decision quickly about which policy to choose.

Take your time and start checking out various options for health insurance before you turn 65. Prepare a list of questions that you want to ask. Ask questions about what added benefits come with your policy. Ask what is and is not covered. Ask what would be best for your financial and health situation.

As you begin your research into healthcare coverage, work on a list of things that you need and want, and what you think will be the most beneficial to you. Furthermore, preparing helps narrow the field when you are faced with multiple choices when it comes to health care coverage. Health insurance is an important decision and you want to make the most beneficial decision.

How to save on Medicare supplement plans

When choosing Medicare supplement plans, also known as a Medigap, make sure to compare their costs. All Medigap plans are standardized, they offer the same coverage, but the costs will vary depending on the insurance company offering them.

The American Association for Medicare Supplement Insurance(AAMSI) offers an online database with the contact information for Medigap insurance agents. The database is great tool to assist you in finding knowledgeable agents who will help you compare the costs of Medigap policies. When speaking with an insurance agent find out if they only sell policies form one company or from multiple ones.

When purchasing a plan, always inquire about “household discounts.” However, it is important to realize that not every insurance company will see you as qualified for a discount. Lastly, remember that you do not have to keep the same insurance plan every year. Make sure to compare the available plans each year, as insurance rates are subject to change.

Medicare supplement insurance policies may have added no cost benefits

Often, when seniors are choosing their Medicare supplemental plans, or Medigap, they overlook the added no cost benefits. Obtaining such benefits can save seniors thousands of dollars each year. Directory

According to the American Association for Medicare Supplement Insurance (AAMSI) each year approximately 35 million people turn 65, thus becoming eligible for Medicare. Roughly 13.1 million people have Medigap. Some, but not all, of the Medigap policies now offer, no cost benefits. Seniors considering Medicare options should ask questions of their insurance agents about the various benefits attached to Medigap policies.

The added benefits programs offer free access to gyms and fitness centers, discounts on eyeglasses, eye exams, discounts on hearing aids and exams. The list of benefits is varied and each Medigap plan may have its own no cost benefits to entice seniors. The American Association for Medicare Supplement Insurance holds an online for consumers seeking to connect with Medicare agents. Remember, you need to ask about benefits or you may miss out.

Social Security COLA goes up in 2018, but so do Medicare Premiums

This year will see one of the largest Social Security cost-of-living adjustment since 2012. However, Medicare premiums are said to increase as well.

Even though the Social Security COLA is not announced until October, inflation trends are pointing to an increase of roughly two percent. Previously, there was zero COLA in 2016 and only a 0.3 percent in 2017.

The cost-of-living adjustments are determined automatically through a formula tied to the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). From 2013 through to 2015 annual COLA increases have averaged about 1.3 percent. Low COLAs are relatively rare, but 2018 will be an unusual year for retirees.

The last couple of years saw non-protected Medicare beneficiaries paying most of the cost of rising Part B premiums. In 2017 they are paying $134/monthly versus protected beneficiaries who are paying roughly $109/month.

For a retiree receiving the average Social Security benefit of $1,360 per month, a two percent increase would translate into $1387.20 per month. However, Medicare Part B premiums are taken off Social Security. Next year, the impact of Part B premium cost will vary based on the “hold harmless” Social Security provision.

The “hold harmless” law states that the Part B increases must not exceed the amount of the COLA — ensuring that net Social Security benefits do not decrease. This provision applies to roughly 70 percent of those enrolled in Medicare in both programs. The “hold harmless” provision does not include those who delayed filing for Social Security benefits, and possibly some state and federal government retirees. Well-to-do seniors are not protected under the “hold harmless” law.

When the 2018 COLA kicks in it will help spread Part B costs across the total Medicare program, in effect leveling the playing field where non-protected enrollees get lower premiums and protected enrollees will pay more.

Across the board it appears the COLA formula, even with the assistance of the “hold harmless” law, is not able to keep American seniors stable with ever increasing inflation. Rising health care costs threaten to dramatically eat into net Social Security benefits over time. Many seniors may find themselves working longer to delay the number of years of Medicare payments to be made.

Health Coverage Options for Pre-Medicare-Age Spouses

Medicare does not offer coverage for younger spouses or dependent children when the other spouse qualifies for Medicare. No one may receive Medicare benefits prior to the age of 65, unless eligible at a younger age due to a disability. What can be done to cover the younger spouse?

There are some options that may be considered for the younger spouse who is not ready to retire. Those options include planning on working past the retirement age of 65, if that is at all possible, which would permit the younger spouse to continue to be covered under an employer health insurance plan until they are eligible for Medicare.

Failing that option as a possibility, there may be employer options open, such as the employer providing retiree health benefits. This is something that would need to be checked with the benefits administrator along with asking whether or not your spouse may continue under their plan as well. In addition, if your spouse is employed, they may switch to their employer’s provided health care plan.

Individual health insurance through the Health Insurance Marketplace, or Obamacare, may be worth considering as well, especially since the proposed health care plan by the current White House administration did not pass, keeping the health care plan in place. Thus, insurance pricing is currently very competitive. The policies offer comprehensive health coverage, insurers cannot deny coverage or charge extra for pre-existing conditions.

An option to consider is COBRA. If you work for a firm that has 20 or more workers, once you make the change to Medicare, your younger spouse could stay with the company insurance for 18 to 36 months. While this is an expensive option, it may work for you depending on your circumstances. If the company has fewer than 20 workers, continued coverage may be available provided your particular state has what is referred to as “mini-COBRA.”

If your income is below the 400 percent poverty level ($64,080 for couples, $27,520 for individuals) then you may be able to receive a tax credit to reduce the amount you will have to pay for a health insurance policy.

For information on insurance plans in your state visit https://www.healthcare.gov/ or call the toll-free helpline at 800-318-2596.

What is not covered by Medicare Part A and Part B?

Medicare Part A and Part B does not cover every medical procedure. If you find that some of the services you need are not covered under Medicare, you will need to cover the remainder yourself. If you have supplemental insurance or additional Medicare plans, they may offer the necessary coverage.

Medicare Part A and Part B cover hospital stays, outpatient care, medical supplies and more. However, even if Medicare Part A and Part B covers medical procedures, the plans still require a co-payment, a deductible or co-insurance.

Some of the services that Medicare Part A and Part B do not cover are:

• Routine foot care
• Hearing aids
• Exams for fitting hearing aids
• Eye exams for prescribing glasses
• Dentures
• Long-term care/custodial care
• Cosmetic surgery
• Acupuncture
• Most dental care
• Treatment not medically necessary
• Vaccinations/Immunizations
• Prescription drugs taken at home
• Non-prescription drugs