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Foreign Travel With Medicare May Be Problematic

Do you travel a lot? If so, make sure you check whether or not Medicare is in force when you are abroad.

Read over your insurance policy and find out what it does and does not cover. If, at any point you do not understand what the document encompasses, talk to a qualified insurance agent and have them walk you through your policy before you start to travel with Medicare.

You may not know that Medicare Advantage Plans and Original Medicare do cover urgent or emergency medical services anywhere in the United States and its territories. So if you have a Medicare Advantage Plan, you are getting urgently or emergency medical care that:

  • Limits on how much the plan bills you by being out of network
  • Must cover follow-up care in relation to the emergency if delaying it puts your health in danger
  • Your plan cannot demand you see an in-network provider
  • You can appeal if your plan denies care costs
  • You do not need a referral
  • That if the condition was not an emergency but looked/felt like it was, Original Medicare/ Medicare Advantage must cover care

What happens if you are denied coverage of an urgent or emergency medical assistance because you went to an out-of-network provider without an OK or a referral? Appeal the denial and get the physician to provide the appropriate documentation that the medical services rendered were urgently needed or in response to an emergency. Your State Health Insurance Assistance Program can help you in putting together an appeal.

Medicare does not cover medical costs while you are travelling outside of the United States. However, the plans must cover care in certain circumstances, including: paying for care received on a cruise ship while that vessel is in U.S. territorial waters; paying for E.R. services in Canada while traveling a direct route between Alaska and another state and the nearest treating medical facility is in Canada; and in certain limited cases, Medicare may also pay for non-emergency inpatient care in a foreign hospital.

There are a few Medigap policies that offer coverage for travelers’ abroad and they include Medigap plans C through G, M and N and offer 80 percent of the cost of emergency care.

If you do not know what your plan does and does not cover, check your policy for specific rules, and if that is not clear, contact the insurance agent and ask them to discuss the relevant sections and what they mean when you are travelling outside the United States.

Posted on Friday, May 31st, 2019. Filed under Medicare.

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 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.

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.

When is the Best Time to Buy Medigap Coverage?

According to the Medigap website, the best time to enroll in Medigap policy is during the six month Medigap enrollment period which begins the month a person is 65 and has already enrolled in Medicare Part B.

Missing the enrollment period, often means that you will not be able to enroll. The most popular plans might already be closed. Therefore, it is best to buy what you need right away.

However, for individuals who did not buy a Medigap policy during the six-month open enrollment period, there are other ways you may search for a policy. The first route to take is visit the Medicare.gov website where under the “Supplements and Other Insurance” tab you will find a tool to help you compare Medigap policies.

When shopping for Medigap insurance remember that by law, all policies provide the same basic benefits. The only difference between the policies is the price. Depending on what you want and need make certain to compare deductible and co-pay amounts prior to buying a plan. If you want to localize a search to your home area, the Medicare.gov website can assist with that as well. Medicare supplemental plans can be found by clicking on “Find Health and Drug Plans,” which appears as a menu choice under the “Sign Up/Change Plans” tab.

Another way to find a Medigap policy, if you did not register during the enrollment period, is to check insurance company websites or talk to the AARP. Lastly, do research on the possibility of using Medicare Advantage Plans.

Before signing up for Medicare Advantage, make sure to have laid out the benefits you require and have an established budget. This is because some premiums may cost more than having a Medicare plan with a Medigap supplement.

Taking the time, before the enrollment period begins, to acquaint yourself with your options can save you time and money when choosing a Medigap plan.

Posted on Friday, December 29th, 2017. Filed under Medicare.

Does Medicare Provide Coverage Anywhere in the United States?

Increasingly Americans travel to other states to visit relatives, take vacations and take care of family. As people move between states it is important to keep track of Medicare coverage. For instance what happens if your home state is South Dakota and you take up residence in Florida to care for a family member? Do you need to get a Medigap plan in Florida or one in South Dakota? Would there be any out-of-network expenses involved here? These are some of the questions many people ask.

Original Medicare offers coverage anywhere in the United States provided medical professionals accept Medicare and nearly all do. When you have Original Medicare, you should also consider Medigap plans which offer additional coverage for copayments, deductibles and coinsurance. For anyone traveling inside the country it is important to note that once you have a plan, you may retain that plan regardless of your location in the United States.

If you decide to move out of your home state, you can keep your current Medigap policy as long as you have Original Medicare. If you want to switch to a new Medigap policy, however, you will have to check with both your current and new insurance company to see the Medigap policy options they offer. There are 10 standardized Medigap plans, this means that you may be able to reaming with your plan. Therefore, you may get a Medigap policy in South Dakota or in Florida.

What if you decide to switch to a Medigap issuer in Florida? You can certainly do that once you have established residence there, but it is not required that you do so. If you do make the decision to switch, you might be charged more in Florida because you do not have “guaranteed first rights.” “Guaranteed first rights” are rights that you have in certain situations when insurance companies are required to offer certain Medigap policies.

Your situation may look different if you are enrolled in a Medicare Advantage plan or in Medicare Part D when you decide to move out of state. If your current Advantage plan is not available in the area you are moving to, your plan is required by Medicare to disenroll you. If this happens outside of the special election period (SEP) you will be returned to Original Medicare. However, if you notify your plan provider before you move, you SEP will be changed. The SEP will begin one month before the move and last three months. If you forget to notify your provider about your move, you can still do so the month of the move. In such a situation, you will also receive a three month SEP, which begins the same month of the move.

Always check with an experienced insurance agent if you have any questions about how changes in your situation may affect your Medicare coverage.

Posted on Friday, December 1st, 2017. Filed under Medicare.

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.

Posted on Friday, September 29th, 2017. Filed under Medicare.

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.

Posted on Monday, September 25th, 2017. Filed under Medicare.

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.

Posted on Friday, September 22nd, 2017. Filed under Health Insurance.

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.

Posted on Monday, September 18th, 2017. Filed under Medicare.
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