Archives 2020

Medicare M Plan and Unique Cost-Sharing Options

Medicare AdvantageThe new Medicare M Plan offers unique cost-sharing options which are quite attractive to Medicare beneficiaries who are relatively healthy. Policy M provides half of the deductible for Medicare Part A, which is $1,100 per benefit period in the year 2010. For instance, if have a Medigap M plan and you are admitted to the hospital, you must pay $550: which is half of the $1100. For those who are not satisfied with Medicare Advantage, the open enrollment period the perfect opportunity to return to Medicare and the most competitive supplement plan available.

Medicare Advantage customers who lose their plan can always return to the original “tried and true” Medicare system along with a Medicare supplement or Medigap plan. Although Medicare plans are age-based, a good plan will pay for deductibles and 20% co-insurance that Medicare does not pay. This means that most medical expenses are fully covered, unlike Advantage plans that have co-payments and other direct costs. Here’s the best part: there is no medical signature for a customer who is missing out on their benefit plan. Even those with uninsurable conditions are guaranteed coverage by the insurer of their choice.

There are three types of Medicare Advantage plans. Medicare HMOs offer the most economical option, but enrolled people have restrictions on receiving medical coverage, as HMOs generally do not pay for out-of-network care. If you stay in your medical network, you will find co-payments are reasonable, so this is a very popular and affordable option for seniors. For those interested in choosing a Medicare Advantage plan in 2011, you may be confused by all the options available. And the fact that a Medicare Advantage plan is the most popular doesn’t mean it’s right for you. The best advice is to do homework and compare policies. Also, even if you signed up for a plan in 2010, that doesn’t mean your coverage will stay the same this year. The devil, as they say, is in the details.

Current regulations still apply to the deductible of Medicare Part A, in the sense that if you get admitted and you leave for at least 60 days, you will have to come back within the calendar year and you this deductible has to be paid one more time. With a supplemental plan for Medicare M, you are also liable to pay the Part B deductible for Medicare, which in 2010 was $155. In addition to this deductible, there are no co-pays for doctor’s office and the plan will pay the 20% co-insurance.


Part D Drug Plans and the Extra Help program

To ask if you qualify for Extra Help program, contact the Social Security Administration or visit your local Social Security office. Homes, cars, life insurance cash, and money received from family or others to pay for Medicare part D plans and household expenses do not count as resources. Some people with higher annual incomes may qualify for the Extra Help program. The Social Security Administration has a program available to qualified people, called Extra Help. Extra Help can save people who qualify for up to $ 3900 a year. Extra Help can help you with premiums, deductibles, and co-payments associated with a Medicare prescription drug plan. To qualify for Extra Aid, a person must be enrolled in a Part D prescription drug plan by 2010; Resources should be limited to $ 12,510 for an individual or $ 25,010 for a couple. Resources would include things like bank accounts, stocks, bonds and mutual funds.

In addition to the premium and copayment adjustments, we have noticed a significant change in the Part D program. This year, many companies are no longer stopping the mail order for Level 3 drugs. As many of you know, during the last two years, you can receive medication for three months for a two month co-payment if you do so in the mail. You can still do this for Tier 1 and 2 drugs, but not for Tier 3 in all companies. To make matters worse, Kaiser Family Health reports that drug manufacturers have raised their drug prices in an attempt to collect what Medicare will pay. Consequently, Medicare simply refused to include covered drugs in the first two years.

The bottom line is that you don’t change your drug coverage just because someone talks about buying a single cheaper drug. For the purposes of this article, suppose you already have your Medicare plan. So the next question is, what next? Medicare was easy, mainly because there is only one place where you can get it, namely the federal government. However, once you have your Medicare, you only have one third of the way. Medicare covers 80% of your hospital and medical expenses, but there are still two other health insurance plans needed. If you are about to turn 65, you have no doubt already signed up for Medicare or at least read the application information. So the first question to ask is whether you should get Medicare supplement plan and prescription drug coverage from Part D or if you should enter a Medicare Advantage plan.


Medicare will help the elderly pay for their premium

Many elderly and disabled people must settle for a limited income so they cannot pay monthly premiums. Others may come with minimums or even without additional bonuses. Some of MA’s plans even reduce the amount withdrawn from social security by a Part B premium.

Obviously, most older people and people with disabilities are worried about the price. Plans that cover services and provide the most flexibility can be very expensive.

Unfortunately, Part C is the only supplemental insurance that most people can afford. Also, there are many beneficiaries of Medicare who are trapped in their Advantage policies as a result of health problems.

MA’s plans are from private insurance companies, which set their own rules within the range allowed by Medicare. To make sure you receive the value of your money, read how the coverage is provided. For example, Advantage plans establish their own networks of separate providers and do not pay for non-emergency care provided by people outside that network. This makes it essential to verify the list of doctors and make sure your doctor is considered in the network.

Some plans also include some additional benefits, called value-added services. Even if they are not part of your health coverage, they can be very valuable to you. Some of these included services can make a big difference. Examples are dental plans, doctor visits and health club memberships.

Some areas of the nation, such as urban areas, may have 2 dozen of Advantage policies, but there isn’t any Humana medicare Advantage policy available in certain parts of the country. If you are lucky enough to have several options where you live, be sure to compare coverage and cost.

The final health reform bill did not include cuts to Medicare benefits. The amount you pay for medical appointments, hospitalizations, prescription drugs or any other Medicare medical treatment has not increased.

The final design eliminated the so-called screw hole. This is a loophole in Medicare insurance that allows recipients to pay the full price of premiums and prescriptions. Beneficiaries of Medicare who are yet to fill their insurance gaps will this year get a $250 discount and brand name drugs at a discount of 50% next year. What beneficiaries pay for prescriptions will decrease each year until the coverage gap is eliminated.

As for the people who can change their current Advantage plan, now can be a good time. Of course, you will have to wait until the Annual Subscription Cancellation Period (from January 1 to February 14, 2014).

Currently, Medicare supplement policies are not affected by the Affordable Health Care Act: Beneficiaries of Medigap may continue to use current providers and their coverage will not change.