Archive for the ‘Medicare’ Category

Anyone 65 years of age and over who has signed on for Medicare is likely going to realize that Medicare only covers a finite group of health care costs, leaving gaps in their medical insurance coverage. To help pay some of the health care costs that standard Medicare does’nt cover, such as co-payments, co-insurance and deductibles, there is Medicare supplemental insurance plan – also known as Medigap – which may cover what Medicare doesn’t cover.

“When you choose a Medigap plan, it is important to find the best policy for you,” said Alan Weinstock, insurance broker at “Medicare Supplement Plans”. “Seniors should talk to someone who knows [about it] and can help them compare rates, plans and benefits for Medicare supplement insurance before they buy.”

For older Americans who are ready to choose a Medicare supplemental insurance policy, here are five tips to help them learn further about Medigap insurance.

Medigap Insurance and the Policies Companies Sell

There are Medigap plans ranging from A through L; however, while the insurance companies can sell only standardized Medicare supplement insurance policies, they don’t have to offer every Medigap plan. There is a caveat, though: Insurance companies must offer Medigap Plan A if they offer any other Medigap policy. State laws may also affect which plans are offered by companies.

Important Information about Medigap Policies

In order to buy a Medigap policy, there are some important points you need to know:

1. You need to have Medicare Part A and Part B.
2. There are monthly premium rates you have to pay for Medicare supplemental insurance.
3. Your policy cannot be cancelled, even for health reasons, as long as you pay your premium.
4. Each plan only covers one person. That means you and your spouse will have to buy separate policies

Choosing the Best Time to Buy Medicare Supplement Insurance

The best time to buy Medigap insurance is during your Medigap open enrollment period, which is the six-month period that begins on the first day of the month in which you turn 65 and enroll in Medicare Part B. During this period, insurance companies cannot use medical underwriting, so they cannot refuse to sell you a Medigap policy, charge you more because of health problems or make you wait for coverage to start, except in some cases for pre-existing conditions.

After the open enrollment period, Medigap insurance companies are generally allowed to use medical underwriting. Therefore, there is no guarantee they will sell you a policy.

Insurance Company Pricing of Medicare Supplement Insurance

Insurance companies decide individually how to price their policies. There are three ways they can set the price: community or no-age rated, issue-age rated or attained-age rated. Be sure and ask them how they do it, because the way they set the price affects how much you pay now and in the future.

Know What Medigap Policies Don’t Cover

Medigap policies don’t cover long-term care, hearing aids, eyeglasses, private-duty nursing and prescription drugs, vision or dental care. Prescription drug coverage can be obtained by joining the Medicare Prescription Drug Plan, or Part D.

The important thing is to seek out experts and ask questions when looking to purchase Medigap insurance.

Health insurance is all good for securing your health in your old days. After retirement you will have no income source like when you have your job. You will have your pension policy or pension but there is a big room for doubt that how much the income would then help you to recover from some dangerous or severe disease like diabetes, high blood pressure cholesterol, heart disease, asthma and so on. All these can be dangerous and fatal in terms of affecting health. One such plan is called the Medicare original plan which saves all your tension about your health and unknown crisis. This plan comprises of different small policies which help you in the time of crisis providing you with the expenditure that will be billed by your hospital. But there is a problem. There are a lot of medical costs that are covered by the Original Medicare plans. Rather to say almost all of the medical costs are covered by the original Medicare plans. So you can solute your problem now by doing or applying for a health insurance like Medicare health insurance. This will help you to save your future and health when you would need that.

But still there remain some costs that the Original Medicare does not cover therefore in such situations there is the need for the Medicare Supplement Plans. It helps the beneficiary to pay for those costs are not been included under the policy coverage of the original Medicare plans. It is the complete solution as there is some more you can do by doing a parallel insurance policy side by side with Medicare policy. And that is Medigap insurance plans. From the very name you can understand the cause of the policy. It is to strengthen your original Medicare plan by supplementing that. It supplements the original and makes it viable to make you 100% beneficiary. In reality it is seen that you would not get all the money promised to you by the Medicare policy because of insurance law. It is normal and common to all insurance policies. Therefore you would not be able to get the benefits from the insurance. But if you do a Medigap Health Insurance Plans or a supplemental Medicare plan then you can snatch the most benefits of an original Medicare policy.  There are 12 plans to help you out in your trouble situation. These 12 different plans or policies are named after alphabetical words like A,B,C,D,E,F,G,H,I,J,K and L.  They claim different kinds of benefits to theirs policy holders. But the basic benefits are provided by plan Ass and B. They are the backbone of this supplement plans. They are called basic plans of these insurance because these two provides benefits similar to the Original Medicare.

You can consult with a medigap insurance advisor and choose your option and plan to secure your health. You can do a   Medigap insurance California which is a reliable insurance company which provides you all the benefits of medigap policy and makes your life tension free and full of enjoyment.

Medicare Supplement Plans also known, as Medigap is a private health insurance that is supplementary to the original Medicare policy. Which means that the Medicare Supplement Plans helps to pay some of the health care costs that the original Medicare does not cover. In other words it bridges the gap between the policy coverage of the original Medicare and the total amount payable. It is somewhat like copayments, coinsurance, and deductibles. The Medicare supplement policies sometimes may also cover certain things that the original Medicare does not cover. The point is that if you are having a Medicare policy it would pay for its coverage but along with that if you are also having a Medicare supplement plan it would help you pay the remaining amount of the medical cost that is left aside by your original Medicare policy. But it should be remembered that Medigap is somewhat different to the original Medicare policy.

Though Medicare Supplement Plans are not directly under government supervision or administration but still every Medigap policy must follow certain state laws and must be clearly identified as “Medicare Supplement Insurance”. According to the rules the Medigap insurance companies can sell only 12 standardized Medigap policies. These policies are identified under the letter cover from A through L. And it is also to be noted that each Medigap policies must offer the same basic benefits, irrespective of whatever company may be selling them. The only thing that can differ from company to company is the amount of premium payable by the beneficiary. The point is that if you purchase a Medigap policy from any company under any letter cover the benefits must be same as provided by other companies under the same letter cover, for example, if you want to purchase a policy under the letter cover C or D the policy coverage and the benefits would be the same irrespective of whatever company you may choose.

In most of the cases the Medicare Supplement Insurance companies can only sell standardized Medigap policies. It is also that the companies must mention the specific benefits that they offer so that you can easily compare them. It may be that each and every company may not offer every Medigap plans A through L, but they are bound to provide clear information about the policies they are dealing with. But the fact is that each company must provide Medigap plan A if they wish to offer any other Medicare Supplement Plans. However to sell the rest of the policies should be decided by the company themselves, although law might affect which ones they offer. But also with that as the Medigap plans are mostly administered by the private companies therefore the amount of the premium payable is totally under their consideration.

Another thing to be mentioned is that once you purchase a Medigap Insurance plan the insurance company must keep renewing it. And they also cannot change the policy coverage or the benefits that they promised to provide while purchasing the plan unless there is any failure on your part in paying the premium. However, the company can increase the rate of premium but that too with prior notice.

The Medicare program provides healthcare coverage to approximately 44 million Americans, making it America’s largest government-sponsored healthcare program. However, even though it provides coverage for many health-related issues, Medicare often does not cover the full cost of healthcare for participants. Participants, therefore, need to be aware of what is and is not covered by their particular plan in order to ensure that they purchase necessary Medicare Supplement insurance or enroll in additional coverage plans, if needed.

In order to determine what kind of Medicare Supplement insurance participants may need, they should first determine what type of Medicare plan they currently have. There are two types of coverage plans for participants: Medicare Part A and Part B.

Gaps in Medicare Part A

Part A is known as the Hospital Insurance plan because it covers inpatient hospital fees, inpatient skilled nursing facility fees, home health fees, and hospice services. However, Part A has a significant amount of gaps in coverage that you will not be reimbursed for.

- A hospital deductible for each unique illness. In 2009, this deductible was $1,068. – Coinsurance payments for the hospital. After the deductible has been met, Plan A will cover the first 60 days of fees in full. However, for days 61 to 90, the coinsurance payment is $267 in 2009. For days 91 to 150, the coinsurance payment is $534 in 2009. – Hospital fees if a patient needs to stay beyond 150 days in the hospital. – Some coinsurance payments in skilled nursing facilities; Part A pays for the first 20 days in full. However, for days 21 to 100, the daily coinsurance payment in 2009 is $133.50. – Coverage for home health aide services that are provided on more than a part-time or an intermittent basis. – Coverage for any home health nursing or aide services where there is no skilled care.

Gaps in Medicare Part B

Part B is also known as Supplementary Medicare Insurance because it provides healthcare coverage for many physician and outpatient services that participants may need. Part B also provides coverage for many types of durable medical equipment, prosthetic devices, supplies needed to perform physician services, and even ambulance transportation. Gaps in Part B include:

- The Part B deductible. An annual deductible needs to be met before Plan B will pay for covered services. This annual deductible for 2009 was $135. – The Part B coinsurance payment of 20 percent. Plan B will pay for 80 percent of an approved charge for services and items covered by Part B. This amount, of course, varies based on the services and items required. – Any portion of a bill that is not covered by Medicare. Participants need to keep in mind that many healthcare providers charge more than the fee that is approved by Plan B. Participants will need to pay the uncovered balance.

How to Fill Medicare Coverage Gaps

When a plan participant has a coverage gap, it is often wise for the participant to fill in the gap in order to ensure that he or she has more comprehensive healthcare coverage. There are several popular ways to fill these coverage gaps, including:

- Government programs, including Medicaid, Qualified Medicare Beneficiary Program (QMB), Qualified Individual Program (QI), and Special Low-Income Medicare Beneficiary Program (SLMB). – Non-standardized group retirement policies. – Non-standardized individual Medigap plans that were issues before July 31, 1992. – Standardized individual Medigap plans that were issued after July 31, 1992.

Participants should be aware that those who are eligible to receive Medicaid will not need Medigap insurance because Medicaid will provide coverage for their healthcare expenses. However, if participants do not qualify for Medicaid but are within 100 percent of the federal poverty level, they can be covered by the QMB. QMB covers Medicare premiums, annual deductibles, and coinsurance payments.

If individuals do not qualify for Medicaid but make too much money to qualify for QMB, they may qualify for the SLMB or the QI. SLMB and QI pay for a portion of the Part B premium, so participants who receive SLMB or QI support may want to purchase Medigap insurance to help with additional costs.

All Medicare participants should be aware of the gaps in coverage that apply to them. By understanding what their coverage gaps are, they can make arrangements to enroll in programs that can help to fill all or some of these coverage gaps, which will help to ensure that they are adequately covered for their healthcare costs, no matter what happens in the future.

You may be wondering the reason why your original Medicare health insurance plan has not covered the actual expenditure that you have to pay from your pocket. There is a gap between the original one and your spent money or your health purposes for the same you have applied your insurance. But the fact is it that every insurance plan is unable to give full coverage of insurance. It is quite normal and natural. You have to supplement the original plan to have the full coverage of that one. You can have this option somewhere and here incase of Medicare health insurance you have this wonderful option where  can ensure your full coverage of money if you face some crisis of your health. Medicare supplemental or medigap insurance will give you the full coverage money of your original policy and you can get this plan only after registering your name under the main one that is original Medicare plan. Otherwise it is not possible to access the medigap health insurance plan. Many private companies sell this medigap plan across USA. You can consult with a medigap insurance advisor beforehand to clear your quarries about this.

Medicare policy coverage starts from the age of 65 of the insurance owner.  Actually if you have purchased a Medicare policy then in normal state your Medicare coverage would start on the 1st day of the month you turn 65. So it means that if you reach the age of 65 on 14th of May your policy coverage would start on 1st of the same month. And medigap insurance plan will also be starting from the same Medicare plan. This supplemental plan makes the gap complete or bridge the gap therefore this is called medigap insurance plans. The name itself signifies its purpose. These are supplementary plans having close relationship with the Original Medicare plans. The supplemental Medicare insurance Plans are totally administered and sold by the private insurance companies and there are 12 standard Medigap plans that are to be sold by them. Though there are total 12 plans in this supplemental plan but the buzz is that there two more 2 plans which are likely to be introduced by the Medicare supplement insurance companies and those are plan M and plan N.

There are various private Medicare Supplement Insurance Companies which offers these benefits of insurance but among them the best Medicare supplement is Medigap insurance California. Medigap California covers all the extra expenditure made by your health purpose and relaxes your future after 65. You can enjoy your post retirement life. You can unhesitatingly leave all the tension about your health on this Supplemental Medicare California. No matter how big the problem is but the solution is here. You do not have to bother about the extra medical costs those are not paid by the original one. Compare Medicare Supplement Plans and choose the appropriate one. So do not waste your time thinking about it and go for a medigap plan which supports the basic one in every possible way.

What is a Medicare Advantage PFFS plan anyway?

Many seniors feel overwhelmed as they start to shop around and compare their Medicare options.  First you have your Medicare Part A & B.  Then you find out about the Medicare supplement plans A – L.  Then they start talking about these Medicare Advantage Private Fee-For-Service (PFFS) plans and you feel like your head is going to explode!  But not to worry.  It’s not as complicated as you may think, especially if you enlist the help of a professional.

Advantage plans are a type of Medicare plan.  But unlike using regular Medicare A & B with a supplement plan to fill in the gaps, a PFFS plan is an all-in-one plan that combines your Medicare benefits with preventive screenings, some vision and dental benefits, and the Part D drug coverage.

With one of these plans, Medicare is paying the insurance company that your working with, and the insurance company pays the doctor or hospital that you receive services from.  The insurance company is hoping that they will pay out less than they receive and be able to make money.

How Predictable Are The Costs?

If you are the type of person who visits the doctor a lot, then a Medicare Supplement plan may be better for you.  But if you rarely go to the doctor, or maybe you go 10 or fewer times per year, an Advantage plan could save you a lot of money.  Medicare Supplement premiums can range from $90 – $165/month for a 65 yr. old, plan F, depending on what state you live in.  But then when you go to the doctor you don’t have to pay out of pocket at all.  Many Medicare Advantage plans have monthly premiums for $34, and some cost $0 per month.  But then when you go to the doctor or receive medical services you pay a co-pay out of pocket.  Your out-of-pocket costs are usually capped at around $3,000 per year, so your risk is limited.  Depending on your situation, you’d have to go to the doctor a lot to spend what you may spend on a Medicare Supplement plan.

Do Some Research First

Your doctor or hospital is not required to agree to the terms of the PFFS plans, and some just won’t take them at all.  Check with your doctor before enrolling to make sure it’s not going to be a problem.  Ask if they accept Medicare Advantage Private Fee-For-Service plans.  As a safeguard, Medicare does give you a 12 month period after enrolling in one of these PFFS plans to switch back to a Medicare supplement plan for any reason.  If you’re switching back during this 12 month period, you don’t have to answer any medical questions.

Now Get Some Quotes

If you would like some free, no obligation quotes on Medicare Advantage and Medicare Supplement plans available in your state, visit www.great-financial-planning.com/medicare-advantage.html

What is a Medicare Advantage PFFS plan anyway?

Many seniors feel overwhelmed as they start to shop around and compare their Medicare options.  First you have your Medicare Part A & B.  Then you find out about the Medicare supplement plans A – L.  Then they start talking about these Medicare Advantage Private Fee-For-Service (PFFS) plans and you feel like your head is going to explode!  But not to worry.  It’s not as complicated as you may think, especially if you enlist the help of a professional.

Advantage plans are a type of Medicare plan.  But unlike using regular Medicare A & B with a supplement plan to fill in the gaps, a PFFS plan is an all-in-one plan that combines your Medicare benefits with preventive screenings, some vision and dental benefits, and the Part D drug coverage.

With one of these plans, Medicare is paying the insurance company that your working with, and the insurance company pays the doctor or hospital that you receive services from.  The insurance company is hoping that they will pay out less than they receive and be able to make money.

How Predictable Are The Costs?

If you are the type of person who visits the doctor a lot, then a Medicare Supplement plan may be better for you.  But if you rarely go to the doctor, or maybe you go 10 or fewer times per year, an Advantage plan could save you a lot of money.  Medicare Supplement premiums can range from $90 – $165/month for a 65 yr. old, plan F, depending on what state you live in.  But then when you go to the doctor you don’t have to pay out of pocket at all.  Many Medicare Advantage plans have monthly premiums for $34, and some cost $0 per month.  But then when you go to the doctor or receive medical services you pay a co-pay out of pocket.  Your out-of-pocket costs are usually capped at around $3,000 per year, so your risk is limited.  Depending on your situation, you’d have to go to the doctor a lot to spend what you may spend on a Medicare Supplement plan.

Do Some Research First

Your doctor or hospital is not required to agree to the terms of the PFFS plans, and some just won’t take them at all.  Check with your doctor before enrolling to make sure it’s not going to be a problem.  Ask if they accept Medicare Advantage Private Fee-For-Service plans.  As a safeguard, Medicare does give you a 12 month period after enrolling in one of these PFFS plans to switch back to a Medicare supplement plan for any reason.  If you’re switching back during this 12 month period, you don’t have to answer any medical questions.

Now Get Some Quotes

If you would like some free, no obligation quotes on Medicare Advantage and Medicare Supplement plans available in your state, visit www.great-financial-planning.com/medicare-advantage.html

If the question is asked what is health insurance? I think that anybody can give an answer. Actually health insurance is an insurance plan that pays for your medical expenses. In some cases this includes the coverage for disability or long-term nursing or custodial care. This type of insurance plans can be provided through government sponsored social insurance program, or by any private insurance company. It can both be purchased on a group basis, as for example by a firm for its employees or can also be purchased by individual customers. In each case the group or the individual need to pay certain premiums against which the health insurance concern provides protection for unexpected health care expenses. This is what that is done by the health insurance plans.

Now the question is what is Medicare Supplement Plan? To answer this we must first learn what is Medicare? Medicare is a type of health insurance plan, which is provided by the private insurance companies. The Medicare plans covers most of the health care expenses that a person may need. But the fact is that Original Medicare plans does not pay for all the medical expenses that you may be in need of. Therefore in this respect is the need of Medicare Supplement Plans. Medicare Supplement Plans are directly linked with the Original Medicare plans and pays for those costs and gaps that are left behind by the original Medicare plans. As the Medicare Supplement Plans bridges the gap between the policy coverage of the Original Medicare plans and that total Medical costs payable, the Medicare Supplement Plans are also known as the Medigap plans.

It is to be noted that one can enroll himself for a Medicare Supplement Plan only if he is having a Original Medicare plan part A and Part B. Medicare Supplement Plans or Medigap policies cannot be bought as individual policies as they can’t pay for the total costs of the medical expenses. Only if you are having an Original Medicare plan you can get enrolled for a Medicare Supplement Plan.

However the Medicare Supplement Plans are sold and administered by the private insurance companies. And there are 12 standard Medigap policies ranging from A through L that are to be sold by the insurance companies. All these twelve policies have their different policy coverage. But along with that it is to be said that no matter from which company you buy you Medigap plan the company is bound to provide same policy coverage and benefits for policies under the same letter cover as provided by the others. Which means that irrespective of the companies selling them the policies under the same letter cover provided the same benefits. For example all plan C Medigap policies covers the same benefits.

Moreover, it is always better to signup for a Medigap plan within thirty days of getting the Original Medigap plan so that you can get the maximum benefits and cost redemption. However, one should seek the help of his/her insurance agent before choosing a plan as they are most aware of the coverage procedure of the insurance companies and they can also help in getting the most suitable. In most cases it is seen that buying a comprehensive plan would cost you few dollars more per month but result in saving you hundreds, may be thousands, of dollars per year in coinsurance and deductibles.

Medicare supplement plans or Medigap is the private health insurance plans that are for those people who already have a Medicare policy. The Medigap or Medicare supplement plans helps the Medicare beneficiaries to bear that extra medical cost that are left aside by the original plans. The name Medigap is suggested because it is believed that these policies bridges the gap between the Medicare coverage and the original expenses or the total bill charged. However in the recent studies it is seen that in the United States about 18% of the people having original Medicare policy goes for the supplement plans also.

Medicare supplement plan is your helping aid to pay off the excess of your medical bill that is left aside by the original Medicare plan. As the name suggests, it is a supplement plan that is bought along with an original Medicare plan. In an original plan there always remains a gap and it cannot pay for the total bill charged. Therefore there is the need for a supplement plan to clear off your dues. It actually bridges the gap between the policy coverage of the original plan and the total bill charged. Therefore a supplement plan is always needed for you if you need to get full medical coverage from your insurance plan.

It is to be noted that the Medicare supplement plans of Medigap plans are totally sold and administered by the private companies and the government has no hand in it. But there are still some preset rules that are to be followed by every company. As for example the companies can only offer 12 standard Medigap plans named A through L. And it is also to be mentioned that the plans under the same letter cover is bound to provide same benefits irrespective of the companies selling them. All that could differ is the amount of insurance premium nothing else. Therefore here in this article let us have a look on some of the benefits provided by the Medicare supplement plans under their letter covers. Part A Medigap plan is your hospital insurance. To go for a Medicare supplement plan a person is required to be enrolled in part A and B of original Medicare before they can go for a medigap policy. A person may obtain a Medigap plan on a guaranteed issue basis during the open enrollment period, which begins within 6 months of turning 65 or enrolling in Medicare Part B at 65 or older.

Part C is that part of the insurance coverage or such a Medicare supplement plan that combines both Part A and B coverage. It also provides some additional services. The Part C Medicare supplement plan is offered only through Medicare approved private insurance companies. The Part D Medicare supplement plan is for your prescription drug coverage. It helps you pay for the medications prescribed by your doctor. In this case it is to be mentioned that the policyholders who enroll themselves for standalone Part D plan may not retain the drug coverage portion of their Medigap policy. But the beneficiary may choose to remove drug coverage from their current Medigap policy and retain all other benefits.

Beginning June 1st, 2010 Medicare Supplement Insurance (Medigap) will include two new choices for consumers – Medicare Supplement Plan M and Medicare Supplement Plan N.

At that time Medigap plans E, H, I, and J will be eliminated as the “Preventive Care Benefit” and the “At-home-Recovery” benefit are removed and these plans become identical to other lettered Medicare Supplement plans.  Medicare has deemed these two benefits unnecessary in the current Medicare structure.  In addition to these changes, a hospice care benefit Co-insurance coverage will be added to all new Medicare Supplement Plans. 

Current Medicare Supplement policy holders will be permitted to keep existing Medicare Supplement Insurance policies, however as of June, 2010 enrollment will cease into ALL current plans.  It is not necassaily beneficial to purchase one plan over another (purchase the one that fits) because all plans purchased after June 1st will be in the “New” Medicare Supplement Plan policy design . Existing Medicare Supplement policies (Policy holders) will be partitioned into one group and plans purchased after June will be partitioned into new policy groups.  However, it is not certain that all Medicare Supplement (Medigap) providers will offer the new plans N and M, so a qualified, independent, advisor is suggested. Since most insurance carriers offer several plans it is important to shop around for the best price.  (For more help go to Medicare Advisor)

An independent  Medicare Supplement Advisor can assist you in finding a plan now; as well as help in 2010 when the new plans roll out.  For individuals turning 65 before June 2010 the independent Advisor will be able to suggest a plan today as well as provide service and alternatives next year when the new plans and premiums become available.  Company employed agents may not be the best solution as they can only suggest their companies plans.  The Senior Advisors Group represents most plans in a given area and are very helpful in explaining the various options available today and the new plans coming next year.  Find Medicare Supplement Plans in your area.

New Medigap Plan Design

Medicare Supplement Plan N will have similar benefits to Plan D, but there will be a $20 co-payment for doctor visits and a $50 co-payment for emergency room visits. It is believed that this co-pay will apply after the $135 deductible is paid. but there is some uncertainty as to how the deductible and co-pay will ben applied. The good news is the cost of these plans is expected to have premiums around 70% of the cost of Plan F or about 77% of current plan D.  Medicare Supplement Plan M will also offer similar benefits to Plan D, but will only cover 50% of the part A deducible and none of the part B deductible. The cost of Plan M is expected to price at approximately 85% of Plan F (or 92% of current plan D).

Industry experts, are enthusiastic about these changes as consumers will be attracted by the lower premiums. As usual these plans were designed by accademics with zero understanding of what consumers want and we’re not certain the design fits exactly what consumers desire. I.e these plans (M & N) don’t include the $135 deductible nor do they include excess charges allowed by most states. however we expect Medicare Supplement Plan N and Medicare Supplement Plan M to provide a real opportunity for consumers.  For plan information in your area go to Find Medicare Supplement Plans. An internal consultant from the Senior Advisors Group will provide information on available plans, and answer questions about the best options and lowest premiums available in your area. (No salesman will visit your home)