Archive for Medicare Advantage

admin | 05/22/2013
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Understanding Medicare- Part D

Part D- This is a prescription drug coverage plan created to help cover most or all of you prescription drug costs and that is offered to anyone with Medicare . There are two ways to get coverage and they are by getting a Medicare Prescription Drug Plan (PDP) or through Medicare Advantage plans such as a Health Maintenance Oranization (HMO) or Preffered Provider Organization (PPO) plan. If you get it through a Medicare Advantage Plan, you get all of your Part A and Part B coverage along with Part D.

With a Medicare drug Plan payments include:

  • a monthly premium
  • yearly deductible
  • copayments
  • costs in the coverage gap
  • costs if you get extra help
  • costs if you pay a late enrollment penalty

Your actual drug care plan costs vary upon:

  • the drugs you are taking
  • the plan you choose
  • whether or not you go to a pharmacy in your plan’s network
  • whether or not your drugs are on your plan’s list of medications covered within the benefit plan

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

 

Category: Compare Medicare Plans, Medicare Advantage, Medicare Tips, Prescription Drug Coverage | Tags: , , , ,
admin | 05/21/2013
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Understanding Medicare- Part C

 

Part C- Medicare Part C, otherwise known as Medicare Advantage is a program that allows you to enroll in private health insurance that offers both Medicare Part A and B benefits. These are separate health insurance plans rather than supplemental insurance. Medicare Advantage can also include prescription drug coverage in addition to vision, hearing, and dental.

There are many different options for Advantage plans including:

1. Health Maintenance Organizations (HMO) – These plans are required to cover both Part A and Part B healthcare, but can also offer additional benefits. You are limited to physicians and hospitals that are within the network except for emergency care. These plans can lower costs making them less expensive than traditional Medicare plans

2. Preferred Provider Organizations (PPO)- These plans allow you to use doctors, hospitals, and specialists within the network but unlike HMOs you are allowed to use health providers outside the network at an additional cost to you without a referral.

3. Private Fee for Service (PFFS)- With this plan you can use any physician as long as they abide by the terms of the PFFS. This plan chooses how much it will pay for the services and you can spend more or less on PFFS plans than on the traditional Medicare Plans.

4. Medicare Special Needs- These plans are limited to people with certain diseases, disabilities, or other health needs and are customized to the needs of that specific group, for example those who have diabetes. These plans also include the Medicare Part D prescription medication coverage.

In addition to these plans, if you enroll in a Medical Savings Account you do not have to pay a monthly premium because you pay a high deductible. Once you pay for the Medicare Part B premium, pay for Medicare covered services, and reach the deductible, the plan will pay for Medicare services. These accounts do not include prescription drugs.

If you have questions choosing a Medicare plan that offers the coverage you need, contact us at MedicareSolutions at 1-800-328-7305 where a licensed sales agent will immediately assist you.

 

Category: Compare Medicare Plans, Medicare Advantage, Medicare Tips | Tags: , ,
admin | 07/17/2012
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Are You Ready For Annual Enrollment?

The Annual Enrollment Period is quickly approaching. This is the period of time where you can make changes to you Medicare coverage. Between October 15th and December 7th every year, you may join, drop, or switch Medicare Prescription Drug and Medicare Advantage plans. You may also choose to revert back to original Medicare Part A and B and leave third party coverage altogether. The changes you make will be effective for the following year, so it is very important that you make sure that you are satisfied with any changes you plan to make. Weighing your option in Medicare is difficult, especially when you are altering an existing Medicare plan. We at Medicare Solutions have put together a short list of questions to help you evaluate your current plan. That way you can make any necessary changes with confidence.

  • Are your monthly medications the same or have others been added that could possibly put you in the ‘donut hole’ sooner than expected?
  • Are you seeing the doctors you need or want to see? Are you visiting the doctor more frequently?
  • Are your copays manageable based on your habits or are they putting you over budget? Are the remaining copays after your Medicare discount still too high for your budget?
  • Are you seeing doctors that are within your network? If you are seeking treatment outside your network, how much extra is it costing you?
  • Does your plan charge a monthly premium? (In addition to your Part B premium)
  • Do you find yourself with a new diagnosis that requires extra benefits that were not included in your original policy choice?
  • Are you utilizing vision, hearing, dental and/or wellness health programs that may or may not be embedded in your policy?

If you are realizing that you aren’t satisfied with your current plan, don’t worry. You have plenty of time to explore different options and make any necessary changes. If you are not satisfied with your current Medicare Advantage plan, Prescription Drug plan, or even Original Medicare plan, then you may choose to do one of the following during the Medicare Open Enrollment Period.

  • Change from Original Medicare to a Medicare Advantage Plan.
  • Change from a Medicare Advantage Plan back to Original Medicare.
  • Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
  • Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
  • Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage.
  • Join a Medicare Prescription Drug Plan.
  • Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
  • Drop your Medicare prescription drug coverage completely.

Are you satisfied with your Medicare plan? Are you having second thoughts about your current coverage? Let us know in the comments section!

 

Category: Compare Medicare Plans, Medicare Advantage, Medicare News, Medicare Tips, Original Medicare, Prescription Drug Coverage | Tags: , , , ,
admin | 07/10/2012
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4 Tips To Help You Save On Prescription Drugs

Medicare Prescription DrugsPrescription drugs can be very costly. Luckily, those who qualify for Medicare have the option to enroll in a Medicare Part D drug plan or a Medicare Advantage plan to help alleviate drug costs. These plans can sometimes cover up to seventy five percent of prescription drug costs. But even with three quarters of the cost covered, prescription medication can still be a serious financial concern. If Medicare already covers some of your prescription drug costs, what can you do to reduce the remaining costs after coverage?

There are a few ways to save on prescription drugs beoynd your Medicare plan’s coverage…

  • First and foremost, see if you qualify for Extra Help with drug costs. If you are enrolled in a Medicare drug plan, live in the United States, and have limited resources and income, you may be eligible. Social Security deals with Extra Help claims. They have information regarding eligibility available on their website and you can even apply online.
  • Second, make sure you are making use of generic drugs. They are significantly cheaper and more accessible than many brand names. Generic alternatives to brand name drugs are available throughout the country and will always save you money over regularly priced brand names. Contact your doctor and pharmacist to see what generics will fit your needs.
  • Another way to save some money on medication is to talk to your doctor or pharmacist about free samples. They receive a certain allotment of samples that they can give to patients free of charge. Don’t be afraid to take advantage of this if you find your prescription in sample form. As long as you are not abusing their generosity, most doctors and pharmacists will be happy to help.
  • Finally, many people don’t know that there are coupons available for many name brand drugs. Sometimes finding them can be as simple as a quick search on a search engine. The key to obtaining these coupons is being willing to ask. Ask your doctor, your pharmacists, even try asking the manufacturer directly, either by phone or email. Like the coupons you use at the grocery store, these coupons often have expiration dates. Make sure to be aware of these dates so you don’t miss out on the potential savings.

Hopefully these tips can help you save some money on your prescription drugs. If you have any more money saving ideas that have worked for you or someone you know, feel free to share them in the comments. Do you think you could find another way to save money with a Part D drug plan? Let us know!

Category: Compare Medicare Plans, Medicare Advantage, Medicare Tips, Prescription Drug Coverage | Tags: , , , , ,
admin | 06/14/2012
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Your Medicare Plan’s Half Birthday

Medicare Plan Half BirthdayIf you opted to change your Medicare Advantage or Prescription Drug Plan during Open Enrollment last year, then you’ve had your new policy for over half a year. At this point, you most likely have a good sense of how the plan is performing for you and your needs. It is a very good idea to take this opportunity to evaluate your plan and decide whether or not you need to make use of the Open Enrollment Period this year. To make things a little easier, we have included a short list of questions to help you figure out if it’s time to explore new Medicare options.

  • Are your monthly medications the same or have others been added that could possibly put you in the ‘donut hole’ sooner than expected?
  • Are you seeing the doctors you need or want to see? Are you visiting the doctor more frequently?
  • Are your copays manageable based on your habits or are they putting you over budget? Are the remaining copays after your Medicare discount still too high for your budget?
  • Are you seeing doctors that are within your network? If you are seeking treatment outside your network, how much extra is it costing you?
  • Does your plan charge a monthly premium? (In addition to your Part B premium)
  • Do you find yourself with a new diagnosis that requires extra benefits that were not included in your original policy choice?
  • Are you utilizing vision, hearing, dental and/or wellness health programs that may or may not be embedded in your policy?

If the answers to these questions have you feeling that your plan isn’t meeting your current needs, it may be time to start thinking about a new one. The Medicare Open Enrollment Period runs from October 15th to December 7th. This may sound far off at this point in the year, but it is important to be prepared so you can make the right choice. If you are not satisfied with your current Medicare Advantage plan, Prescription Drug plan, or even Original Medicare plan, then you may choose to do one of the following during the Medicare Open Enrollment Period.

  • Change from Original Medicare to a Medicare Advantage Plan.
  • Change from a Medicare Advantage Plan back to Original Medicare.
  • Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
  • Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
  • Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage.
  • Join a Medicare Prescription Drug Plan.
  • Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
  • Drop your Medicare prescription drug coverage completely.

With so many options, it is easy to get confused. Changing your Medicare coverage is a big decision, and if you end up switching to a plan that is not what you hoped for, you’ll be stuck with it for the entire year. It is never a bad idea to ask for help in order to make the best decision. Medicare Solutions has licensed Medicare experts who can put difficult information into simple terms. And the best part is their expertise and advice is free of charge. Don’t hesitate to call 1-877-614-2333 today to speak with our Medicare experts to get the information you need to be ready for Open Enrollment.

Category: Medicare Advantage, Medicare Tips, Original Medicare, Prescription Drug Coverage | Tags: , , , , , ,
ElizabethGHoward | 02/10/2011
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Do You Know the Difference Between Medigap and Medicare Advantage?

Do You Know the Difference Between Medigap and Medicare Advantage?

Do You Know the Difference Between Medigap and Medicare Advantage?

Both “Medigap” and Medicare Advantage plans are often referred to as “supplemental insurance” plans in Medicare articles and literature.  This language is confusing and somewhat misleading. Do you understand the difference?

Nicknamed “Medigap,” it is technically the only real “supplemental insurance”; its formal name is Medicare Supplemental Insurance. Only people enrolled in traditional Medicare can use a supplemental insurance plan.

Medigap is NOT a government run plan. Medigap is private insurance. You can buy it to defray some or most of your out-of-pocket costs. These might include:

  • The hospital deductible for Part A, which is currently $1,100 for each hospital benefit period.
  • Part B costs such as the percentage you pay for doctor’s visits and outpatient services.
  • The costs of emergencies up to plan limits you incur when traveling overseas.
  • Other costs as defined by the plan.

 

There are 10 types of medigap policies, and they are legally standardized, which means that the benefits you get are the same, regardless of who sells them to you.

However, that does not mean you will receive the same price from each insurer so it’s a good idea to check around. To compare the benefits in each Medigap plan, enter your zip code at Medicare Solutions.com to get started.

Medicare Advantage is an umbrella name for a VARIETY of private health plans which include HMOs, PPOs, PFFS (Private Fee For Service plan.)

Medicare Advantage, called “Medicare Part C” is an alternative to the traditional Medicare program. Those who enroll in Medicare Advantage may NOT purchase a Medigap plan or a stand-alone prescription drug plan.

Each Medicare Advantage plan covers all the same benefits as traditional Medicare (called “Part A” and “Part B”), but the plans operate on the copayment system and may offer extra benefits. Sometimes the copayments are lower than traditional Medicare, and sometimes not. Each plan is different.

For example, some plans may include vision and hearing services, and include prescription drug coverage at no additional cost. However, most plans will require you to go to in-network doctors, or to pay high co-pays if you go out of network.

To compare Medicare Advantage plans, go to Medicare Solutions.com and enter your zip code to begin.

Category: Medicare Advantage, Medicare Tips, Supplement Medigap | Tags: , , , , , , , , , , , , ,
Lucy Dylan | 07/01/2010
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What Will the New Medicare Advantage Plan Ranking System Look Like?

Susan Jaffe recently published a great read on Medicare Advantage plan ranking systems. Although the Advantage ratings purportedly help seniors weed out the best possible plans, the ratings system is flawed and most seniors rely on a combination of plan costs and benefits to determine which plan they want. The impending Medicare reforms will be rewarding top-ranked Advantage plans with bonuses, despite the obvious flaws within the system. The Center for Medicare Services (CMS) plans on using the current system at first, and later evaluating which factors work and which do not.  Programs with 4 or 5 star ratings will receive higher bonuses from Medicare.

What will the new MAPD ranking system look like?

What will the new MAPD ranking system look like?

I feel that improving the ratings system is integral to Medicare reform. While costs and coverage are indeed incredibly important facets of every Advantage plan, quality of care and benefits are equally important for seniors. Relying on price alone may net a senior an affordable plan while sacrificing quality.  Unfortunately, many seniors do rely on price. According to Jaffe, over 75% of Advantage plan beneficiaries select plans with less than 3 stars.  Improving the ratings system can make seniors more aware of the quality of their Advantage plan, and possibly provide them with improved health care.  Adding the incentive to perform better could ultimately help seniors out.  However, that incentive needs to be clear and the ratings system needs to be solid.

Another part to the issue raised by Jaffe is that not all plans are rated, and not all areas boast 4 or 5 star rated plans.  By expanding the ratings system, and breaking down all the benefits and coverage associated with the plan, perhaps CMS can provide more comprehensive analyses to facilitate Advantage plan selection for seniors. At the same time, plans need the opportunity to improve their ratings and quality. Improvement should be recognized as a factor in the ratings.   Perhaps adding incentives for improvement in addition to overall rating might be helpful, although not necessarily cost-effective. By making providers accountable for their services and seniors more aware of the ins-and-outs of Advantage plans, perhaps there can be genuine improvements in the Medicare system.

At the same time, I feel that it might be difficult for the bonus system to work as it should, especially because standards of care vary across the country.  Jaffe quotes Vicki Gottlich of the Center for Medicare Advocacy, who raises the concern that a simple average score might bury a plan’s deficiencies beneath its stronger points. And is it really fair to rate a 3 star plan in say, Idaho, to a 5 star plan in Florida? How can the rating system be most effective when there are so many variables involved?

Although the new bonuses may help improve the quality of care available for Medicare, CMS must ensure that all the wrinkles in the rating system are ironed out before applying the ratings to all plans. Perhaps a better path for CMS to follow would be to improve the ratings, helping out both consumers and providers, before analyzing each Medicare Advantage plan.

Category: Medicare Advantage, Medicare News, Medicare Tips | Tags: , ,
Bill Stapleton | 01/08/2010
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Avoiding Medicare Insolvency in 2016

The recent Senate bill entitled “The Patient Protection and Affordable Care Act” is intended to bring insurance to many uninsured Americans and to help the Medicare program avoid insolvency, which is projected to happen in 6 years. Unfortunately, the bill will probably have just the opposite effect.

In addition to making draconian cuts to the Medicare Advantage program, the bill largely increases the number and cost of beneficiaries in Medicare. For example, both the House and Senate bills reduce the coverage gap, or “doughnut hole” in Part D coverage by $500 beginning in 2010. Other additions include increased benefits for dual Medicare-Medicaid eligible and eliminating cost-sharing for preventative services (beneficiaries will not have to pay for any of the cost). Such great cost reduction is certainly an enormous benefit for any senior, but puts a new strain on the need for more Medicare funds.

Additionally, the Senate bill plans to tax companies receiving prescription drug subsidies. Since 2003, companies that continued to provide their own prescription drug benefits qualified for a 28% tax-free subsidy (about $600 per year per retiree). The advantage for companies was the ability to list the subsidy as a reduction to their retiree health liability. The Senate bill will tax the subsidy, thus increasing companies’ tax liabilities and companies will be required to register the change as a loss in earnings.

The response expected from these companies will be to no long provide prescription drug benefits on their own. Thus, the cost falls back on Medicare who will see a dramatic increase in Part D beneficiaries. Increasing the number of Medicare eligibles will only add fuel to the fire: these change merely bring the day of reckoning for Medicare closer than 2016.

Category: Medicare Advantage, Medicare News | Tags: , , , ,
Annie Finneran | 03/25/2009
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Choose the Medicare plan that’s right for you

When your Original Medicare Plan kicks in, it’s time to make some other decisions relative to your health. Being informed about your options can help you make a better decision. Medicare is a national health insurance program for individuals ages 65 or older, individuals under the age of 65 who have been declared disabled, or individuals with end-stage renal disease (ESRD). There are approximately 43 million elderly and disabled Medicare-eligible beneficiaries in the U.S. today.

Medicare is broken down into 4 parts: Medicare Part A, Medicare Part B, Medicare Part C or Medicare Advantage, and Medicare Part D.

Medicare Part A is the Original Medicare. You are automatically enrolled in the Original Medicare Plan which is managed by the federal government. Medicare Part A is the hospital insurance. It covers inpatient hospital care, inpatient care in a skilled nursing facility, home health care, and hospice care. You don’t usually have to pay a premium for Part A because the individual paid Medicare taxes while working.

Medicare Part B is a medical insurance offered by the federal government to eligible beneficiaries. Medicare Part B covers physician services, non-physician services, diagnostic tests, lab services, and ambulance transportation. Preventative care is also covered by Part B. Most people have to pay a premium for Part B.

Medicare Part C, or Medicare Advantage is a combination of Part A and Part B. Medicare Advantage plans are private health plans provided by private insurance companies. Part C is an alternative to Original Medicare and offers extra benefits. Part C plans include Medicare Health Maintenance Organization (HMO), Medicare Preferred Provider Organization (PPO), Medicare Private Fee for Service (PFFS), and Medicare Medical Savings Account (MSA).

Medicare Part D is a prescription drug coverage that helps pay for outpatient prescriptions drugs. You can either add Part D to your Original Medicare Plan or join an HMO or PPO that includes Part D coverage.

Just like choosing health insurance, Medicare insurance should be tailored to your needs. You can choose a plan based on premiums and out of pocket costs, additional benefits, whether referrals are needed, and whether the doctor you currently have is in network or out of network. After you have researched and gathered all the information necessary to make an informed decision, it is then time to choose from a variety of plans that suit your needs.

Category: Medicare Advantage, Medicare Tips, Original Medicare, Prescription Drug Coverage | Tags: , , , , , ,