Unfortunately Original Medicare does not usually provide adequate coverage for all. The expenses that are not covered by Medicare can be covered by a Medicare Supplemental Plan, or Medigap. Medicare Supplemental Plans are designed to supplement Original Medicare and are provided by private health insurance carriers and can help to cover expenses such as coinsurance, copayments, and deductibles.

You may be able to choose from up to 12 different standardized Medigap policies. Medigap policies must follow Federal and State laws. Each plan, A through L, has a different set of basic and extra benefits depending on your health care needs but each policy must offer the same basic benefits no matter which insurance company sells it. However, Medigap policies do not cover long-term care, vision or dental care, hearing aids, eyeglasses, and private-duty nursing.

What you need to know to buy a Medigap policy

• You must have Medicare Part A and Part B
• You pay a premium for your policy to the private insurance carrier

- As long as you pay the premium, your insurance company can’t cancel your Medigap policy.

Of course there are some disadvantages. If, as of December 31 you have prescription drug coverage, you must continue to keep the coverage. If you did not have prescription drug coverage, you cannot add it to your plan.

The main reason why individuals may want to buy supplemental Medicare coverage is because Original Medicare offers limited coverage. Adding a supplemental plan, also add extra benefits, especially for those individuals with disabilities and pre-existing conditions. Medicare Advantage plans are required to cover any individual with pre-existing conditions.

Once the current enrollment is closed on March 31, beneficiaries have limited options to switching their coverage. There are only a few reasons that an individual may be able to change their plan. These specific reasons include:

• Turning 65 after the open enrollment period is closed
• As determined by the Social Security Administration, any individual can join a plan three months before or after their 25^th month of disability
• Permanent home change is grounds for switching plans. If you move out of your plan’s service area, you’re eligible to switch plans.
• If an individual move into or out of a nursing home, they can enroll in a new plan anytime during the specified year.

So if for any reason, you would like to switch your plan to best fit your needs, you still have time. Make sure you call your health insurance provider immediately to get the most out of your insurance.

Last year they introduced their “Take Care” program which features dedicated health care advocates for its Medicare members. It’s their dedication to the community that sets them apart from other health care companies. The “Take Care” Program offers access to Decision Power^SM, a 24/7 access to Health Coaches, tools, and materials that empower

members to learn more about their health conditions and treatments and to stay healthy. “Take Care” offers support such as coordinate care for complicated conditions and coordinated care when transitioning from a hospital to home, and discounts on wellness products and services.

Health Net’s “Take Care” program also offers flu shot, customer appreciation and community events. Some of the events include Senior Wii Bowling events and the Health Net Cup. These events are offered at senior centers throughout Connecticut.

Health Net has a high retention rate with 96% of their Medicare members renewing their Health Net plans each year. 29 out of the 30 hospitals in Connecticut are in the Health Net network and they were ranked 11^th nationally in the 4^th annual America’s Best Health Plans rankings. Health Net has 6 Medicare plans ranging in premiums from $0 to

$179 to meet a variety of needs. Many of their plans offer low or no copayments for physician or specialist office visits, low or no copayments for preferred medications, and optional supplemental benefits.

Some of their plans, with built in prescription drug plans, are The Navy Plan, The Ruby Plan options 1, 2, and 3, and The Sage Plan. A Medicare Advantage plan without a prescription drug program is The Green Plan, and 2 stand-alone prescription drug plans with drug coverage but no medical coverage is The Orange Plan, options 1 and 2.

The Navy Plan is a Point of Service (POS) plan with a monthly premium of $179 and $0 deductible. Primary doctor co-pays are $20 and specialist co-pays are $35. The Navy plan allows the flexibility of using doctor outside of the provider network.

The Ruby Plan provides cost effective medical and prescription drug coverage in one plan and is more affordable than most Medicare Supplement plans. Option 1 has a low monthly premium of $109 with a primary doctor co-pay of $10, a specialist co-pay of $20, and a $0 deductible. The Ruby Plan option 2 has both a $0 monthly premium and deductible but with a primary doctor co-pay of $20 and specialist co-pay of $30. The Ruby Plan option 3 has a low monthly premium of $59 and a $0 deductible. The primary doctor co-pay is $15 and the specialist co-pay is $25.

The Sage Plan has a monthly premium of $119 with a $0 deductible. Primary doctor co-pays are $10 and specialist co-pays are $20. The Sage Plan is Health Net’s chronic condition Special Needs Plan that comes with $0 copayments for generic drugs.

The Green Plan, a Medicare Advantage plan with no prescription drug program, offers both a $0 monthly premium and deductible. Primary doctor co-pays are $15 and specialist co-pays are $25. This is a cost-conscious plan for those with prescription drug benefits through another plan or if you have chosen not to have drug coverage.

The Orange Plan option 1, a separate prescription drug plan with no medical coverage, has a monthly premium of $31.70 and a $295 drug deductible. Option 2, also a stand-alone prescription drug plan, has a $46.20 monthly premium and no deductible. The Orange Plan is Health Net’s Medicare Part D Prescription Drug Plan that features commonly prescribed generic and brand name drugs.

So why choose Health Net’s Medicare Advantage plans over its competitors plans? They are a faithful service to many Medicare beneficiaries throughout Connecticut, they reach out to their community by planning fun and interactive events, and they offer a variety of Medicare Advantage Plans to meet as many situations as possible.

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Medicare Part D Prescription Drug Coverage plan offers coverage for brand name and generic prescriptions drugs to anyone eligible for Medicare and is provided through private insurance plans. In order to be eligible for Medicare Part D, you must be entitled to Medicare benefits under Part A and/or enrolled in Part B. You must also be a resident in the prescription plan’s service area and not be enrolled in more than one Medicare Part D plan at a time. You usually pay a monthly premium and may pay a yearly deductible. Depending on the plan you select, you will also have co-pays or coinsurance for your prescriptions.

Since plans and premiums are changing, experts advise existing Medicare beneficiaries to review their current plans. Lists of covered drugs are changing and so are restrictions and costs so the plan you had for 2008 may not work for 2009. Also, new beneficiaries should look at a variety of plans to see what is best for them and their health needs. Make sure you talk to an expert and learn everything you need to know about the plan you have or are choosing because after Jan. 1, everyone is locked into their plan, with a few exceptions. The few exceptions include people who get low-income subsidies and people who have Medicare HMO or Medicare PPO private health plans.

The premiums of most plans are going up and prescription drugs that were covered last year may not be covered this upcoming year. The Centers for Medicare & Medicaid Services stated that initial deductibles for the standard benefit plan rose from $275 in 2008 to $295 in 2009. Also, beware of the donut hole. This term refers to a “coverage gap.” Within this gap, the beneficiary pays 100% of the cost of prescription drugs before catastrophic coverage kicks in. The initial coverage period covers up to $2,510 worth of prescription drugs. After the initial coverage period ends, the donut hole comes in. The donut hole lasts until you have spent $4,050 out of pocket on co-pays and drug costs. The catastrophic period is when the insurance company pays 95% of additional drug costs once you’re through the donut hole.

There are many people who can help seniors decide what to do when it comes to the Medicare part D Prescription Drug plan. For extra help and more information on Part D, you can visit the Medicare website (www.medicare.gov), call 1-800-MEDICARE, or call your local area agency. There is also a lot of information on the internet to help you in deciding on a plan.

AARP

AARP is the leading nonprofit, nonpartisan membership organization for people ages 50 and over in the United States and has approximately 39 million members. Some of the services AARP provides are informing members and the public on issues important to this age group, advocating on legislative, consumer and legal issues, promoting community service, and offering a wide range of special products and services to members including health insurance coverage.

Medicare covers many healthcare services and supplies but was never intended to cover all heath care costs. Medicare Supplement Plans (or Medigap) help you save on out of pocket costs. AARP Medicare Supplement Insurance Plan offers many benefits including freedom to choose your own doctors and see specialists without referrals, out-of-pocket savings, coverage wherever you travel, and the option to choose a plan that fits your needs and lifestyle. They have outstanding customer service, 99.7% of calls are resolved immediately. Additional services apart from the AARP Medicare Supplement Insurance Plan benefits that you receive are pharmacy savings, vision discounts, and a 24-hour nurse Healthline.

ANTEX

The American National Life Insurance Company of Texas (ANTEX), a major medical health insurance provider that markets to employer and association groups, is an affiliate of American National Insurance Company (ANICO), which is ranked among the largest life insurance companies in the United States. ANICO was founded in 1905 and they operate in North America, Latin America, and Western Europe. ANTEX has been recognized as “A+ (Superior)” by A.M. Best and “AA” by Standard and Poor’s.

Depending on what plan you choose (Plans A-L), you can get a variety of benefits. All of the plans offer basic benefits which include hospitalization, medical expenses, and blood services. From there on you can choose from plans that offer services such as skilled nursing facility, foreign travel emergency, at-home recovery, and preventive care.

Mutual of Omaha

Mutual of Omaha is a full-service, multi-line provider of insurance and financial services products, including Medicare Supplement Insurance. Few of their affiliates that carry affordable Medicare Supplement rates are United World Life Insurance Company (UW), United of Omaha (UOO), and Mutual of Omaha Companies (MOC).

Medicare supplement insurance policies must offer Plan A, basic benefits, but additional benefits, depending on the plan you choose, pay for Medicare Part B deductible, Medicare B excess charges, at-home recovery charges, and foreign travel emergency care.

Some example rates for a 65 year old female and non tobacco user include a United World Life Insurance Company rate of $114.20 for Alabama. If you were from Connecticut, rates include $257.39 for UOO and $194.73 for AARP which is Community rated, or guaranteed issue. If you are from Ohio, rates are as low as $101.54 from UOO. Rates depend on different demographics such as age and location so the above plans do not apply to everyone.

If you need help deciding what plan is best to fit your needs, there are many resources at your disposal to help during the open-enrollment period. In order to make an informed decision, you must know the basics first.

Medicare Advantage Prescription Drug Plans include Medicare Part A (hospital), Medicare Part B (doctor’s office visits), and Part D (prescription drug coverage). Medicare Part D plans only include prescription drug coverage and are usually purchased by people who already have Original Medicare (Part A and B).

Since the lists of covered drugs are changing as well as restrictions and costs, Medicare beneficiaries are being advised to review their current plans to make sure it will still benefit them in 2009. Because the enrollment period will soon come to a close, beneficiaries should review their plan and then begin viewing other plans and pricing. You should consider costs, doctors/providers, and travel when choosing a plan. Costs, such as premium, copayments, coinsurance, and deductible expenses, are changing. You also need to make sure that you’re able to visit the providers you want on your current plan and check to see if there will be additional costs if the provider is out of network or referrals are needed. You may also be travelling in the near future. Are you drugs covered if you travel to another state? You should make sure that your plan provides coverage in other states.

According to the Centers for Medicare and Medicaid (CMS), average monthly premiums for standard Part D coverage will be $28 in 2009, as opposed to the $25 in 2008.

What do you need to do when considering Medicare Part D plan?

1) Assess your needs. What prescription drugs are crucial to your life style?

2) Consult your doctor and pharmacist. Make sure they are still in your network under the plans you are considering.

3) Review all plans and prices to see which is best fit for you.

The Open Enrollment period for Medicare Part D ends on December 31^st which gives you two more weeks to make some very important decisions. Plans begin on January 1, 2009 and late charges and penalties may apply if you wait too long.

Anyone who is eligible for Medicare Part A and/or Medicare Part B is eligible to join the Aetna Medicare Rx- Costco Plus plan if the service is available in their state. The Aetna Medicare Rx- Costco Plus plan benefits include $0 deductible and $0 preferred generic prescription drug co-pay. The plan premiums range from $50 to $70 a month, depending on the region. It also provides coverage for all Medicare-approved Part D prescription drugs and coverage for preferred generic prescription drugs in the “coverage gap.” Save at Costco pharmacies on prescription drugs and get enhanced coverage for generic benzodiazepines and barbiturates, prescriptions that are not covered by Medicare Part D. Maximum co-pays for generic prescription drugs filled at Costco are $5, if nothing at all.

The difference between original Medicare plans and the Aetna Medicare Rx- Costco Plus plan is that most drugs are not covered under original Medicare. The Aetna Medicare Rx- Costco Plus plan uses a formulary which is a list of drugs covered by your plan to meet patient needs.

Information on the plans are available on the Costco website (www.costco.com) , in the Costco Connection member magazine, and in-warehouse displays and literature on the plans. These materials are available to help educate Costco members on the new product. To enroll in these plans, you can use the Aetna website, Costco website, or over the phone with Aetna and Costco sales representatives.

‘”Aetna is committed to finding cost-effective solutions through all of our Medicare plans,” said Frank McCauley, head of Aetna’s Consumer Business Segment. “Teaming up with Costco, which is known for providing great value to its customers, gives us a great opportunity to reach a significant number of Medicare beneficiaries with an innovative prescription drug plan.”