Posts Tagged ‘medicare advantage plans’

What Is Original Medicare? What You Must Know Before You Apply

Tuesday, August 3rd, 2010

If you are nearing the age of 65, you may be asking yourself, “What is Original Medicare Coverage and am I eligible?” These are important questions because for most people nearing retirement age, the Medicare program will take over as the primary source of health insurance.

Original Medicare was first passed into law in 1965 and is the federally managed, single payer, health insurance program from for U.S. citizens and naturalized citizens age 65 or over. The program has expanded over the years to include some people with disabilities and people with End Stage Renal Disease. Although the Federal Employees Health Benefits program is another government health insurance program that covers Federal employees, Medicare is generally considered the closest example of a single payer health insurance program in the United States.

Although Medicare is now considered to have 4 parts, Original Medicare is most often associated with what is called Part A and Part B. Part A covers hospital inpatient, skilled nursing facility, and home health care benefits. Part B covers doctors’ services, medical supplies and equipment, and hospital outpatient care. Part B also covers many other services such as clinical laboratory services, imaging, ambulatory surgery, cancer treatments, preventive services, and much more.

Generally speaking, eligibility is not complicated. If you are a U.S. Citizen or naturalized citizen nearing the age of 65, or disable or have End Stage Renal Disease, you are probably eligible. Eligibility questions can be addressed to the Social Security Administration at 1-800-772-1213.

Enrollment into Medicare Part A and B is automatic if you are receiving Social Security benefits at the time you turn age 65. If you have been receiving Social Security Disability Insurance for 24 months, you enrollment is also automatic at the end of the 24 month. Generally speaking, you should receive your red, white and blue Medicare card about 3 months prior to the month of your enrollment.

Those nearing 65 but not yet receiving Social Security benefits must submit an application to the Social Security Administration. All Medicare applicants have a 7 month, initial enrollment period that begins 3 months before the sixty-fifth birthday and ends on the last day of the third month following the month of your sixty-fifth birthday.

The one stable piece of information to hold onto is that Medicare enrollment is always done through the Social Security Administration. If you are already receiving benefits, your enrollment will be automatic and you won’t need to do anything at all. If you are not receiving SSA benefits by your sixty-fifth birthday, you will need to submit an application through the Social Security Administration. As this is quite an important change in your life, you should not hesitate to seek answers to your questions through the Social Security Administration toll free number, 1-800-772-1213.

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Proposed Changes to Medicare Advantage Plans

Monday, April 19th, 2010

Medicare Supplement Insurance is not the only Medicare-related coverage that is going through changes within the next few months due to the new health care reforms proposed by President Obama. Medicare Part C Plans, which are commonly known as Medicare Advantage plans, are also experiencing change.

Here’s a bit of background information on Medicare Advantage Plans:

Medicare Advantage Plans are Health Maintenance Organization (HMOs), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans, or Medicare Special Needs Plans. In order to enroll with a Medicare Advantage plan, you need to have Medicare Parts A and Part B, and you may have to pay a monthly premium to your Medicare Advantage Plan for extra benefits that they offer. Advantage plans are privately provided. You should not be simultaneously enrolled in a Medicare Advantage Plan and a Medigare Supplement Plan as they counter one another.

Reports state that Medicare Advantage Plan payments to private health insurers will be capped at 2010 rates for all of 2011. The proposed health care laws stipulate $130 billion in cuts over the next 10 years to these plans to prevent government overpayment to insurance providers.

As next year’s payments will not be able to match rising health care costs, what could occur is that insurance companies will offset the loss of payment increases by the increasing premiums that their customers pay.

Medicare Advantage Plans and drug plans additionally must have significant differences betwixt their products due to CMS regulation requiring elimination of duplicate prescription and health plans. These differences range from plan types, client out-of-pocket costs, premiums, and formulary offerings.

Starting in 2014, Medicare Advantage Plans will have to spend 85% of health insurance premiums collected by insurers on providing health care to their customers as an additional limiting factor to overcompensation of insurance executives.

Learn more about Medicare supplements. Stop by Richard Cantu’s site where you can find out all about Medigap and what it can do for you.

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Find The Best Medicare Supplement For You

Friday, April 2nd, 2010

Choosing your Medigap policy can often seem complicated. Fortunately, there are numerous great resources out there for people who are looking to purchase this type of coverage.

Medigap (also known as Medicare supplemental insurance) is available to those that are eligible for Medicare coverage. However, there are some factors to consider that may be a bit confusing….

For instance, spouses must have separate policies when applying for Medigap coverage. This insurance is offered on a standard system of 12 different plans from which to choose, all ranging in coverage type and amount. Additionally, each of these policies are offered by many different private insurance companies, which gives you even more power in choosing the exact Medigap insurance coverage for your needs.

The way that supplemental insurance functions is that you first choose the plan that best suits your needs, based on the existing coverage that you have and what you desire. Then, you can comparison shop with the companies that sell Medicare supplements to determine which one has the best rates and service for the plan that you need. All companies which provide supplemental Medicare coverage will offer all 12 plans, so you don’t need to worry about that. All you have to do is choose the one that you like best.

Your reasons for choosing a Medigap insurance provider are allowed to be whatever you want them to be. You can pick the one with the lowest rate, or the one with the best customer service. You can even pick a company just because you happen to like their website, if that’s what you choose. It’s all up to you.

First, you should determine what you need and what you can afford. Please remember that your coverage will be different if you are healthy than if you have medical conditions or a constant need for doctor’s visits. Be sure that you are asking questions so that you understand everything very clearly before you make any decisions about what you’re going to do or which plan you want.

Medigap insurance providers and policies do not have to be complicated. If you take things one step at a time and allow yourself to figure things out and learn as you go, it can be a simple process. If all else fails, you can easily find a private insurance company that deals with this type of coverage and get their assistance in choosing the best insurance policy to cover the gaps in your Medicare insurance.

Learn more about Medicare supplements. Stop by Richard Cantu’s site where you can find out all about Medigap and what it can do for you.

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