Tag Archives: Medicare Advantage Plans

The Truth About Medicare Advantage Plans

Medicare Advantage Plans have gotten a bad rap over the past few years. One prominent website that sells Medigap plans practically rails against Advantage plans (like HMO’s and PPO’s). The owner of the site goes so far as to say that Medicare beneficiaries are always better off with Original Medicare (Part A and Part B) than with a Medicare Advantage Plan. Why are some people so vocal in their opposition to these plans? Here are some reasons why I think this is the case.

1. Many unscrupulous agents have sold Medicare Advantage Plans without really considering what was in the best interest of the Medicare beneficiary. Stories have abounded about “grandma” being rolled over into some new plan that did not include her doctor or medication.

I have personally been in the kitchen with Medicare Beneficiaries who were crying, because some fool agent preferred making a commission to helping that person get what the best plan for their situation.

The good news is, Medicare and CMS (the Center for Medicare and Medicaid Services) have clamped down hard on these kinds of activities. The bad news is, there are still a host of agents (and agencies) who are still engaged with this sort of nonsense.

2. Low and Even Zero Plan Premiums Can be Misleading

Many Medicare Advantage Plans have very low or even zero plan premiums. Many folks see this and think that they are getting something for nothing. The truth is however, not that simple. Co-pays, Co-insurance and higher drug costs with many of these plans can actually cost more than premiums for a Medigap policy.

In addition to this, as we have been looking at some of the plans for 2010, there are some plans that have no out of pocket maximum (no stop loss, if you will). If you end up getting really sick with some of these plans, you might be responsible to pay a large sum of money for your share of your medical costs.

3. Restrictions to Networks and Plan Rules

Another gripe often leveled against Medicare Advantage plan is that Medicare Beneficiaries are restricted to seeing only providers that are approved by the plan. In an HMO (Health Maintenance Organization) for example, you must normally choose a Primary Care Physician (PCP) and if you want to see a specialist, you must get a referral from your PCP before you do so.

With all of those “strikes” against Medicare Advantage Plans, perhaps you are expecting me to say, along with that other author I mentioned, that Medicare Advantage Plans are never the right choice for people with Medicare.

That however is not the case. There are many situations we have encountered where it appears at least (in our judgment) that a Medicare Advantage Plans is in the best interest of a client and does provide better protection than Original Medicare (Part A & Part B) alone.

There are many, many, many people who absolutely, positively, under no circumstances, cannot afford to pay a monthly premium (for a Medicare Supplement Policy and or a Prescription Drug Plan).

I am of the opinion that if you CAN afford to pay a premium for Medigap and a Part D Plan (and it does pay to shop around) that you should pay the premiums and be done with it. If you can’t afford it however, there may indeed be plans that offer protection over and above Original Medicare (plans for example that provide a comprehensive Maximum Out of Pocket, or MOOP).

Are Medicare Advantage Plans right for everybody? Of course not. Just as there is not one retirement plan, or life insurance plan or long term care plan that is not right for every person, there is simply no way to say that Medicare Advantage is “best” or that a Medigap policy is “best.”

It is however, too simplistic to say that Medicare Advantage is never in the best interest of a Medicare Beneficiary. Medicare Advantage Plans may have gotten bad press (for a variety of valid reasons), but these plans, in my opinion are a still a good choice for many people.

The opinions expressed in this post are the personal opinions of Tony Jackson and should not be construed as a sales message or a promotion of any insurance company, policy or plan.

Comparing Medicare Advantage plans and Medicare Supplement Insurance

Medicare is a medical insurance program meant for seniors who are at least 65 years old, those younger than 65 but who may have a disability, and also individuals who have been diagnosed with End-Stage Renal Disease (kidney failure). In the year 2003, the Medicare Modernization Act reinstated the Medicare + Choice program with Medicare Advantage (MA), or Medicare Part C. Medicare Advantage Plans offer added benefits that are not covered under the original Medicare.

A Medicare Advantage Planis a kind of Medicare health plan provided by a private company that contracts with Medicare to give you a package of benefits inclusive of Part A and Part B benefits. Some categories of the MA Plans are Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.

A Medicare supplement insurance or Medigap, offered by private companies assists in handling some of the health care costs that is not covered by the Original Medicare. Some examples of such costs are copayments, coinsurance and deductibles. Besides, several Medigap policies also include coverage for services not included in the Original Medicare. One of these is the cost of medical care while travelling outside the U.S. Medicare Advantage Plan is just an approach to receive Medicare benefits, while a Medigap policy or Medicare Supplement Insurancecomplements your Original Medicare benefits. The following 8 aspects of Medigap throw significant light on Medigap policies

1.You must qualify for Medicare Part A and Part B.

2.If you are a Medicare Advantage Plan beneficiary you are eligible to apply for a Medigap policy, but prior to the initiation of your Medigap policy you must leave the Medicare Advantage Plan.

3.Monthly premium has to be paid to the private insurance company in against your Medigap policy apart from the monthly Part B premium that one pays to Medicare.

4.A Medigap policy is good only for one individual. Separate policies are required for married couple if both need Medigap coverage.

5.Medigap policy can be bought from any insurance company that’s certified in a state to sell one.

6.Medigap policies sold after January 1, 2006 are not permitted to consist of prescription drug coverage. For prescription drug coverage one needs to join a Medicare Prescription Drug Plan (Part D).

7.Medigap policy can be renewed and this implies that the insurance company cannot revoke your Medigap policy until you are paying the premium.

8.It’s illegal for anyone to sell you a Medigap policy if you have a In contrast to the conventional Medicare, the benefits provided by the Medicare Advantage plans or Medigap policies are based on where you live. When choosing between the two one should consider plans available in an area and that which most suit your requirements.

If you would like help understanding benefits of Medicare Plans provided by Medigap4seniors that provide you a package of benefits inclusive of Part A and Part B benefits! Please visit us @ Medigap4seniors.com or E-mail @ . You may call us @ 888.502.5553.

Medicare Supplements vs. Medicare Advantage – Should you change

Every year on November 15th, thousands of seniors have a very important decision to make. This date marks the beginning of the Annual Enrollment Period (AEP), which spans for 45 days and is the only time during the year in which Medicare recipients can enroll or dis-enroll in a Medicare Advantage Plan. Many people start exploring their options as early as September in an attempt to make sure they are enrolled in the best and most affordable plan for the next year.

The big advantage to Medicare Advantage Plans is their low monthly premium. However, do not expect this to last forever as the new Health Care Reform Bill cut over $130 billion in funding for this program, which will undoubtedly have an effect on how much consumers will pay for these plans beginning in 2012. Furthermore, these plans have significantly increased their monthly premium over the past few years, despite cutting benefits. These plans are cheap, but that is their only advantage.

Medicare Supplements can be very affordable as well, especially if you shop all companies to make sure you are getting the lowest price for the plan you choose to enroll in. All Medicare Supplement Plans are standardized by the Center for Medicare Services (CMS), which means all companies must offer the same plans and benefits. They cannot change the plans, nor can they offer additional benefits. Although, some companies do offer discounts for eyeglasses and gym memberships.

Medicare Supplements are now more affordable with the addition of Medicare Supplement Plan N. This plan has a low monthly premium that is often 30% cheaper than Plan F, which is the most popular plan. People who purchase Plan N will have to pay the Part B deductible, which is $155 in 2010, and will have $20 co-payments at the doctor and $50 co-payments for Emergency Room visits. This can be a great plan for people who are in great health and are on a tight budget.

The reason many seniors leave Medicare Advantage Plans in favor of Medicare Supplements is because the Advantage Plans often have provider networks. Furthermore, many doctors and hospitals across the nation have stopped accepting patients who are enrolled in these plans. With Medicare Supplements, you can visit any doctor, hospital, or specialist as long as they accept original Medicare. This is obviously a huge benefit for people who want the freedom to visit the provider whom they feel will provide the best care.

Medicare Supplements are standardized by Medicare, which means they cannot offer additional benefits. People who purchase these plans will need to purchase a Prescription Drug Plan in order to make sure their prescriptions are covered for the next calendar year. These plans change every year, which means you will need to compare plans every year to make sure you have the most affordable plan available. Make sure to compare not only the monthly premium, but also the co-payments for the specific prescriptions you need.

There are many ways to shop for Medicare Supplements and Prescription Drug Plans. The easiest way to research all plans and companies is to consult with a national insurance broker who can help you compare all Medicare Plans and offer honest advice. In addition, they should be able to provide insight into upcoming changes and other company specific issues. Do not hesitate to call the experts at Medicare Supplement Shop if you need any assistance.

What Is Medicare Advantage

A Medicare Advantage plan is Part C of Medicare. It is the program that allows Medicare beneficiaries to enroll in a private health plan to receive Medicare cover and also enjoy a few added perks. Medicare Advantage plans are offered by private insurance companies approved by Medicare. Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules fixed by Medicare.

Understanding Medicare Advantage

Traditional Medicare is a Fee for Service plan that covers many healthcare services. When you receive your healthcare service, you show you Medicare Card that is issued to you when you enroll in Medicare. This original plan pays for many health services and supplies but does not cover all your healthcare costs like copays and deductibles.

Medicare Advantage Plans are health plan options approved by Medicare, but offered through private health insurance companies. If you join one of these plans, you are still in Medicare, but generally get all your Medicare coverage through private companies and use the insurance that the plan provides.

The main differences between Traditional Medicare and Medicare Advantage are as follows:

Firstly, copays and deductibles are lower with Medicare Advantage than with traditional Medicare.

Medicare Advantage plans provide Medicare Part A or Hospital Insurance and Medicare Part B or Medical Insurance. However, Medicare Advantage Plans do not cover hospice care, which is covered by Original Medicare even if you are in a Medicare Advantage Plan.

Medicare Advantage plans may also offer extra benefits such as vision, hearing, dental, preventive care services, and health and fitness programs.

Medicare Advantage plans have Medicare Part D (Prescription Drug Coverage) built in. With Traditioanl Medicare, Part D has to be purchased separately.

Finally, with Traditional Medicare, you can see any doctor or hospital. Many Medicare Advantage plans work with contracted providers doctors and hospitals with whom they have worked out a long-term contract.

Different types of Medicare Advantage Plans

Health Maintenance Organization (HMO) Plans
Preferred Provider Organization (PPO) Plans
Private Fee-for-Service (PFFS) Plans
Special Needs Plans (SNP)

Other Medicare Advantage Plans

A HMO Point of Service (HMO POS) Plan that allows you to get some services out-of-network for a higher cost.

A Medical Savings Account (MSA) Plan combines a high deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year. You will then also have to pay out of pocket for care, until the MSA plan deductible is met, after which plan coverage begins. MSA plans may or may not have contracted providers, but MSA plans cannot restrict access to a network of doctors, facilities or suppliers.

When you enroll in a Medicare Advantage plan, you pay a monthly premium to Medicare and also a monthly premium to Medicare Advantage for the added benefits it offers.

Medicare thus offers you the option of getting your health insurance through Traditional Medicare or through private insurance with a Medicare Advantage plan. If you choose a Medicare Advantage plan, you must specifically opt to and give the authorization to receive your healthcare through the plan.

To make the right choice, compare costs and benefits carefully. Professional help is always at hand. So contact a knowledgeable insurance dealer who can explain the details and help you select the best Medicare plan.

High Deductible Medicare Supplement Plan F Dont Buy It!

Finding the perfect Medicare Supplement Plan has never been easy, especially considering the many changes that have been made to the Medicare programs over the past 10 years. There was the introduction of Medicare Advantage Plans that created an entirely new insurance option, and now the restructuring of Medicare Supplement Plans, which has created additional plans available for purchase. Several plans, including High Deductible Plan F, that may have been attractive ten years ago should not even be considered today.

Medicare Supplement Plan F is the most popular option because it provides the most benefits. People who purchase this plan rarely have any out of pocket expenses as all deductible and copayments are paid for by the insurance company. In addition, this type of plan has no networks, which means people who purchase this plan can visit any doctor or hospital that accepts original Medicare.

The high deductible version of this plan is much less exciting.
High Deductible Medicare Supplement Plan F has a $2000 annual deductible that must be met before the insurance company begins to pay the 20% coinsurance for medical and hospital services. However, if you just had original Medicare, the deductible for the hospital is only $1100 and the deductible for doctors and medical services is only $155. After the original Medicare deductibles have been met you will only pay the 20% that Medicare does not pay. This means if you purchase this high deductible Plan you would need to spend $5600 at the hospital before your insurance company pays a dime!

The only reason to ever purchase High Deductible Medicare Supplement Plans F would be for catastrophic coverage. If you fell very ill and needed intensive medical care over a long period of time this plan would limit your financial burden. However, you can likely get a Medicare Advantage Plan for FREE that has a maximum out of pocket cost that will be less than $5600 and this type of plan will provide better coverage in the near term because there will be no deductibles, only co-payments. In addition, many Medicare Advantage Plans have a prescription drug benefit as well.

With Medicare Advantage plans as an option, purchasing a High Deductible Medicare Supplement Plans F is not a good idea for most people, especially considering these plans normally cost between $40 and $60 per month. Most experts consider these plans a waste of money and would recommend people stick with only original Medicare or purchase a Medicare Advantage plan instead.

Another new option for people who are on a budget is Medicare Supplement Plan N, which is one of the cheapest plans, but only has an annual $155 deductible. The coverage is much better than high deductible Medicare Supplement Plans F, and it is only slightly more expensive. Medicare Supplement Plan N will be available June 1st, 2010 and will be offered by several well-known companies.
While many insurance agents push high deductibleMedicare Supplement Plan Fbecause it is cheap on a monthly basis, most people realize after taking a close look at the benefits compared to other plans there are better options available. You should consult a national insurance broker who specializes in this type of insurance and can give you quotes and guidance regarding new and better options.

How to hearing with florida medicare & florida medicare supplement

You keep hearing regarding Medicare, Medicare Advantage Plans and Medicare supplement policies, and currently you’re confused on that one you would like, and that one you’re eligible for, and that one you get for complimentary. Traditional Medicare has been around since the 60s. it’s a central insurance program. yank employees who have paid FICA (Federal Insurance Contributions Act) or self-employed taxes are contributing to the Medicare program already.

These persons, once they reach the age of sixty five and become Medicare eligible, are going to be permitted to enroll in what’s remarked as ancient Medicare half A, that are hospital advantages.Part A usually covers eightieth of major medical hospital charges, when the deductible has been met. Members won’t ought to pay premiums for Medicare half A.

That is when Florida Medicare Supplement policies are available in. A Florida Medicare Supplement policy is intended to fill within the gap in ancient Medicare coverage. There are many various varieties of Medicare supplement policies. At this point they’re identified by the letters A through L, though M through P are going to be introduced within the returning years. every of those Medicare supplement policy includes a completely different combination of advantages, included services, premiums, deductibles, etc. you have got known for a jiffy that when you switch sixty five, you may be eligible for Medicare. because the time gets nearer, you begin paying a lot of attention when individuals mention Medicare choices.

Therefore, it’s necessary that customers go looking fastidiously to search out that Medicare supplement policy can best meet their desires.Many of those Medicare supplement policies will facilitate cowl prescription prices, that is an element D of ancient Medicare.This is as a result of the Florida Medicare Plans set ups Advantage Plan already includes further advantages, and can already be serving to members pay things that ancient Medicare doesn’t cowl. Therefore, solely those older adults who are enrolled in ancient Medicare components A and B can got to purchase a Medicare supplement policy to assist them pay their medical expenses.

If you have got a heavy health downside, travel lots, or split time between 2 homes, you’re happier with ancient Medicare and a Medicare supplement policy. this can be as a result of there are not any network restrictions with ancient Medicare, and therefore the Medicare supplement policy can assist you pay off the deductible and coinsurance. Medicare Advantage Plans do need members to ascertain in-network physicians.

Medicare Supplement Plans Purchase At The Annual Enrollment

People who buy these Medicare supplemental quotes can visit almost any specialist, hospital, or doctor, and often pay very less or nothing at all for these kinds of purchases. The only difficulty with Medicare Supplement Plans is the agencies that offer this kind of Medicare supplemental quotes have under-writing guidelines, which might make it difficult to qualify if you have preexisting circumstances. Using definite issue guide-lines to buy one of these plans might make a big difference in the worth of care you get and you”re other expenses for physician and hospital services.

The most frequently used assured issue period is the period of preliminary enrollment, which starts on the first-day of the month where you are both registered in Medicare (Part B) and over the age of sixty five. This time extends for 6 months and you may register in any plan with any agency during this specific time without responding to any of the health queries. A lot of seniors buy Medicare Supplements (Plan F) in the initial registration period, however over the past few years a lot of people have been influenced to buy Medicare Advantage Plans that offer lower coverage.

The second most liked assured issue period happens when adults choose to work after their sixty fifth year of age. During this period they are frequently covered by company plans that offer higher coverage to normal Medicare. Though, when they finally leave when they retire their company plan, they have a sixty three day assured issue period where they might register in the insurance plan of their selection. This assured issue period in addition includes people who have left, although are still covered on their earlier companies plan.

Medicare Supplements Plans approximately always offer higher exposure to Medicare-Advantage-Plans, which is why a lot of people are opting to register in normal Medicare and buy supplemental-insurance. A lot of seniors over the years have received correspondences informing them of their coverage with the current benefit plan will be finished at the end of the current year. These insured adults have a special assured issue time frame, where they might register in any kind of plan with any agency without giving explanations to any of the health questions. People who have physical conditions and issues should utilize this period to buy a Medicare Supplemental quote.

The Inside Scoop On Medicare, Medicare Supplements, Medicaid, Medicare Advantage Plans, And Medigap

It gets befuddling due to all the language that streams together. Case in point you have Medicare, you have Medicare supplements, and you have Medigap, Medicaid, Medicare Advantage and everything else.

So for the normal individual, they begin looking in and they sort of block it out, however perhaps what I could demonstrate rapidly is the thing that Medicare is and what its target is. Medicare is health insurance for the elderly and debilitated individuals who meet all requirements for it, however it is in a qualification. It was marked into law 1965 and Medicare itself comes in four parts. Medicare part A, B, C and D.

It is pretty simple to recall that that An and B are the two privilege parts. Part An of Medicare is essential the hospitalization profits that you might get. Part A profits likewise offer talented nurturing consideration, hospice mind and some home mind health profits, however is paid for by goodness of you paying your fico or government managed savings charges over the greater part of the years. So you don’t pay an alternate red penny for that.

For Medicare Part B, you can select in on that or withdraw of it when you turn 65 and there are exceptional explanations behind that, which I will clarify later, however part B is essential your specialist profits, outpatient administrations and things of that nature and for that you do pay a premium. In 2013 the premiums are $104.90 and that changes as it is balanced each year dependent upon expansion calculates and different things.

So you have Medicare part An and Medicare part B, which are the qualification parts of the Medicare program. Well in the event that you had barely Medicare part An and B what you might find is that its not set to be sufficient to blanket all you needs. Essentially it is just set to blanket around the range of 48% of your sum medicinal expenses and with the high cost of doctor’s visit expenses today you can recognise the reality quite rapidly that you are set to need something to fill those holes and that is the place they come in with that term Medigap protection and that is a differentiate protection program.

It’s an arrangement you buy through a private insurance agency, additionally alluded to as Medicare supplements. You buy that by paying a premium and most the greater part of your doctor’s visit expenses are set to be secured as a consequence of having Medicare part An and B and after that having the Medicare supplement protection and the Medicare approach.

Right away part C became possibly the most important factor when congress was taking a gander at the entire scenario and understood that they have a wave of seniors taking a stab at them, in excess of ten thousand individuals a day are maturing in and qualify to be beneficiaries or beneficiaries of Medicare parts An and B profits. That’s a pricey thing the extent that the regulatory sets back the ol’ finances for the administration to oversee the An and B profits. So they passed this plan change act in 1997, where they now pay insurance agencies to assume control over the organization of the part An and B profits and that made part C or what now is regarded as Medicare Advantage items.

They began offering harshly around the year 2000 and those are exceptionally ubiquitous, on the grounds that a hefty portion of them have a zero premium or an extremely low premium versus a given, where you might have a Medicare supplement stack or a Medigap strategy and pay a high premium for that and also requiring the professionally prescribed medication program. With part C Medicare Advantage plans, what that bears an individual is then they just pay no premium or an exceptionally low premium and just pay when they utilize it instead of paying the given premiums for the Medigap Insurance.

Part D is the professionally prescribed pill profit and how that lives up to expectations is that it can either be included or joined into a part C plan, or it might be what they call a standalone physician endorsed medication program that you buy with an extra premium with a Medigap arrangement. So might be the Abc’s. A, B might be the qualification divide of Medicare. C might be the Medicare Advantage programs that numerous individuals are taking out today and afterward part D might be physician recommended medication programs.

Right away Medicaid is a health profit for individuals with low livelihoods, then obviously you have the contrasts being that Medicare is a legislature program and Medigap are protection strategies that you buy through a private insurance agency. Medicare Advantage programs again is an alternate approach that you might buy with a Medicare affirmed insurance agency.