New Medicare Coverage? Put It to Good Use in 2021!

If you have new Medicare coverage, now is a great time to learn about your revised benefits and see how they can work best for you. Check out your basic costs to learn about tests covered under Medicare, items, and other services to see whether they have changed. For cost-specific information, create a Medicare account.

Medicare can assist you in taking better care of yourself this year through preventative services such as yearly wellness visits and screenings for breast cancer, diabetes, and heart disease. Most of these services are free for beneficiaries and are vital to maintaining your overall health. By targeting issues early, these programs help keep you from getting sick and slow disease progression.

To discuss preventative services, contact your doctor, who will also tell you the best time to schedule them. Understanding your coverage and taking advantage of these preventive services is an excellent way to jump-start 2021. Before you leap, be confident in your plan choice. If you have questions, contact your Medicare provider, who can help answer questions and ensure that you are getting the most out of your benefits.  

For more information about Medicare or to schedule an appointment with a specialist who can guide you through the process, contact Senior Health Medicare today.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Three Ways to Save on Medicare Expenses

Medicare expenses can pile up. If you need assistance paying for health or prescription costs, check out these three resources that might help cover your expenditures:

Medicare Savings Programs: There are four savings programs run by every state. They can help you pay for your premiums and other expenses. To see whether you qualify, contact your state Medicaid program.

Extra Help: Those with limited revenue or resources can qualify for Extra Help for Part D drug costs. If you have applied for Medicaid or one of the Medicare Savings Programs, Extra Help will automatically be enacted for drug costs. You can apply for free online through the US Social Security Administration.

Medicaid: A joint federal and state program that is tailored to help those with limited income and resources, aiding with medical costs. Medicaid offers benefits not typically covered by Medicare, such as nursing home and personal care services. Every state has its own guidelines.

The most efficient way to save money is to choose the right health and drug coverage. The Medicare Plan Finder compares Medicare coverage options. You can also reduce your Medicare premiums by enrolling on time, reporting changes in income, and shopping around for plans.

To learn more about Medicare costs and lower them with help from professionals, contact Senior Health Medicare today. Our experts are ready to assist you with all your Medicare questions, concerns, and needs.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Medicare Advantage VS Medicare Supplement Plans

Entering Medicare can be confusing, intimidating, and might leave you feeling vulnerable. There are countless predatory insurance companies and salespeople trying to win you over. It’s crucial for those 65 years old or over to stay informed regarding all options and make the best decisions possible in order to get the most bang for your buck. Navigating through the Medicare Advantage versus Medicare Supplement (also known as Medigap) plans is easier than you think. Read on for our pro- and con- list.

Medicare Advantage plans are cheap, but they automatically un-enroll you from original Medicare.

Pros:

  • Monthly premiums are relatively inexpensive, with some costing $0 per month.
  • Part D drug plans are usually included (for convenience, not efficiency.)
  • Fitness memberships or other incentives are sometimes included.

Cons:

  • Small and intricate medical networks determine your available medical providers. You most likely will have to change your doctor to become “in-network” before claims are covered.
  • Extremely high out-of-pocket costs (OPCs) if you aren’t in perfect health.
  • If OPCs rise due to illness or injury, you cannot revert to original Medicare, thereby paying the high OPCs eternally.
  • Network restrictions equal limited nationwide coverage. Insurance is usually not applicable in remote medical facilities, so traveling is an issue. For example, The Mayo Clinic will not take Medicare Advantage plans.

Medicare Supplement (Medigap) plans cost more, but the coverage they provide is exemplary.

Pros:

  • Almost everything is covered, depending on your plan. OPCs are relatively low/non-existent.
  • Eligibility allows you to enroll in a supplement plan, not only during the Annual Election Period.
  • Coverage is easier to comprehend and predictable.
  • Doctors usually accept original Medicare and your corresponding supplement plan.
  • Is almost always accepted nationwide.

Cons:

  • Medicare supplement plans are more expensive than Medicare Advantage plans.

With either choice, you can continue to pay a monthly Part B premium to Medicare. The main things to consider are:

  1. Do you want the choice of any provider or are you willing to choose a provider from within a network?
  2. Would you rather buy a separate prescription drug plan or get drug coverage included in one plan?
  3. Would you rather pay higher monthly premiums and have lower out-of-pocket costs for services or pay a low monthly premium and co-pays for services as you use them?

Your Medicare needs are personal. Navigating through the options can be confusing and misleading. To talk to a professional and learn more about Medicare, contact the experts at Senior Health Medicare today. Our agents are ready and available to help you make the best decision possible…for your health and wellbeing.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Protect your Medicare Card from Fraud

Medicare card fraud is rampant during open enrollment periods, which is currently running until December 7th. Medicare fraud results in higher health care costs for taxpayers, so it’s important to know how to protect your Medicare card and number. The most imperative thing to keep in mind is that your Medicare card should be guarded with the same security as your credit card. Doctors or hospital settings are the only people who should have those numbers.

Safeguard your card by taking the following steps:

  • Keep your Medicare number private. If anyone calls asking for your number, don’t give it. This is a common Medicare scam.
  • Money or gifts for free medical care should be refused. It’s a common ploy by identity thieves who say they need your number to verify certain things.
  • Keep track of your doctor’s appointments and upcoming tests, and use a calendar to record appropriately. Look for items and services listed on your Medicare statements, along with other details that might be incorrect. If you see a suspicious charge or service and you know the provider, call the office directly to inquire.
  • Stay alert during the coronavirus pandemic since con artists take advantage of people who are highly distracted or disoriented.

If you suspect Medicare fraud, call 1-800-Medicare or call the Medicare Drug Integrity Contractor at 1-877-7SAFERX. To speak with a professional regarding your Medicare plan, contact Senior Health Medicare today.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a frivolous decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com. Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com

Four Things to Ascertain About Your Retiree Insurance Coverage

If you have Medicare and a group health plan (retiree coverage from a former employer), Medicare will generally pay your healthcare bills first, and your group health plan coverage pays second. Below are some questions you can ask yourself to help navigate your retiree insurance coverage versus Medicare coverage.

  1. Following your retirement, will your employer coverage continue? When you have retiree coverage from an employer or union, they generally control it. Employers are not required to provide retiree coverage; they can modify benefits, premiums, or cancel coverage.
  2. Do you know the cost and specific coverage? Employers or unions might offer retiree coverage for you and/or your spouse but under certain limits and restrictions. It might only provide “stop loss” coverage, which begins paying your out-of-pocket costs once they reach a certain amount.
  3. When you are eligible for Medicare, what happens to your retiree coverage? If you were eligible for Medicare but didn’t sign up for it during any period of time, retiree coverage might not pay your medical costs. When you become eligible for Medicare, it is imperative that you enroll in both Part A and Part B to get full benefits from your retiree coverage.
  4. How does your retiree coverage work with Medicare? Obtain a copy of your plan’s benefit booklet and check out the summary plan description. Your employer or union usually provides this. You can also call your employer’s benefits administrator if unable to locate this information in the booklet.

If your former employer goes bankrupt or closes the business, Federal COBRA rules might protect you if any other company within the same corporate organization continues to offer a group health plan to its employees. That specific plan is required to provide you with COBRA continuation coverage. If COBRA continuation coverage is unavailable to you, purchasing a Medigap policy is possible, even if you are no longer in your Medigap open enrollment period. 

Your State Health Insurance Assistance Program (SHIP) can advise whether to purchase a Medicare Supplement Insurance (Medigap) policy. Your retiree coverage is probably similar to coverage under Medicare Supplement Insurance (Medigap) since Medicare pays first after you retire. Retiree coverage isn’t the same thing as a Medigap policy, however, they both usually offer benefits that fill in some of Medicare’s gaps in coverage (coinsurance and deductibles.)  Sometimes retiree coverage provides extra benefits such as coverage for additional hospitalizations.

For more information regarding Medicare or retiree coverage, contact the experts at Senior Health Medicare today. We strive to provide answers with quality customer service, satisfaction, and care.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a decision to take carelessly. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Tips for Navigating Medicare Open Enrollment

Open enrollment for Medicare runs now through December 7th, with changes taking effect on January 1st, 2021. If no action is taken, 2020 coverage continues next year. However, now is the time to verify whether there’s a more cost-effective option to suit your circumstances. The annual fall enrollment period is for adding or changing coverage related to an Advantage Plan (Medicare Part C) and prescription drugs (Part D), meaning you can switch, add, or drop those parts.

About 62.7 million people are enrolled in Medicare; most are 65 or older. A third of beneficiaries are enrolled in Advantage Plans, and the remainder are enrolled in Part A (in-patient coverage) and Part B (outpatient care) plans. Part D, a standalone/supplemental plan, is also offered by private insurance companies.

By September 30th, Advantage Plans or prescription drug plans should alert beneficiaries about whether their coverage is changing for the upcoming year. Specific options vary significantly from year-to-year despite being federally regulated. Check your notice to see whether any changes will be taking place. Prescription coverage, deductible costs, and in-network doctors are some examples of adjustments that could change.

If you wanted to drop your Advantage Plan instead of switching to another, you’d be left with original Medicare (Parts A and B) and would need to get a standalone Part D prescription drug plan if you wanted that coverage. Medigap (supplemental Medicare policies) help cover cost-sharing aspects of original Medicare, which is Part A and Part B outpatient coverage, including copays and insurance.

When initially enrolling for Plan B to purchase Medigap, beneficiaries receive a six-month window without having to answer health questions and be penalized for pre-existing conditions. One exception is that if the beneficiary had an Advantage Plan for less than a year or it is their initial enrollment. In that case, a unique enrollment window of 12 months is allotted for a Medigap policy.  

For further reading, check out the original article. For Medicare questions or concerns, contact the experts at Senior Health Medicare who are available to guide you through the process of open enrollment.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Difference Between Medicare and Medicaid

Sharing the same prefix makes Medicare and Medicaid easily interchangeable, but in reality, they are entirely different. To add to the confusion, both are structured by the government to assist people with healthcare costs. Beyond sharing prefixes and the healthcare realm, the two programs have nothing else in common.

Medicare: an insurance program paid from trust funds which those covered have paid into.

  • For seniors 65+ or those with a qualifying disability
  • Federal government sets standard benefits and costs
  • Private plans might provide additional (varying) coverage and costs
  • Parts A and B provided by the government; Parts C and D provided by insurance companies

Medicaid: an insurance assistance program serving low-income people.

  • For individuals, families, and children with limited income and resources
  • State sets Medicaid programs based on federal guidelines
  • Different programs exist for specific populations
  • Both mandatory and optional benefits available

Both Medicare and Medicaid include premiums, deductibles, copays, and insurance costs. Specific Medicaid groups are exempt from out-of-pocket expenses, and there are four different Medicare savings programs available. Some people can have both Medicare and Medicaid; these people are called “dual eligible.”

To enroll for Medicare, enroll with either Social Security directly (Parts A and B) or a private insurance company (Parts C and D) to choose the coverage you need. To enroll for Medicaid in Michigan, visit their website.

Both Medicare and Medicaid are two very different healthcare programs. It is imperative to understand the differences. If you are dual-eligible, learn how they can work together for your benefit.

For more information about the differences between Medicare and Medicaid, visit the U.S. Department of Health and Human Services website. To enroll in Medicare Parts C and D, contact Senior Health Medicare today.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

COVID-19 Sparks Regulatory Changes to Medicare

In response to the global COVID-19 pandemic, Congress and the Trump administration implemented a record number of legislative, regulatory, and sub-regulatory changes to the Medicare program. These alterations allow for unprecedented flexibility to healthcare providers, Medicare Advantage Plans, and Part D plans. Some of the changes waived Medicare participation conditions, allowing patients to be treated in alternative care settings. Other changes allow for telemedicine services to be eligible for Medicare reimbursement to physicians and other healthcare providers.

Significant COVID-19 changes that include telecommunication reimbursement include telephone visits, physician supervision services, urban and rural areas, and new sites (including patient homes). Hospitals can now provide alternative services at locations, including other healthcare facilities, expansion sites (hotels or community facilities), and specific services at patients’ homes. Moreover, licensed providers can provisionally offer services outside of their enrollment state. 

Both the benefits and unintended consequences of these policy actions should be carefully analyzed by policymakers and stakeholders to provide patients access to healthcare, and so providers can offer high-quality care. As the COVID-19 pandemic continues, stakeholder input and analyses should inform the regular rulemaking process to guarantee any permanent governing adaptations improve the Medicare program. The effects of these policies should be meticulously studied to determine the most efficient way to prepare for future public health emergencies.

Want to know more about the new regulations or need some assistance navigating through Medicare terminology, plans, policies, etc.? Look no further; Senior Health Medicare is here to help you find your path through the Medicare world. Click here to read more information about regulatory changes. 

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

7 Costly Medicare Mistakes Seniors Should Avoid Making

There are many parts to Medicare, and with that comes confusion and a good chance at missing something. It is essential for everyone approaching age 65 to get informed on Medicare and sign up for the right plan at the right time. Neglecting the chance to act at making the best Medicare decisions could cost you. Here’s how to avoid these seven common mistakes so you can get the right coverage without overpaying on premiums and deductibles, experiencing gaps in coverage, or getting hit with high penalty fees.

  1. Deciding without fully understanding each Medicare plan.

Medicare has many plan options making it very confusing and hard to decide which plan is best. It is essential for new enrollees to do their homework on Medicare before their enrollment period, so they know precisely the action they need to take. It’s necessary to become familiar with the differences between Original Medicare with a Medicare Supplement or “Medigap” plan, and Medicare Advantage plans, also known as “Part C.” Not knowing what your final choice has to offer could leave you with a plan that doesn’t fully cover your specific healthcare needs.  

  1. Going out of your plan’s network.

It is essential to realize when you sign up for Medicare, not every health provider will accept your specific plan and that this could change every year. Most places accept original Medicare and therefore, any Medicare supplement plan, but if you have a Medicare Advantage plan, you might not be covered if the provider is out of network. Always make sure to check if the doctor or hospital you are going to is in your network or it could mean an expensive bill. One more thing to be wary of here is that doctors and hospitals can stop taking Medicare Advantage plans ANY TIME, even though you have to wait until fall to change your plan. We see doctors jumping out mid-year, and that puts people at a crossroads: either I see my current doctor and pay for visits/procedures out of pocket, or, I find a new doctor who is in my network (for now). One more thing – if you think that your plan covers emergencies out-of-network, we want to kindly remind you that the insurance companies dictate what is considered an “emergency.” What you find emergency room-worthy actually isn’t up to you.

  1. Missing your enrollment periods.

There are enrollment periods that vary from person to person, depending on when an individual turns 65 or when they decide to leave their current job that provides them with healthcare benefits. When turning 65, eligibility to sign up for Medicare begins three months before your birthday month and continues for three months after. If you turn 65 and still have healthcare coverage through your job, you may want to delay your Part B enrollment until you seek full benefits from Medicare. This depends on the situation, size of the company, and the cost comparison, so you definitely want to discuss this with an expert to be sure you make the right moves. The Annual Enrollment Period (AEP) is the same for everyone, every year, which begins October 15th and goes until December 7th. This is the only time frame for current Medicare beneficiaries to change Part D prescription plans or Medicare Advantage plans. You can change a Medicare Supplement plan any time you want, however. It’s important to become familiar with these time frames, so you aren’t left without coverage at any time or hit with late-enrollment fees or penalties.

  1. Ignoring your Annual Notice of Change (ANOC).

The Annual Notice of Change (ANOC) is sent out to all Medicare beneficiaries before the Annual Enrollment Period stating any changes to plans and costs that will take place the following January. If you don’t read your NAOC, you might not know if your plan details or costs have changed, and it could leave you without coverage in certain areas and/or more expensive bills. You might learn it is in your best interest to keep the plan you have, but ignoring this critical update from your insurance company could result in getting stuck in a plan that costs way too much or doesn’t take care of your needs.

  1. Improperly signing up for Medicare Part B.

Once you turn 65, you are automatically enrolled in Medicare Part A (which covers your facility costs at the hospital) because you worked more than 40 quarters (10 years) and it does NOT come with a premium. Medicare Part B, however, not only comes with a premium (income-based, starting at $135.50 per month for 2019) but also comes with huge penalties and expenses if you enroll or delay enrollment improperly. If you are still working and you plan to continue working after your 65th birthday, you will need to find out the answers to a few critical questions. First off, is your company larger than 20 employees? If so, they MUST offer you health coverage while you are still employed. However, this does not mean you have to or should take this. It’s best at that point to compare your predicted costs with your employer plan versus your options under Medicare. About 50% of the time, it makes sense to leave your employer plan for Medicare. Definitely something you want to discuss with an expert. Okay, here is another common situation, let’s say you decide not to take Medicare Part B, and your employer is found to be less than 20 employees, otherwise known as not-credible coverage. If your plan is found to be not-credible coverage then when you go to take Medicare Part B, Medicare charges you a 10% penalty of the premium (about $13.50 per month at the lowest income bracket) for the rest of your life. That penalty can really add up. Lastly, let’s say that you take your Medicare Part B while you are still working and your employer has over 20 employees, so you stay on this insurance, too. The problem people run into with this is that when you take your Medicare Part B, not only are you paying a premium for coverage you aren’t using, but you run the risk of lapsing your Open Enrollment window. This is the time that lasts for six months (three months before and three months after your 65th birthday) in which you can choose any Medicare Supplement plan you want, with no medical questions asked. When you lapse this window while it’s sitting as your secondary insurance to employer coverage, when you retire, you will have to be reasonably healthy to get supplemental coverage.

  1. Missing your opportunity to switch plans.

There are many reasons a beneficiary might want to change Medicare plans, but it is easy to miss the chance to do so when it comes to prescription and Medicare Advantage plans. Just like enrollment, there are only specific periods where switching is possible. You can make changes to your prescription and Medicare Advantage plans during AEP. With Medicare Advantage plans, you have a 1-year trial period from the first date active, which allows you to switch to Original Medicare anytime within that timeframe if necessary. There are other unique opportunities to change, including life events like moving to a new area where your current plan doesn’t exist. The most common reason to switch plans is to save money, so make sure you understand your enrollment windows.

  1. Signing up for the same plan as your spouse.

When you get health insurance through an employer, often you can choose a plan that covers you and your spouse. With Medicare, you each need an individual plan, and it isn’t always the best option to go with the same insurance company, let alone plan. As you age, the chances of having different healthcare needs than your spouse become higher, so it is significant for beneficiaries to pick a plan that is specific to you and your personal needs. Often, healthy couples can and should take the same plan, because some insurance companies offer household discounts. Comparing companies and rates is the best way to decide what’s most cost-effective for you and your spouse.

Medicare is confusing, and finding a helpful resource isn’t always easy. Here at Senior Health Medicare, we aim to be that helping hand that you can rely on so you can avoid making these mistakes and navigate Medicare with ease. If you have any further questions about this blog or anything Medicare-related, please feel free to comment on this post or contact one of our helpful experts by phone.

 

How You Can Help Prevent Medicare Fraud

Medicare fraud is happening all the time, which results in higher taxes and healthcare costs for everyone. People and companies who get access can steal your Medicare number and personal information to scam the system for illegitimate products and services. It is important for beneficiaries to understand how to spot and protect from fraud to keep costs from rising even higher in the future. Not to mention, keeping your confidential information safe.

Doing Your Part

  • Keep your Medicare card, Medicare number, and Social Security number safe as you would protect a credit card. Only give this information to doctors, Medicare providers or someone you know should have it.
  • Keep records of all doctor’s visits and services provided. Always check your Medicare statements to ensure every detail is accurate.
  • Be sure to check you were given the right medications before leaving the pharmacy.
  • Never accept special offers on free or discounted Medicare.
  • Ask any questions about your Medicare or billing costs. It is your right to know.
  • Be aware of providers who claim they know how to bill Medicare even though they don’t usually offer that particular service.
  • Always report suspected incidences of Medicare fraud.
  • Never accept anything from a door-to-door salesperson claiming they are from Medicare. Medicare never sends representatives to your home.
  • Don’t let the media influence you about your health because they don’t always have your best interest in mind.

How to Spot & Report

If you have any suspicions whatsoever never hesitate to call Medicare. If you think a charge on your statement isn’t correct, call your provider and ask them about it. Always review your Medicare claims for any errors to stop fraud from happening early on. View your claims as soon as they are processed by logging into MyMedicare.gov or give them a call. When reporting Medicare fraud, make sure you have any records indicating possible existing errors and documents providing proof of services. To report any suspicious activity, you can call 1-800-MEDICARE (1-800-633-4227), report online at the Office of Inspector General or call them at 1 800 447 8477.

Medicare can be confusing for enrollees, which makes it easy for criminals to take advantage. If you have any questions or would like more general knowledge on Medicare, leave a comment, or give us a call. Here at Senior Health Medicare, we strive to educate beneficiaries on Medicare so that you and your loved ones stay protected and feel confident in your Medicare decisions.