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How to Select the Right Medicare Plan
by RealPTC Expert
Just deciding which way to go when choosing from the combination of different types of healthcare coverage is confusing for many people eligible for Medicare. For most people, having choices is a very good thing. But what about when you have thousands of plans to choose from?
When it comes to Medicare, you have nothing but choices. Depending upon your circumstances, you may want to stay with traditional Medicare, or Medicare Parts A and B. If you choose this path, you'll probably want to get a Medicare Part D (prescription drug) plan, too, to ensure your medications are covered. Or, you might be more interested in a Medicare Advantage plan, which can combine traditional Medicare with drug coverage and other benefits. You also may be interested in even more coverage, such as that offered through a Medigap (supplemental) plan.
Fortunately, help is available. A Medicare advisor offers education on available Medicare programs, answers questions, and offers detailed plans of action to get the most out of your insurance choices. You also should know the basics beforehand.
Traditional Medicare
Medicare Parts A and B, also known as traditional or original Medicare, have been around since 1965. Medicare Part A is free to most people who've worked and paid Medicare taxes for at least 10 years and provides people with inpatient hospital coverage. Medicare Part B, which costs most people $96.40 in 2009, covers outpatient medical expenses.
People who have traditional Medicare can see any doctor they want in any facility they want without a referral, as long as that doctor or facility accepts Medicare patients. But traditional Medicare's benefits are limited.
Not only does traditional Medicare not cover most outpatient prescription drugs, if a beneficiary uses their coverage frequently enough, it can get very costly. That's why we also have Medicare Advantage and Medicare Part D plans available.
Medicare Advantage Plans
Medicare Advantage, also known as Medicare Part C, combines Medicare Parts A and B in one plan so you can get your Medicare Part A and Part B coverage in the same place. Medicare Advantage plans also often include prescription drug coverage and other benefits not commonly found under traditional Medicare, such as vision and dental services.
This program works just like private insurance - you have different types of plans to choose from depending upon what type of provider access you want (for example, health management organizations (HMO), preferred provider organizations (PPO) and more) and what health conditions or prescription drugs you take. You also can choose from a number of different levels of coverage. All Medicare Advantage plans must offer at least as much coverage as that offered under traditional Medicare. If they offer prescription drug coverage, that coverage must meet minimum Medicare Part D standards as well.
Medicare Part D
Medicare Part D is prescription drug coverage. Like Medicare Advantage, Part D is offered by private companies who are reimbursed for providing healthcare coverage. Also like Medicare Advantage, a minimum amount of coverage is required for a plan to qualify as a Part D plan and many different plans, some with different levels of coverage, are offered throughout the United States. Part D plans are best for people who use prescriptions, but don't need to see their doctors often.
Medigap Medigap, or Medicare supplemental plans, is sold by private companies to fill the "gaps" in traditional Medicare. This includes the cost of deductibles, co-payments and coinsurance. It also may cover other services that Medicare does not insure. In 2009, there are 12 Medigap plans - A through L.
Although Medigap may offer some additional coverage if an individual chooses to keep traditional Medicare, you can't buy a Medigap plan if you have Medicare Advantage. Because most Medicare Advantage plans offer better coverage and frequently more benefits than Medigap, having both is usually unnecessary. You can have both Medigap and Medicare Part D, but it may be more expensive to do this than simply purchasing a Medicare Advantage plan instead.
Comparing And Contrasting
It's no wonder that people are confused. There are thousands of plans available throughout the United States, and an average of 40 Medicare Advantage and Medicare Part D plans in any given area.
This is where a Medicare advisor can come in handy. With so many options in just one area, choosing a plan might feel like throwing darts at a board. Using a Medicare advisor can help you narrow down your choices so you know which combination of Medicare coverage will work best for you and which plans will give you the best and most affordable coverage for your needs.
Jim Allsup writes for Allsup, a provider of Social Security disability, Medicare and workers' compensation services, including Allsup Medicare Advisor, Medicare assistance services for people with disabilities and seniors.
Medicare Frequently Asked Questions
by RealPTC Expert
Straight talk. Answers to 3 FAQ's about Medicare and Medicare Supplement Insurance. You don't need to be a Medicare expert or devote hours reading info and researching online to understand your Medicare and Medicare Supplement options.
Q: What is the difference between Original Medicare and Medicare Advantage (MA) Plans?
A: There are several key differences between Original Medicare and Medicare Advantage Plans. Original Medicare is your government Medicare. Medicare Advantage is private Medicare that takes the place of your government Medicare. You will have similar out-of-pocket expenses with an MA plan as you would with Original Medicare alone.
It is important to understand that in general an MA plan is the same coverage as Original Medicare. You may get some extra benefits such as dental or eyeglasses, and some of the plans include drug coverage as well, but the base coverage will be the same as original Medicare.It is not the same as Medicare plus a Medigap or Supplement Plan. You can not get a supplement plan to cover your out-of-pocket expenses when you are enrolled in an MA plan.
Q: What are my potential out-of-pocket expenses with my Medicare coverage?
A: Medicare itself is great coverage but there are some gaps in the coverage that many beneficiaries fill with a Medicare Supplement policy.
Medicare Part A covers hospital room and board, short-term skilled nursing care and hospice care.
There is a deductible for Part A. Currently the deductible is $1132.00. This means that you will pay the first $1132.00 before Medicare benefits are paid. This is not an annual deductible. It is a benefit period deductible. A benefit period starts the day you are admitted to the hospital and ends 60 days after you are released. It is possible that you could encounter the Part A deductible more than once in a year. After the deductible is met Medicare covers 100% semi-private room and board for 60 days. From day 61-90 the is a daily co-insurance of $283 per day. After 90 days Medicare provides coverage for an additional 60 lifetime reserve days with you paying a daily co-pay of $566.
Skilled nursing facility following a hospital stay of at least 3 days is covered by Medicare at 100% for the first 20 days. Days 21-100 have a $141.50 co-pay per day.
Hospice is covered by Medicare with very limited co-pays.
The deductibles and co-insurances increase from year to year.
Your exposure on the A side of Medicare are your deductible, and the various co-insurances mentioned above.In addition, Medicare doesn't cover the first 3 pints of blood.
Medicare Part B covers medical expenses in or out of the hospital such as doctor visits, inpatient and outpatient medical and surgical services and supplies.Diagnostic testing, speech and physical therapy, and durable medical equipment are Part B expenses.
There is a calendar year deductible for Part B. This year the deductible is $162.00. After you have met your deductible medicare covers 80% of approved amounts for covered services.
Your exposure on the B side of Medicare includes the deductible and 20% of approved amounts for covered services and any Part B excess charges. Part B excess charges are charges for covered services that exceed Medicare approved amounts.
Q: How can I limit my exposure and cover the gaps in my Medicare coverage.
A: You can supplement your Medicare coverage with a Medigap insurance policy.
There are 10 Medicare supplement policies that are approved by Medicare. All of the supplements have the same basic benefits.
Medicare supplement basic benefits for Medicare Part A cover all of your hospital co-insurances and will extend your covered days beyond Medicare coverage for and additional 365 days. The Part A deductible and skilled nursing co-insurance coverage are optional benefits.
Your supplement will automatically adjust to the changes in Medicare deductibles and co-pays from year to year.
Under Medicare Part B, Medicare Supplement basic benefits will cover your 20% co-insurance.
You can choose a supplement plan that includes optional benefits such as Part B deductible, Part B excess, and foreign travel emergency coverage.
Seek the guidance of a broker who specializes in Medicare to help you determine which of the 10 Medicare Supplement Plans best suits your needs.
Stephanie Coutavas is an Insurance Professional specializing in Senior Insurance Solutions and Medicare Insurance. Co- founder and Senior Broker at MedicareQuote4U.com-Common Sense Insurance Solutions Group. Stephanie decided to specialize in Medicare because, "I saw the effects of the confusion and misinformation in the senior market. I really feel that with the proper,correct information, presented in an understandable way that our Seniors can position themselves for the future and achieve the peace of mind and security that they deserve at this exciting stage of life. We strive one client at a time to make sure that we address the individual and that they are better for having met us, regardless of whether they choose us as their broker."
Whether you are receiving Medicare Benefits before age 65, helping a parent or loved one or just not sure if there might be a better value for your health care $$$, we can help. Call us at 1-888-347-5552 to speak with a licensed Medicare Supplement Specialist or visit us at http://www.medicarequote4u.com. We are your Medicare Supplement experts and we are standing by to help.
Mortgage Protection Critical Illness
by RealPTC Expert
You have perhaps gotten some ads in the mail about a product that will pay your mortgage if you pass away, turn into disabled, or turn into critically ill. Many consumers see these ads, along with certain even ask for more information. But even though homeowners are interested they are certainly not really sure what this product is.Level vs. Decreasing Term Life Insurance cover
Disability and Critical Health problems
Critical condition insurance will protect you if your condition is terminal or critical, you need certain surgery or if you end up unemployed owing to the condition. If you have family responsibilities then there can be no debate about the advantages of having a critical health problems insurance plan plan set up as well as in place should the worst happen.
Medicare Advantage Plan
by RealPTC Expert
Medicare Advantage Plans have gotten a negative rap over the past few years. One prominent website that sells Medigap plans practically rails against Advantage plans (like HMO's and also PPO's). The owner of the site goes so far as for you to say that Medicare beneficiaries are always better off with Initial Medicare (Part A and Part B) than with a Medicare Advantage Plan. Why are usually some individuals so vocal in their opposition for you to these plans? And listed below are certain reasons why I believe this is the situation.2. Low as well as Even Zero Plan Premiums Can be Misleading
3. Restrictions to Networks and also Plan Rules
Medicare Supplement Plan
by RealPTC Expert
Individuals insured by Medicare Parts A (hospital charges) and Part B (medical and physician charges) should not have confidence in Medicare alone. Medicare has deductibles and only covers 80% of approved expenses after the deductible. A significant, catastrophic medical related cost might leave you with high medical expenses to pay off. Let's test each one of these in more detail:
