Top Five Misconceptions about Medicare and Medigap

medicare mythsMedicare can be complex – there are “parts” and “plans”, changes and updates, ins and outs that only the most experienced or devoted person could follow and understand. Moreover, there is a great deal of misinformation out there about Medicare and Medicare supplement plans, particularly this time of year as we approach the end of year annual election period. As an independent Medicare insurance and Medigap agency, we hear these misconceptions over and over. It is an uphill battle to fight against the misinformation and misunderstandings regarding Medicare and Medigap plans. But in a small way, this article may help shed some light on the top five misconceptions about Medicare companies and the helping hand medicare you can get.

1. “When I turn 65, I’ll get Medicare for free.”
Unfortunately, this one is not true in most cases. There is a premium associated with Medicare Part B (currently $134/month) that is typically paid as a deduction from your social security check. If you are not receiving Social Security, you can also pay this quarterly by receiving a bill. This amount can be higher or lower based on your income. Find out how much you will pay for Medicare Part B.

2. “The end of year enrollment period applies to Medicare supplement, or Medigap, plans.”This misconception is very prevalent this time of year, as we approach October 15, which is the start of the annual election period. Many people mistakenly believe that this end-of-the-year period also applies to Medicare Supplement, or Medigap, plans. However, that is not the case. The end-of-the-year period only applies to Medicare Advantage and Part D plans. You can actually change Medigap plans at any time but do have to qualify medically (in most states) when you do so.

3. “Medicare Advantage plans are a type of Medicare supplement.”Medicare Advantage plans are completely independent of and different from Medicare supplement plans. On the contrary, they take the place of Medicare A & B, whereas supplement plans (also called Medigap) “supplement” Medicare. If you opt on to a Medicare Advantage plan, which is a privatized version of Medicare, instead of Medicare itself, you can go back to having Medicare during the annual election period, but to get a Medicare supplement, you generally would have to qualify medically. You can also get supplements as maeng da from independent suppliers and still get the advantage of Medicare.

4. “Medicare does not cover any preventive care.”This one was more true in the past than it is now. Medicare does now provide coverage for a good bit of preventive care (much of this is relatively new). Here is a breakdown we did previously of some of the more common preventive care that Medicare does cover. Most importantly, Medicare does cover a “welcome to Medicare” physical when you turn 65 and also an annual wellness check-up even if it is at specialized institute as Imagine Wellness Centre.

5. “I need to find out if my doctor takes this Medigap plan (or the related misconception of, “I am going to ask my doctor which Medigap plans pay him faster or more”)This misconception is easily understood, when you consider that it is rooted in (for most people) years of worrying if their insurance is paying their claims in full or quickly enough. However, these concerns do not carry over to “over-65” insurance, at least if you are talking about Medicare and a Medigap plan. For Medigap plan, claims are paid through the Medicare “crossover” system. And, they are paid in the same amount on the same time schedule, regardless of which company you have for your Medigap carrier. Additionally, Medigap plans do not have networks – if a doctor takes Medicare, they are required to take the standardized Medigap plans.

While there is a lot to decipher and understand related to Medicare and Medigap plans, it is crucial to your health and financial well-being to do so, it is important to know that there is also other solutions for any health problem such as hiring acupuncture Miami
where they offer a new way of giving your body good health. If you have any questions about this information or wish to further discuss Medicare and Medigap plans, you can contact us online or call us at 877.506.3378.

Comparing Part D Plans – A Step-by-Step Guide to Using Medicare.gov

This article is re-posted (with revised dates and updated information) from a previous blog post in 2013.

Comparing Part D plans is an essential task for those on Medicare. Part D is the part of Medicare that covers prescription medications, and frankly, is often the most confusing and complex part of Medicare. It can also be the most expensive, particularly if you have chosen the “wrong” Part D plan.

Part D has an annual enrollment period (contrary to Medicare Supplement plans, which do not). This year, the Part D annual enrollment period, or AEP, runs from October 15 through December 7. Any changes made to your coverage during this time period will take effect on 1/1/16.

So, why do you have to compare plans each year? Can you not just choose a plan and stay with it? Yes, you certainly can stick with the plan that you have now. If you take no action during AEP, your plan will carry you into the next year (as long as it is not being discontinued). But, this is not always a wise strategy. Many things about the plans change from year to year.

Each year, insurance companies have to have their plan outlines/designs approved by the Centers for Medicare and Medicaid Services (CMS). Medicare/CMS sets forth minimum guidelines that they must maintain, but they can expand on those as they see fit. Typically, premiums, deductibles and co-pays on each plan change each year. Also, there is the variable of your actual medications, which may have changed and may make a different plan a better option.

So, how to do you compare the Part D plans. Fortunately, Medicare has put all of the plan information on their website (2016 information will be available around 10/1/15). However, the site is not always very user-friendly. Here are the steps to follow to compare the Part D plans:

  1. Point your web browser to http://medicare.gov.
  2. Click the green button named “Find health and drug plans” (mid-way down, left hand side).
  3. Enter your zip code and click “Find plans”. You may be prompted to enter your county (if your zip code spans multiple counties) – if so, select your county and click “Continue”.
  4. Answer the next two questions and click “Continue”.
  5. This will take you to the drug entry screen. You should enter your medication names exactly as they are listed on the label (in other words, don’t list the brand name if you take a generic equivalent). Then, select the dosage and frequency when prompted. Once you have entered them all, select “My Drug List is Complete” (below the drug names).
  6. Next, select your preferred pharmacy. This is important as co-pays etc can vary on some plans from one pharmacy to the next. Choose the pharmacy that you use now or would most likely use and click “Add Pharmacy” below the pharmacy name. Then, click “Continue to plan results” at the bottom of the screen.
  7. Under “Summary of search results”, select ONLY the checkbox beside “Prescription Drug Plans”. Then, click “Continue to plan results”.
  8. This brings up all the plans for your area and the results are sorted by “lowest estimated annual retail drug costs”. In other words, the plans are listed in order of which plan would cost the least to you over the course of an entire year, taking into account premiums, deductibles, and co-pays for your specific medications (that you entered).

This is truly the best way to compare Part D plans. You can even sign up for the plan you want right there on the Medicare website, or you can get information about contacting to company to enroll. It is a little cumbersome and time-consuming, but the savings that can result are significant. Each year for the last 10 years, I have had a client save $2000+ on Part D costs simply by changing plans to one that fits their medication profile better.

We perform the Part D comparisons at no cost for our Medicare clients, as most independent agencies do (or should do). If you want more information or have questions, please contact me online or call us at 877.506.3378.

Going on Medicare Part 3 – Medigap vs. Medicare Advantage

**This is Part 4 in a 5-part series intended to assist people turning 65 or going on Medicare with understanding Medicare, Medigap and other Medicare plan options.**

This article focuses on the difference in the two types of Medicare insurance plans – Medigap plans and Medicare Advantage plans. Contrary to what many people think, these are NOT the same thing, work very differently, and there are some distinct advantages/disadvantages to the different types of plans.Medigap vs. Medicare Advantage – Two Distinct and Very Different Options

Commonly, individuals going on Medicare refer to all plans that are secondary to Medicare as Medicare Supplements. This is, obviously, incorrect. An employer group health plan, Medicare Advantage plan, etc. is NOT a Medicare Supplement.

Medicare Supplements are also called Medigap plans. These two terms are interchangeable. These Medigap plans cover the same things from company to company – plans are Federally-standardized. Below, we’ve listed some major bullet-point differences between the plans:

  • Medicare Advantage plans have networks and some (HMOs) require referrals; Medigap plans do not have networks – you can go anywhere that takes Medicare.
  • Medicare Advantage plans have co-pays and deductibles but lower premiums; with Medigap, you pay a larger premium but it is more comprehensive coverage. The Medigap fills in the ‘gaps’ in Medicare A & B so you don’t, in most cases, have any out of pocket co-pays or deductibles.
  • Medigap plans do not include drug coverage; Medicare Advantage plans sometimes include Medicare Part D prescription drug coverage, within their plan.
  • If you take a Medicare Advantage when first eligible (when leaving employer coverage or turning 65), you have to qualify medically if you ever want to return to the more comprehensive coverage of a Medigap plan. However, you can always go the “other way” – from Medigap to Medicare Advantage.

There are obviously some other factors to consider when comparing these two types of plans, but these are the primary differences in the plans. Other things you will want to consider are your own personal health, your financial means and the future of the Medicare Advantage program since the onset of health insurance reform.

What’s right for one person may not be right for another. It’s most advantageous to you to work with an independent agent who can simply provide all of the information for both types of plans, so that you can compare in one centralized place and make an educated decision.

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If you prefer to speak with someone by phone, please call me directly using the information below:J. Garrett Ball, President
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Now that the Medicare Enrollment Period is Over, What Changes Can I Make?

The Medicare enrollment period lasts from October 15 through December 7. This is also called the Annual Election Period, during which you can elect which Part D plan you are going to have for the following year. The enrollment period also applies to Medicare Advantage plans. It does not, however, apply to Medigap or Medicare Supplement plans contrary to popular misconception.

Now that the enrollment period has come and gone, what changes can you make to your coverage? If you have a Medigap plan, you can easily change into another Medigap plan, as long as you are in relatively good health. If you are on a Medicare replacement plan now (i.e. Medicare Advantage), you have until February 14 to “get out” of that plan and return to Medicare with a Part D prescription drug plan. In doing so, you can also pick up a Medicare Supplement plan to fill in the gaps in Medicare.

After February 14, you will be locked in, if you have a Medicare Advantage plan, to whatever plan you have for the remainder of the calendar year.

If, however, you have a Medicare Supplement plan, you can change plans at any time, for any reason, as long as you can meet the new plans medical criteria. There are some exceptions to this if you are still within your initial open enrollment period (6 months from the time you go on Medicare Part B or turn 65) or in some states, which mandate additional open enrollment periods. But generally speaking, as long as you can qualify medically, you can change Medicare Supplement plans.

Additionally, all Medicare Supplement plans are standardized, so they all provide the same coverage. It is easy to compare based on the rates of the various plans. For example, if you have a Plan F, you can switch to any other Plan F and expect the plan to work the exact same way and provide the exact same coverage. Rates for Medicare Supplement plans do vary greatly so this is essential to do on at least a bi-annual basis.

If you have any questions about this information or wish to compare the Medigap plans in an unbiased and centralized way, please call us at 877.506.3378 or contact us on our Medigap quotes page.

Medicare Part D Comparison – Information Is Up on Medicare.gov

The Medicare Part D annual enrollment period starts on October 15. This is the one time of year that you can make changes to your Medicare Part D Rx coverage (unless you fall into one of a few exceptions, “Special Election Periods”).

In some year’s past, Medicare did not post the comparison information in advance of the enrollment period. In response to increasing numbers of “Baby Boomers” and computer-savvy Medicare-eligibles, this year Medicare.gov rolled out the 2013 data at midnight on October 1. This comparative information is essential in comparison the Part D drug plans. Compare the Part D plans on Medicare.gov.

If you are on a Part D Rx plan now, it is highly advisable that you compare the available plans to make sure you have the plan that is most advantageous for you. The 2013 plans have changed dramatically in some cases, although the overall “average” picture is that the plan premiums went up only slightly and benefits stayed relatively the same. That doe not account for each individual plan, which could have changed drastically or stopped/started covering some of your specific medications.

Although this time of year, the enrollment period, does not actually apply to Medigap (Medicare Supplement) plans, many people believe that it does. And actually, it is a good time to compare the Medigap plans, since many companies change their rates on a calendar-year basis. Also, when doing a re-evaluation of your Part D plan, it may make sense to “shop” your Medigap plan as well. These plans are Federally-standardized, so each company is required to offer the same coverage plan. Typically, rates can vary by as much as 50-70% from one company to the next. So if you have had your plan for more than a year, there is certainly some savings to be had. Compare 2013 Medigap plans.

If you would like Medicare-Supplement.US to provide this customized rate quotes information for 2013 Medigap plans, simply request the information online. The Medigap comparative information will be provided to you by email within an hour (during business hours). Not all companies release their rates online, so if you are comparing rates that way, it is imperative to understand that you are not viewing all plan options. If you have questions or would like to speak to someone directly, call 877.506.3378.

Medicare Enrollment Period – What Changes Can You Make?

The Annual Election Period (AEP), or Medicare Enrollment Period, as it sometimes called, is the period of time during which some changes can be made to your Medicare plan coverages. There are many misconceptions about this period and what changes you can make during it. It is important to understand how this period works and exactly what steps you need to take during this period to ensure continued quality Medicare plan coverage.

Original Medicare – Parts A & B
If you are already on Medicare Parts A & B, you do NOT need to do anything during this period to continue to have Medicare coverage. If, however, you do not have Medicare Part B yet, you can sign up at this time for it to take effect on 1/1/13. This is useful if you are leaving, or losing, employer group coverage.

Medicare Part D
Medicare Part D is probably the most important thing to understand, as it relates to the Medicare enrollment period. This is the only time of year that you can change your Part D prescription drug plan. Part D plans do change each year, so it is essential to know how your plan is changing and make sure it is still the most advisable choice for you. You will receive a plan notice of change around October 1 – this will detail how your plan is changing for the next year. Often, plan premiums, deductibles, co-pays, tier structures, etc. will all change on a plan from year to year. You can compare all of the plan options to make sure yours is still the best for your current needs by using an independent brokerage (like Medicare-Supplement.us!) or by going to the Medicare website (www.medicare.gov). Either way will allow you to choose a plan based on your current medication needs.

Medicare Supplements (Medigap)
Contrary to popular misconception, you can actually change Medigap plans at any time of the year. The end of year period is a good time to do it, particularly if your plan rates have changed during the year. However, you can do it at any time. You can enroll in, disenroll from, or change your plan to another option. Because these plans are Federally-standardized, coverage is the same with every plan. For example, a Plan F with one company is the exact same as a Plan F with another company. So, if you can find a lower-priced option for the plan you have, and are able to change, switching plans is a wise thing to do to reduce your premium costs.

Medicare Advantage
Medicare Advantage is the type of plan that replaces Medicare – basically, it is a privatized version of Medicare. The Annual Election Period (October 15-December 7) is the only time of year that you can make changes to this plan (unless you fall in a special election period circumstance – i.e. losing other coverage, moving out of your plan’s area, etc.). So, if this is the type of plan you have chosen, it is wise to make any changes to it at this time. You can compare the other options and make changes as necessary.

If you have any questions about the Medicare enrollment period, please contact us at Medicare-Supplement.US or call us at 877.506.3378. Medicare-Supplement.US is an independent Medicare insurance brokerage that can assist you with comparing the plan options and choosing a suitable plan.

Comparing Medicare Part D – Why You Should and The Process for Changing Plans

Comparing Part D plans is an essential part of any sound financial strategy. Part D plans can change each year, and most do change on a regular basis. The coverage changes, the premium changes, and some plans may choose to discontinue coverage altogether. Insurance is an ever-changing industry, and this is never more true than in the case of Part D plans. Because of that, it is absolutely critical that you re-evaluate your Part D plan on an annual, or at the very least, bi-annual basis.

The biggest things that you need to look for when you are evaluating and comparing your Part D plan to other options are the premium, deductible and co-pays/coverage. While one plan may have a lower premium, note whether the deductible is higher and/or whether the co-pays are larger. Often, plans will put forth an enticing lower premium but have the plan loaded with a large deductible and high medication co-pays. This is okay for someone in good health, but if your health changes or if you are on a lot of medications, this is not going to be something that will benefit you in the long run.

Towards the end of the year, usually in September or October, you will receive a packet from your current Part D plan regarding the coverage for the following year. If you have not received this by the end of October, we recommend contacting the plan to notify them of this and obtain this packet. This will be required in order to make a careful and effective evaluation of the plan options. The packet will contain a comparative chart, showing how the plan is changing from the current plan year into the next year. It should be relatively easy to understand if the premium, deductible, or co-pay structures are changing. Also, if your medications are moving to a new “tier”, this is something that you can find out from the packet, and it will be important to know as you evaluate the plans.

Each year, you have the opportunity to change plans during the annual election period. It is my recommendation that you carefully evaluate the plan options each year, as these plans change very frequently. If you wish to make a change, you simply apply for the new plan. You cannot be enrolled in two plans at one time, so when Medicare processes your enrollment into the new plan, they also disenroll you from your old plan. The process is seamless and easy to do. It can be done online with Medicare, by calling 1-800-MEDICARE or by contacting the new plan directly.

If you have any questions about this process, Part D plans in general or Medigap plan options, please contact us on our website or call us at 877.506.3378.

This concludes our five-part series on Part D plans. Hope you have found it to be enlightening and beneficial. Part D is the most confusing, and least enjoyable, part of Medicare for most people. However, it doesn’t have to be. With a little knowledge of the Part D system, how it works and how to easily compare plans, you can save hundreds, even thousands, of dollars a year. And, that’s enjoyable for anyone!

The Medicare Annual Enrollment Period Myth

Each year the myth grows stronger – the myth about Medicare’s annual enrollment period applying to Medicare Supplement plans. Most people, for one of several reasons that we will discuss later, believe that you can only change Medicare Supplement plans at a certain time of the year. Moreover, most believe that, during this time period, you can change without medical underwriting of any kind (i.e. no health questions). We intend to do our part, however small, to eliminate this incorrect thinking.

Put simply, you can change Medicare Supplement plans at any time of the year. There are no annual enrollment period that you must adhere to. However, when you do change, no matter what time of year it is, you do have to “qualify” medically in most situations. The exceptions to this are if you turning 65 or just going on Medicare, losing some other type of coverage, or moving out of your plan’s service area.

There are several significant factors that exacerbate this myth. The first and foremost factor is that there IS an annual enrollment period for some Medicare plans, including the Part D plans that are often paired with Medicare Supplement coverage. Also, Medicare replacement plans called Medicare Advantage plans have this same annual enrollment period. For these plans, you can only change, cancel or enroll in a plan during the AEP (Annual Election Period), which runs October 15 to December 7 each year.

The other related factor that causes this misconception is the glut of advertising associated with the aforementioned plans. These plans advertise leading up to and during the annual enrollment period, and this period is often referred to as the Medicare enrollment period. This leads many people to the conclusion that you can only change all types of Medicare coverage during this period.

Now, you certainly CAN change your Medicare Supplement during this end of year time period, but that is not the NOLY time that you can change your plan. It may, however, be a convenient time to re-evaluate your options since many people are re-evaluating their Part D Rx plans at this same time.

Comparing Medicare supplement plans is very easy to do. Since the plans are standardized and there are no restrictions on when you sign up for a plan, you can do this all online and at any time. If you want to compare your supplement plan options, give us a call at 877.506.3378 or contact us online at Medicare-Supplement.US.