4 Facts Regarding Medicare Supplement Insurance

By B. Loughead

 

Although Medicare supplement insurance has become an extremely popular topic of discussion, there are certain misconceptions about it that everyone needs to be aware of. There are 4 facts about this insurance that need to be taken into consideration before you sign up for any particular plan.

Fact #1: Medicare supplement insurance costs will vary from one carrier to the next - despite the fact that these plans are identical, regardless of who you purchase them from, the cost of your premium will vary from one insurance carrier to another. So be sure that you shop several companies before committing to buy. No insurance carrier is required to offer all 12 plans so one insurance company may try and talk you into the plans they sell when another plan may be what you actually need.

Fact #2: No matter who you purchase Medicare supplement insurance from, it is the same coverage - this insurance covers the gaps found in Medicare. There are different levels of benefits provided by this comprehensive 12-plan program labeled as Part A through Part L and many private insurance carriers may provide one or more of them. However, no matter who you purchase these plans from, the coverage will be identical. So if a company tells you that their plans offer certain unique benefits over other companies, don't believe them.

Fact #3: Only one Medicare supplement insurance plan is needed - according to the law, you only need one supplement insurance plan. You can easily cover the gaps in your Medicare coverage by purchasing Medigap insurance. So if Plan D covers your specific needs, you will not need to purchase any other supplemental plans. As it currently stands, trying to sell you additional plans is illegal according to the Federal Government.

Fact #4: You are the only person who can be covered by a Medicare insurance policy - your Medicare policy covers you and no one else, unlike traditional insurance policies that oftentimes include coverage for your husband or wife. Married couples have to purchase individual policies should they want Medicare coverage. So if a private insurance carrier tries to tell you that you can purchase a Medicare insurance policy that covers both of you, they are not on the level and you should keep shopping other providers.

In closing, remember that up to 80% of some hospitalizations, equipment, and treatments will be covered by Medicare. The exact amount will be determined by whether you have Part A only or Part B as well. Choosing the right medicare supplement insurance policy will determine if you are covered 100%.

Summit Medigap is an independent insurance agency that specializes in Medicare supplement insurance. We make Medicare seem easy™. For more information about Medicare supplement insurance visit http://www.SummitMedigap.com/ or call us at 1-888-40-Summit (888-407-8664). We have helped many people in Florida, Georgia, North Carolina, South Carolina, Michigan, Texas and Colorado to name a few.

Definitions Of The Most Common Medicare Terms

By B. Loughead

There are a number of Medicare terms that everyone should know if they are policy holders or are about to be. We have listed the more common ones below.

Appeal - a formal complaint that an individual files if certain drugs and services are not covered by their particular Medicare plan when they feel that they should be.

Co-pay - the portion of any medical services and/or prescription medications that you are responsible for paying.

Deductible - the amount of money that must be paid by the insured for medical care before Medicare covers any such expenses.

Doughnut hole - the coverage gap found in some Medicare drug plans (scheduled to close in 2020).

Dual eligibility - refers to being eligible for both Medicaid and Medicare.

Enrollment period - the limited time period that an individual can enroll in a health care plan or switch to a different one.

Grievance - a formal complaint made to Medicare when your health care plan or the person administering medical treatment to you has treated you improperly or poorly.

Home health care - short-term care provided while you are recovering at home from an illness or injury. Occasional part-time skilled care as well as some medical equipment, services, and supplies are included in a home health care plan.

Hospice care - care administered to those individuals with a terminal illness or medical condition (covered in Part A). Counseling and physical care are included.

Long-term care - Medicare does not cover ongoing health or personal care that an assisted living facility or a nursing home would provide.

Medicaid - federal and state programs that are separate from Medicare. This assists those individuals with limited assets and low incomes to pay for their medical expenses.

Medicare Advantage - alternative health care for Parts A and B that are provided by a private insurance carrier.

Medicare Part A - pays for hospice care, hospital stays, and some home health care.

Medicare Part B - pays for lab tests, medical equipment, physician visits, and some medical services.

Medicare Part D - coverage that is provided for some brand name and generic medications.

Medigap - private insurance that covers the gaps in Part A and Part B coverages. It is also sometimes referred to as Medicare Supplement Insurance.

Out-of-pocket expenses - those expenses that you are responsible for and are not covered by Medicare insurance.

Premiums - payments for health care coverage that is usually made on a monthly basis.
Skilled nursing care - medical care provided by licensed LPN's (Licensed Practical Nurses) or RN's (Registered Nurses).

For more information, the entire Medicare glossary is available online at the US Government Site for Medicare or you can click Medicare supplement information.

Summit Medigap is an independent insurance agency that specializes in Medicare supplement insurance. We make Medicare seem easy™. For more information about Medicare supplement insurance visit http://www.SummitMedigap.com/ or call us at 1-888-40-Summit (888-407-8664). We have helped many people in Florida, Georgia, North Carolina, South Carolina, Texas, Colorado and Michigan to name a few.

Deadline Approaching For People Who Had Universal Healthcare To Sign Up For A New Medicare Plan

Deadline Approaching For People Who Had Universal Healthcare To Sign Up For A New Medicare Plan

By B. Loughead

  

The time is now for people who had Universal Healthcare to sign up for new Medicare Supplement Insurance or Medicare Advantage Plan. The Special Election Period (SEP) is almost over. This past February (2013), Florida state regulators chose to put two subsidiaries of Universal Health Care Group Inc. into receivership as it was announced that the financially troubled company had filed for Chapter 11 bankruptcy. The future of the St. Petersburg-based health care corporation is clouded and uncertain due to continued financial struggles and state regulatory commission challenges. The shutdown will affect both employees and members alike in the state of Florida, but there is some speculation regarding those individuals in the states of Georgia, Nevada, North Carolina, and Texas as well.

As it currently stands, there are approximately 100,000 members (40,000 Medicare and 60,000 Medicaid) while there are roughly 37,500 Medicare policy holders covered by the Universal Health Care Insurance Company. Although the states of North Carolina and Texas both have HMO facilities, it is speculated that the receivership orders in Florida will not affect them. However, there is still a great deal of concern for members as some 900 seniors in the St. Pete area alone will be affected and will need to find another health care provider as a result of the bankruptcy filing.

In addition to the thousands of Universal Health Care members that will be impacted by the shutdown, hundreds of employees will also be out of a job and add to the current economic woes of the country. Interestingly enough, and despite this "doom and gloom" scenario, those members who are impacted by the Universal Health Care shutdown now have the opportunity to be covered by Medicare supplement insurance. Current Universal members are enrolled in Medicaid or Medicare as it is. However, they were assigned to original Medicare Part A & Part B if they had not chosen a new plan as of the April 1st deadline.

As it currently stands, the company is continuing to operate while negotiations with lenders continue and the proposed reorganization under Chapter 11. For now, this protects them from any lawsuits and/or collection efforts. Additionally, Universal Health Care has agreed to a merger with America's 1st Choice for the Florida, Nevada, and Texas HMO's as well as part of their Universal Health Care Insurance Company. According to several news articles, Universal will seek the bankruptcy court's permission to continue with the sale of the company and have not yet consented to receivership. What is important is the fact that those members who feared the worst do have other options to consider.

CMS has granted these beneficiaries, along with other impacted Universal Health Care Inc. (HMO) and Universal Health Care Insurance Company Inc. (PFFS ) plan members a Special Election Period (SEP), to enroll into another plan of their choice. Valid effective dates for this SEP are March 1 - May 31, 2013. It is important that people impacted by this contact an independent agent quickly to make the deadline.

Summit Medigap is an independent insurance agency that specializes in Medicare supplement insurance. We make Medicare seem easy™. For more information about Medicare supplement insurance or to compare plans visit http://www.SummitMedigap.com/ or call us at 1-888-40-Summit (888-407-8664). We have helped many clients in Florida, Georgia, North Carolina, South Carolina, Michigan, Colorado and Texas to name a few.

Why Medicare Supplement Plan N Might Be Right For Your Needs

By B. Loughead

As of June 1st, 2010 the landscape of the Medicare Supplement market changed significantly with the advent of Medicare Plan N (and M). At that time, the US Government required all companies who were marketing and selling Medicare Supplement plans to abide by the newly modernized and upgraded Medigap chart. Supplement Plans M and N were a part of this modernization process and promised to be better choices for both existing and new Medicare beneficiaries. Now the only question was, are these plans right for you?"
                                                                                                           

What Medicare Supplement Plan N Covers

Although it is similar to Medicare Plans D and F, Medicare Plan N utilizes a system for sharing costs in order to keep a person's premiums down. Unlike Plans D and F, it will cover all or a portion of the deductibles incurred in Medicare Parts A and B. A new co-pay structure was implemented in exchange for insurance premiums that could be up to 30% lower than what they were. Under Plan N, doctor visit co-pays are $20 and emergency room visit co-pays are $50.
In addition to the change in the co-pay structure, if a hospital admission is required because of the visit to the ER, the $50 co-pay will be waived. In addition to the above, Medicare supplement Plan N provides 100% coverage for deductibles under Part A but no coverage for Part B deductibles.

The Medicare basic core benefits are not covered under Plan N including:

• all expenses after Medicare benefits run out for in-patient hospital care
• coverage for in-patient hospitalization charges under Part A
• emergency benefits when traveling internationally
• initial 3 pints of blood
• Part A co-insurance for palliative medication in hospice care
• Part B co-insurance expenses

It is estimated that the premiums incurred under Medicare Plan N will cost about 77% of Plan D and 70% of Plan F premiums. For individuals with budget concerns, Plan N will most likely be better than any of the Medicare Part C Advantage plans.

Additional Considerations

Many individuals claim that Medicare supplement Plan N was the better option for them because the out-of-pocket expenses are considerably lower and there are no restrictions where networks are concerned. Additionally, not every healthcare insurance provider offers Plan N so you will need to search for those companies who do offer it should you want this coverage. Be sure that you spend time researching to this before committing to any insurance provider.

Summit Medigap is an independent insurance agency that specializes in Medicare supplement insurance. We make Medicare seem easy™. For more information about Medicare supplement insurance or to compare medicare plans visit SummitMedigap.com or call us at 1-888-40-Summit (888-407-8664). We have helped many clients in Florida, Georgia, North Carolina, South Carolina, Michigan, Colorado and Texas to name a few.

The Difference Between Medicare Advantage And Medicare Supplement Insurance

By B. Loughead

 

Medicare is the US Government's federally administered nationwide social insurance that was established in 1965. Americans who are 65 years of age or older are guaranteed access to health care through this program. However, younger individuals with disabilities or who are in the end stage of renal disease are covered by Medicare. Medicare benefits are broken down into four categories as follows:

• Part A - hospital insurance                                   

• Part B - medical insurance
• Part C - Medicare Advantage plans
• Part D - prescription drug plans

Part A covers any hospitalization that is required while Part B covers visits to the doctor as well as any medical equipment that the patient may need. Consequently, there are gaps in these coverages which can be covered by either a Medicare Advantage or Medicare Supplement plan.
Private companies offer Plans that work with Medicare and oftentimes include prescription coverage. They can be HMO's, PPO's, or private services but they will not negatively impact you despite receiving Medicare benefits. Secondary health insurance policies related to Medicare coverage are known as Medicare Supplements. They are also referred to as "Medigap" policies which are standardized by the Federal Government. As with Medicare Advantage Plans, Medicare Supplements also work with Medicare.

Both types of plans are similar to one another with certain aspects, but there is also a considerable difference between them as well as many different options. They provide additional coverage to your existing Medicare, but one of the primary differences is that Medicare Advantage premiums are usually lower than Medicare Supplement plans. They include benefits and prescription drug coverage that your original Medicare does not. Out-of-pocket expenses are also higher.

There are certain services that Medicare Supplements do not cover and there is no provider network with Supplement plans whereas there is with Advantage plans. Although there are provider networks, you will pay additional costs for going outside of that provider network. Another significant difference between Advantage and supplement insurance is that Advantage plans limit the times during the year that you can enroll in one of their plans.

Conversely, Supplement plans allow you to enroll whenever you want throughout the entire year. Finally, you are required to have both Medicare Parts A and B in order to enroll in Medicare Advantage and Medicare supplement plans. More information regarding either type of plan is available at Medicare's official website. You should talk with a licensed professional from an independent insurance broker before making any decisions.

Summit Medigap is an independent insurance agency that specializes in Medicare supplement insurance. We make Medicare seem easy™. For more information about Medicare supplement insurance visit http://www.SummitMedigap.com/ or call us at 1-888-40-Summit (888-407-8664).

How To Compare The Different Medicare Supplement Plans

By B. Loughead

 

As it currently stands, there are 7 additional Medicare Supplement plans to choose from (F through N) in addition to plans A, B, C, and D. Each plan's benefits differ in one way or another with one exception and that is the fact that basic benefits coverage is required of all of them. In

1990, Medicare standardized their different plans in order to decrease the amount of confusion that consumers were experiencing as they compared different coverages offered by the different healthcare insurance providers.

As a result of this standardization, it is easier for the consumer to understand the comparison of these different benefits and the associated cost comparisons between healthcare insurance providers. As a result, the terms "MediGap plans" and "Medicare supplement" basically mean the same thing and are commonly used interchangeably. As a result of having so many Medicare plans to choose from, it is important to research each one in order to decide which will be best for your personal needs and situation.

One of the first things to be aware of when searching for supplement plans and comparing the ones you find is that many websites who advertise these are only there for one reason and that is to collect your personal information. In many cases, insurance providers will purchase leads or develop lead generators to accomplish this instead of actually doing what they advertise. Basically, these companies don't know the proper ways of developing new business so they resort to these somewhat underhanded methods.

Many of these companies make it appear as though they actually sell the different Medicare supplement plans but the reality is that they will collect your personal information and sell it to numerous insurance agents. Here are two ways that you can tell if they are legitimate healthcare insurance and Medicare supplement plan providers. First of all, there will be a toll-free number to call and secondly, there will be a statement promising that they will never sell your personal information to anyone else.

Do price comparisons of these different Medicare plans when searching through the different companies that offer them. The better insurance brokers will be able to provide you with these comparisons from those insurance providers operating in your local area. In most cases the prices will differ despite the fact that the supplement plans they offer are identical. Remember, it is better to do plenty of research in order to make a well-informed decision when purchasing the Medicare supplement plan that is right for you.

Summit Medigap is an independent insurance agency that specializes in Medicare supplement insurance and we will never sell your personal information to anyone. We make Medicare seem easy™. For more information about Medicare supplement insurance visit http://www.SummitMedigap.com/ or call us at 1-888-40-Summit (888-407-8664).

A Basic Guide To Medicare Advantage Plans (Part C)

By B. Loughead

 

The coverages of Medicare Parts A and B as well as additional benefits are combined under Medicare Advantage plans (Part C). Most of these plans will also include prescription drug coverage or Medicare Part D. If you want to enroll in one of the Advantage plans that are available through private companies, you can do so provided that you already have or can qualify for regular Medicare coverage. You won't need all three of these coverages nor will you have the need for any type of Medigap coverage if you enroll in Plan C.

The Differences Between Original Medicare and Medicare Advantage Plans

Although everything that Medicare usually covers is covered by a Medicare Advantage plan, there are some differences between them to be aware of. Most of the time, the difference is in the amount you pay for health care out-of-pocket. Some of those differences include:

• co-insurance or paying a different percentage share of your medical bills
• co-pays
• deductibles
• Network of providers available
• In Network vs. Out of Network

Additionally, emergency medical and urgent care is included in Medicare Advantage plans (Part C). In some instances, routine dental, routine vision, and/or wellness programs may also be covered by some plans. Most will include Part D coverage. However, Part C coverage does not include any hospice care, even with a Medicare Advantage plan, as it is still covered under Medicare.

The Different Types Of Medicare Advantage Part C Plans

In order to determine which type of Part C plan will facilitate your needs, you need to review the different types of plans that are currently available. There are several different plans including the following:

HMO - Health Maintenance Organization Plan
MSA - Medical Savings Account Plan
PFFS - Private Fee-for-Service Plan
POS - Point of Service Plan
PPO - Preferred Provider Organization Plan
SNP - Special Needs Plans

Information regarding these six different types of plan is available online simply by using the abbreviation or what it stands for as the keywords for your Google search.

Part C Enrollment

In closing, the enrollment process for Medicare Advantage plans (Part C) will differ based on which private insurance carrier you select. However, enrollment periods are identical regardless. Enrollment is allowed once you are eligible for Medicare, but there is a 7-month waiting period that begins 90 days prior to your 65th birthday and continues for 120 days afterwards. Finally, if you are less than 65 years of age and are receiving SSDI (Social Security Disability Insurance), you will qualify once you have been receiving SSDI for 2 years and 1 month.

Summit Medigap is an independent insurance agency that specializes in Medicare supplement insurance. We make Medicare seem easy™. For more information about Medicare supplement insurance visit http://www.SummitMedigap.com/ or call us at 1-888-40-Summit (888-407-8664).