Category Archives: Medicare

Articles about Medicare which can include prescription plans, medicare part d, donut holes, medigap, medicare supplements and other subjects important to people who need or use medicare.

“I Sell Money.”

Posted on by
Reply

Yes, that is what I do.  Pretty plain and simple.  Twice this past week, I have been challenged to come up with a new elevator speech.  You know the one, where someone asks you “What do you do?”   So, I woke up at 4:30 A.M this morning to this realization.  I used to say, I am an insurance agent. But in reality, my end product is money.  Money from insurance companies when you or your family need it most.  When you get sick or hurt, it is your medical insurance that pays those big bills.  If you become sick or disabled, there is money to pay those pesky bills.  When you die, (notice I did not say if), your family will have money to take care of your final expenses.  And if your family depends on you financially, there is money so that they can go on with their lives.  And, if you are lucky enough to retire, I sell money so that you can never outlive your money.  Pretty good idea, right?

To get a bit more technical, I use insurance products to leverage money.  Not nearly as compelling is it?  How about, “I sell dollars for pennies?” That is an old one, but true.  Insurance is a great product.  But how do you know if you are getting a good deal?  That is where I come in.  I sell for a lot of reputable and financially loaded insurance companies.  But some have better products to meet your needs than others.  Some of them give you a better deal for your money. I can help you understand what it is that they are offering to do and help you shop for the one that is best for you and your family.

A Plan F is a Plan F, is a Plan F

Posted on by
3

A Plan F is a Plan F is a Plan F.  I say this often to my potential clients. It is true, but not the whole truth.  Because the Centers for Medicare and Medicaid (CMS) have standardized all Medicare Supplement Plans (also known as Medigap Plans), it is true that the level of benefits are the same. All Plan F plans must cover Medicare deductibles and co-insurance, no matter which company you purchase from.

However, a Plan F from one company to another company can and does vary significantly.  I am an independent insurance agent who specializes in this. The following are ways that they can vary and you need to consider when choosing a Medicare Supplement Plan:

  1.    Rates can vary significantly.  In Virginia, as of this writing,( September 17, 2012) a Plan F rate for a 65 year old female can range from a low of $92.13 per month to over $300 per month.  (We are talking identical coverage!) These rates vary due to many factors such as the area in which you live.  For example, a person who lives in one zip code can pay $20/per month less than their neighbor who lives down the road but in a slightly different zip code.  A smoker may pay more with some companies.  Males may have a higher rate with some companies.  Some plans have rates which are guaranteed to increase every year as you get older.  Some plans level off their rates after age 75.  (Unfortunately, all of them can – and do- raise their rates on an across the board basis.)
  2. There are extra “Perks” and extra Costs.  For example, you must be a member of AARP to buy their Plan F from United Health Care.  Currently, this is an additional cost of $16 per year.  But on the Perk side, the AARP/UHC plan includes a Silver Sneakers benefit.  That alone, could save you over $50 per month if you are already paying for a fitness center membership.  Mutual of Omaha has a 7% couples’ discount.  And companies are adding more perks (benefits that are not required by law) every day trying to get your business.
  3. Ratings and Customer Service.  Have you ever had a question and had to talk to someone in India, or be put on hold for what seems like a lifetime?  This is a consideration when purchasing a plan you will probably keep for many years.  Though in my experience, this is usually not a big consideration because these plans (as long as they are from a reputable company) work like a dream.  It is rare to be dissatisfied with a Plan F as long as you can afford to pay the premiums.

So the bottom line is – Shop plans with a knowledgeable agent who can enroll  you into best plan for you.

 

 

Original Medicare Benefit Coverage

Posted on by

What is the difference between a Medicare Supplement policy and a Medicare Advantage policy?

They both are meant to enhance Original Medicare (Part A and Part B) benefit coverage. However, they are distinctly different and can not be interchanged.

A Medicare Supplement (also known as a Medigap policy) is purchased for a premium from a private insurance company. The plans are standardized and a good plan (such as Plan F) will basically cover all medical expenses that are not covered by Original Medicare.

Medicare Advantage Plans (also known as Medicare Part C), are plans that are contracted with the Center for Medicare and Medicaid (CMS). You enroll in a specific plan managed by an insurance company. That plans then is responsible for paying for your medical expenses. You are responsible for co-pays and co-insurance.

These plans have to be ,by law, be as good as or better than Original Medicare. They may include extra benefits such as a built in prescription drug plan and discounts on medical related services

Medicare Prescription Plan

Posted on by

What is a Medicare Prescription Plan and how do I get one?

Medicare Prescription Drug Plans (also known as Medicare Part D and PDPs) are generally highly recommended if you have Medicare and no other creditable prescription drug coverage. To get Medicare Drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. Sometimes a PDP is included in your Medicare Advantage Plan at no additional cost. These plans are called “MA-PDs”.

Medicare Advantage Plans

Posted on by

What is the difference between PFFS, PPos and HMOs in the Medicare Advantage Plans?

PFFS is a private fee for service plan. There is no contract between the medical provider and the insurance company other than the underling Medicare rules. You can use any provider who accepts Original Medicare payment, who is willing to treat you and accepts the plan’s terms and conditions. The provider can decide on a patient-by-patient, and a visit-by-visit basis at the time of service whether to treat you. Emergencies are an exception to these guidelines.

PPOs are Preferred Provider Organizations. There are contracted with certain medical providers and prefer that you use them. However, you may go outside of the provider list and still have coverage without a referral. This however, may result in additional costs for you.

HMO’s are Health Maintenance Organizations. The insurance companies restrict you choice of providers to those they have contracted with. In addition, a referral from your primary care physician is generally required.

Donut Hole

Posted on by

The Donut Hole, also known as the Medicare Part D coverage gap, can be very stressful (read expensive.) However, it is better this year (2012) than before. All approved Medicare Part D plans allow only a limited amount of benefits each year. In 2012, when you and your insurance company have spent $2,930 on drug costs, you end up paying for prescriptions out of your pocket. Starting this year, when and if you reach this gap, you receive a 50% discount on most brand name drugs and a 14% discount on generic drugs.

As always, after you’ve spent a certain amount for prescriptions out-of-pocket ($4,700 in 2012), catastrophic coverage starts and you only pay 5% of your prescription cost for the rest of the year.

This year, the 50% discounts are applied to your out-of-pocket totals, so it may be faster to get through the donut hole.

Also, Prescription Drug plans can change significantly from year to year. It is a wise idea to shop for the best plan for you each October/November. For more information or help, call your agent or visit www.Medicare.gov.