If your Medicare plan is not renewing take advantage of this Special Enrollment Period

Medicare Advantage and Part D plans are calendar year plans. Each year insurance companies offering these plans can choose to non-renew a plan or exit a service area.

If your Medicare Advantage or Part D plan is not going to be offered for the following year you are entitled to a Special Enrollment Period. This enrollment period gives you more time beyond the Annual Enrollment Period to choose a new plan.

The Special Enrollment Period begins December 8th and ends February 29th.

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Some considerations for the Special Enrollment Period

There are a few things that you should be aware of if your Medicare plan is not renewing for the following year.

The first consideration if your Medicare Advantage plan is not renewing is whether you should choose a new Advantage plan or purchase a Medicare supplement.

Losing your Advantage plan gives you Guaranteed Issue Rights when buying a Medicare supplement. If you chose a Medicare Advantage plan because you were unable to qualify medically for a supplement, this is your opportunity to get a Medicare supplement.

If you decide to buy a Medicare supplement policy you can/must apply as early as 60 days prior to losing coverage, but no later than 63 days from when your coverage ends. You must apply for the Part D between December 8th and January 31st if you did not submit an application during the Annual Enrollment Period.

Medicare Supplement Plan F Benefits

You have the right to buy Plan A, B, C, F, K, or L though any insurance company that offers these plans in your State.

The second thing to consider especially if you have decided to stay with a Medicare Advantage plan or are losing Part D is when to submit an application to avoid a lapse in coverage.

A plan’s effective date is the 1st of the month following the application date. If you wait until January 1st or later to submit an application your plan will not become effective until February 1st, leaving you without coverage (other than original Medicare) during January.

If you are enrolling in a Part D or Medicare Advantage plan during the Special Enrollment Period you are allowed to make one plan change. This is different than the Annual Enrollment Period where you are able to submit multiple applications with the last submitted becoming the one to be issued.

Each year thousands of people have plans that do not renew for the following year. Taking advantage of the Special Enrollment Period for non-renewing plans is your protection and your right to choose a new plan.

For some people, losing a plan is actually a blessing as they are able to buy a Medicare supplement. Ff you are not interested in a Medicare supplement you may not really be losing that much as your plan was an annual plan to begin with.

Choose This AARP Medicare supplemental plan if you want the best coverage

Choosing a supplemental Medicare plan without a good understanding of what’s available is a lot like gambling without knowing the rules of the game.

Each year in the United States approximately 10,000 people turn 65 and a good percentage of them purchase or join a Medicare plan that is not right for them.

If you are considering purchasing an AARP Medicare supplemental plan continue reading to learn which plan will give you the best coverage.

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All AARP Medicare supplemental plans are not created equal

Before diving into which Medicare supplement will afford you the best coverage let’s address a little confusion surrounding supplemental plans from AARP.

A Medicare Advantage plan like AARP Medicare Complete is not a Medicare supplement. Medicare Advantage plans do not supplement original Medicare but rather are another way to receive your Medicare benefits.

AARP Medicare Complete

Medicare supplemental insurance is also known as Medigap. Medigap policies offer standardized coverage from one carrier to the next. The basic benefits of an AARP Medicare supplement available from United HealthCare will be identical to the same plan offered by another company.

There are 10 Medigap policies available; A, B, C, D, F, G, K, L, M, and N. A high deductible plan F is also available. The degree to which a plan will fill the gaps varies depending on the plan chosen (Massachusetts, Minnesota and Wisconsin have their own unique Medigap polices).

The most comprehensive coverage available from United HealthCare is AARP Medicare supplement Plan F. For a little less premium Medicare supplement Plan G comes in second.

AARP Supplemental Medicare Plan F Benefits:

Medicare Part A – Plan pays:

• Hospital deductible
• Hospital coinsurance
• Blood (first 3 pints)
• Skilled Nursing facility care coinsurance
• Hospice care copay/coinsurance

Medicare Part B – Plan pays:

• Part B outpatient deductible
• Outpatient coinsurance – this is the dreaded 20%!
• Part B excess charges covered 100%
• Blood
• Medicare preventative care coinsurance

Additional benefits covered:

• Foreign travel expense for emergency care (plan limits apply)

AARP Medicare supplemental plans also include some value added benefits that are beyond what Medigap requirements.

AARP Supplemental Benefits:

• Discounts on vision care
• Nurse health line
• Discounts on pharmacy services

The pharmacy discounts are not to replace Medicare Part D insurance. Medicare supplement policies do not include Part D coverage and it is a wise choice to enroll in a Part D plan even if you do not currently require medications.

AARP Part D – Pros and Cons

Shopping for a Medicare supplement

One major benefit of Medigap policies being designed as standardized plans is the ease of comparing plans from one company to another. If for instance you are interested in a lower cost option from United HealthCare you may consider AARP Medicare supplement Plan N and you can compare the premium to all other companies offering that plan in your State.

When comparing plans determine if you will benefit from the value added benefits like vision discounts offered by AARP Medicare supplemental plans. The potential savings should be factored in when choosing between the same plan offered by different insurance companies.

Another nice benefit of standardization is the fact that shopping for a Medicare supplement online is a no brainer. Most companies will allow you to enroll online to save you the hassle of meeting with an agent. If you are interested in the most coverage compare AARP supplemental Medicare Plan F to to other companies to get the most bang for your buck.

What is Medicare Advantage insurance and is it right for you?

A recent survey found that a significant percentage of people either don’t know what type of plan they are enrolled in or couldn’t identify the differences between Medicare Advantage insurance and Medicare supplemental insurance.

This doesn’t bode well for people on Medicare choosing the best type of plan for their needs. In order to make a sound decision you must start with the facts.

After reading this article you will be able to define Medicare Advantage, identify some pros and cons and have an idea whether or not it is a good option for you.

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What is Medicare Advantage insurance?

First let’s clear up the nomenclature. A Medicare Advantage plan, Part C, and MA plans all mean the same thing. It is sometimes referred to as a Medicare replacement plan.

It’s also important to know that a Medicare Advantage plan is not a Medicare supplement, aka Medigap insurance policy. These are two different types of plans.

Medicare Advantage defined

An Advantage plan is a Medicare health plan that is available from a private insurance company that has been approved by Medicare to provide your Medicare benefits.

An Advantage plan will provide all of your Part A (hospital) and Part B (medical) benefits and always include coverage for emergency and urgent care. The majority of Advantage plans include Part D drug coverage.

Most plans require that you use a network of providers. Types of plans include:

• Health Maintenance Organization (HMO) Plans
• Preferred Provider Organizations (PPO) Plans
• Health Maintenance Organization – Point of Service (HMO_POS) Plans
• Private Fee-for-Service (PFFS) Plans

There are also Special Needs Plans (SNP) for people who:

• Have both Medicare and Medicaid
• Have certain qualifying chronic health conditions
• Reside in a institution like a nursing home

Medicare Advantage insurance plans often include extra benefits such as dental, vision, hearing, gym memberships and other health and wellness programs.

Why Medicare Advantage is not a Medicare supplement

By definition Medicare Advantage provides all of your Part A and Part B coverage. A Medicare supplement on the other hand, fills in the gaps of original Medicare and generally pays the hospital deductible and the 20% of Part B charges that would be your responsibility.

Pros and Cons of Medicare Advantage – points to consider

First it should be noted that everyone’s needs are different and what may be a major drawback to one person may be a non-issue or minor inconvenience to another.

Pro and con observations have been gleaned from comments and questions posted to articles on this site.

Pros

• Medicare Advantage premiums are often much lower than premiums for a Medicare supplement and sometimes a premium is $0.
• Cost sharing in the form of co-payments, coinsurance and deductible lends certainty to out-of-pocket costs.
• By law plans must include an annual maximum out-of-pocket amount.
• You often save money because you are not required to purchase a stand-alone Part D plan.
• The extra benefits that are not included in original Medicare can be quite valuable.

Cons

• Network restrictions can limit your choice of providers especially if you develop a condition that requires specialists.
• Some out-patient services and out-of-network services (PPO Plans) may require a higher cost sharing than original Medicare.
• Plans are annual and a plan can change benefits, premiums or not renew for the following year.
• You must renew, drop or shop for a new plan each year.
• You have a limited ability to cancel your plan mid-year and cannot switch to another plan. (Some special circumstances apply).

Medicare Advantage Plans – What Are The Costs?

Should you enroll in a Medicare Advantage plan?

Once again, everyone’s needs are unique but there is a general profile of people who often choose the Medicare Advantage insurance option.

If you are interested in coverage beyond original Medicare and a Medigap insurance policy is out of reach financially, then an Advantage plan is a good choice.

If saving money, having the peace of mind of an annual maximum-out-of-pocket amount and network restrictions are not an issue this type of plan may be a good choice.

To some degree whether or not an Advantage plan is a good choice may be limited to what options you have available. Plans are offered County-by-County and in some rural Counties you will have few choices.

Medicare Advantage Enrollment 2012

Annual enrollment for plans with a 2012 effective date begins October 15  and ends December 7 at midnight. Start early and do your homework to determine if this type of Medicare insurance plan is right for you.

Top five things to consider when trying to find a new Medicare plan

Whether you are new to Medicare or are interested in switching to a new Medicare plan there are certain things you must consider if you are going to choose the best plan for your circumstances.

Too many times people jump into a Medicare plan because a friend or family member has a specific plan or worse yet a plan is chosen based on monthly premium alone.

This article will give you a road map to follow by detailing the top five things you should consider when choosing a new Medicare plan.

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Finding the right Medicare plan in 5 steps

1. Before you even think about choosing a plan do your homework and know what your options are. Take the time to understand the difference between a Medicare Advantage plan and a Medicare supplement policy. The Medicare and You Handbook is a good place to start.

With a little knowledge you should have an idea whether a Medicare Advantage plan or Medicare supplement is your best choice. This will allow you to compare apples to apples.

2. Learn what options you have available. If you are interested in a Medicare supplement you should know that not all companies offer every standardized supplement available. Take a look at the offerings from more than one company to compare which supplemental plans each offers.

Medicare Advantage plans are offered County by County. For instance, you may have an AARP Medicare Complete plan available while your neighbor in another County may not. Also take note that plan benefits and premiums can vary from one County to the next. Visit the Medicare website to see all plans available in your area.

3. Once you know which type of plan you are interested in and have access to a list of available options you can’t get around the question of budget. Your budget should not only take into consideration the monthly premium but also what services are and are not covered as well as any out-of-pocket cost sharing amounts that may be required.

4. Beyond budget the next important point to consider is whether you will be subject to any network restrictions. If you are interested in a supplemental Medicare policy this will be less of a factor as you will be able to use any provider that accepts Medicare assignment.

If you are considering a Medicare Advantage plan be aware that many plans require that you utilize a network of providers. Provider network types include PPO, HMO and HMO-POS plans. Understand the benefits and limitations of each network before you enroll.

5.Once you have decided on a specific type of plan, found plans available in your area and determined which plans fit your budget it’s time to get down to plan specifics.

If you have decided that your new Medicare plan will be a Medicare supplement you should review the plan’s outline of coverage. Plans are standardized from company to company but you should know what is and is not covered in a specific plan. If you want the most comprehensive plan you should take a look at Medicare supplement Plan F.

The Summary of Benefits document is the most important piece of information to review when you are comparing Medicare Advantage plans. The Summary of Benefits will detail all covered services and provide information about your cost sharing responsibility. If your New Medicare Advantage plan includes Part D review the plan’s formulary to see the list of covered drugs as well.

If you follow these steps you should be able to choose a new Medicare plan that will meet your needs. You can save time by shopping and comparing plans online.

Undeniably the best Medicare resource – Medicare And You 2011 handbook

The is no shortage of questions when it comes to Medicare. If it wasn’t confusing on its own the changes are enough to keep people asking questions. The official government handbook, Medicare And You 2011 is the best place to start to understand all you need to know about the Medicare program. Once you have the basics down you can intelligently choose a Medicare plan that will meet your needs and budget.

What’s in the handbook?

Section one of the Medicare and You 2011 handbook includes information on when and how to sign up as well as the basics of Medicare. Both the costs and coverage of Medicare Part A is explained as well as an expansive listing of Medicare Part B covered services. In reviewing the costs for Medicare Part B , the late enrollment penalty is also discussed.

A list of Medicare Preventive services is also included as well as a detail of what is not covered by Medicare. Knowing what is not covered can help you decide if pursuing a Medicare Advantage Plan is perhaps the right choice for you.

In section two of the Medicare handbook, your Medicare choices are explained. here you will learn the difference between a Medigap policy (Medicare supplement) and a Medicare Advantage Plan (Part C). Medicare Part D is also discussed.

It’s important to note that this is basic information and you will need to consult individual plan information to choose either a Medicare Advantage  Plan or Medicare supplement policy.

Section three gives you important information about getting help paying for your health and prescription drug costs. States have programs that pay Medicare premiums and in some cases help with co-payments, coinsurance and Medicare deductibles. It’s important to note that qualifying income amounts can change on an annual basis.

In section four of the Medicare and You 2011 handbook you learn about your Medicare rights and how to protect yourself from fraud and identity theft.

The fifth section of this Medicare resource discusses planning ahead. Many people falsely believe that long term care coverage is included in Medicare benefits but this is not the case. Although this section is brief it should start you on a quest to learn more about long term care options including long term care insurance.


In section six you will find helpful resources and tools to ensure that you understand your Medicare coverage and can find information easily when it’s required. Medicare related definitions are included in section seven.

The Medicare and You 2011 handbook is specific to your geographic region and section eight will allow you to find and compare plans in your area. Although information is accurate at the time of printing you are advised to visit www.medicare.gov to get the most up to date plan information.

If you are new to Medicare or just need a handy Medicare resource the Medicare and You 2011 handbook is the best place to start.

What is Medicare Part C?

Enrolling in Medicare and deciding on a Medicare Plan or Medicare supplement can be a daunting task. To make things even worse, the terminology is new and not very descriptive. Part A, Part B, Part D and now Medicare part C!

Most people know that Medicare Part A is your hospital coverage that requires a deductible and generally speaking, co-pays for extended hospital stays.

Medicare Part B is your outpatient coverage that includes the dreaded 20% cost sharing that is your responsibility and Medicare Part D is the all too familiar and very important prescription drug coverage.

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Do I need Medicare Part C?

It would sound like with Parts A, B and D, you would have things covered, Right? Well maybe. But if you are unable to afford a Medicare supplement, Part C may be very important.

Medicare Part C is another name for a Medicare Advantage Plan. This is often confusing because it is mistaken for the standardized Medigap Plan C, which is a completely different thing.

A Medicare Advantage Plan is another way to receive your Medicare benefits. A private insurance company contracts with and is approved by CMS to administer your Medicare benefits. Insurance companies are able to design plans that meet the minimum guidelines set by CMS, while offering you benefits that will give you value. If you choose their plan because of perceived value, they then make a profit by administering your Medicare.

Medicare Part C is not for everyone, but many people find it to be an affordable alternative to purchasing a Medicare supplement. Some of the benefits of Medicare Part C include:

• Often times lower monthly premiums than purchasing a Medicare supplement. Some plans have no monthly premium.
• Your Part D drug coverage is often included in the Part C Advantage Plan.
• Having fixed cost sharing, particularly by having set co-pays for various services like doctor’s visits. This eliminates the uncertainty of the 20% cost sharing for outpatient services.
• Medicare Part C plans generally have an annual maximum amount out-of-pocket. Original Medicare does not have a maximum. The question often becomes, “20% of what?”.
• Most plans include many benefits beyond what original Medicare offers. These benefits can include; dental, vision, hearing and often gym memberships and transportation to and from medical and pharmacy visits.

Medicare Part C plans are offered by many private insurance companies. You can find plans available in your County by going to the Medicare website and searching for plans your area.

Now that you know that Medicare Part C is is another name for a Medicare Advantage Plan, why not do your homework to determine if a plan is right for you?

Medicare modernization act brings about new additions to standardized Medigap options

If you signed up for the free mini-course offered on the web form to the right and read the daily lessons, you know the difference between a Medicare Advantage Plan and a Medigap insurance policy (aka: Medicare Supplement).

This article is going to look at one new plan in particular; Medigap Plan N.

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A brief overview

Most people know Medigap by its more common name, Medicare supplement insurance. A Medicare supplement is not an Advantage plan. A supplement is offered by a private insurance company to fill the gaps that original  Medicare Parts A and B leave for the beneficiary. Normally this would be the hospital deductible and the 20% coinsurance for outpatient services.

You must maintain your Parts A and B (and pay the Part B premium) while paying the insurance carrier a premium for your supplement. An Advantage Plan, on the other hand, is when a private insurance company contracts with the government to administer your Medicare Plan. You still maintain Parts A and B and pay the Part B premium when you elect an Advantage Plan.

Originally, the benefit with an Advantage Plan was that you avoided the high monthly premium  of a Medicare supplement. You also had some affordable cost sharing in the form of deductibles, coinsurance and co-pays with an Advantage Plan. Or, if there was a premium, in many cases it was considerably smaller that a premium for a supplement.

Reasons to consider Medigap Plan N

Here are some good reasons to consider Medigap Plan N. Keep in mind that everyone has different needs and not all features will appeal to everyone.

• No network restrictions. Use any provider that accepts Medicare.
• Plan design allows premiums to be lower than many Advantage Plans.
• No out of pocket costs for hospital stays. Part A deductible is paid by the plan ($1132 for 2011).
• Foreign travel covered in emergency situations.
• Skilled nursing facility coinsurance covered.
• Includes 100% Part B coinsurance (no 20% responsibility), except up to a $20 co-payment for office visit and up to $50 co-payment for ER.
• Generally no underwriting except for renal disease question.
• Premiums lower than most other standardized plans and often lower than an Advantage plan.
• No restrictive enrollment periods.

This plan is almost a hybrid. You have the benefits of a supplement and the convenience of an Advantage Plan. The co-pays for office visit and ER are a small price to pay for a substantially reduced premium.

What’s the catch?

If you are looking for a zero dollar Advantage plan, this is not it. But in the long run, you may pay less with Medigap Plan N than an Advantage Plan. Just the fact that you will not pay a deductible or a copay, for a limited number of days, if you are hospitalized is huge! Not to mention that many Advantage Plans now offer the same benefit for outpatient surgery and durable medical equipment as original Medicare. That is, they pay 80% and you pay 20%. Think about it. You have an Advantage Plan with little or no premium but you have to pay 20% for outpatient surgery. You may reach your maximum amount out of pocket quickly (which will most likely be more than the annual premium for Medigap Plan N.

The second thing to consider is that Medigap Plan N, like all Medicare supplements, will not include prescription drug coverage. You will need to purchase a stand alone Part D plan. I encourage you to explore your options to determine if a Medigap Plan N is right for you. This plan option becomes available starting with June 2010 effective dates.

To learn more about your plan options, you can visit the Medicare website or speak with a local agent who specializes in Medicare insurance plan options.

A brief look at the pros and cons of a Medicare HMO

As the premiums for Medicare Supplement plans continue to rise many Medicare beneficiaries are turning to Medicare Advantage plans.

One popular type of plan is a Medicare HMO Advantage plan. People looking to to lower their health care premiums may bristle at the perceived lack of freedom with a Medicare HMO Advantage plan.

A HMO plan requires you to have a primary care physician that coordinates your care and typically refers you to HMO network specialists and facilities to receive your care.

On the surface this seems like less freedom of choice. But even those people who have original Medicare or original Medicare and a Medicare Supplement choose a primary care physician and generally accept their recommendations as it relates to care with a specialist or health care facility.

Whether or not less choice is a factor depends more on how comprehensive the HMO network is than whether you can choose from all providers that accept Medicare assignment or only the ones in the HMO network.

So the network for a Medicare HMO Advantage plan can be either a blessing or a curse. It all depends on whether you feel you will have enough choice in network.

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Benefits of a Medicare HMO Advantage Plan

The main benefit for most people, and the one that draws them to a HMO plan is the low monthly premium or in some cases no monthly premium. This benefit is coupled with the fact that unlike a Medicare Supplement you will have cost sharing in the form of deductibles, co-pays and co-insurance.

The good news is that the co-pays for many services are affordable for most people. In fact, cost sharing for a Medicare HMO Advantage plan is often less than for a PPO or private fee-for-service Medicare Advantage plan.

Another benefit is that all providers in the network will accept your plan. One big disadvantage of a private fee-for-service plan is that there is no network and providers can accept your plan on a visit by visit basis. It’s nice to save money on premiums but it’s more important that you have coverage when you need it.

A Medicare HMO Advantage plan is often rich in benefits that go beyond what original Medicare provides. Many HMO plans include generous vision, dental and hearing benefits. Some plans include discounts on medical related supplies and supplements. Gym memberships are also a popular addition to Medicare HMO Advantage plans.

In the end you need to weigh the savings in monthly premium against your potential for some out-of-pocket cost sharing. One feature of an Advantage plan that ads some peace of mind is that typically you have a maximum calendar year out-of-pocket amount that you would be responsible for. This feature will limit your liability when it comes to your share of the cost.

Choosing a plan

It’s best to do your homework. Check out the official Medicare website to compare plans in your area. Go to the plan website and search for the provider directory in your area to see if the HMO network will meet your needs.

If saving some money by lowering your monthly premiums is your goal you may find a Medicare HMO Advantage plan to be a viable option for you.