Category: Senior Health Medicare

Many people assume they have to stay on Medicare once they are a member, which isn’t always the case. Government rules state that those 65 or older need to either be on Medicare or have an employer plan that meets Medicare guidelines. To avoid penalties, it’s crucial to have at least one type of insurance coverage.

If a new employer offers insurance that meets the Medicare-specific rules, the employee can unenroll from Medicare Part A and Part B. In this case, there’s no issue with going in-and-out of Medicare. Without re-enrolling in Medicare, an employee can end up paying for both plans.

If you are over 65 and losing your job, when you leave the company, your employer is required to fill out a form confirming you have been on that plan since you were at least 65. That form is helpful for enrolling in Medicare; they will give you a period where you are eligible to join Medicare after reaching 65.

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), workers and their families who lose health benefits have the right to choose to continue group health benefits provided by their group health plan. For limited periods and with specific limitations (job loss, reduction in work hours, job transition, death, divorce, etc.), qualified individuals might be required to pay the entire premium for coverage up to 100 percent of the cost of the plan.

COBRA might be beneficial in a pinch, but overall, it could be a more expensive proposition. Typically, employers foot some or much of the monthly premiums; without an employer, you’ll be paying in full. Also, COBRA coverage doesn’t count as qualifying insurance instead of Medicare.

The different parts of Medicare play a critical role in creating the most tailored plan to suit your needs. Have a backup plan to pay for the things that won’t be covered under Medicare, such as dental work and routine hearing or vision care, long-term care, cosmetic procedures, or medical care overseas.

Medigap – a supplemental policy – is typically paired with Medicare to help cover out-of-pocket costs like deductibles and coinsurance. These are standardized regardless of which insurance company sells them. Depending on where you live, the premiums can vary among locations.

To learn more or consult with a representative about Medicare, contact the experts at Senior Health Medicare today.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the member to retain the most cost-effective plan. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Yearly, more than 795,000 people in the United States have a stroke. The significant problems resulting from a stroke can include problems with balance, hearing or vision, paralysis, decreased mobility, and more. To fully understand what Medicare covers during recovery, read on.

Rehabilitation Services
Medicare will cover hospital, rehabilitation center, or skilled nursing facility care for those who have suffered from a stroke.

Medicare Part A will cover any inpatient rehabilitation necessary, as long as the patient’s doctor deemed it necessary. Stroke recovery care is factored into the requirements and costs associated with a typical skilled-nursing-facility. 

Medicare Part B will cover any needed outpatient rehabilitation such as physical therapy as long as the patient’s doctor noted it is necessary.

Medical Equipment
Medicare Part B will cover durable medical equipment as long as it is medically necessary for stroke survivors. Items on this list include wheelchairs, walkers, lifts, canes, etc.

If you have high risk factors for stroke, be vigilant and discuss your Medicare coverage with your provider. It is crucial to understand your costs fully, should you suffer from a stroke in the future. Take note of equipment, charges, services, and more in the event you will need to utilize your coverage.

To speak with one of our expert representatives regarding Medicare and coverage for stroke victims, contact Senior Health Medicare today.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and evaluation in order for the member to retain the most cost-effective plan. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

As new COVID-19 vaccines are approved in the United States, health departments in all 50 states received their first round of vaccines. Frontline healthcare workers and residents of long-term care facilities were the first ones to receive doses.

Medicare will cover the coronavirus vaccine, thanks to the CARES Act, which was passed by Congress in March 2020. Medicare Part B is required by the CARES Act to 100 percent cover FDA-Approved COVID-19 vaccines. This means if you are a Medicare beneficiary, you will have no out-of-pocket costs for the COVID-19 vaccine.

The COVID-19 vaccine was developed with $10 billion in funding from the federal government. Under the CARES Act, the vaccine is free to all. The Medicare Trust Fund covers 100 percent of the vaccine’s cost for those Medicare and/or Medicaid beneficiaries. Private insurers are required to offer the vaccine for free to plan members. No money is allowed to be collected from vaccine patients by providers who administer the vaccine. Even if the insurance company (or Medicare) doesn’t reimburse the provider, they still are banned from billing the patient for the balance.

Those without insurance can get the vaccine for free under the CARES Act. Providers who administer the vaccine to people who do not have health insurance can submit a reimbursement request.

If you get the COVID-19 vaccine and receive a bill, it might have been for other services not related to the shot. If your only reason for an office/doctor visit is due to COVID-19, you should not receive a bill. If you received other services in the same visit, your regular Medicare cost-sharing would apply.

Currently, the CARES Act specifies only two Federal Drug Administration (FDA)-approved vaccines for COVID-19: the Pfizer/BioNTech vaccine and the Moderna vaccine. Several other vaccines are in development and testing stages; if they are approved for use by the FDA, Medicare will cover those also. Both approved vaccines require two doses (or shots) for complete immunity. Depending on the shot you obtained, you should receive a second dose three or four weeks later.

The chances of getting COVID-19 from the vaccine are impossible. Most vaccines introduce a live virus into the body to provoke an immune response. The Pfizer/BioNTech and Moderna vaccines do not include any actual coronavirus. Instead, they use messenger RNA (mRNA) technology. This process provides genetic coded cells needed to produce proteins that stimulate the immune system. It is a novel implication in vaccines; however, this has been used in cancer immunotherapy for years and is rigorously tested.

For more information about the COVID-19 vaccine related to Medicare, contact the experts at Senior Health Medicare today.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

If eyeglasses or other corrective lenses are deemed “medically necessary” (after cataract surgery, for example), they might be covered by Medicare. Otherwise, Parts A and B of Original Medicare will not assist with prescription sunglasses, contact lenses, or eyeglass costs.

Medicare Advantage Plan (Part C) might offer eyeglass, contact, and prescription sunglass vision coverage. Vision benefits such as routine eye exams might also be covered. Each plan is different, so make sure to talk to your provider regarding eye health items offered within your plan and how they are covered.

Medicare Part B will help pay for corrective lenses following cataract (implanting an intraocular lens) surgery. One pair of standard-frame eyeglasses or a single set of contact lenses, along with 20 percent of the Medicare-approved amount for the lenses after each surgery, will be covered. In these cases, the Part B deductible will apply, and you will also pay 20 percent of the Medicare-approved amount. Any additional costs for upgraded frames will also be your responsibility.

Talk to your healthcare provider to determine the price of your item, service, or test. The exact amount you will owe depends on factors such as other insurance you have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location of your test, item, or service.

Oftentimes, your doctor or medical provider might recommend you receive services more often than what Medicare covers. They might also suggest services that Medicare doesn’t cover. In this case, you might have to pay some (or all) of the expenses. To understand why your doctor recommends certain services and whether Medicare will pay for them, ask questions and gather information.

Contact lens and glasses coverage is limited outside of a Medicare Advantage plan. Make sure you consider your eye health needs when you select the Medicare coverage for you.

For more information, refer to the full article on Medicare.gov.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

If you have new Medicare coverage, now is a great time to learn about your revised benefits and see how they can work best for you. Check out your basic costs to learn about tests covered under Medicare, items, and other services to see whether they have changed. For cost-specific information, create a Medicare account.

Medicare can assist you in taking better care of yourself this year through preventative services such as yearly wellness visits and screenings for breast cancer, diabetes, and heart disease. Most of these services are free for beneficiaries and are vital to maintaining your overall health. By targeting issues early, these programs help keep you from getting sick and slow disease progression.

To discuss preventative services, contact your doctor, who will also tell you the best time to schedule them. Understanding your coverage and taking advantage of these preventive services is an excellent way to jump-start 2021. Before you leap, be confident in your plan choice. If you have questions, contact your Medicare provider, who can help answer questions and ensure that you are getting the most out of your benefits.  

For more information about Medicare or to schedule an appointment with a specialist who can guide you through the process, contact Senior Health Medicare today.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Medicare expenses can pile up. If you need assistance paying for health or prescription costs, check out these three resources that might help cover your expenditures:

Medicare Savings Programs: There are four savings programs run by every state. They can help you pay for your premiums and other expenses. To see whether you qualify, contact your state Medicaid program.

Extra Help: Those with limited revenue or resources can qualify for Extra Help for Part D drug costs. If you have applied for Medicaid or one of the Medicare Savings Programs, Extra Help will automatically be enacted for drug costs. You can apply for free online through the US Social Security Administration.

Medicaid: A joint federal and state program that is tailored to help those with limited income and resources, aiding with medical costs. Medicaid offers benefits not typically covered by Medicare, such as nursing home and personal care services. Every state has its own guidelines.

The most efficient way to save money is to choose the right health and drug coverage. The Medicare Plan Finder compares Medicare coverage options. You can also reduce your Medicare premiums by enrolling on time, reporting changes in income, and shopping around for plans.

To learn more about Medicare costs and lower them with help from professionals, contact Senior Health Medicare today. Our experts are ready to assist you with all your Medicare questions, concerns, and needs.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Entering Medicare can be confusing, intimidating, and might leave you feeling vulnerable. There are countless predatory insurance companies and salespeople trying to win you over. It’s crucial for those 65 years old or over to stay informed regarding all options and make the best decisions possible in order to get the most bang for your buck. Navigating through the Medicare Advantage versus Medicare Supplement (also known as Medigap) plans is easier than you think. Read on for our pro- and con- list.

Medicare Advantage plans are cheap, but they automatically un-enroll you from original Medicare.

Pros:

• Monthly premiums are relatively inexpensive, with some costing $0 per month.
• Part D drug plans are usually included (for convenience, not efficiency.)
• Fitness memberships or other incentives are sometimes included.

Cons:

• Small and intricate medical networks determine your available medical providers. You most likely will have to change your doctor to become “in-network” before claims are covered.
• Extremely high out-of-pocket costs (OPCs) if you aren’t in perfect health.
• If OPCs rise due to illness or injury, you cannot revert to original Medicare, thereby paying the high OPCs eternally.
• Network restrictions equal limited nationwide coverage. Insurance is usually not applicable in remote medical facilities, so traveling is an issue. For example, The Mayo Clinic will not take Medicare Advantage plans.

Medicare Supplement (Medigap) plans cost more, but the coverage they provide is exemplary.

Pros:

• Almost everything is covered, depending on your plan. OPCs are relatively low/non-existent.
• Eligibility allows you to enroll in a supplement plan, not only during the Annual Election Period.
• Coverage is easier to comprehend and predictable.
• Doctors usually accept original Medicare and your corresponding supplement plan.
• Is almost always accepted nationwide.

Cons:

• Medicare supplement plans are more expensive than Medicare Advantage plans.

With either choice, you can continue to pay a monthly Part B premium to Medicare. The main things to consider are:

1. Do you want the choice of any provider or are you willing to choose a provider from within a network?
2. Would you rather buy a separate prescription drug plan or get drug coverage included in one plan?
3. Would you rather pay higher monthly premiums and have lower out-of-pocket costs for services or pay a low monthly premium and co-pays for services as you use them?

Your Medicare needs are personal. Navigating through the options can be confusing and misleading. To talk to a professional and learn more about Medicare, contact the experts at Senior Health Medicare today. Our agents are ready and available to help you make the best decision possible…for your health and wellbeing.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Medicare card fraud is rampant during open enrollment periods, which is currently running until December 7th. Medicare fraud results in higher health care costs for taxpayers, so it’s important to know how to protect your Medicare card and number. The most imperative thing to keep in mind is that your Medicare card should be guarded with the same security as your credit card. Doctors or hospital settings are the only people who should have those numbers.

Safeguard your card by taking the following steps:

• Keep your Medicare number private. If anyone calls asking for your number, don’t give it. This is a common Medicare scam.
• Money or gifts for free medical care should be refused. It’s a common ploy by identity thieves who say they need your number to verify certain things.
• Keep track of your doctor’s appointments and upcoming tests, and use a calendar to record appropriately. Look for items and services listed on your Medicare statements, along with other details that might be incorrect. If you see a suspicious charge or service and you know the provider, call the office directly to inquire.
• Stay alert during the coronavirus pandemic since con artists take advantage of people who are highly distracted or disoriented.

If you suspect Medicare fraud, call 1-800-Medicare or call the Medicare Drug Integrity Contractor at 1-877-7SAFERX. To speak with a professional regarding your Medicare plan, contact Senior Health Medicare today.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a frivolous decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com. Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com

Open enrollment for Medicare runs now through December 7^th, with changes taking effect on January 1^st, 2021. If no action is taken, 2020 coverage continues next year. However, now is the time to verify whether there’s a more cost-effective option to suit your circumstances. The annual fall enrollment period is for adding or changing coverage related to an Advantage Plan (Medicare Part C) and prescription drugs (Part D), meaning you can switch, add, or drop those parts.

About 62.7 million people are enrolled in Medicare; most are 65 or older. A third of beneficiaries are enrolled in Advantage Plans, and the remainder are enrolled in Part A (in-patient coverage) and Part B (outpatient care) plans. Part D, a standalone/supplemental plan, is also offered by private insurance companies.

By September 30^th, Advantage Plans or prescription drug plans should alert beneficiaries about whether their coverage is changing for the upcoming year. Specific options vary significantly from year-to-year despite being federally regulated. Check your notice to see whether any changes will be taking place. Prescription coverage, deductible costs, and in-network doctors are some examples of adjustments that could change.

If you wanted to drop your Advantage Plan instead of switching to another, you’d be left with original Medicare (Parts A and B) and would need to get a standalone Part D prescription drug plan if you wanted that coverage. Medigap (supplemental Medicare policies) help cover cost-sharing aspects of original Medicare, which is Part A and Part B outpatient coverage, including copays and insurance.

When initially enrolling for Plan B to purchase Medigap, beneficiaries receive a six-month window without having to answer health questions and be penalized for pre-existing conditions. One exception is that if the beneficiary had an Advantage Plan for less than a year or it is their initial enrollment. In that case, a unique enrollment window of 12 months is allotted for a Medigap policy.  

For further reading, check out the original article. For Medicare questions or concerns, contact the experts at Senior Health Medicare who are available to guide you through the process of open enrollment.

Senior Health Medicare is a superior resource for Medicare guidance, information, and ongoing client support. Selecting a Medicare plan is not a flippant decision. It requires annual revisiting and re-evaluating in order for the client to stay in the most cost-effective coverage. Senior Health Medicare is here to serve as your resource through all the years to come. Contact us today at 888-404-5049 or visit us on the web at www.seniorhealthmedicare.com.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.