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Medicare Advantage Insurance

One of the options you will be considering when looking at Medicare is if you will want to receive original Medicare Insurance (Parts A and B) and Medicare Advantage (part C). So what is the advantage to Medicare Advantage, if there is an advantage at all? Both of these options will cover many of the same services; it is a matter of deciding what will be the best for you and your health.

What is the Advantage of Medicare Advantage?

Medicare Advantage is an insurance option that is run through private organizations. These are organizations that you would recognize like Blue Shield, United Health Care, and Kaiser Permanente. Medicare Advantage includes what you would find in Original Medicare with the doctor and hospital care. But it also may include things that you would not find. These additional offerings will depend upon which plan and organization that you go through. But you can expect these offerings to include things like prescription drug coverage, vision, dental, and gym memberships. Medicare Advantage Insurance is also considered a less expensive option. The premiums that you pay in Medicare Advantage can be less expensive that the premiums in Plan B especially if it is combined with the premiums for a Medigap policy which many do include if they go with Original Medicare. Also, Medicare Advantage includes a Maximum Out-of-Pocket Expense which is a limit to the amount you pay out of pocket. The cap varies between plans, but after you reach the limit, all of your services are covered.

Of course, with every plan, there are also drawbacks. Because the program is run through private companies, there may be stricter rules and more limited options for care available. If you are not satisfied with Medicare Advantage Insurance, you can switch to Original Medicare, but it will be difficult to add Medigap at that time. Your Medigap options may be limited or even nonexistent. So it is important when looking at your options that you know exactly what you are signing up for. If you need information or have any questions, please call us. We have extensive knowledge and have helped countless others before you make the best decision for them.

Medicare Health Insurance

What is Medicare? Medicare is a federal government funded program aimed to help adults over the age of 65 to receive Medicare Health Insurance. It also provides health insurance for disabled adults under 65 and anyone who has been diagnosed with End-Stage Renal Disease (permanent kidney failure).

Medicare has four different parts:

Part A is hospital insurance which includes help paying for inpatient hospital care, a skilled nursing facility, limited home health and hospice care.

Part B is medical insurance which contributes toward doctor services and outpatient care such as diagnostic tests, ambulance rides, and preventative care. Preventative care includes things like pap tests and mammograms as well as medical equipment and supplies. You will pay a premium each month for Part B. The cost will either be taken out of your social security if you are getting those benefits or you will receive a bill.

These two offerings make up what is called original Medicare. And where this can cover a significant portion of your medical insurance needs, this will not cover all of your medical costs. With the extra cost, some people want to consider how to get those additional costs covered through Medicare Parts C and D

Part C which can also be called Medicare Advantage plans. Part C includes what is covered in Medicare A and B and may help lower your costs and get additional benefits.

Part D helps you manage the costs of your prescription drugs because original Medicare did not include any coverage for this need.

While parts A and B coverage is the same across the United States, there is a large difference in the cost and coverage of parts A and B throughout America. Many healthcare providers actively work to keep those costs down by offering preventative services, provider partnerships, and wellness programs.

History of Medicare in America

Every day we hear more and more about America’s health care system. But this is not new. You may be tempted to think that in the wake of Obamacare and Trumpcare that this wave of health talks is the first time America has been swept up. But that is just not the case with the History of Medicare in America. Did you know that when Teddy Roosevelt ran for president in 1912, his platform included a national health insurance system? But that message never really got much steam until the presidency of Harry S. Truman.

Truman wanted to address many issues in the healthcare industry. He had concerns about the lack of availability of health professionals in rural areas, he wanted to bring more attention to public health services to help curb the spread of infectious diseases, he wanted to invest in medical research, and finally, he wanted to provide a national health insurance plan. What?! Sounds familiar doesn’t it? There was a strong attack against the bill, and with the start of the Korean War, Truman was forced to drop the bill.

America’s health care system

However, that was not the end of it. In 1965, President Lyndon Johnson signed a health insurance bill for the elderly and needy. This bill is what we know today as MediCare. In an unusual twist, former President Harry Truman and his wife Bess were the first recipients of MediCare. But Medicare was to go through many more changes. The next few decades brought the change past Medicare Parts A and B. We saw the additions of Medigap and the addition of hospice care were included in the benefits. In the nineties, Medicare C was added, and in 2003 President George W. Bush signed Medicare D into law. And we have continued to see changes as the Affordable Care Act was enacted. It seems there are no easy answers when it comes to healthcare but we can expect to see more changes coming our way. We will have to wait and see what changes are around the bend for Medicare in the next few years.

That time of the year is coming up again! The Medicare Annual Enrollment Period is just around the corner. Each year from October 15 to December 7th you have the ability to enroll for Medicare. But as you prepare to enroll, now is an excellent time to go over what plans there are and more importantly than that, to look over what is important to you so that as you look through plans you can find the one that will meet your needs. You won’t want a plan that will keep you in a compromising position all year long. Make sure that you are well informed and take the time to know what you really want. For example, If you know that you are going to be on a fixed income you will want to make sure that you are looking at plans that will have low out of pocket costs. Or if you want to ensure that you are maintaining the best health possible then you may want a plan that is very proactive in prevention care.

When you are looking at you coverage make sure that you read the fine print to see what is covered in your care. You may be surprised at what you find there. Many health plans offer extras that are included in their plans such as wellness check ups, 24 hour hotlines to speak to nurses and discounts on fitness and nutrition plans. There is also often preventative care available to you. And the easiest way to prevent expensive out of pocket costs is to make sure that you are catching things before they really blow out of control. In fact, the Center for Disease Control has made an estimation of about 100,000 lives could be saved each year if they received the recommended preventative care. You will also want to know not only what doctors and hospitals are covered but what specialists and specialized medical facilities will be available to you.

We hope that these tips will help you prepare for open enrollment, but if you have any questions about Medicare, please let us at Bernardini & Donovan help you.

There are some people in the world that just know things. They are the mavens that can rattle off facts, dates and details that the rest of the population just never grasped. This blog post is not for them. This post is for those of us who don’t know the first thing about Medicare and the deadlines needed to sign up.

So first things first. You become eligible for Medicare when you turn 65. But the deadlines for signing up extend to the months that surround you birthday. However, there is an exception if you already are receiving Social Security benefits you are automatically enrolled in Medicare A and B. But if that is not the case then you need to sign up yourself. You have a window of enrollment that last seven months. The seven month window begins three months before your birthday month, goes through your birthday month and continues on for the next three months after your birthday. So if your birthday was in June you could sign up for Medicare starting March 1st and it would end September 30th. If you miss this deadline you can join during open enrollment from January 1 to March 31 each year.

The reason that you will want to make sure that you sign up during these seven months is so you will avoid any fees that come with signing up late. The monthly Part B premiums will be raised by 10% for each 12 month period you wait to sign up for Medicare. “The idea behind the penalty is to give people a financial incentive to enroll in insurance from the get-go as opposed to waiting until they have some kind of negative health event,” says Mark Duggan, an economics professor at Stanford University.

It is important to note that if you or your spouse are still working for an insurance providing company when you or your spouse turn 65 it is not mandatory to enroll at that time, you can stay with your current provider. However, once the household member that they insurance is provided through retires then you will need to enroll. You will have an 8 month period enrollment time. The 8 month time period starts the month after the employment ends or when your insurance coverage from that job ends.

We hope this information helps, but if you have more questions please feel free to contact us at Bernardini & Donovan