Tag Archives: medicare

What Does Your Employers Plan Mean For Your Subsidies?

For most, health insurance options through your workplace are good news. If, however, you had plans to secure subsidies to help you pay for an individual health plan outside of your work, your employer’s offer of coverage may be a problem for you. Make sure you do not opt out of health care through your work only to find yourself without tax credit.

How does qualification for health care subsidies work? According to the Affordable Care Act (ACA), anyone who is at an income level of 400% or less of the federal poverty levels can qualify for tax credits to help them cover the cost of health insurance. These subsidies are available in your specific state and can be applied for during the open enrollment period, which ends February 15th.

If, however, you work somewhere that offers affordable health insurance and you choose not to accept a plan through your workplace, you will not qualify for subsidies. The same is true if you are eligible for coverage through Medicare. The government is committed to helping every American get the health care he or she needs, but if you choose to opt out of perfectly good coverage there will be no aid for you. That is because your job-based plan counts as the now federally mandated minimum essential coverage. Securing a plan through your workplace will also help you avoid the tax penalties that could be assessed if you do not have coverage.

To understand how your employer’s coverage affects your subsidy eligibility and what to do if you want a plan other than the one offered through your workplace, do not hesitate to contact Bernardini & Donovan Insurance Services today. Located in Redlands, we are here to help you secure the best protection for you and your family today. Connect with a certified agent; call us today!

Of all the government assistance programs out there, people tend to have the most questions about Medicare. It’s true that this government-run health insurance plan can be confusing, because it is so detailed. However, if you just know a few basics about it, it will make learning the rest so much easier.

First of all, you become eligible for Medicare at age 65, regardless of whether or not you are still working or have retired. You can use it in conjunction with your employer-sponsored health insurance while you’re still working, or if you’re able to retain that insurance after you retire. Medicare then acts like a backup insurance plan to cover the things your primary insurance doesn’t cover, such as co-pays. You can also get Medicare if you are legally disabled, regardless of your age.

When you first become eligible for Medicare, you are automatically signed up for Part A. Part A covers hospitalization and all the expenses involved with a hospital trip or stay. Part A is free. You have the option of signing up for Part B when you enroll in Part A, though it’s not required. Part B covers doctor visits, lab work, and any medical work outside of a hospital, except prescriptions. You have to pay a small monthly premium for Part B.

If you don’t sign up for Part B when you first get Medicare, you have the option of signing up for it during the open enrollment period each year. However, the longer you wait, the higher your premium will be, so it’s best to get it right away. Another important thing to remember is that if you’re legally disabled and getting disability payments from the government, you must wait two years after becoming legally disabled before you become eligible for Medicare.

For more information about Medicare in California, please contact Bernardini & Donovan Insurance Services in Redlands!

Medicare offers older Americans many health benefits to offset the high cost of medical care. The following guidelines can help you determine if you qualify for what Medicare has to offer.

Individuals age 65 or over qualify for Medicare if:

  • They are U.S. citizens or permanent legal residents and
  • They or their spouse are eligible for Social Security benefits, even if they’re not receiving them yet. (Applicants must have earned at least 40 credits for approximately 10 years of employment)
  • They are government employees or retirees who have paid Medicare taxes during employment
  • Applicants can qualify on their spouse’s employment record if their spouse is 62 and they are 65 or older. This includes a divorced spouse or one who is deceased. Individuals qualifying for Medicare through same sex marriages must live in a state that recognizes this status.

Individuals under 65 qualify for Medicare if:

  • They have been receiving SS disability benefits for 2 years or receive disability benefits from the Railroad Retirement Board
  • They have Lou Gehrig’s disease
  • They suffer from kidney failure and have paid SS taxes for a specific time period.

For more information on Medicare eligibility as a health insurance option in California, contact Bernardini & Donovan Insurance Services located in Redlands, CA.

When considering Medicare Advantage Plans, it helps to take a closer look at their benefits and costs so that you can more easily understand the plans.

As you may know, these plans contract annually with Medicare and a fixed monthly amount gets paid by Medicare. That amount can change yearly, based on Medicare, and varies by county. 

The nice thing about these plans is that they sometimes offer coverage for things that Medicare does not cover. This can include things like eye exams, prescription coverage and dental visits, but it does vary by county.

You should know that there is a monthly premium for these plans and it is in addition to the Medicare Part B premium. 

While some services under these plans require co-payment, they are often at a lower amount than the Medicare fees. And legally the amount is not allowed to exceed the Medicare fee amount.

If you want more information on Medicare Advantage Plans, then contact Bernardini & Donovan Insurance Services today.

If you are approaching the age of 65 and looking forward to enrolling in Medicare for healthcare coverage, be aware that it does not cover everything. Medicare will leave you with things like co-payments, coinsurance and of deductibles. 

Contact a private insurance company right away and learn about Medicare supplements, also known as Medigap. These affordable supplements kick in coverage that the original Medicare doesn’t. If, in your retirement you are looking forward to traveling abroad, you will definitely want a Medigap policy that will provide coverage when you leave the country. 

Medigap supplements are not the same as a Medicare Advantage Plan. You can only have one or the other. Also, you must have Medicare Part A and Part B to have a Medigap policy. You will pay a private insurance company for the policy as well as the Part B premium you pay to Medicare. Additionally, be aware that there are no Medigap policies sold anymore that cover prescription drugs. That ended in 2006. One more reminder, your spouse will need his or her own Medicap policy as each covers only one person. 

For more information about Medicare supplements, contact Bernardini & Donovan Insurance Services serving the Redlands, Island Empire and California residents. 

Medicare Advantage Part D plans are a good solution for California residents interested in getting prescription drug coverage to go with regular Medicare coverage.

Also known as Prescription Drug Plans or PDPs, Medicare Part D plans are actually private insurance plans that offer medication coverage. Medicare beneficiaries should note that these plans only offer coverage on eligible prescriptions and not all of them.

Medicare Advantage Part D plans are affordable, with the average monthly premium in California coming in at $58.11 for 2013.

If you have Medicare but do not have prescription drug coverage, remember being without coverage for 63 days or longer can result in a penalty fee.

Since Medicare Advantage Part D plans fall under private insurance, their cost and availability can vary. A qualified insurance agent can help you navigate through the available options to find the most cost effect Part D plan to meet your needs.

For more information about Medicare Advantage Part D Plans in California, contact Bernardini & Donovan Insurance Services today.

Medicare Advantage plans are alternatives to traditional fee-for-service Medicare. The plans are sponsored by the federal Medicare program, which pays private health insurance companies to administer and provide coverage to those eligible for Medicare. In other words, Medicare coverage is provided by an insurance company like Humana or United Healthcare rather than directly from the Centers for Medicare and Medicaid Services.

There are several types of Medicare Advantage plans from which to choose:

1. Health Maintenance Organizations or HMOs.

These plans require beneficiaries to select a primary care doctor who manages all healthcare needs. Services from specialists require a referral from the primary care doctor before the plan will pay benefits.

2. Preferred Provider Organizations or PPOs.

These plans include a number of in-network providers who charge a lower co-payment than providers outside the network.

3. Private Fee-for-Service Plans or PFFSs

These plans allow beneficiaries to go to any Medicare-approved doctor or facility, as long as the specific plan is accepted by the provider.

4. Special Needs Plans or SNPs.

These plans are for people with people with certain health conditions or who are living in a nursing home.

To learn more about the Medicare Advantage plans that are available to California residents, please contact Bernardini & Donovan Insurance Services.