Bernardini & Donovan Insurance Services

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Medicare Part D Stand-Alone Plan

Medicare helps provide medical coverage for older citizens as well as some disabled citizens. Medicare Part D is one of Medicare’s stand alone plans and helps cover the cost of prescription medications. Who is Eligible for Medicare Part D? Anyone who is eligible for regular Medicare benefits is eligible for Medicare Part D. This includes individuals who are 65 or older or individuals under the age of 65 with certain disabilities. You must be a US citizen or a permanent resident to be eligible. Enrollment is done when you first enroll or during open enrollment periods. It is done through private insurance providers. What Does Part D Cover? All policies cover every therapeutic category of medications, but not all actual medications are covered. In addition, all plans must cover all or nearly all of the medications in six of the medication categories including antidepressants, antipsychotics, anticonvulsants, antiretroviral, immunosuppressant and anticancer

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Do I Need More Coverage Than The Original Medicare?

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

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Employer sponsored coverage, and Covered California premium subsidy, consumers be ware!

It has been brought to our attention through various sources that consumers are being misinformed and misled when it comes to qualifying for premium assistance through Covered California. We want to address this issue, as it has the potential for severe consequences. Employees who are offered coverage through their employer cannot receive subsidy if their employer offers “affordable” coverage. How is “affordable” coverage defined under the Affordable Care Act? To determine if the coverage is “affordable” or not, we look at the employee ONLY monthly rate for health insurance coverage. The cost to add dependents, spouse, children, etc. DOES NOT play a role in this calculation. If the employee only pays less than 9.5% of the gross household income for health insurance, the coverage is deemed “affordable”. A simple calculation would look like this. Let’s say the gross HOUSEHOLD income is $50,000. 9.5% of the gross family income would be

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The Basics of Medicare Advantage Part D Plans

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.

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What Types of Medicare Advantage Plans are Available?

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

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The Value of an Agent When Finding the Right Large Group Health Insurance Plan

The value of an agent is apparent when you need answers to questions concerning large group health insurance plans and policies. A reputable agent doesn’t just sell you a policy. They explain it in the finest detail so you understand exactly what you are getting for your money. Your agent is the one you contact when you have to file a claim or if you need to update your policy. When the insurance company has questions concerning an accident or health claim, your agent is the one who acts on your behalf to make sure all of your insurance needs are meant. Large group health insurance policies are designed to provide the best possible coverage for individuals who are part of a specific group. Because several people are subscribing as a unit, the cost of coverage can be dramatically reduced. If you have any questions concerning insurance coverage for large

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