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February 3, 2014September 8, 2016

Costs & Benefits of Medicare Advantage Plans

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.

January 29, 2014September 8, 2016

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 medications. Study the different policies and find one that fits your prescription medication needs.

Conclusion

Don’t struggle with out-of-pocket prescription costs. Consider Medicare Part D coverage. For more information about Medicare Part D and how you can sign up for coverage, contact Bernardini & Donovan Insurance Services.

January 24, 2014September 8, 2016

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 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.

January 23, 2014September 8, 2016

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 $4750. So, the EMPLOYEE ONLY would have to pay less than $396 per month ($4750 divided by 12 months equals $396 per month) for the coverage to be “affordable”. It is quite easy for an employer to provide “affordable” coverage. If the EMPLOYEE ONLY pays less than 9.5% of the gross household income on a monthly basis, ALL family members are disqualified from receiving subsidy through Covered California.

However, the children, based on the gross HOUSEHOLD income, may still qualify for Medicaid. Bottom line, if your employer offers you coverage, you need to check and see if it is affordable before looking to Covered California for subsidy. It is quite likely you will NOT be eligible for it.

Call us with questions at 909-792-5100.

January 20, 2014September 8, 2016

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.

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

January 15, 2014September 8, 2016

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 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.

January 1, 2014September 8, 2016

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 a large group of individuals contact Bernardini & Donovan Insurance Services. They can answer your questions and help you get the coverage you need.

December 27, 2013September 8, 2016

Buying Group Health Insurance for Small Businesses — Why You Need an Agent

Purchasing group health insurance can be a rather intimidating task for any small business owner. This is especially true when you try to do it all on your own without any help. However, the process can be made a lot easier and less daunting when you decided to let a professional agent assist you in choosing the right group health insurance plan for your small business.

The value of an agent is hard to sum up in just a few words or even a couple of sentences. For starters, an agent sells insurance plans for multiple insurance companies, which means they have a variety of options at their disposal. At the same time, however, some agents may only sell for one or two insurance companies and can actually offer a lower premium cost. Agents can help ensure that you pick the right small group health insurance in regards to cost, the plan itself, and more.

For many small businesses, the problem with purchasing group health insurance is the cost. Many small businesses are hanging on by a thread as it is and cannot really afford to purchase health insurance, which is now required. In order to see if you can save money or qualify for a tax credit, considering the new Obama SHOP exchange is a good idea. Group health insurance can be quite expensive for a small business owner, so the SHOP Exchange may assist in lowering costs.

For any questions or help with finding the right group health insurance for your small business, call Bernardini & Donovan Insurance Services of Redlands, CA, and speak to a professional and helpful agent.

December 23, 2013September 8, 2016

How an Agent Can Help You Navigate Through the SHOP Exchange

Individuals who are interested in understanding the benefits of having a small group health insurance plan should talk to an agent that specializes in the SHOP Exchange. Customers will quickly learn the value of an agent when they begin considering the many insurance options that are available through the Exchange. Agents who work with the Exchange are familiar with the different policy variations can work with small groups who are looking to purchase the right type of health insurance.

For more information about health plans for small or large groups of people, contact the reputable agents of Bernardini & Donovan Insurance Services. They can answer your questions and find the right health insurance plan to meet your group’s individual needs. The company’s agents specialize in servicing the needs of both large and small groups. If you or your group needs assistance navigating the SHOP Exchange, call their office today and speak with one of their qualified agents.

December 18, 2013September 8, 2016

Latest News on Large Group Health Insurance

When it comes to the Affordable Care Act changes are coming not only for those on individual plans but group plans as well. New projections are showing that up to 80 million Americans that previously had group health insurance plans provided by their employers may be without coverage as of January 1, 2014.

The ACA is requiring many changes to the minimum levels of coverage that must be offered as part of a health insurance plan. This means a more comprehensive plan for employees and family members that are covered by each plan. Unfortunately, many small businesses may be unable to provide the new minimum levels of benefits because the cost may be too great.

Individuals and families that become affected by the loss of group benefits must then find coverage through the health insurance marketplace. Many individuals that are navigating through the ACA enrollment period have recently learned the value of an agent to assist in the process. An agent can help break the different policies down and also help ensure you have the proper coverage for you and your loved ones.

For more information on the Affordable Care Act or to contact a certified Covered California agent, visit Bernardini & Donovan Insurance Services online today.

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