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HomeSenior Health Insurance › Part D Drugs Medigap Medicare Advantage Get the Best Price for Your Medigap Plan Senior Health Insurance Applications Frequently Asked Long Term Care Questions Understanding Long Term Care Senior Dental Insurance Basics How to Select a Medigap Plan Frequently Asked Questions about Medigap Senior Health Insurance Available Medigap Plans Medicare Overview An Introduction to Health Insurance for Seniors

Part D Drugs



Prescription drug coverage, also known as Medicare Part D, is an important add-on to Original Medicare. Many Medicare eligible people are unaware that is not included when they enroll with Medicare.

What is Prescription Drug Coverage?

It is prescription coverage for people on Medicare. Original Medicare doesn’t cover (most) prescription drugs, so there are other options to cover your prescription drug needs.

Choosing a Part D plan

The best way to choose a Medicare Part D prescription drug plan is get a list of your current drugs so that you are able to make sure how and if your drugs are currently on a plan’s formulary (list of drugs the plan covers). Once you do that you’ll be able to see which is the least cost effective (this does not mean it will have the lowest premium).

Ways to Get Part D

If you go with Original Medicare or with the Original Medicare/Medigap combo you’ll want to get a stand-alone drug plan, however, if you go with a Medicare Advantage plan many times drug coverage is included.

To learn more got to our site dedicated to Medicare Healthcare for seniors.

Medigap



Medigap, or by its formal name, Medicare Supplement insurance, fills in the gaps of Original Medicare. What this means is the Original Medicare offers basic coverage, but there are still copays, coinsurance, deductibles, excess charges, and limitations on coverage of blood transfusions and hospital stays -this is where Medigap fills in.

Medigap is considered to be the strongest financial protection against runaway health costs for persons 65 and over.

Medigap plans range in coverage, but all plans give an additional 365 days of hospitalization

The good news is Medigap plans cover A LOT. The bad news the premiums can be somewhat expensive. The rule of thumb is the more coverage, the more you pay each month, but the less you pay out for medical services (in the case of Medigap Plan F most of our clients do not pay anything out of pocket besides their premium)

There are 10 standarized Medigap plans available that vary from basic to comprehensive coverage. What this means is all Medigap plans are lettered plan A-N, and each lettered plan is equal to its counterpart in coverage (ie All Plan As have the exact same coverage, no matter the insurance company), so you only have to compare plans based off price. Now that you have a little more info on Medigap, find out does Medigap cover dental? Click here to get an instant Medigap quote or go to Senior65, our dedicated site for people over 65.

Medicare Advantage



Medicare Advantage (MA) is offered by a private company that is contracted through Medicare to provide seniors with Part A and Part B benefits. These plans are usually HMOs or PPOs, but can also be a Private Fee-for-Service Plan, Special Needs Plan, or Medicare Medical Savings Account Plan.

How do Medicare Advantage Plans Work?

Medicare Advantage plans replace Original Medicare in the following ways:

  • Medicare Advantage must follow Medicare’s rules
  • Medicare Advantage plans are local, HMO/PPO type networks
  • Medicare pays toward your care each month to your chosen provider of Medicare Advantage plans
  • Medicare Advantage plans can charge different out-of-pocket costs for services depending on provider and plan
  • Although MA must follow Medicare’s rules, these plans may set up how you receive services**
  • Most MA plans offer prescription drug coverage
  • You cannot have Medigap and Medicare Advantage at the same time

**Each Medicare Advantage plan may set up its own way of how your receive services, such as if you need a referral for a specialist and if you have to stay in network. You will need to check with your provider to see how your plan works for you.

Why Choose Medicare Advantage?

Medicare Advantage offers a lot of benefits at a low-cost. These plans are inexpensive, basic plans, that can limit your out of pocket costs, as long as you read the fine print, and are okay with copays and a limited network, this might be the right fit. If you have further questions go to our dedicated Senior Healthcare site.

 

Get the Best Price for Your Medigap Plan



If you have read through our earlier pages, such as our Medicare vs. Medigap and our “Available Plans” pages, it’s time to learn how to get the best price.  Follow the steps below and you will be ready to win the Medigap pricing game.

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Step 1:  Understand that Medigap Policies are Standardized.

There are currently 12 Medigap policies for sale and these are named for the letters of the alphabet “A” through “L.”  After June 1st, 2010, 4 plans will be discontinued (E,H,I and J) and two will be added (M and N) for a new total of 10 plans.

It’s important to understand that every “A” plan across the country is exactly the same as every other “A” plan.  Every “B” plan is also standardized, and so on.  That means that, even though one insurance provider may quote you a different price than another, if they are both quoting prices for plans of the same letter, those plans are essentially the same. 

Step 2:  Know the Difference Between Medigap and Medicare Advantage Plans.

Medigap plans are insurance policies sold by private insurers that were designed specifically to fill in the gaps left by Medicare.  Medigap plans may help you pay for some of your Medicare deductibles and coinsurance.  These plans also offer additional medical benefits that Medicare does not cover at all.  As with any insurance policy, you pay a premium for Medigap plans.

On the other hand, Medicare Advantage Plans are a way to receive Medicare benefits through a private insurer.  You also pay a premium for these plans and you may elect ones that offer additional benefits.

In order to enroll in a Medicare Advantage Plan, you must first enroll in Medicare Parts A and B.  Then you pay an additional premium for the Medicare Advantage plan in order to receive additional benefits, which can include prescription drug coverage if you elect it.  In joining such a plan, your Medicare benefits and the additional benefits you elected are all wrapped up into one health plan, and you receive these benefits using one card.
 

If you join a Medicare Advantage Plan, your Medigap policy won’t work.  In fact, some unscrupulous insurance agents were selling unsuspecting seniors useless duplicate policies, so Congress made it illegal to sell a Medigap policy to anyone who already has a Medicare Advantage Plan.  So, if you already have a Medigap policy and plan to enroll in a Medicare Advantage Plan, it doesn’t make much sense to keep Medigap.

Step 3:  Educate Yourself on How Policies are Priced - and Choose Wisely.

Companies set prices in different ways, and it pays to understand these differences because they can have a very big impact on the cost of your policy over time.  In most states, Medigap policies are priced in one of three ways:  “attained age,” “issue age,” or “community rated.”

Attained age policies are priced based on the subscriber’s current age and the premiums change over time.  These can appear to be the least expensive, especially for those applying on or near their 65th birthday.  However, these can turn out to be the most expensive in the long run, as the premiums tend to increase steadily every three to five years.  Ask an 80-year-old subscriber and they’ll tell you these policies can get really costly, really quickly.

Issue age policies are priced based on the subscriber’s age when they apply, and they only change over time based on health care inflation, not based on age.

Community rated policies are priced based on the subscriber’s location, meaning that everyone in that area gets the same price, regardless of age.  Like the issue age policies, once you buy, premiums do not rise simply because you have gotten older.

Over the long run, choosing an issue age or community rated policy tends to be less expensive, even though their premiums may be higher in the short term.  The advantage of these types of policies is that their premiums should not get prohibitively expensive as you get older.

Step 4:  Don’t Worry Too Much About Service.

Typically, if you pay less for an insurance policy, you’d expect to get sub-par service, but we hear from the Medicare Rights Center that Medigap service is consistently good because the formula is very straightforward.  If Medicare pays 80%, Medigap kicks in 20%.  Because of this sort of simplicity, there is not much room for haggling and therefore not much room for huge gaps in service.

Tip 5:  Take Advantage of Your Window.

There is a specific window of opportunity for signing up for a Medigap policy, which is the first six months after signing up for Medicare.  During this window, you have what is called “guaranteed issuance,” which means that insurers cannot deny you coverage based on pre-existing conditions or expensive prescription drugs that you may need.  Also, if you sign up for a plan but find another plan at a better price and you’re still in that magical window, you can make the switch.  After that it gets much harder.

What’s Next?
Now that you know how to get the best price on a policy, you are ready to a quote.  To do so, visit our quote engine and enter your zip code in the box at the top of the page.  (The rest of the info is optional.)  Then hit the “Next Step” box at the bottom of the page and you’ll see a list of Medigap plans available for sale in your area.

If you would prefer to get personalized help in selecting the right Medigap plan for you, visit our new senior health insurance site called Senior65.com which has medigap audio overviews and easy quotes. You can also contact a licensed Medicoverage agent.  We’re here to help.

Senior Health Insurance Applications



Currently there are no online applications for Senior Medigap plans. Senior65.com is in the process of developing a new online Medigap application, but in the meantime, you will need to select one of the plans below, print out the associated health insurance application PDF, fill it out, and then fax it to us at the number on the cover sheet.  If you are applying for a plan outside of California, please contact us.


AnthemAnthem Blue Cross California:
Anthem Medicare Supplemental Application

BlueBlue Shield California:
Call for Medigap Application

HealthNetHealthNet California:
Call for Medigap Application


UnitedHealthOneUnited Health California:
Call for Medigap Application

Frequently Asked Long Term Care Questions



Why should I consider LTC insurance?

You’ve worked hard, saved, and invested wisely for a secure future. Don’t let unexpected long term care expenses deplete your assets or affect your retirement plans. Purchasing a long term care insurance policy can help you preserve your assets, your financial independence, and your retirement plans.

Can I finance my own Long Term Care without insurance?
Yes, but LTC is very expensive. Within the next 10 years, it is estimated that the average cost of a nursing home could be as high as $100,000 per year. 1/3 of all couples exhaust their finances after just 13 weeks in a nursing home.

Won’t Medicare pay for my long term care?
This is a common misconception. Medicare was not designed to cover long term care expenses - it pays for some skilled nursing facility and home health care expenses after a brief hospitalization. Medicare currently only pays for approximately 2% of all nursing home and home health care services. A recent survey by AARP showed that 60% of its members believe that Medicare will be the primary source of financing for their long term care needs. Medicare, on the other hand, specifically points out in its guidebook of benefits that a person should not depend on Medicare as a primary source for long term care assistance. Also, keep in mind that Medicare may not be around by the time you need assistance.

Will Medicaid provide for my long term care?
Medicaid is intended as a safety net for the poor. In order to qualify for Medicaid, you must divest yourself of assets, which means spending down to the poverty level.

Can my family provide long term care?
Yes, nearly 1 in 4 households - some 22.4 million US families - provide care for elderly relatives.  Studies have shown, however, that 67% of children become clinically depressed while taking care of their parents. We are living longer lives than ever before. With this comes the effects of aging and longevity - reduced physical or mental ability. You can help prevent the emotional and financial burden that disability can place on a family with Long Term Care Insurance.

Is Long Term Care insurance for everyone?
Before purchasing a long term care policy, you need to consider the following factors with your agent:
Your net worth
The potential out-of-pocket costs for long term care
The premiums for the policy

A Medicoverage agent can help you with this process.

Additional Considerations

  • Women:  75% of the current over-65 nursing home population is comprised of women. Women live an average of 5 to 7 years longer than men and are more likely to need long term care services for an extended period of time.

  • Aging Parents:  Children of aging parents might want to consider long term care insurance for their parents. If long term care services are ever needed, it can enable children to ensure quality care for their parents as well as avoid the time, cost and emotional demands of caring for their parents themselves.

  • Family History of Illness:  People with a family history of debilitating illnesses such as Alzheimer’s or strokes should consider purchasing a long term care policy, for obvious reasons.

    The most important thing to remember is this: the longer you wait to purchase a long term insurance policy, the more expensive it will be. Procrastination is your enemy.

    Speak with a Medicoverage agent today at 1 888 285 MEDI. Don’t wait until you need long term care because by then it will probably be too late.

     

    Understanding Long Term Care



    Sometime in the future you may need non-medical assistance in your home. This is usually the case when you become injured or very old. You may need someone to assist you in performing the Activities of Daily Living (ADL) such as eating, using the toilet, bathing, getting out of bed, dressing, etc.

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    These services can be administered by a non-medically-trained caregiver but are still very expensive.  Additionally, these services are not always covered under your traditional health insurance plan, and when they are, such benefits are often limited to a certain number of days.

    Long Term Care (LTC) Insurance is designed to help pay for the high cost of home care. In 2010, roughly 9 million US seniors will need long-term care services.  While most recipients are 65 and older, over 40% currently receiving LTC are aged 18 to 64 years old.

    Is LTC right for you and your family?  Check out our Frequently Asked Questions page and then contact us to speak to one of our agents.

    Senior Dental Insurance Basics



    There is a lot of confusion when it comes to senior dental insurance.  We address the main dental issues in the three points below.

    1) Medicare or Medigap Dental?

    Neither Medicare nor Medigap supplemental insurance plans will cover dental services. If you are a senior and want dental insurance, you will have to buy a separate policy.

    2) Senior-Specific Dental Plans?

    Some companies, like Delta Dental, offer special plans designed for seniors, while other companies allow seniors to purchase the same coverage as those under 65.

    3) Do Seniors Need Dental Insurance?

    Older people who haven’t had a history of dental problems still need to see a dentist. Seniors have the highest rate of oral cancer and dentists often spot the disease first.


    If you are a senior and are interested in a dental plan, visit our Senior65 contact page to get in touch with a agent who can steer you in the right direction.

    How to Select a Medigap Plan



    Identifying the best Medigap plan depends on your individual medical needs and your budget.  To pick the one that’s right for you, we recommend that you first review the available plans page to see what each plan covers and compare their offerings to the benefits you care about.

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    Currently, the most popular Medigap plan is Medigap Plan F. These plans seem to cover the key benefits that many people want and is less expensive than the others. Having said that, everyone is different and it’s worth it to invest a few extra minutes to get familiar with what all the plans have to offer before you make a decision.  As you think about which benefits are most important and which you can do without, consider the following (which all correspond to Medigap plan benefits):

    • Do you have a chronic health care condition that frequently lands you in the hospital?
    • Do you travel overseas often?
    • Do you have a disability that requires a skilled nursing facility?
    • What is your family health history?  Has anyone in your family required hospice care?
    • Would you like to have your preventative care covered?


    Medicoverage has recently launched a new site dedicated to senior health insurance that offers a easy way to compare medigap plans. Check it out.

    Finally, one of the more challenging questions you must answer is whether you want your Medigap policy to pay for your Medicare coinsurance/copayments and deductibles.  To figure this out, you must look at your current expenditures on coinsurance/copayments and deductibles:  i.e. are you using your Medicare (or other insurance) a lot already?  If so, do you think that paying the monthly premium for the Medigap policy would cost you less than the total of all these expenditures?  If the answer is yes, then you should elect a Medigap policy that covers these expenses.

    Now it’s time for you to learn how to win the Medigap pricing game.  Visit our “Getting the Best Price” page to learn how.

    Or if you’d prefer, you can move right into getting some quotes by visiting our senior quote engine.

     

    Frequently Asked Questions about Medigap Senior Health Insurance



    What is Medigap?

    Medigap is nickname for Medicare Supplement insurance.  Medigap plans fill in the “gaps” of Original Medicare.

    Who offers Medigap plans?

    Many top health insurance companies offer them, including Blue Cross, Blue Shield, Aetna, AARP United Healthcare,  and others.  You can enroll in any Medigap plan offered in your area. What you may not know is that they are all standardized and regulated by the Federal government. What this means for you is that you shop based by the best price.  Read our Medicare vs Medigap page to get a better understanding of how this all works!

    Who is eligible for Medigap?

    Medigap is mainly intended for people age 65 or older, who are enrolled in both Parts A and B of Medicare; however in some circumstances persons under 65 and enrolled in Medicare may be eligible.

    What services and benefits does Medigap offer?

    Depending on the plan, the following benefits and services can be covered by Medigap:

    • Additional 365 hospitalization days
    • 1st Three pints of blood for a transfusion
    • Part A and B deductibles
    • Part A and B coinsurance and copays
    • Part B excess charges
    • Foreign emergency travel care
    • Hospice respite care

    Click here for an overview of all the Medigap plans.

    Does Medigap Cover Prescription Drugs?

    No. You’ll want to enroll in a stand-alone drug plan. Click here for an overview of the new Medicare Part D prescription plan.

    How Much Does Medigap Cost?

    The cost of a Medigap plan depends on your age, zip code and desired coverage. Click her to get a Medigap quote.

    Where can I sign up for Senior Medigap?

    We have just launched a new site called Senior65.com that is dedicated to helping you understand and sign up for Medicare Supplement Insurance.

    Available Medigap Plans



    Medigap plans are standardized plans lettered “A” through “N”.  Click on the PDF link below to see a table summarizing these standardized Medigap plans, which are available for enrollment.

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    Current Medigap Plans Summary Table

    UPDATE: 2015 FIGURES: K $4,940 and L $2,470.

    Not all Medigap policies may be available in your state, but when you enter your zip code into our quote engine, plans that are not available in your area will automatically be filtered out.

    NOTE:  In Massachusetts, Minnesota and Wisconsin, Medigap plans are standardized in a different way, so the plans outlined on these tables do not apply to you.  In order to get information on plans in your state, call the appropriate number listed below:

    • Massachusetts:  1-800-243-4636
    • Minnesota:  1-800-333-2433
    • Wisconsin:  1-800-242-1060

     

    Which Plan Should I Select?

    Now it’s time for you to learn the best way to find the Medigap plan that’s right for you. Our suggestion is to weigh your monthly budget, your current needs, and more importantly future needs, before you choose a Medigap plan. By far the most popular plan is the plan that covers the most: Medigap Plan F. This plan covers everything that Medigap covers, but as you guessed it, it’s the most expensive Medigap plan. If this plan is not within your budget there are options, including a Medigap Plan F with a high deductible. 

    Visit our How to Select a Medigap Plan page to learn how. You can also visit our new site www.senior65.com that clearly shows what Medigap benefits go with each plan.

    Or if you’d prefer, you can move right into getting some quotes by visiting our senior quote engine.

    Medicare Overview



    It is easy to get confused between Medicare and Medigap.  Both have the prefix “Medi” and both have different versions that are identified by letters such as Medicare part B or Medigap plan B.  Let’s get it straightened out right here. 

    What is Medicare?

    Medicare is Federally sponsored health insurance for people age 65 or older, or for people of any age that have certain disabilities.  Medicare covers many health care products and services that are considered medically necessary, but there many things (gaps) that it does not cover.  Medicare is divided into 4 sections or “parts” that cover many health care services and supplies.  These parts are explained below.

    The 4 Parts of Medicare

    Medicare Part A

    This is basic hospital insurance.  It helps cover inpatient care in hospitals. It also covers the costs associated with skilled nursing facilities, hospice care, and even some home health care.

    Medicare Part B

    This is general medical insurance. It helps to cover many doctors’ services and outpatient care. It also helps to cover some costs associated with preventive care and services.

    Medicare Part C

    This is where you will find Medicare Advantage Plans. Advantage plans are Federally approved private health insurance options that include both Part A and B above and other additional costs such as prescription drugs.  At one time Medicare Part C was a popular choice but with the addition of Medicare Part D, most people purchase go with Part A,B and D over Part C.

    Medicare Part D

    This is the most recent addition to Medicare. It’s the new Medicare prescription drug coverage option that is run by private insurance companies, but these plans are approved by and under contract with Medicare.  This will cover some of the cost of prescription drugs.


    If you understand the above, you have a pretty good understanding of Medicare.  And it’s important to understand Medicare so that you can make a good, informed decision about purchasing Medigap insurance to fill in the gaps left by Medicare.

    What is Medigap Insurance?

    Medigap is a nickname for Medicare supplemental insurance plans.  Medigap plans are private health insurance plans that are designed to help cover the “gaps” in coverage in Medicare. Examples of these gaps would be co-insurance,  co-payments, deductibles and certain medical care not covered under Medicare. While Medigap does address many of the shortcomings of Medicare, Medigap plans currently sold do not cover long-term care, dental, vision or private nursing.

    It’s also important to understand that Medigap policies are different from the Medicare Advantage Plans mentioned above.  Medicare Advantage Plans are ways to get Medicare benefits, while Medigap plans are ways to get benefits that are not covered by original Medicare.  Medigap plans supplement Medicare.

    Medigap Plans are Standardized by the Federal Government

    Even though Medigap plans are run by private companies such as Blue Cross or United Health, every Medigap policy must be standardized and must follow Federal and state laws.  The Feds have labeled the different Medigap plans by letters “A” through “L.”  There are multiple “A” plans offered by multiple companies, but they’re all basically the same plan. This makes it easy to compare “A” plans between two companies since they are the exact same coverage but not necessarily the same price. To clarify further still, that means that each private company that offers a certain plan has to offer the exact same benefits as their competition.  The same can be said for the “B” plans, the “C” plans, and so on. 

    Next Steps

    We get so many visitors researching Medicare, Medigap, Medicare Advantage or Part D drug coverage that we have just launched a new site dedicate to Senior Medicare Insurance. It’s called Senior65.com and it offers clear information and instant quotes without adding any personal information. http://www.senior65.com here.

    An Introduction to Health Insurance for Seniors



    Medicare is the Federal health insurance program covering eligible persons age 65 or older, and those under 65 with certain disabilities. Medicare is, however, not comprehensive.

    Medicare pays for less than half of what it costs a typical senior for health care. Medicare will not pay for things like deductibles, coinsurance, hearing aids, eyeglasses, prescription drugs, or long term care. That is why there are other Medicare health plans available, such as Medicare Supplement health insurance (Medigap). Medicare Advantage, and Part D (prescription drug coverage). 

    seniors researching insurance

    How to Finally Understand Medigap Insurance

    We have written step-by-step guides to help clarify the often complicated landscape of Medicare and Medigap.  Those guidelines are provided under the links to the left and are also described below.


    STEP 1:  Understand Original Medicare. You want to know what Original Medicare covers, doesn’t cover, and its limitations of coverage before you decide which Medicare insurance might be right for you. Click here to see the 2015 Guide to Medicare costs and here to read what Medicare doesn’t cover.


    STEP 2:  Learn the difference between Medicare Advantage and Medigap. While MA plans have $0 to low monthly premiums,and added perks like drug coverage, dental and vision,  they limit their network of doctors and hospitals and cover things differently than Original Medicare. Whereas, Medigap plans do not cover prescription drugs and generally have higher monthly premiums, however they can cover all out of pocket Original Medicare costs while keeping Medicare’s nationwide network, and offering extras like 365 additional hospital days and foreign emergency healthcare.  Once you become familiar with the benefits offered under by MA and Medigap plans, you should seriously consider which are most important to you. This will prepare you for step 3.


    STEP 3:  Learn whether or not you need a stand-alone drug plan. If you go with a Medicare Advantage plan, more than likely, you will not need to enroll in a stand-alone drug plan. However, if you stay with Original Medicare and/or enroll in Medigap, you’ll want to consider a stand-alone prescription drug plan.


    STEP 4:  It’s time to get some Medicare Insurance quotes.  Simply enter your zip code in the box near the top of the page, then click the “next step” button at the bottom.  You can enter your contact information as well, but that info is optional.


    If you would prefer to have personalized help at any time, feel free to visit our Senior65.com site dedicated to seniors or contact one of the licensed agents who are ready to assist you at 800-930-7956.

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