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

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 plan has the lowest estimated annual expense.

Ways to Get Part D

If you go with just Original Medicare or with the Original Medicare/Medigap combo you’ll want to get a stand-alone Part D 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 Health Insurance.

Medigap



Medicare Supplement insurance, also known as Medigap, fills in the gaps of Original Medicare. With Original Medicare there is coinsurance, deductibles, excess charges, and limited hospital stays. A Medigap plan would help pay for some or all of the cost where Medicare only pays partial fees..

The good news is Medigap helps pay for some or all of your out of pocket expenses. The bad news the premiums can be somewhat expensive.

Visit our dedicated site to learn all about how Medigap works and what it covers.

Click here to get an instant Medigap quote

 

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 with, at a minimum, equivalent benefits to Parts A and B. 

  • Medicare Advantage plans often have local HMO/PPO type networks
  • Medicare Advantage plans can charge different out-of-pocket costs for services depending on provider and plan
  • Although MA must follow Medicare’s guidelines and rules, these plans may set up how you receive services**
  • Many 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 site for Seniors and those who are Medicare eligible.

 

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.

It’s important to understand that every “A” plan across the country is exactly the same as every other “A” plan.  Every “G” 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.  As with many insurance policies, you pay a premium for Medigap plans.

On the other hand, Medicare Advantage Plans are a way to receive, at a minimum, equivalent Medicare benefits through a private insurer.  You may 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 may 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.
 

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..

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.

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.  visit our new Medicare insurance site called Senior65.com which has Medigap instant quotes. You can also contact a licensed agent.  We’re here to help.

Medicare-Eligible Health Insurance Applications



Currently there are no online applications for Medicare-Eligible 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 a major retirement organization 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.

    Medicare-Eligible Dental Insurance Basics



    There is a lot of confusion when it comes to Medicare-Eligible 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 Medicare-Eligible and want dental insurance, you will have to buy a separate policy.

    2) Medicare-Eligible Specific Dental Plans?

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

    3) Do You Need Dental Insurance?

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


    If you are eligible 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.

    Frequently Asked Questions about Medigap Health Insurance



    We have just launched a new site called Senior65.com that is dedicated to helping you understand and sign up for Medicare Supplement Insurance.  Please visit the website for all your frequently asked questions.

    Available Medigap Plans



    Most state offer plans based on standardized lettered plans such as Medigap Plan F or G.  In Massachusetts, Minnesota and Wisconsin, Medigap plans are standardized in a different way so make sure you check you local laws if you live in one of the three states listed.

    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. Currently the majority of our clients who select Medigap go with Plan G because it offers good benefits at usually a fair price.

    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 Medicare insurance quote engine.

    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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    • Do you have a chronic health care condition that frequently lands you in the hospital?
    • Do you travel overseas often?
    • 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.

    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 instant Medigap quotes..

     

     

    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 Federal health insurance for people age 65 or older, or for people of any age that have certain disabilities or end-stage renal.  Medicare covers many health services that are considered medically necessary, but there many health care related services that it does not cover.  We will address how to address these “gaps” in coverage later below.

    You have two timeframes to enroll in Medicare 1) Initial Enrollment Period and 2) The Special Enrollment Period. 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. Medicare Advantage plans are federally approved private health insurance options that cover include, at a minimum, equivalent benefits to Medicare Part A and B above as well as additional benefits such as prescription drugs.

    Medicare Part D

    Part D is Medicare’s prescription drug coverage option where private insurance companies cover some or all of the cost of prescription drugs.

    Once you understand the above, you will have a pretty good understanding of Medicare.  And it’s important to understand Medicare first so that you can make an informed decision whether Medigap insurance to fill in the gaps left by Medicare is right for you..

    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, 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 replaces original Medicare with equiviilanet or better coverage where as Medigap supplements the “gaps” not covered by Medicare. .

    Medigap Plans are Standardized by the Federal Government

    Even though Medigap plans are run by private companies such as Blue Cross or Humana, every Medigap policy must offered standardized core benefits according to Federal and state laws.  The plans are labeled the different Medigap plans by letters “A” through “L.”  There are multiple Medigap plan G’s plans offered by multiple insurance companies, but each will offer the same core benefits. This makes it easy to compare Medigap G plans between two companies since they are the exact same core benefits but not necessarily the same price.

    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 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 Medicare Insurance



    Medicare is the Federal health insurance program covering eligible persons age 65 or older and those under 65 with certain disabilities or end-stage renal. Medicare can help pay much of your health care cost, but it will not cover not all costs.

    Medicare will not pay for deductibles, coinsurance, or prescription drugs. That is why there are other Medicare health plans available, such as Medicare Supplement health insurance (Medigap). Medicare Advantage, and Medicare Part D prescription drug coverage

    seniors researching insurance

    How to Finally Understand Medicare Insurance

    Below is a quick step-by-step guides to help clarify the often complicated landscape of Medicare insurance.

    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 read How Medicare Works.

    STEP 2:  Learn the difference between Medicare Advantage and Medigap.

    Medicare Advantage Plans (MA) can have $0 to low monthly premiums and added perks like drug coverage, dental, and vision. Depending on the plan you select, they can limit their network of doctors and hospitals.

    Medigap plans do not cover prescription drugs and generally have higher monthly premiums. They can cover most or all of the out of pocket Original Medicare costs and offer extras like 365 additional hospital days and foreign emergency healthcare.  Standard Medigap plans work with Medicare’s nationwide network so if a doctor accepts Medicare, they should accept your Medigap plan.  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 free online tool will help you learn more and decide between Medigap and Medicare Advantage.

    STEP 3:  Learn whether or not you need a stand-alone drug plan.
    If you go with a Medicare Advantage plan it may include presciption drug benefits. In that case, 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 Medicare Part D stand-alone prescription drug plan.


    Ok It’s time to get some Medicare Insurance quotes. 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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