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Friday, December 7, 2012

Medicare Advantage Health Plans Offer the Benefit of Predictable Costs

No one likes uncertainty, especially when it comes to money. If you are enrolled in Medicare, you know all to well that Medicare has some gaps in coverage. Medicare is a safety net and was never intended to pay 100% of covered services. Cost sharing with original Medicare includes hospital deductibles, co-pays and co-insurance for outpatient services. The biggest area of uncertainty is outpatient services. Medicare beneficiaries are required to pay 20% of medical costs.

One of the main reasons that individuals enroll in Medicare Advantage health plans is because of the predictable cost. With an Advantage plan, you know ahead of time what your costs will be for any services rendered.

Many Advantage Plans have predetermined co-pays for covered services. Although plan design varies from one Medicare Advantage health plan to the next, medical services with co-pays, may include:

Primary care doctor visits Visits to a specialist Urgent care visits Emergency room visits Some outpatient testing Ambulance service And other Medicare covered services

Knowing your costs ahead of time can bring peace of mind. In addition, if you have an idea what your responsibility will be, you may be more likely to seek medical treatment.

Medicare Advantage health Plans can mean certainty.

The biggest benefit that an Advantage plan has to offer, is the feature that ensures beneficiaries have an annual maximum out-of-pocket amount. Original Medicare does not offer a maximum out-of-pocket amount. In the case of outpatient services, you are responsible for 20% of the charges for covered services no matter what that may be.

Medicare Advantage health plans typically give a dollar amount indicating your maximum annual responsibility. When you have reached that amount, through deductibles, co-pays and co-insurance, your responsibility stops and the plan pays covered expenses at 100%.

Advantage Plans often include coverage for additional services not covered by Medicare, such as; dental, vision, hearing and sometimes health club memberships. When on a fixed income, these benefits can make a big difference.

If you are looking for a plan that will ensure predictable costs, you may want to consider a Medicare Advantage health plan.

Medicare Supplement Insurance - How is it Priced? New 2010 Modernized Medicare Supplement Plans What to Watch Out for in Medicare Supplement Coverage How Can You Find Best Medicare Supplemental Insurance Plans? Medicare Supplement Plan N - Smart Alternative To Medicare Advantage

Medicare Supplement Plans That Make Sense

Most of us would not be able to afford medical coverage if it weren't for the Medicare program. There are many different advantages to using Medicare, and more than likely you are already enrolled in Medicare part A and part B, which covers your hospital stays and doctors visits along with general medical coverage. There may be some gaps in coverage, however, and these generally show up in the form of annual deductibles and co-pays. If you would like to have additional Medicare supplement insurance which will cover these gaps, it is available in a type of insurance that is known as Medigap.

Medigap is a Medicare supplementary policy that helps to pick up any out-of-pocket expenses when you are using Medicare. It is important for you to look at these various policies that are available and to do a comparison in order to choose the one that is going to be right for you. The reason why this is the case, is because there may be some things that are covered under some of these policies that are going to be unnecessary for you. The best way to keep your premiums as low as possible is to compare Medicare supplement insurance in this way and you choose one that will result in the lowest premium and the lowest out-of-pocket expenses in the balance.

This can be a little bit difficult, but the Medigap insurance makes it a little bit easier because it is regulated. Regardless of which insurance company you happen to go with, the policies are going to be standardized and you will get the same exact coverage. For example, if you went with one insurance company and chose Medigap plan C, you're guaranteed to get the same exact coverage with any other insurance agency when choosing Medigap plan C.

One thing that is not regulated in Medigap insurance is going to be the amount of money that you're going to spend. As a matter of fact, there is going to be quite a variation in the cost of these policies, even when you are choosing the same one. That is why it can benefit you to do a little bit of comparison shopping, either by calling the various companies or by doing so on the Internet. In that way, you'll be certain to be getting the coverage that you need without paying too much for the policy.

Medicare Supplement Insurance - How is it Priced? New 2010 Modernized Medicare Supplement Plans What to Watch Out for in Medicare Supplement Coverage Medicare Supplement Plan N - Smart Alternative To Medicare Advantage How Can You Find Best Medicare Supplemental Insurance Plans?

Medicare Supplemental Insurance: Is It For You?

Medicare Supplemental Insurance, also known as Medigap, covers voids left behind by Medicare coverage. Supplemental insurance is designed to assist with copays, coinsurance, and deductibles. Medigap is provided by private insurance plans approved by Medicare, but the cost of Medigap coverage is paid by the insured party only. Parties who are participants in Part C Medicare coverage (aka Medicare Advantage Plans) are not eligible for Medigap coverage. In fact, it is illegal for insurance representatives to sell Medigap coverage to any individual enrolled in a Medicare Advantage Plan.

Medigap can be of great assistance to parties with healthcare costs. The supplemental coverage can help with preventative care costs, blood administration costs, Medicare Plan A and B deductibles and extra costs not covered by Medicare. There are 12 different Medigap plans approved by Medicare (labeled A-L), and each have their own level of comprehensiveness. There are numerous options that are designed to meet the needs of each individual Medicare recipients. For example, Medigap Plan E assists Medicare A recipients with deductibles, but Medigap Plan F assists with Medicare B deductibles.

Medigap plans F and J are "high deductible" plans that carry a $2000.00 deductible. The cost advantage to these plans is lower premium rates when compared to other plans, but the ailing party must pay a higher deductible once Medigap coverage kicks in.

Private insurance companies cannot, by law, refuse to sell Medigap to eligible parties if: the plan is offered in the purchasing party's state; the plan is offered in a state where the purchasing party is moving to; have dropped Medigap for a Medicare Advantage Plan, and want to switch back within one year; the eligible party moves out of an area where Medicare Advantage is offered, or if Medigap A, B, C, D, F, K or I is sold by any Medigap provider in the eligible party's state. These rules protect potential Medigap purchasers from discrimination by Medigap providers, regardless of preexisting conditions or medical history.

The cost of these plans vary by the breadth of coverage. The only difference between the plans is the premium as offered by the private insurance companies. The amount of coverage amongst like plans does not change. Since the cost can vary greatly among insurance providers for the same coverage, it is important to comparison shop for the best rate.

Medigap plans K and L are the only plans that cover partial hospice costs, as well as skilled nursing costs. Plans K and L are best for those with terminal illness or those eligible for hospice care. Medigap plans A-J are best suited for members of either Medicare A or B plans.

Medigap plans do not cover prescription drug costs. The only exceptions are for parties who purchased a Medigap prescription drug plan prior to January 1, 2006. Otherwise, Medicare D offers prescription drug coverage to parties receiving Medicare, and therefore there is no need for Medigap to cover prescription drug costs.

Medicare urges all eligible participants to purchase Medigap during his or her open enrollment period. Medigap's greatest asset is in its ability to assist with high copayments and with acute care procedures not covered by Medicare A and B. The US federal government urges all Medicare recipients to enroll in Supplemental Medicare Insurance as a vanguard for the unexpected.

Why You Need Supplemental Insurance

Insurance, as a whole, is important. A person needs to be covered in every way possible just in case something were to happen. What many people fail to realize is that health insurance does not cover all of the medical treatments that may occur. There are a lot of out of pocket expenses that can occur with an unexpected accident or sickness. Let's take a look at a few reasons why supplemental insurance is important.

1.) Most insurance policies cover only a portion of the bill. So if you have a deductible that has not been satisfied for the year that has to come out of your own pocket. If there is a co-payment, you have to pay a percentage of the bill out of your own pocket. Take for example if you have 80/20 coverage, 80% of the bill your health insurance and 20% has to come out of your own pocket. If the bill is large, you have to pay 20% of the large bill out of your own pocket.

2.) If you are married or have children that you have to take care of and your spouse or child gets sick or becomes injured then chances are there is lost income. If your child gets sick, you may have to take off work in order to take the child to and from the hospital. There are also gas expenses that can go along with that. If your spouse is laid up in the hospital, you may have to take of work to care for him/her and remember, your spouse isn't working either. Two incomes are being adversely affected. If the spouse is hurt on the job, workman's compensation may cover some of the income if you make under a certain amount, but it still doesn't make up for the spouse's lost income and the hospital bills that still have to be paid.

Supplemental insurance is relatively inexpensive and for the cost of the premium, it's definitely worth the piece of mind to protect you and your family. It's not meant to replace health insurance or cover all of the costs but it definitely can help pay bills and give your family money when in need.

National Medicare Supplemental Insurance

Medicare supplemental insurance is one of the many types of private insurance plans for health that are intended to provide a supplement for the original plans in Medicare. If this insurance plan covers you, it will pay off some of the costs you will incur in seeking healthcare. Most of these costs are not covered by the initial policy that you took.

Medicare supplements are very important. This is because we all find that we need health care and medication at some point in time. Hence the reason why we need to insure ourselves so that in the eventuality that we become sick, get admitted into hospital or have other medical needs, we will not have to look for money. The insurance plan will cover all the incurred costs to enable our quick recovering by providing the best medical services possible under our cover.

These plans, however, only pay for cases which they deem to be most necessary, medically speaking. The premiums for each insurance policy will vary. However, they are determined using three primary methods. First, the policy writers will check the age that has been attained. This contains the lowest premiums especially for senior citizens over the age of 65 years. The older you get, the higher the premiums. Adjustments are normally made annually, after 3 years or 5 years. The adjustments also entail inflation that also increases the premiums to be paid.

The age of issuance is also another method that is factored in to the premiums to be paid by the insured. This is where the premiums are chiefly based on how old you were when you purchased that insurance cover. The premiums do not increase the older you grow. They will only increase due to the adjustments that the supplement makes to factor in the inflation.

The final method that is used to determine the premiums that you will pay is the community rated method. With this method, everyone who is found within the same geographical location will pay standardized premiums. This is regardless of their age.

To conclude, after you have picked to plan that suits you best, ensure you purchase the policy for supplement of your Medicare that has the lowest premiums. It may prove expensive at first but the premiums will not increase each year as you grow older.

How Much Does Medicare Part A Pay?

Most of us know that The Part A program provides compensation for healthcare or medically needed services for hospitalization, however there are certain caps in benefits you should be aware of in order to make precautionary arrangements. To conceptually grasp and understand Part A, you need basic information about the programs payment allocation, for hospitals, nursing facility, or home health care, as well as benefit periods and coinsurance amounts. How much Medicare Part A pays depends on how many days of inpatient care you have during what is called a benefit period or spell of illness.

A benefit period or spell of illness refers to the time you are treated in a hospital or skilled nursing facility, or some combination of the two. The benefit period begins the day you enter the hospital or skilled nursing facility as an inpatient, and continues until you have been out for 60 consecutive days. If you are in and out of the hospital or skilled nursing facility several times but have not stayed out completely for 60 consecutive days, all your inpatient bills for that time will be figured as part of the same benefit period.

Hospital Reimbursement.

Medicare Part A pays only certain amounts of hospitalization for any one benefit period.

The Deductible.

For each benefit period, you must pay an additional amount before Medicare will pay anything. This is called the hospital insurance deductible. The deductible is increased every January.

First 60 Days.

For the first 60 days you are an inpatient in a hospital during one benefit period, Part A hospital insurance pays all of the cost of covered services. However, non-essentials, such as televisions and telephones, are not covered. You pay only your hospital insurance deductible within this time frame. If you are in more than one hospital, you still pay only one deductible per benefit period and Part A covers 100% of all your covered cost for each hospital.

Days 61 - 90.

After your 60th day in the hospital during one spell of illness, and through your 90th day, each day you must pay what is called a coinsurance amount toward your covered hospital cost. Part A of Medicare pays the rest of covered cost.

Reserve Days

Reserve days are a last resort coverage. They can help pay for your hospital bills if you are in the hospital more than 90 days in one benefit period, however the payment is quite limited. If you are in the hospital for more than 90 days in any one spell of illness, you can use up to 60 additional reserve days of coverage. During those days, you are responsible for a daily coinsurance payment. You do not have to use your reserve days in one spell of illness, however you can split them up and use them over several benefit periods. You have a total of only 60 reserve days in your lifetime. Whatever reserve days you use during one spell of illness are gone for good. In the next benefit period, you would have available only the number of reserve days you did not use in previous spells of illness.

Psychiatric Hospitals.

Medicare Part A hospital insurance covers a total of 190 days in a lifetime for inpatient care in a specialty psychiatric hospital. If you are already an inpatient in a specialty psychiatric hospital when your Medicare coverage goes into effect, Medicare may retroactively cover you for up to 150 days of hospitalization before your coverage began. In all other ways, inpatient psychiatric care is governed by the same rules regarding coverage and co-payments as standard hospital care. There is no lifetime limit on coverage for inpatient mental health care in a general hospital. Medicare will pay for mental health care in a general hospital to the same extent as it will pay for other inpatient care.

Skilled Nursing Facilities.

Despite the common misconception that nursing homes are covered by Medicare, the truth is that it only covers a limited amount of inpatient nursing care.

For each benefit period, Medicare will cover only a total of 100 days of inpatient care in a skilled nursing facility. For the first 20 of 100 days, Medicare will pay for all covered cost, which will include all basic services excluding television, telephone, or private room charges. For the following 80 days, the patient is personally responsible for a daily co-payment; Medicare pays the rest of covered cost. Reserve days, available for hospital coverage, do not apply to a stay in nursing facility. After 100 days in any benefit period, you are on your own as far as Part A hospital insurance is concerned. However, if you later begin a new benefit period, your first 100 days in a skilled nursing facility will again be covered.

Home Health Care.

Medicare Part A pays 100% of the cost of your covered home health care when provided by a Medicare approved agency, and there is no limit on the number of visits to your home for which Medicare will pay. Medicare will also pay for the initial evaluation by a home care agency, if prescribed by your physician, to determine whether you are a good candidate for home care. However, if you require durable medical equipment, such as a special bed or wheel chair, as part of your home care, Medicare will pay only 80%.

Hospice Care.

Medicare pays 100% of the charges for hospice care, with two exceptions. First, the hospice can charge the patient up to $5.00 for each prescription of outpatient drugs the hospice supplies for pain and other symptomatic relief. Second, the hospice can charge the patient 5% of the amount Medicare pays for inpatient care in a hospice, nursing facility, or the like every time a patient receives respite care. There is no limit on the amount of hospice you can receive. At the end of the first 90 day period of hospice care, your doctor will evaluate you to determine whether you still qualify for hospice, meaning your disease is still considered fatal and you are still estimated to have less than 6 months to live. A similar evaluation is made after the next 90 day period, and again every 60 days thereafter. If your doctor certifies that you are eligible for hospice care, Medicare will continue to pay for it even if it exceeds the original six month diagnosis. And if your condition improves and you switch from hospice care back to regular Medicare coverage, you may return to hospice care whenever your condition warrants it.

By knowing exactly what Medicare Part A pays, an educated decision can me made as far supplementing the gaps.