Understanding The Medigap Insurance Basics

Before you enroll in additional Medicare coverage, you must have traditional Medicare coverage. If you are married, you and your spouse will have to have separate Medigap policies. This is the same as having separate Medicare coverage for each one of you.

Medigap plan A provides a basic set of benefits. These benefits include covering coinsurance for up to a year after Medicare benefits cease. This coverage provides co-payment insurance coverage except for the preventative services outlined in plan B.

Once you get past this basic set of benefits in Plan A and B, supplemental Medicare insurance policies begin to show their differences. Some of the different plans cover hospice care coinsurance and co-payment. Others provide coverage for skilled nursing facility care coinsurance. Some of the plans provide coverage for the deductibles of both plan A and plan B. Quite simply, all other supplemental Medicare insurance plans offer a basic set of benefits in Plan A or Plan B, along with additional items.

Determine which MediGap insurance policy is best for you?

Helping people become comfortable with their Medigap options during the critical purchasing   time is important to us.  When we provide a Supplemental Medicare Insurance quote, we provide you with the education between the types of supplemental medicare policies.

Do not let a salesman convince you that their Medicare supplement policy is any better than that offered by another company. The federal government regulates what each of these supplemental policies cover. The only real difference is that you pay more at one company then you may at another. There can be significant cost differences between two different companies offering the same exact benefits.

In order to get the best insurance policy we feel that you need to understand what each of the plans offer. Keeping up with all the government Medicare changes takes time, and we find most people would benefit from professional assistance that can help them match up their needs with the right Medigap plan.

If you are considering purchasing supplemental Medicare insurance, consider calling a professional like Steve Richardt. Having someone on your side who understands the differences in Medigap coverage helps you make the right decision.

Supplemental Medicare insurance is often called MediGap insurance. This specialized policy is meant to cover medical expenses that traditional Medicare does not cover, or does not cover as thoroughly as you would like.

When comparing MediGap quotes, it’s important to remember that there could be quite a bit of variation in the quote from competing companies. We recommend taking the time to carefully look and consider the coverage before signing up for any new policies.

Step 1) Consider how the insurance company arrived at its quoted price.

Was this number just an initial estimate, or did they take the time to weigh the factors that are specific to you as an individual. For example, did you tell them you were a smoker/non-smoker? Your premiums could go up or down substantially based upon the specifics provided by you.

Answering questions about you is often times not enough. The Medicare supplemental insurance quote that you receive could also depend on family factors. The healthy history of not just you, but your family can impact quotes.

Step 2) Consider how each company calculates lifestyle & medical history.

The answers you provide reflect the level of coverage that is being offered, and your payment. Each insurance company has a custom approach to how they calculate your lifestyle choices (like smoking) and medical history. The reason why each quote you get will have a unique cost is because each company calculates these factors differently. Sometimes it can be helpful to ask them to define this for you.

Step 3) Consider hiring a professional agent to negotiate and find you the best option.

If the previous 2 considerations seem challenging then hiring a agent might be your best option. These initial considerations are just the beginning when you consider the changing government legislation and negotiation.

More people are finding it beneficial to hire a professional insurance agent who is up to speed with the new regulations and familiar with negotiating with the big insurance companies.

An agent like Steve Richardt is not tied to one plan or company. He obtains various supplemental Medicare insurance quotes for you and compares them objectively. He also takes the time to demystify the MediGap insurance process, and objectively help you figure out the best options available to you.

To start the process of learning more about Medicare supplemental insurance and how it works, please contact Steve Richardt, of Richardt Insurance. We look forward to working with you.

Quite simply, some doctors accept Medicare, but not all services and treatments are covered by Medicare.  Depending on your coverage, you may be responsible for meeting a deductible and then also paying a coinsurance payment. You may also have to pay out of your own pocket for any prescriptions.

Supplemental Medicare insurance can help to cover treatment costs that Medicare will not pay for.  For example, you may need to be in the hospital for a long term stay and Medicare will not pay for all of your stay after a certain number of days.

If you purchase supplemental insurance, you may have to pay a copayment initially, but then the insurance will pay for treatments and medical care that Medicare won’t cover.  You may also have to meet an annual deductible or you may have a coinsurance payment when you buy supplemental insurance.

If you don’t have supplemental Medicare insurance, you will have to pay out of pocket after the limits of Medicare have been exhausted. This can add up to thousands of dollars.

As you grow older, you may need special tests and treatments to maintain your health.  If you only rely upon Medicare to help you with all your medical costs, you can be paying out of your own pocket for treatments covered by supplemental Medicare insurance. Be proactive and start looking for supplemental insurance today.

Don’t wait until it is too late to buy supplemental insurance for your Medicare plan.  You should consider getting Medicare insurance quotes from different insurance companies as soon as possible so that you can protect yourself against very high medical bills.

In this post, we want to discuss changes to other Medicare supplement insurance plans that, we believe, will be welcomed by consumers seeking to purchase Medigap insurance.  Some of the changes affect all the plans; others are specific to individual plans.

Two of the most significant changes affect all supplemental Medicare insurance plans sold in the United States.  One eliminates preventive care and at-home recovery benefits from all plans.  The other adds a hospice care benefit and makes this benefit basic.  There are a couple of small caveats to the hospice care benefit, however.

The hospice care benefit requires that recipients pay 5 percent of the Medicare-approved amount for inpatient respite care (excluding room and board).  It also requires a co-payment of $5 or less for outpatient prescription drug plans for pain and symptom management.

On other change affects Plan G only.  It increases the Medicare Part B excess charge benefit from 80 percent to 100 percent.

All changes to supplemental Medicare insurance plans apply only to plans purchased on or after June 1.  These changes do not mean you have to run right out and purchase a new Medicare supplement insurance plan. If you already have any of plans E, H, I or J, you can go on receiving the benefits now available under those plans.  All you have to do is continue paying the premiums.

If you find that Plan M, Plan N or another plan would better meet your needs once the changes have been implemented, you can make the switch.  This might be an attractive alternative in terms of cost.  For example, if you currently have  plan F, you can have similar benefits with Plan M, except you’ll pay 50 percent of the Medicare Part A and Part B deductibles.  However, Plan M could cost about 15 percent less than Plan F.

Plan M and Plan N:

The new Plan M will include all the benefits of Medigap Plan A.  It also will cover half of the Medicare Part A and Part B deductibles and a portion of the cost of foreign travel emergencies.

The new supplemental insurance Plan N will include the Plan A benefits, except it will require a $20 co-payment for office visits and a $50 co-payment for emergency room visits.  Also covered are foreign travel emergencies and the Medicare Part A deductible.

Plan N could cost 30 percent less than Plan F, so it’s a good idea to review your coverage and compare it to what’s available after June 1.  To learn more, talk to Steve Richardt Insurance and ask about a supplemental Medicare  insurance quote.

4 Plans Out

Going away are plans E, H, I, J and, as mentioned above, the high-deductible Plan J.  A brief review of these five plans will help put the eliminations and additions into perspective.

Medicare supplement insurance plans E, H, I and J all include the benefits found in Medicare supplement insurance Plan A.  That is, they cover inpatient hospital care; Medicare Part A coinsurance; 365 additional days of care after Medicare coverage ends; medical costs, including Medicare Part B coinsurance; and blood, including the first three pints each year.

Plan E adds skilled nursing facility coinsurance, the Medicare Part A deductible, foreign travel emergency and preventive care not covered by Medicare.  Plan H also adds skilled nursing facility coinsurance, the Medicare Part A deductible and foreign travel emergencies, but does not include preventive care.

Plan I offers skilled nursing facility coinsurance, the Medicare Part A deductible, Medicare Part B excess charges (100 percent), foreign travel emergencies and at-home recovery, but does not offer preventive care.  Plan J has all the benefits of Part I and also includes the Medicare Part B deductible and preventive care.

2 Plans In

The new Plan M will include all the benefits of Medicare supplement insurance Plan A, just as its predecessors have.  In addition, Plan M will cover half of the Medicare Part A deductible and a portion of the cost of foreign travel emergencies.

Coverage under the new Medicare supplement insurance Plan N will include the Plan A benefits, except it will require a $20 co-payment for office visits and a $50 co-payment for emergency room visits.  Also covered are foreign travel emergencies and the Medicare Part A deductible.

The reasoning behind these changes has to do with streamlining the plans and getting rid of benefits that are seldom used, such as preventive care and at-home recovery.  However, all Medicare supplement insurance plans will include a hospice care benefit beginning in June.

Most experts in the field of Medigap insurance agree that these changes are both necessary and beneficial to consumers.  The potential savings in out-of-pocket costs and the valuable new benefits will make Medicare supplement insurance plans M and N popular choices in the marketplace.

For more information, talk to one of the experts at Richardt Insurance, and be sure to ask for a Medicare supplement insurance quote.

People are buying more insurance? It seems counter-intuitive in a time when so many of us are cutting back on almost everything.

In fact, the upswing in Medicare supplemental insurance has been going on for a couple of years and is expected to continue well into the future. Why?

The simple — and probably best — answer is that it saves money. Medicare supplemental insurance actually helps control rising health-care costs.

Here’s how:

Medicare provides limited coverage for surgery, ongoing therapy and long-term hospital stays, among other medical necessities. A Medicare supplemental policy fills the gap (thus the term “medigap” insurance) between what Medicare covers and the actual cost of care.

The gap can be pretty wide, and you have to fill it out of your own pocket. At today’s cost of medical care, a reasonable monthly insurance premium for gap coverage can be a real bargain.

Of course, you need to shop around for the right Medicare supplemental insurance. Close to 200 companies offer the policies, but just eight of them insure more than half the policyholders. You should take time to find out which one is the right match for you.

Even though the coverage is the same for the plan you choose, different companies might charge widely divergent premiums. So do your research before you make a choice.

One suggestion: Talk to someone who has already done the legwork. Chances are, when about 65 percent of seniors have Medicare supplemental insurance, you have an associate, friend or family member who has a policy.

Recently, 32 people were accused of Medicare fraud in New York, Michigan and Florida. The defendants were accused of receiving payments for unnecessary health care tests and procedures that were never received by beneficiaries as a means of milking Medicare for money to line their own pockets. This is a crime that puts strain on both Medicare and Medicare supplements. As Assistant Attorney General Lanny Breuner said, “Medicare fraud is not a victimless crime. It hurts every American taxpayer by raising the cost of health care.”

The Miami Herald put together this short video about the recent Medicare fraud:

Kansas Medicare Scams

While Kansas itself has not been implicated in the recent scams, it’s important to remain on your toes to keep that as the case. The Federal Bureau of Investigation (FBI) has a list of frauds and ways to avoid being scammed yourself. According to the FBI, “Medicare fraud can take the form of any of the health insurance frauds described above. Senior citizens are frequent targets of Medicare schemes, especially by medical equipment manufacturers who offer seniors free medical products in exchange for their Medicare numbers. Because a physician has to sign a form certifying that equipment or testing is needed before Medicare pays for it, con artists fake signatures or bribe corrupt doctors to sign the forms. Once a signature is in place, the manufacturers bill Medicare for merchandise or service that was not needed or was not ordered.”

The tips they offer to avoid being scammed are as follows, verbatim from the FBI’s own warning:

–Never sign blank insurance claim forms.

–Never give blanket authorization to a medical provider to bill for services rendered.

–Ask your medical providers what they will charge and what you will be expected to pay out-of-pocket.

–Carefully review your insurer’s explanation of the benefits statement. Call your insurer and provider if you have questions.

–Do not do business with door-to-door or telephone salespeople who tell you that services of medical equipment are free.

–Give your insurance/Medicare identification only to those who have provided you with medical services.

–Keep accurate records of all health care appointments.

–Know if your physician ordered equipment for you.

Kansas Medicare Supplement Scams
Another big way that scammers make money (often, again, from senior citizens) is by selling fake Medicare supplement plans.

These are fairly easy to spot, so long as you know what to look for. Be wary when looking for plans to fill the gap in Medicare, and try to stick to these rules.

Avoid Door to Door Sellers If someone comes knocking at your door to sell you a Medicare supplement plan, your alarm bells should be going off. It can happen legitimately, but more often than not, it is someone trying to either sell you bad insurance or insurance that doesn’t help at all.

Buy Local Medicare Supplements It’s important that you buy local Medicare supplements both to receive the best plan for your particular area of the country, but it is also easier to avoid a scam when dealing on a local level.

Don’t Repeat Coverage Sometimes, a scam will involve selling legitimate insurance but only insurance that covers something you already have insurance for through Medicare. This saves the scammer money by never having to pay out on the insurance, and you pay double for the same coverage.

Kansas has not been a hotspot for Medicare scams, and it’s important it remains that way. Keep your eyes open for the aforementioned signs, and you’ll be just fine.

Plan A benefits, which are also offered in the other 12 standard Medicare supplements available, include, among others:
• Co-insurance ($267/day in 2009) for days 61-90 of a hospital stay
• Co-insurance ($534/day in 2009) for hospital stays beyond 90 days, up to an additional 60 days during the insured’s lifetime
• Coverage up to 365 days after use of Medicare hospital inpatient coverage, including lifetime reserve days
• Reasonable cost of the first three pints of blood each year
• Co-insurance (20 percent) for doctor and medical bills under Medicare Part B after payment of the Medicare Part B deductible ($135 in 2009)
• Co-insurance (50 percent) for outpatient mental health services after payment of the deductible

Medicare Supplement Plan B is a lot like Plan A, but there is one significant difference: It covers the Medicare Supplement Part A deductible for hospitalization ($1,068 per benefit period in 2009). But this requires some more explanation.

Usually, medical insurance deductibles are annual. You meet them over the course of a year, and they start all over again the next year. The Medicare Supplement Part A hospitalization deductible is per benefit period. The benefit period begins as soon as you enter the hospital as an inpatient and ends when you’re released and haven’t received skilled care somewhere else for 60 consecutive days. So you could face more than one deductible a year.

What the Bill Does
The bill would lower the age of eligibility for Medicare from 65 to 55. According to the Associated Press story about possible expansion, “Medicare now covers seniors 65 and older, as well as disabled people of any age. People in their mid-50s are among the most vulnerable to losing coverage, particularly in an economy where employers are still cutting jobs. But buying into Medicare would not be cheap. A current buy-in available to those 65 and older who don’t qualify because of work history costs about $550 a month.”

Who Would the Bill Affect
While the bill would obviously affect those without health care who range in age from 55 to 65. According to this Huffington Post take on the possible expansion, “a Medicare buy-in program could cover more people (at a similar cost) than the public option in either the Senate or House of Representative’s legislation.” There is great speculation across the board about whether or not this would lower coverage as well. But one thing is certain: changing part of Medicare will affect all of it. The need for Medicare Supplement plans might be more pressing than before.

What Part of Illinois Population Would the Bill Directly Affect
According to the 2000 Census Report for Illinois, the amount of people from ages 55 to 65 in Illinois was 1,040,633. This number is believed to have grown. If the bill passes, this is a fairly large number of people suddenly eligible for health care, which could mean an increased need for Illinois Medicare Supplements as well as a changing Medicare policy.

While all of this has yet to come to fruition, it is reported that Senate Democrats are attempting to push a bill through before Christmas, as to get it in this legislative session. This is an important story to watch for anyone with Medicare or a Medicare Supplement.

Amongst these challenges is weight gain. As of late the United States Department of Health and Human Services (HHS) has recognized obesity and weight problems as medical illnesses, meaning the possibility of covered treatment exists. If you are a senior citizen with an Arkansas Medicare Supplement plan and seeking aid in your weight loss goals, there is help.

While weight loss can be a difficult challenge for anyone, there are a number of factors which make the process more challenging for senior citizens. As you age, you begin to lose muscle mass while gaining body fat.

Senior citizens …

• Have a muscle mass decrease of about 27 percent by age 70
• Have a lower metabolic rate due to muscle loss
• Have a harder time exercising
• Can be troubled with join and bone issues or thyroid disease or cholesterol problems

Despite these challenges though, some of the health benefits of achieving this goal can be much more significant amongst elderly people. By making slight adjustments to your diet and physical activity, you can dramatically improve your risks of diabetes, heart disease, joint pain, and other ailments. The best recommendation for dealing with issues of obesity at old age is to reduce caloric intake, and adjust the types of calories you consume. Sometimes however, these independent adjustments are not enough and further medical aid is required. As of late, there are Medicare coverage options to address these problems.

HHS has made revisions to Medicare policies which address the topic of obesity. Text which described obesity as a non-illness has been removed from the Medicare Issues Manual. As a result medical challenges can be taken into consideration.

The law states that Medicare covers necessary medical care for illnesses and injury, by revising the manual to include issues of obesity, it is now possible to have these medical troubles covered by Medicare. However, it is predicted this will not greatly affect coverage. There needs to be extensive research to prove that medical improvements can be had through specific interventions such as weight loss programs and even weight loss procedures and surgeries. The process to prove these necessities will likely be a slow one, and overshadowed by other medical needs.

However, if you are eligible for Medicare coverage, the cost of these treatments will depend on the type of Medicare plan you have. In most cases basic medicare covers 80 percent of an approved service, and beneficiaries cover the remaining expenses. With a Medigap plan–supplemental coverage–you will likely pay little to nothing on an approved procedure. Call your provider to attain the exact amount. The last type of coverage–Medicare Advantage Plans– are privately purchased Medicare replacements that will generally cover all that basic Medicare covers and possibly more.

In the event that you are in need of obesity treatment, it is wise to invest in an Arkansas Medicare Supplement. These treatment plans are generally costly or expensive programs which include the cost of physical fitness experts and special food items. The cost of making up the difference for these treatment plans can be more expensive than the cost of investing in a Medicare supplement.