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Do You Qualify For Original Medicare Coverage? Key Tips To Help You Know For Sure

Sunday, November 14th, 2010

If you are nearing the age of 65, you may be asking yourself, “What is Original Medicare Coverage and am I eligible?” These are important questions because for most people nearing retirement age, the Medicare program will take over as the primary source of health insurance.

Although the Medicare program has evolved since it first started in 1965, Original Medicare is the single payer, Federal health insurance program for U.S. citizens and legal residents age 65 or older. It now also includes coverage for individuals eligible for Social Security Disability benefits, those who have kidney failure, or ALS (Lou Gehrig’s disease). There is one other Federal insurance payer, the Federal Employees Health Benefits program that covers Federal employees.

Although Medicare is now considered to have 4 parts, Original Medicare is most often associated with what is called Part A and Part B. Part A covers hospital inpatient, skilled nursing facility, and home health care benefits. Part B covers doctors’ services, medical supplies and equipment, and hospital outpatient care. Part B also covers many other services such as clinical laboratory services, imaging, ambulatory surgery, cancer treatments, preventive services, and much more.

Generally speaking, eligibility is not complicated. If you are a U.S. Citizen or naturalized citizen nearing the age of 65, or disabled or have End Stage Renal Disease, you are probably eligible. Eligibility questions, however, can be addressed to the Social Security Administration at 1-800-772-1213.

Enrollment into Medicare Part A and B is automatic if you are receiving Social Security benefits at the time you turn age 65. If you have been receiving Social Security Disability Insurance for 24 months, you enrollment is also automatic at the end of the 24 month. Generally speaking, you should receive your red, white and blue Medicare card about 3 months prior to the month of your enrollment.

Those nearing 65 but not yet receiving Social Security benefits must submit an application to the Social Security Administration. All Medicare applicants have a 7 month, initial enrollment period that begins 3 months before the sixty-fifth birthday and ends on the last day of the third month following the month of your sixty-fifth birthday.

The one stable piece of information to hold onto is that Medicare enrollment is always done through the Social Security Administration. If you are already receiving benefits, your enrollment will be automatic and you won’t need to do anything at all. If you are not receiving SSA benefits by your sixty-fifth birthday, you will need to submit an application through the Social Security Administration. As this is quite an important change in your life, you should not hesitate to seek answers to your questions through the Social Security Administration toll free number, 1-800-772-1213.

Get free information about private management of your Medicare benefits. Learn more about Medicare Advantage PPO Plans. Need drug coverage? Medicare Part D in 2010 may be right for you!

Tags: affordable health insurance, medicare advantage plans, Medicare eligibility, Medicare enrollment, original medicare, Original Medicare Coverage
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The New Look Of Medicare Advantage Plans And Original Medicare

Friday, September 24th, 2010

The Centers for Medicare and Medicaid Solutions present positive aspects to an estimated one hundred million individuals, or about 1 in three Americans. Yet, the centers have not had a permanent chief executive since the tumble of 2006.

President Obama intends to nominate Harvard professor and Massachusetts pediatrician Donald Berwick, who’s recognized for his operate to improve patient care, to supervise Medicare and Medicaid. Berwick heads a nonprofit group for improving efficiency in health proper care. He’s the president and CEO of the Institute for Health care Improvement, a nonprofit group in Cambridge, Mass. The Institute functions to eradicate needless deaths, suffering, awaiting assist, and waste inside of wellbeing treatment systems around the globe.

Berwick can be a professor of pediatrics and health consideration policy at Harvard Medical School, as well as a professor of well being policy and management with the Harvard School of Public Health.

How Wellbeing Treatment Reform Impacts Medicare

The ultimate wellbeing proper care reform invoice didn’t consist of Medicare bonus cuts. It did not boost the share you shell out for physician office visits, hospital stays, prescription drugs, or some other healthcare therapy below Medicare.

The final monthly bill phased out what’s referred to as the doughnut hole. That is a gap in Medicare protection that leaves beneficiaries to pay complete value for prescriptions and premiums. Medicare beneficiaries who drop into the protection gap will receive a $250 rebate this year, and also a 50-percent low cost on brand-name drugs next calendar year. The percentage that beneficiaries shell out for prescriptions will reduce each yr until the hole in protection is removed.

Following that, Medicare beneficiaries will spend about 25 percent for his or her prescriptions soon after they’ve paid a deductible till they reach catastrophic coverage. Then, they will pay only 5 p.c, and can no lengthier must shell out full price for prescriptions besides during the deductible interval.

Health and fitness Treatment Reform Promotes Prevention

Parts of the reform laws are created to boost wellbeing proper care quality, and prevent the need for hospitalization by supporting preventive care. The monthly bill eliminates co-pays and deductibles for preventive consideration, and gives protection for yearly check-ups.

Hospitals may also acquire incentives to become sure people are ready to go residence when released, and to stop pointless readmissions. Medical doctors will probably be inspired to coordinate the care that individuals obtain from various professionals to do away with gaps in treatment.

Medicare Savings to extend Medicare Advantages by Almost a Decade

The health and fitness attention reform payment acquired more than $400 billion in Medicare financial savings over the next decade. Most of those savings end result from decreasing annual will increase in repayments to house health and fitness agencies, hospitals, and skilled nursing facilities. The annual enhance could be lowered by a productiveness issue to encourage providers to be additional effective.

A 1997 expenses reduced Medicare spending by more than the present health and fitness care reform, but Congress has handed expenses to moderate individuals 1997 cuts to Medicare. Congress could do the identical for the present health and fitness consideration reform provisions. While the present reform has no pay cuts for physicians, previous legislation did pass with spend cuts for health professionals which will take effect on April 1st of this 12 months, and within the years to appear.

Changes to Medicare Gain Plans

Medicare now will pay 14 percent additional per enrollee to personal Medicare Benefit plans than exactly the same proper care would price under unique Medicare. The ultimate wellbeing reform invoice brought these funds additional in keeping with unique Medicare. Medicare Benefit plans nonetheless need to offer coverage that’s as very good or better than genuine Medicare, and Medicare Supplement Options still cover gaps from the unique Medicare.

The expenses prevents Medicare Advantage strategies from charging greater than unique Medicare for particular solutions. It also needs Medicare Benefits plans to invest no less than 85 percent of taxpayer cash on medical services for users, rather than utilizing that money for marketing or preserving it as earnings. Users who see premium raises, or bonus reductions in their Medicare Gain programs can alter to another plan or unique Medicare.

The Congressional Spending budget Office (CBO) estimates that the mixture of Medicare savings, and elevated revenues from the monthly bill greater than pay back for coverage for the uninsured. As being a outcome, the CBO says the monthly bill will decrease the deficit more than the initial ten years as well as long-term to make Medicare offered to seniors retiring in coming many years.

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Tags: affordable health insurance, beneficiaries, medicaid, medicare, medicare advantage plans, minnesota, prevention
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Medicare Advantage 2010 Or Original Medicare: Making The Right Choice For You

Friday, September 3rd, 2010

What will it be for 2010, Original Medicare or an Advantage plan? Typically, the average person turning 65 and about to be enrolled into Medicare is unclear on just how to receive his or her benefits. Do you choose Original Medicare or one of the many private, Medicare Advantage plans? 2010 is a year of great financial change for many Medicare insurance companies due to the recent health insurance reform of the Obama administration. However, this will not affect the actual working of either traditional Medicare or the privately managed Advantage plans.

Medicare Advantage plans in 2010

The essential working of the plans, whether they are Medicare Advantage PPO plans, HMO plans, or private fee for service plans, remains largely the same as the Advantage plans in 2009. One significant difference for 2010 is that the costs premium and out-of-pocket costs appear to have generally increased from 2009, and that there are far few plans offering zero premium options, and more plans whose cost sharing more closely mirrors that of Original Medicare.

What are you getting when you join a 2010 Medicare Advantage plan? The Medicare program requires that the Advantage plans offer you the same core services that you receive in Original Medicare. However, the Advantage plans deliver your benefits according to their own policies and procedures. When you join an Advantage plan, that plan takes over management of all of your Medicare health benefits and become the only and single payer on your medical expenses. You are still in the Medicare program, but instead of the Federal government managing your benefits, the private, Advantage insurance takes over. The Advantage plans are not supplemental insurance and will never pay after Medicare. They pay instead of Medicare, and Original Medicare will never pay on charges while you are enrolled in a private plan.

Medicare Advantage PPO Plans and HMOs

Medicare Advantage PPO and HMO plans are in charge of all of your benefits. As mentioned above, that remains true for as long as you remain enrolled in such a plan. The health maintenance organization (HMO) is made up of a network of health care providers, and when you become a member, you are generally required to receive all of your care from within the network. Normally, if you go out of the network, you would pay the charges out of your own pocket. The only exception to that rule is if you need emergency or urgent care services. A PPO, or preferred provider organization, also includes a network of providers. However, the PPO allows you to receive services out-of-network from providers of your choosing as long as they agree to submit claims to the insurance company.

If you join a Medicare Advantage plan, can you still get drug coverage? The answer to that is a solid yes. In fact, most advantage plans include drug coverage, also generally known as Medicare Part D. In 2010, just as in 2009, if you need drug coverage and want to join an HMO or PPO, you must accept the drug coverage offered by the plan. However, if you join a private fee for service plan that does not include Part D, then you would be allowed to join a separate, stand-along prescription drug plan.

How do you know which kind of plan is best for you? That is tough question. In large part that depends on your understanding of your medical needs and knowing what would make you feel secure. Those able to afford the more expensive, private coverage may prefer to join the Advantage program. Generally speaking, Medicare beneficiaries requiring light to moderate health care are likely to have a better experience in an Advantage plan than those whose health care needs are more extreme. If you are thinking of joining a private plan, we advise giving careful consideration to your health care needs, your cost expectations, and then speaking with plan representatives to determine what is best for you.

Is a Medicare Advantage PPO plan the right choice? Find out today. Learn more about how health insurance works today!

Tags: affordable health insurance, medicare advantage hmo, medicare advantage plans, medicare advantage ppo, medicare health insurance, medicare health plans, original medicare
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Key Tips To Help You Know If You Qualify For Original Medicare Coverage

Thursday, August 12th, 2010

In the United States, health insurance might be broken down into two general categories–Medicare and non-Medicare private health coverage. Medicare is the government run, Federal health insurance program for people 65 years or older, disabled people who have worked the minimum number of years to qualify for Social Security Benefits, and people of any age who have End Stage Renal Disease (ESRD). All other insurance, with the exception of the Federal Employees Health Benefits program and Mail Handlers is private insurance.

What does Original Medicare coverage include? In short, the program provides a broad range of services through Part A and Part B. Part A helps cover inpatient services such as hospital inpatient stays, skilled nursing facility services, and home health care. Part B is your Medical insurance covering doctor visits, hospital outpatient services and surgery, medical supplies and equipment, and physical therapy.

So, how do you know if you eligible for Medicare? If you are a U.S. citizen or naturalized citizen and you fall into one of the categories above (65 or over, disabled, or have ESRD), you may be eligible for Medicare benefits. If you are unsure, the most certain way to determine your eligibility is to call the Social Security Administration (SSA) at 1-800-772-1213 between the hours of 7am and 7pm (in any time zone).

However, if you are already receiving Social Security Benefits prior to your 65th birthday, then you will be enrolled into Medicare Part A and Part B automatically. The way this works is that approximately 3 months before you turn 65, you will receive you initial enrollment packet that will include your Medicare card. If you want to enroll into both A and B, sign your card and keep it in a safe place. If you want to refuse Part B, simply sign the back of the card form that you receive, put an “x” in the box that says you are refusing Part B, and send the card back using the return envelope. After the SSA receives and notes your decision, you will receive a new card listing your enrollment into Part A, only.

Those of you nearing 65 and still working or simply choosing to put off receiving Social Security benefits will need to apply directly with the Social Security Administration. The time to do this is during the Initial Open Enrollment Period, which begins 3 months before your sixty-fifth birth day, and ends 3 months after the month of the sixty-fifth birthday.

More on Medicare, find out about Medicare Part D in 2010 and the truth about Medicare Advantage PPO plans.

Medicare Advantage Plans: Proposed Changes

Sunday, April 18th, 2010

Medicare Supplemental Insurance is not the sole Medicare-related coverage that may endure changes within the next few months due to the health care reforms proposed by President Obama. Medicare Part C Plans, commonly known as Medicare Advantage plans, may also be experiencing change.

Here is some background on Medicare Advantage Plans:

Medicare (Part C) Advantage Plans are Health Maintenance Organization (HMOs), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans, or Medicare Special Needs Plans . You must have Medicare Parts A and Part B to enroll in a Medicare Advantage plan, and you may need to pay a premium to your Medicare Advantage policy for the extra benefits that they provide. Advantage plans are privately operated. You may not be enrolled in a Medicare Advantage plan and a Medigap plan at the same time as they counter one another.

Current reports state that Medicare Advantage Plan payments to private health insurers will be limited to 2010 rates for the entirety of 2011. The proposed health care laws stipulate cuts amounting to $130 billion over the next ten years to these plans to prevent government overcompensation to insurance providers.

Seeing as next year’s payments cannot match rising health care costs, what may occur is that insurance companies will offset the loss of payment increases by increasing the premiums that their customers are required to pay.

Medicare Advantage Plans and drug plans additionally must have significant differences betwixt their products due to CMS regulation requiring elimination of duplicate prescription and health plans. These differences range from plan types, client out-of-pocket costs, premiums, and formulary offerings.

Beginning in 2014, Medicare Advantage Plans will need to spend 85% of insurance premiums collected on providing health care to their customers as another limiting factor to overcompensation of insurance executives.

Looking to find the best deal on a Medigap Plan, then visit www.gomedigap.com to find the best advice on a policy for you.

Tags: affordable health insurance, medicare, medicare advantage plans, medicare insurance, medicare part c, medicare part d, medicare supplement insurance, medicare supplement plans, Medicare supplement quotes, medicare supplemental insurance, Medigap plans
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Find The Best Medicare Supplement For You

Sunday, April 4th, 2010

Choosing your Medigap insurance policy can often seem complicated. Fortunately, there are many great resources for people who need to purchase this type of coverage.

Medigap (also known as Medicare supplemental insurance) is available to those that are eligible for Medicare coverage. However, there are some factors to consider that may be a bit confusing….

For instance, spouses must have separate policies when applying for Medigap coverage. This insurance is offered on a standard system of 12 different plans from which to choose, all ranging in coverage type and amount. Additionally, each of these policies are offered by many different private insurance companies, which gives you even more power in choosing the exact Medigap insurance coverage for your needs.

The way that supplemental insurance works is that you first choose the plan that suits your needs, based on the existing coverage that you have and what you want to change. Afterwards, you can comparison shop with the companies that sell Medigap insurance to determine which has the best rates and service for the plan that you need. All companies who sell supplemental Medicare coverage will offer all 12 plans, so you don’t need to worry about that. All you have to do is choose the one that you like best.

Your reasons for choosing a Medigap insurance provider are allowed to be whatever you want them to be. You can pick the one with the lowest rate, or the one with the best customer service. You can even pick a company just because you happen to like their website, if that’s what you choose. It’s all up to you.

The first step is determining what you need, and also what you can afford. Remember that your coverage will be different if you are healthy than if you have medical conditions or a constant need for visits to the doctor. Make sure that you are asking questions so that you understand everything very clearly before you make any decisions about what you’re going to do or which plan you want.

Medigap insurance providers and policies do not have to be complicated. If you take things one step at a time and allow yourself to figure things out and learn as you go, it can be a simple process. If all else fails, you can easily find a private insurance company that deals with this type of coverage and get their assistance in choosing the best insurance policy to cover the gaps in your Medicare insurance.

Want to find out more about Medigap, then visit Richard Cantu’s site on how to choose the best policy for your needs.

Tags: affordable health insurance, medicare advantage plans, medicare supplement insurance, medicare supplement plans, Medicare supplement quotes, Medicare supplemental insurance plans, medicare supplemental insurance quotes, medicare supplements, medigap, Medigap plans, Medigap quotes
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