To many average people, the Medicare world is abundantly frustrating and confusing.
Why is that?
There are several major reasons, but one has to do with the unique terminology that's used in the Medicare system.
Some people are passively familiar with the Medicare parts: part A, part B, part C, part D and part E.
Fewer people actually understand how these parts work together, because it's really counterintuitive and not what you would imagine when you start researching Medicare coverage.
Medicare Parts A and B … And Part C
Medicare parts A and B are pretty straightforward – part A is hospital or inpatient care, and part B covers outpatient care. Simple, right?
Medicare part C is where it gets a little strange, to put it mildly.
Medicare part C is also known as “Medicare Advantage.” It's a system where private insurers offer different types of Medicare plans that cover a wider array of services.
So Medicare part C or Medicare Advantage plans can include part A coverage, part B coverage, and even part D coverage. Huh?
Medicare Part D
Medicare Part D is also relatively straightforward in that part D is simply prescription drug coverage.
So Medicare part C or Advantage plans can cover prescription drugs, and then they include Medicare part D.
Years back, the government started talking about the “doughnut hole” or gap in coverage for Medicare part D, and promising to improve Medicare part D for seniors.
A big part of the problem, though, is that Americans didn't know what they were talking about. How does a part C include a parts A, B and D?
That just doesn't fit the lexical or semantic logic or the “logic of words” that we usually use in other areas of our lives.
In addition, Medicare part C plans can add dental hearing and other services to the Medicare part A and part B combination. After you know this, you can kind of squint at the rest of it and figure out how the “parts” are put together – but without this road map, the whole thing seems like “Greek” to someone who doesn’t work in the industry and know the jargon.
Using Your Knowledge
Now that you know this strange trick of the Medicare system, it's easier to evaluate how Medicare serves a senior citizen.
At Comprehensive Medicare Solutions, we help cut through this and many other language and structural issues around Medicare for America's elderly.
We help to deal with Medicare Advantage plans and other areas of the Medicare system. Contact us with questions and we will help make your journey to Medicare coverage successful.
Nearly 90% of the senior citizens in the United States are at risk of developing serious health conditions like high blood pressure. As you age, you will have to put more emphasis on staying healthy. There are so many things you can do to improve your overall level of health and wellness. If you have made a New Years’ resolution to get fit, you need to work hard to achieve your goals.
The longer you wait to get a grip on your health, the harder it will be to avoid deadly diseases. The following are some things you need to do to get healthy in 2021.
Use All of Your Medicare Advantage BenefitsAs most senior citizens know, having a comprehensive health insurance policy is imperative. One of the most popular insurance programs on the planet is Medicare. If you are paying a bit more to have a Medicare Advantage plan, you need to make sure you are getting your money’s worth. Most people fail to realize that Medicare Advantage policies have lots of perks.
For instance, Medicare Advantage plans have tons of health and wellness programs. These programs can provide you with a discount on a gym membership in your area. By going in and working out, you can get your body in top-notch shape this year.
These policies also cover vision and dental care. Fully utilizing your Medicare Advantage health insurance policy will allow you to keep your body in great shape for years to come. These policies allow you to get top-notch medical care without paying tons of money out of pocket. If you need help choosing a Medicare Advantage plan, contact the team at Comprehensive Medicare Solutions.
Make Healthy Changes To Your DietMost people eat a very unhealthy diet. If you are surviving on a steady supply of fast food and sugar-filled sodas, you have to make some changes. These unhealthy meals are horrible for your body, which is why you need to opt for cleaner and tastier dishes. Cooking more at home will allow you to eat healthily and save money.
Even if you are a novice in the kitchen, you can find some easy and delicious healthy recipes online. Trying new dishes is a great way to expand your horizons and find new things you love to consume.
Stay Connected With the Help of the Internet2020 was a very bad year for senior citizens in the world. Many seniors have been in quarantine for nearly a year due to the COVID-19 health pandemic. Rather than losing touch with friends and family members, you need to utilize the power of social media. Using popular social media platforms to connect with the people you love can help you stay mentally strong during this pandemic.
Find The Right Medicare Options With Our Help!Are you looking for affordable health insurance options in 2021? If so, Comprehensive Medicare Solutions can assist you in finding the right health insurance policy.
If you've done any research into the Medicare program, you've seen that Medicare Advantage plans help to augment the Medicare Part A and Part B provisions of traditional original Medicare plans.
But what do these plans really offer?
Aside from their impact on Part D drug pricing, Medicare Advantage plans are popular with seniors, because of the auxiliary services they help to fund.
Vision is something that many marketplace plans don't fully cover, and that's true with original Medicare as well. Medicare Advantage plans may well contribute to treatment for vision problems that occur as you get older. Without this kind of coverage, the care involved in treating poor vision (glasses, contact lenses, etc.) can get expensive – and it’s not as if your vision is something you don’t need! For better safety on the road and much more, seniors need to anticipate the need for vision care. That is one aspect of how a Medicare Advantage plan may help.
Dental is another type of independent healthcare coverage that is difficult to cover with some traditional Medicare strategies. Likewise, it's often not offered by employers prior to retirement. That's a problem, because people's teeth tend to get worse as they age.
Too many Americans are unable to pay for modern dental care, and have to resort to tooth extraction, where with better coverage, they would have been able to keep more teeth in their mouth. Medicare Advantage plans can help with dental coverage or the cost of dental work.
Many of America's seniors end up needing hearing aids or other assistance with auditory issues. This is another item where a Medicare Advantage plan may offer some assistance. Ask professional Medicare consultants about how this type of coverage may work by adding to an original Medicare plan.
Health and Wellness Programs
These types of preventative care are often offered by employers, but when people retire, they find themselves without this kind of assistance. This is something to ask a Medicare Advantage plan professional about when you're putting a plan together.
We all know that in this day and age, emergency care has become extremely expensive. Medicare Advantage plans may contemplate this and help out with the traditional Medicare coverage of things like a trip to the ER in an ambulance.
For more on Medicare in Nevada, talk to Comprehensive Medicare Solutions about fine-tuning your coverage and protection as you age.
Some people just don't deal that well with deadlines. In fact, that describes more than a few people.
When we're facing large planning deadlines in our lives, we like to know about them. We like to have a little heads up and a little leeway to change our planning over time. That helps, especially if we are prone to procrastination or not the type to rush from day to day making snap decisions.
With that in mind, the age of 65 and a person's transitioning to senior status is kind of a rude awakening for a lot of us.
It might be great to get your AARP card and get 10% off a cup of coffee, but you have big life decisions to make, and if you're not prepared, that can be intimidating or annoying, or even make you lose some sleep at night.
As a newly minted American senior, it's on you to sign up for the government program known as Medicare that will help you to make sure you have access to medical services as you age.
The majority of Americans consider this a monumental piece of progress in American law and policy. Without Medicare, how would America's seniors navigate the insanely expensive markets of our healthcare sector?
But that means that after your 65th birthday, the clock starts ticking, and you need to figure out how to get adequately enrolled. That makes some people nervous – but you don’t really want to put this off or avoid it, because it’s a big deal.
It's an unfortunate reality that the medical system has become so complex and expensive that most seniors need supplemental coverage in addition to basic Medicare.
Medicare will usually end up paying the majority of balances, but the supplemental insurance will come in to cover deductibles and other exclusions.
This, however, makes many seniors groan when they figure out that they need to not only enroll for Medicare, but choose a supplemental plan, too. It just seems like an unfair amount of work.
Personal and Local Support
At Comprehensive Medicare Solutions, we are here to help you make the decisions that will determine the quality of life of your golden years.
With personalized assessments, we will put together a tailored explanation of benefits and make sure that you understand where you're at when it comes to your medical coverage. We also offer support with an eye for local rules and community realities. Get assistance from a firm that knows about Medicare – and cares!
In the past few months, Americans have put a renewed focus on staying healthy. Getting quality medical care when you are sick can be extremely expensive. If you are one of the 27 million individuals who are uninsured in the United States, paying for medical care can be a financial nightmare. As you enter your retirement years, the medical care you need to remain healthy will increase substantially.
The only way to avoid financial ruin caused by overdue medical bills is by investing in a great health insurance policy. For years, seniors have relied on the Medicare to meet their health insurance needs. If you are attempting to navigate your way through the world of health insurance policies, check out the helpful information below.
Get details about the network coverage provided over the years, you and your primary care physician will develop a great relationship. When the time comes to select a Medicare plan, you need to focus on the details of each option. The Medicare policies at your disposal will have very specific guidelines regarding the medical procedures and doctors in their network. When going to these approved doctors, you will only have to meet your minimum co-pay.
If you go out of the network for medical care, the bulk of the cost will be your responsibility. This is why you need to make sure the Medicare policy you are considering has your doctor in their network. Paying a bit more for a wider network of doctors will be worth it. With this wider network, you will have coverage for a wider range of procedures.
Consider Your Budget as retirement approaches, many individuals focus on downsizing their lifestyles. Reducing the amount of possessions and property you are financially responsible for can be a great weight off of your shoulders. Most seniors have a firm budget they abide by to avoid financial hardships. One of the main things you will notice about the different Medicare policy options is the price.
Some policies have lower monthly premiums but higher deductibles. While these policies will save you money monthly, they can actually cost you more money in the long run. This is why you need to find a policy that offers the right mix of value and coverage. Allowing professionals familiar with Medicare to help you with the policy selection process can help you avoid making expensive mistakes.
Assess Your Future Medical Needs the older you get, the harder it will be to keep your body completely functional without some type of medication. If you are already on a number of medications, you need to assess what the cost of these prescriptions will be on a particular Medicare policy. Having detailed information about your medical history and future health concerns can make choosing the right Medicare policy much easier.
We Can Help You Choose the Right Medicare OptionAre you unsure about how to choose the right Medicare policy? If so, contact the professionals at Comprehensive Medicare Solutions for help.
Last year, Medicare benefits paid out over $688 billion. Millions of senior citizens in the United States rely on Medicare to get the medical attention they need. Many plans also offer preventative care and free yearly physicals. If you are in the market for a new health insurance plan, you need to check out all of the options Medicare has to offer.
Working with professionals who have intimate knowledge of how Medicare works and how to get the best deal on a new policy is a wise move. Trying to make this decision without this guidance can lead to the wrong policy being selected. Once you have the right Medicare policy, you need to work hard to get the most out of it. The following are some ways you can accomplish this goal.
Selecting the Right Doctor Isn’t EasyGetting quality medical care is only possible if you work with a knowledgeable and passionate doctor. Most people are surprised to learn just how many doctors are located in their general area. The first step in getting the absolute most out of your Medicare insurance policy is finding the right doctor. While this may sound like an easy process, it is anything but.
Narrowing down the selection of medical professionals in your area can be easy if you look at your Medicare policy’s network coverage. Looking at the list of doctors in your area that takes Medicare insurance is just the first step. You also need to consider what the doctor in question specializes in and how well they have performed for other patients in the past. Asking friends or family members in your same age group about which doctors they use is a great way to make this process easier.
Get Familiar With Your Medicare BenefitsOnce you select a Medicare policy you can afford, take some time to get familiar with what it covers. Many Medicare policies provide seniors with tons of extra benefits. These benefits typically include things like:
Figure Out How to Avoid Surprise Medical BillsThere is nothing as frustrating as receiving an astronomical medical bill for a procedure you thought you were covered for. It is your responsibility to find out what your Medicare policy covers and how much out of pocket costs you have to contend with annually. By getting this information, you can set an accurate and detailed budget for your medical expenses. Failing to get familiar with your coverage can result in tons of overdue medical bills and higher levels of stress.
Start Using Your Medicare Coverage Today!
Do you need help finding the right Medicare policy? If so, it is time to contact the professionals at Comprehensive Medicare Solutions.
What's the worst thing about turning 65?
For some people, it's having to navigate the wild and weird world of Medicare for the first time. It can be daunting, frustrating, and abundantly confusing. Maybe you’ll have more questions than answers. It’s not something that a lot of people find fun to deal with.
To be fair, while most seniors have no idea what’s “in” Medicare until they start to head toward that magical age, others have been dealing with Medicare for a while. If you’re a caregiver or family member helping an elderly person, or someone who works in the insurance industry, you've seen the Medicare nightmare up close and personal.
The alphabet soup and confusion around Medicare health coverage is, by many accounts, pretty insane. As a government program, this model has endured for many decades, but as a bureaucracy, its language is a frustrating language of inside baseball jargon and overcomplex representation (what is a DMEPOS fee schedule??). That makes it harder for the end customers, America's seniors, to figure out what they're getting when they go on Medicaid at the age of 65.
These are supposed to be your golden years. They're not supposed to be a time when you have to learn a whole new insurance landscape, and basically become your own medicolegal accountant. People just don't have the stamina to dig into these details, which are well beyond what any of us learned in high school or even beyond. In some ways, the landscape of Medicare is actually deliberately obfuscated, or at least it seems that way to a great number of people.
We're here to help with Medicare from our offices in Las Vegas, NV area. We help seniors pick out supplemental plans and navigate this government program well. That takes particular attention to detail and dedication to listening to our customers and figuring out their unique situations. We have what it takes to make Medicare “not scary!” Get access to resources and get questions answered on our web site. We have coverage sheets, data on sign-ups, and more along with our trained staff who are ready to help you take the first step and every step after that.
Our philosophy of personalized needs assessment and tailored explanation of benefits means putting Medicare to work for you. Everyone is different and has different needs – we can help you to sort through Medicare Advantage and supplements plans and come out with the right solution. Call us and we will help to get you started.
If you've been following along with our series, you're now experts in Original Medicare. You now that Original Medicare is composed of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
Alone, they cover your Medicare covered medical expenses at 80-20 coinsurance split, but only after the deductible has been met. This is good enough coverage for a small group of individuals, but for those who need help with prescription coverage and want more comprehensive medical coverage, Original Medicare just isn't enough.
You need to be enrolled, or be enrolling into BOTH Medicare Part A and Medicare Part B to be eligible for any Medicare Advantage Plan or Medigap Policy..
When you hear the term "Part C" being mentioned, know that the conversation is about Medicare Advantage Plans. Medicare Advantage Plans are often mentioned as Part C because they take the place of Original Medicare; Medicare Advantage encompasses both Medicare Part A and Medicare Part B in one plan, usually with added benefits like vision or dental.
Medicare Advantage Plans can come in multiple forms. In Nevada they are:
How Does Medicare Advantage Cost So Little?
Medicare Advantage Plans are provided by private insurers, and take the place of Medicare. What happens is that Medicare pays participating private insurers a set dollar amount to take medical responsibility for beneficiaries. This is good for Medicare, as it is a much more efficient way to manage care, and this is good for beneficiaries because private insurers can usually offer much more benefits than what Original Medicare is can cover.
Be aware that under a Medicare Advantage Plan, you are going to be required to get services and supplies from a set network of providers.
What do Medicare Advantage Plans cover?
Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you're in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you're always covered for emergency and urgently needed care.
Extra services that may be covered under Medicare Advantage Plans in Nevada include:
Medicare Advantage Plans typically work off of copayments to protect the Medicare beneficiary from financial hardship, and many of those copays can be as low as zero dollars. They also offer there members a maximum out-of-pocket to protect them from overly expensive medical expenses. Meaning that once a member reaches a certain dollar amount with regards to their medical expenses, they would no longer pay medical for the rest of the plan year.
This is a much more affordable option to Original Medicare, as Original Medicare does not offer any stop loss protection.
Comprehensive Medicare Solutions contracts with all the major insurance carriers in Nevada and can help any beneficiary with their insurance decision. Our advisors work with clients on a one-on-one basis to help them find the best tailored plan option for their needs. Reach out to one of our Comprehensive Medicare Solution Advisors if you are interested in learning more any Medicare Advantage Plan in Nevada.
At Comprehensive Medicare Solutions, we help our clients to navigate the complex medical environment of the Medicare federal healthcare program. We understand the kinds of assistance that individuals and businesses need in working with the Medicare system and its unique complexities and idiosyncrasies.
One of the best ways to understand the complexity and frustrating alphabet soup in the Medicare world is to read Medicare transmittals. These routine bulletins are put out by the Centers for Medicaid Services (CMS) routinely as a way to instruct whoever is working with Medicare, in a practical sense, about changes.
Read through some of these broadsides and you'll see a lot of things about National Coverage Determinations (NCDs) or FFS (Fee for Service) or MACs (Medicare Administrative Contractors) – long and confusing acronyms that have to do with elements of Medicare services like a regional auditor or a particular technology tool, or someone with a specialized role or responsibility. It's bad enough that there are so many of these fancy names, but when they're made into acronyms, it's even harder to understand what's being talked about. What’s a module developer? What does CMS do with MLN? How does the file get updated?
You also see a lot of multistage instructions without a lot of contacts. Sometimes there are specific step-by-step processes that one of the stakeholders has to follow, and it's easy to get lost in the weeds, because all of these steps are listed without really explaining the background. In many cases, it's too complicated to be easily included in every communication, so CMS just assumes a level of familiarity.
Medicare is a bureaucracy. Some people would say it's the quintessential bureaucracy. Reading through these transmittals sometimes feels like reading legal poetry of the stream of consciousness variety.
How do you understand something that changes so much and has so many moving parts? The Medicare world is a world unto itself, and understanding it takes a great deal of tenacity and patience.
We have the expertise to help guide clients through Medicare advantage plans, Medicare supplemental coverage and Medicare drug price plans. We'll show you why some options are better than others, and what you can expect from a given plan, as well as how to work with the Medicare system, instead of just eyeing it warily from a distance. Talk to Comprehensive Medicare Solutions in southern Nevada about how to tackle all of the practical aspects of working with Medicare, and tell us about your goals. We’ll help you to get there.
Why is Medicare Part B so important?..
If you have been following our series, you know what Medicare Part A is, and know what it does and does not cover. We mentioned that Medicare Part A is part of Original Medicare, and Original Medicare has two parts. Those parts are Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
Medicare Part B (medical insurance) is a valuable asset and is available for beneficiary enrollment during the first 3 months before the beneficiaries birth month, the beneficiaries birth month, and 3 months after the beneficiaries birth month. If you ever wanted to enroll in a Medicare Advantage Plan or Medigap policy, you are going to need to have both Medicare Part's A and B.
Medicare Part B covers beneficiaries with 2 types of services:
Typically, Part B will cover things like:
Medicare Part B needs to be applied for. It's not like Part A..
Unlike Medicare Part A, where majority of Americans get automatically by paying taxes to Medicare for 40 quarters (10 years), Medicare Part B needs to be applied for.
Some beneficiaries will automatically qualify for Medicare Part B, but the majority will need to sign up for Part B. Those that want to know how to apply for Part B can apply here.
There is a late enrollment penalty if you choose to not enroll into Medicare Part B during your initial enrollment period
Part B does have a premium, but it is a standardized premium set by Medicare. It does not vary from state-to-state, but it does vary based on income. When applying during your 7 month for your Part B benefits, premiums will be deducted automatically from one of these:
The standard Part B premium amount in 2020 is $144.60. Most people will pay the standard premium amount, but like mentioned earlier, if your income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). Medicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago.
Some individuals may qualify for state funded assistance in the form of Medicaid or other, and typically will have some or all of their Part B premium.
Social Security can help determine if you qualify for extra help.
For those who don't know, and think that Original Medicare is sufficient enough insurance for there medical needs, there is a deductible and coinsurance responsibility to the beneficiary. In 2020, the Part B deductible was $198, and is subject to benefit periods. After the beneficiary met there deductible for the year, they are then responsible to pay 20% coinsurance of the Medicare-approved amount for:
Most individuals find themselves in a scenario where Original Medicare doesn't cover enough and it becomes too expensive to go to the doctor. It also doesn't cover prescription drugs. This is when beneficiaries decide to consider Medicare Advantage Plans or Medigap Policies. These plans help fill the gaps where Medicare leaves off, and they also offer this coverage at a much more affordable rate.
Our team of experts can help you get started in the initial phase of getting Part B and finding the right coverage that fits your specific needs. Feel free to reach out to us any time for question.