Part of our four part series about: Original Medicare, Medigap Policies, and Medicare Advantage Plans
Medicare Part A, also known as hospital insurance, is part of Original Medicare. Original Medicare consists of two parts: Medicare Part A and Medicare Part B (Part B will be covered in a later post).
Medicare Part A Covers:
Click on medicare.gov website to take advantage of that tool.
Medicare Coverage is Based on 3 Main Factors:
There are services Medicare Part A doesn't cover
Medicare Part A does not cover physician visits, physical therapy, speech therapy, occupational therapy, and durable medical equipment.
With ONLY Medicare Part A, you do not qualify for any type of Medicare Advantage Plan or Medigap Policy.
If you only have Medicare Part A (hospital insurance), you can still qualify for a Stand Alone Prescription Drug Plan. Great news about that is that you can still get help with the cost of your medication through a private insurer. Locally in the Southern Nevada Valley, there are many options available to individuals to enroll into a Stand Alone Prescription Drug Plan.
If you are an individual that wants to know more about what Medicare Part A does and does not cover, please feel free to contact one of our agents here at Comprehensive Medicare Solutions. We can give you resources on what kind of coverage is available to you, and we can help guide in the direction on how to enroll into Medicare Part's A or Part B, Stand Alone Prescription Drug Plans, Medicare Advantage Plans, or a Medigap (Supplement) Policies.
Information about Medicare Part B, Medicare Advantage Plans, and Medigap (Supplement) Policies in further series..
Surprise! Medicare Advantage Plans are not free.
When it comes time for folks start looking for plans, they get shocked when they see some Medicare Advantage Plans that have $0 premiums. A lot of questions get asked behind those zero premium costs, and the "It's too good to be true" mentality sets in. The reality is that it is real, it's not a trick. It's a great thing for members to see, but it's also important for them to understand why carriers are able to offer plans with no premium.
Medicare Advantage Plans, also known as Medicare "Part C" or "MA Plans", are offered by private insurance companies that take over the care of Medicare beneficiaries. Each private insurance company that offers Medicare Advantage Plans must follow the rules set by Medicare to insure complainant care for its beneficiaries. By joining a Medicare Advantage Plan you still retain your Medicare Part's A and B, but the difference is that you go to approved physicians and facilities for care, unlike Original Medicare. The benefit of this is that copays are much lower than Original Medicare.
Through the agreement that the private insurance carriers and Medicare agree upon, Medicare will pay a fixed amount for members coverage each month based on the average cost of medical expense typically filed in the service area. These companies must follow Medicare’s coverage rules to be eligible for participation, and Medicare Advantage Plans have yearly contracts with Medicare that must be filed before the Annual Election Period (AEP) for that specific year. The plan must notify you about any changes before the start of the next enrollment year.
Medicare pays private Insurance carriers an agreed amount to provide care for Medicare Beneficiaries
Medicare would never contract with private insurance companies if it was not in the best interest of the Medicare beneficiary. Medicare Advantage plans have many benefits that Original Medicare does not, and in many cases provide a more affordable way to receive care.
Check with your local Advisor to see what Medicare Advantage Plans are available in the area.
No denying to anyone, mental health is important. During these times, it's more important now than ever. What could be some big triggers of stress? Well, it could be the Covid-19 Pandemic or it could be the protests/riots that have been spotting up all around the world this last week.
Whatever the case may be, it's so important now that Medicare beneficiaries get the mental health care they need. Mental health disorders affect about 20% of older adults in the U.S., according to the Centers for Disease Control and Prevention (CDC). Unfortunately, nearly one in three of those seniors does not receive treatment.
Some Good News!
Those of you that are on a Medicare Advantage plan, you have mental health resources available to you. At least in Southern Nevada, it may differ if you are on another states Medicare Advantage plan.
The unfortunate side effect to having poor mental health is that it can lead to diseases like:
As Advisors, we always tell our members to take advantage of their benefits. If you have mental health resources available in your plan details, why don't you use it?
There's no shame in worrying about mental health. It's actually an important component to being healthy.
So do yourself a favor, if you're feeling anxiety please reach out to a professional. It might do you some good to speak out what's on your mind.
You can find out what mental health benefits are provided by calling the number on the back of your insurance card; and if your insurance carrier doesn't have what you're looking for, reach out to Comprehensive Medicare Solutions.
We deal with ever carrier in Southern Nevada, and we can help you with any Medicare question you may have.
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The decision Medicare Beneficiaries must make when it comes to picking an insurance, do I go with Medigap or Medicare Advantage? Now both types of policies have great benefits, but it is ultimately up to the member to determine what features they're looking for when it comes to a new policy.
Are You Looking For Affordability or Portability?
What is a Medigap Policy?
About two-thirds of the 61 million seniors and disabled Medicare beneficiaries choose traditional Medicare, Parts A and B, which cover hospitals, doctors, and medical procedures. About 80% of these beneficiaries supplement their insurance with Medigap (Medicare Supplement) insurance, Medicaid, employer-sponsored insurance, and/or stand-alone Medicare Part D prescription drug policies.
Medicare Supplement insurance plans are provided by private insurers and are not connected/endorsed in any way by the United States Government. Instead, Medicare funds Medicare plans to provide benefits.
Traditionally, Medicare Supplement Plans are the more expensive options when it comes to picking a plan, but it has some amazing features. When you have a Medigap plan to supplement your Original Medicare, you are covered for any hospital or doctor visit/procedure in the United States that accepts Medicare. These means that you can travel anywhere across the U.S. for medical services. You do not need a referral for services. a Medigap (Supplement) Policy is great for someone who travels a lot or that has specific providers they see that are in different states.
What is a Medicare Advantage Plan?
Available from private, Medicare-approved insurance companies. Medicare Advantage Plans are labeled under (Part C) and include all of Medicare Part A, Medicare Part B, and in some cases even include Prescription Drug Benefits (Part D).
In Southern Nevada, Medicare Advantage Plans are marketed and provide by Major Insurance Carriers. Local, they may have no premium or a lower one compared to the significant premiums for Medigap and prescription drug insurance policies. Just like Medigap Policies, Medicare Advantage plans cover hospital and doctor visits/procedures, but with little to no copays. In most instances they include prescription drug coverage and they also cover many services that are not covered by Medicare.
Locally, Medicare Advantage plans operate at HMO's or PPO's. A little more than one-third of Medicare beneficiaries choose one of these plans.
Medicare Advantage Plans require its members to stay in network when receiving care. If they choose to elect services out of network or without a referral, the member would be subject to 100% of the cost of the service. It's important to be aware of this when considering a Medicare Advantage Plan, but typically when members receive care within network, they are responsible too little or no copay's for services. This is why Medicare Advantage Plans are so appealing, they have little to no out-of-pocket expenses.
Ultimately, It Is A Big Decision When Figuring Out What Type of Medicare Policy Is Right For You
Good news is that there are many reasons why a person could change their plan. Take the time and evaluate your needs, then get in contact with Comprehensive Medicare Solutions. We are contracted with every major insurance carrier in Southern Nevada and are happy to help Medicare Beneficiaries find the right plan that fits their needs.
Feel free to contact us at any time. Click here to leave us a message or call us
One In Every 3 Medicare Beneficiaries Has Diabetes
In the United States, 3.3 million Medicare beneficiaries use one or more of the common forms of insulin. For many of them, insulin is critical for their health management. Unfortunately, the costs of insulin can be too much to afford and leaves beneficiaries to go without treating their condition.
According to cms.gov, the Centers for Medicare & Medicaid Services (CMS) announced that over 1,750 standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs through the Part D Senior Savings Model for the 2021 plan year.
What this means to Medicare beneficiaries is that access to a insulins will be at much predictable cost rather than subject to a percentage projection. Beneficiaries will have access to a broad set of insulins at a maximum of $35 copay for a month. Typically individuals that take insulin would be subject to the coverage gap sometime during the year and would be responsible for 25% of the cost of their insulin at that point. What will happen starting the 2021 plan year, is that insulin will no longer be subject to the coverage gap and instead will be at the predictable cost of no more than $35 for the whole year.
Sited by the Centers for Medicare and Medicaid Services, for the first time, CMS is enabling and encouraging Part D plans to offer fixed, predictable copays for beneficiaries rather than leaving seniors paying 25 percent of the drug’s cost in the coverage gap. Both manufacturers and Part D sponsors responded to this market-based solution in force and seniors that use insulin will reap the benefits.
Individuals taking insulin could see an average savings of $466, or 66%
It is anticipated that beneficiaries will have Part D and Medicare Advantage Plan options in all 50 states that will provide this benefit. Beneficiaries will be able to enroll during Medicare open enrollment, which is from October 15, 2020 through December 7, 2020, for Part D coverage that begins on January 1, 2021.
Plan benefits will not be available for any 2021 Medicare plan until October 2020, but when it comes to that time, please feel free to reach out to us. We are contracted with every single plan in Southern Nevada and will be more than happy to discuss any changes to your existing plan or any other plan that you are interested in.
Give us a call or send us a message, we give unbiased answers to your Medicare questions.
In the last couple of months, U.S. healthcare providers nationwide have began ramping up telehealth solutions in order to continue serving patients despite lockdowns and stay at home orders. According to a new survey from Updox, the place for virtual care and complete healthcare communications, conducted online by The Harris Poll among more than 2,000 U.S. adults aged 18+, nearly half of Americans (42%) have reported using Telehealth services since the pandemic first began. The survey shines light on consumer preferences of telehealth both now and post-COVID.
According to the survey, 65% say telehealth visits are more convenient than in-office appointments, and 63% say they don’t have to worry about being exposed to other potentially sick patients.
Americans who like using Telehealth services also like it because it’s easier to schedule an appointment via Telehealth than an in-office appt (44%), and because follow-ups/communications post-appointment are more streamlined (38%).
This Doesn't Mean The End of Face-To-Face Appointments
It's important to understand that after stay at home orders are lifted and we work on returning to regular life, we will have to make some changes. Healthcare providers understand this and it is expected that Telehealth will rise substantially by the year 2025.
Traditional doctor visits will not go away, preventative care will not change. What will change is the ease of seeing and making a doctors appointment. The future is bright and the healthcare system will not go away.
All Major Medicare Plans in Southern Nevada Offer Some Form of Telehealth for Members
Contact your healthcare provider to see how they conduct virtual visits. There are options for you, don't let stay-at-home orders keep you from receiving care.
Why is it important to be active?
According to the U.S. Department of Health and Human Services, "Physical activity can provide immediate benefits. Physical activity can help to boost your mood, reduce stress, improve sleep, and sharpen your focus — benefits that can be especially important during stressful times. Physical activity can also help you live a longer, healthier life by reducing the risk of many common chronic diseases, like type 2 diabetes and some cancers." Click here to learn more.
It's understandable right now that many Americans may feel that they aren't able to workout or be as active as before due to social distancing orders are still in place. This is further from the truth.
According to the Physical Activity Guidelines for Americans, adults need a mix of activities to stay healthy, including at least:
Take a few minutes to figure out how to add physical activity to your life. Find something you enjoy, such as jogging or running, dancing, or playing sports.
If these are things you are unable to do, Medicare Insurance carriers in the Southern Nevada Valley do provide other options.
Almost every Medicare Advantage Plan in Nevada offers there members at-home workout kits for them to use during social distancing.
These complimentary kits to members include:
Stress Under a Pandemic is Justified
The continued news of Covid-19 is stressful and causes strong emotions among both adults and children. Fear and anxiety of the uncertain tomorrow is something we are all facing. Some days it may feel like we are never going to go back to regular life, others feel like the world is collapsing on itself. This is normal and most of the population feels this way. The world is not going to end, and there is a light at the end of this "Covid Tunnel". The CDC has provided ways you and your family can reduce the stress of uncertainty in the following ways.
Stress during an infectious disease outbreak can include:
According to the CDC, individuals who may respond more strongly to the stress of this crisis would be our Medicare clients. this is due to the face that those who are older and with chronic disease are at higher risk for severe illness from Covid-19.
It's recommended that you take care of yourself during this time. Ways to cope with stress:
Feeling The Need To Speak To Someone For Advice?
In addition to these resources, Google (in partnership with the CDC, White House, and FEMA) have created an online self-assessment tool for anyone to see if they should pursue care from a professional or if they should self-isolate at home.
You can take the assessment by clicking here
Everyday we speak to new and existing clients about questions and concerns they may have when choosing a new Medicare insurance policy. From first hand experience, let us tell you, there is no one size fits all insurance policy that will satisfy every Medicare beneficiary in Southern Nevada.
Before Deciding on a Medicare Policy, Make Sure You Check Off These Questions:
If you aren't already speaking with an Advisor, and it's coming time to choosing a plan, please reach out to us by clicking here.
Our Experts Have Heard it All, Some of the Most Common Questions We Hear Are:
Comprehensive Medicare Solutions are experts in Southern Nevada and are contracted with every insurance carrier in the area. We are an unbiased source to finding the information you need. If you are a loved one are looking to learn more about Medicare in Southern Nevada, please reach out to us for an unbiased response. Our team has been helping Medicare Beneficiaries for over 20+ years, let our experience be your resource.
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There's no reason you should find yourself unable to find the insurance coverage that you need. We have experts available Monday-Friday, 8am-5pm to answer any questions that you may have about Medicare, and what it covers. We deal with every plan in Southern Nevada, and are the experts when it comes to benefits. As of right now, the Annual Election Period is over, but that doesn't mean that you can't find out if you qualify for a Medicare Plan due to a life changing event.
Life Changing Events That Qualify Me for Medicare Insurance
In the state of Nevada, there are many life changing events that will qualify an individual to be eligible for Medicare Insurance throughout the year. Some of these include:
There are Many reasons why one might be able to enroll into a Medicare plan throughout the year. These are just a few reasons. If you would like to know if you qualify for a Medicare plan, or just have general questions regarding coverage, pease give us a call. We have experts ready to help.
call us at: (702) 550-3909 or leave us a message here