Tag Archives: medicare supplements

Medicare and Home Health Care Coverage Change

April 28, 2017 David Higgs

Many of my Medicare clients ask if Medicare covers home health care. The short answer is yes, but it has some restrictions. In the past, one of those restrictions was that the patient’s medical condition would be expected to improve as a result of the home health care. As a result, that meant that many beneficiaries who have a permanent condition would not be eligible for home health care coverage because their situation was “permanent”.

This restriction has recently been modified to include beneficiaries whose condition would not improve, but would also not worsen. Beneficiaries who have a condition that can be maintained so that it does not get worse can now be eligible for home health care under Medicare. There are other restrictions and you can read more about how Medicare covers home health care at the following link to Medicare’s website at: https://www.medicare.gov/coverage/home-health-services.html

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare. He can be reached at email: David@ChoicesInMedicare.com or go to website: www.ChoicesInMedicare.com

Medicare Card Numbers Still Changing

March 29, 2017 David Higgs

You may recall a few years ago when the government announced they were prohibiting insurance companies to continue using social security numbers as ID numbers. However, it you look at your Medicare ID card, the government is the last entity to continue using social security numbers for identification. As I previously reported, this will end but the process is taking a while. The latest info I have seen is that new Medicare cards will be going out next year in April and should be completed by the following April in 2019. If you want to read more about this, a recent article is linked here: http://www.modernhealthcare.com/article/20170322/NEWS/170329971

Continue to protect your Medicare card and only use when absolutely necessary. For those who have a Part C, Medicare Advantage Plan, remember that you should not show your Medicare card to any provider or pharmacy. Only show your Medicare Advantage Plan card. For those who have a Medicare Supplement Plan, they will continue to show their Medicare card and their Supplement Plan card to providers.

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan. I don’t charge any fees nor increase your cost.

Medicare Eligible Seniors Who Also Have an ACA Plan Should Consider Their Options.

February 2, 2017 David Higgs

Seniors who either already have Medicare or who will soon become eligible for Medicare and also have an ACA Health Plan (aka “Obamacare Plan”), should carefully consider their coverages. This creates a lot of confusion for seniors in this situation as there is no single source to confirm what they should do. In general, having both will duplicate coverage and be more expensive than just having a Medicare Supplement or Advantage Plan. A recent article that describes some of the issues is linked below.

http://khn.org/news/officials-warn-some-older-marketplace-customers-to-switch-to-medicare/

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan. I don’t charge any fees nor increase your cost.

New 2017 Medicare Costs at a Glance

January 3, 2017 David Higgs

With the hectic Medicare Open Enrollment period ended, I wanted to post the key, new Medicare numbers that will be in effect for 2017. These are the key changes to Medicare’s premiums and coverages. As I predicted, CMS did not increase the Part B premium as initially indicated and came in just under a 10% increase.

Part A deductible – Will be $1316 up from $1288 (per 60 day Benefit Stay)
Part B Deductible – Will be $183 up from $166 (Annual deductible)
Part B Premium – Will be $134.00 up from $121.80 (Will not apply to existing 2016 beneficiaries who have it taken out of Social Security)
Part D Maximum Deductible – Will be $400 up from $360 (Some plans don’t have a deductible)
Part D Premium National Average – Will be $35.63 up from $34.10 (Is used to determine Part D Penalty)

Feel free to contact me if you have any questions or need assistance with selecting a Medicare Plan. I don’t charge any fees nor increase your cost.

Medicare Part B Premium Increase for 2017

September 8, 2016 David Higgs

The latest news on Medicare Part B 2017 premium increase is “stay tuned”. Congress is still working on this and the final determination won’t come until October 1st at the earliest. Like last year, there is a strong possibility that the “Hold Harmless” provision will protect existing Medicare beneficiaries who have their Part B premiums deducted from their Social Security check. That will leave the others to take a larger load of the increase.

While a 22% increase is being discussed, my guess is it will be negotiated down like last year. I will keep readers apprised. If you want to read more on this, I have linked an article here: http://www.miamiherald.com/news/business/article100185427.html

If you have questions about Medicare, call me, with no cost or obligation. This is what I do and enjoy it.

When Should You Enroll in Medicare? You Might be Surprised.

August 5, 2016 David Higgs

One of the most common questions (concerns) when I first speak with my clients is regarding if and when they must enroll in Medicare Part B. This arises as they either read about it, heard it from a friend or received correspondence stating they “had” to enroll but gave no clarifications. I also find many should have enrolled and did not know they needed to enroll. There are several key clarifications.

In short, people who become eligible for Medicare while they are working and on their employer’s health plan (or spouse’s) do not “need” to enroll in Medicare if they work for a company with 20 or more employees. If they work for a company with less than 20 employees, they do need to enroll in Medicare because it will be considered primary coverage to their small company’s health plan. Confused yet?

Regardless of whether or not they need to enroll in Medicare Parts A and B, the first thing I help prospective clients with, is to determine if they should stay on their company’s health plan or move to Medicare. This involves comparing the incremental cost to move from the employer plan to Medicare coverages. In most cases, Medicare coverages (including supplemental) is richer coverage than most employer plans.

A recent article just noted that over 750,000 Medicare beneficiaries have made the mistake of not enrolling when they should have and will be paying penalties averaging 30% for the rest of their lives. As a result of complaints, Congress is considering legislation to help address this problem. What is also interesting, is this figure does not talk about the number of beneficiaries who do enroll in Medicare needlessly and are spending potentially thousands of unnecessary dollars. If you want to read more about this, you can follow the link to the article: http://www.philly.com/philly/health/20160803_How_to_save_big_on_Medicare__Know_when_to_sign_up.html

If you have questions about Medicare, call me, with no cost or obligation. This is what I do and enjoy it.

Medicare Beneficiaries Should Get in the Habit of Asking

June 21, 2016 David Higgs

Another constant reminder I recommend all my Medicare clients do is to always ask about prescription alternatives. A recent study showed that doctors are easily influenced by drug company reps in what they should prescribe. In many cases, these prescriptions are for costly Brand name drugs in which there is a lower cost alternative. The study found that in many cases, a $12 complimentary meal to the doctor could end up costing patients hundreds of dollars more than the cost of a suitable equivalent. I am not against the free market and how a company chooses to promote its products, but I want my clients to be aware of their choices. If you want to read more about this study, you can click on the following link: http://well.blogs.nytimes.com/2016/06/20/drug-company-lunches-have-big-payoffs/?_r=0

So, my recommendation to my clients anytime their doctor prescribes something, is to always ask the doctor if there is a generic or lower cost drug available, do they have any samples they can provide and if the drug is totally necessary.

Medicare Advantage Plan Study Shows Lower Avoidable Hospital Admissions

May 26, 2016 David Higgs

A recent study has just been released that shows that Medicare Beneficiaries on Part C Medicare Advantage Plans had about 10% less avoidable hospital admissions than those on Original Medicare. While my clients on Medicare Supplements have more comprehensive coverage than my Medicare Advantage Plan clients, this study is encouraging in showing Medicare Advantage Plan clients also get good medical care and helps stretch their coverage dollars.

If you want to learn more about this study, you can go to the following link: http://www.aafp.org/news/practice-professional-issues/20160517mahospitalization.html

Medicare Beneficiaries, Shop, Shop, Shop!

May 19, 2016 David Higgs

Last month, I posted about how I am always reminding my Medicare Beneficiary clients that they are the Customer. They should ask questions about procedures and how they can save money by doing so. Another recent study validates this.

Researchers at the University of Pennsylvania Health System recently confirmed how much can be saved and how much transparency exists for medical procedure costs. They gave an example of shopping around for a CT scan over a 3 state area and finding a cost variance from $437 to $2239!

Beneficiaries with a Medicare Supplement have less need to shop around due to the coverage. But Beneficiaries with either Part C Medicare Advantage plans or those who only have Parts A and B, can benefit by checking around.

If you want to read more about this topic, you can go to the following link: https://consumer.healthday.com/health-technology-information-18/cat-scan-news-88/out-of-pocket-x-ray-ct-scan-costs-vary-widely-710984.html

Proposed Changes to Medicare Payments

May 6, 2016 David Higgs

CMS, who manages Medicare, has recently announced some proposed changes to how Medicare reimbursements will be made. These proposals are targeting such areas as: Hospital Observations status, Physicians, Skilled Nursing Facilities, Part B drugs, etc. The various proposals are accepting comments in June. The main goal of the proposed changes is to reward better patient health and cost efficiency.

You can check back on this blog for updates once these proposed changes have been finalized or go to CMS.gov.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare. He can be reached at email address: David@ChoicesInMedicare.com or go to website: www.ChoicesInMedicare.com

Helping seniors transition to Medicare