Tag Archives: medicare insurance plans

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

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.

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

News Update on Mergers (Aetna/Humana & Anthem/Cigna)

Lately, there has been a lot of attention in the news to the pending mergers between Aetna and Humana as well as Anthem and Cigna.  The latest news is about the federal suits to stop the mergers.  The main thing I want my clients to know is that with or without the mergers, their Medicare Plan will remain in place.  This will mainly pertain to Medicare Advantage Plans and Part D drug plans.  If there are going to be changes, they will occur at the Annual Election Period (AEP) where they can make a change if needed.  In addition, if the merger(s) proceed, it will be years not months.  As usual, I will help my clients with this.

Feel free to call me with any questions as this process continues.  David.

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 Beneficiaries Should Get in the Habit of Asking

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.

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 Advantage Plan Study Shows Lower Avoidable Hospital Admissions

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

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 Beneficiaries, Shop, Shop, Shop!

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

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

 

Proposed Changes to Medicare Payments

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

Medicare Patients are the Customers!

I am always reminding my clients, especially my Part C Medicare Advantage clients, that they are the Customer.  They can and should ask how and where they can lower their medical costs.  If a doctor prescribes a test, they should ask why it is needed and more importantly, where can they get that test done that will cost them the least based upon the specific Plan they have.  Most of us are not accustomed to asking our doctors these types of questions.  We think “they are the doctor, they should know best.”  In many cases they don’t have any idea of the variances in costs for certain medical tests.  Costs vary widely based upon where a test is administered and which Plan a patient has.

This is less of an issue for my Medicare Supplement clients; however, this concept of asking, also applies to prescriptions.  As almost everyone has a Prescription plan (whether it is a stand-alone Part D drug plan or it is embedded in a Medicare Advantage Plan), there are many variables to lowering drug costs.  Here too, ask for lower cost alternatives such as Generics and shop around at different pharmacies.  A recent article describing proof that both doctors and patients are missing opportunities to lower costs is linked below:

http://khn.org/news/by-not-discussing-cost-issues-doctors-patients-may-miss-chances-to-lower-out-of-pocket-expenses/

The bottom line is Medicare Beneficiaries should get in the habit of asking questions regarding how, where and when they can save money when something is prescribed.  I do it and I recommend my Medicare clients do it.

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

CMS Finalizes 2017 Medicare Advantage Payment

CMS has just released their 2017 Medicare Advantage plan capitation rate.  On average, the payment will increase by .85%.  You may recall that Medicare Advantage plans, also known as Medicare Part C, are one way Medicare Beneficiaries can get their Medicare.  This shifts the risk and responsibility for a Beneficiary’s Medicare claims from Medicare to the private insurance company offering the Medicare Advantage plan.

This slight increase probably means most plans will not have to change their benefits much.  We will know in October when all 2017 plans will be published.  The increases fluctuate from year to year.  If you want to know more about this news story, click on the link below.

http://www.bloomberg.com/news/articles/2016-04-04/u-s-increases-2017-medicare-advantage-rates-less-than-expected

If you have questions about Medicare coverages or the difference between Medicare Advantage plans and Medicare Supplements, contact me at:  David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com website.

Medicare Beneficiaries’ Cognitive Health Tied to Heart Health

Here is another reason Medicare Beneficiaries should strive for improved Heat Health:  improved cognitive health.  A recent study released in the Journal of the American Heart Association found that the more heart-healthy steps people attain, the quicker and sharper their thinking skills.  So, not only will efforts to improve heart health help you live longer, but will help your memory and thinking skills.

To see more of the article, click on the following link:  http://consumer.healthday.com/cardiovascular-health-information-20/heart-attack-management-and-prevention-news-365/a-healthy-heart-may-protect-an-aging-brain-709040.html

If you have questions about Medicare, contact David Higgs at David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com

Medicare Telehealth Bill

Earlier this month, a bipartisan bill was introduced in both the Senate and Congress to allow Telehealth services to be covered by Medicare.  The Medicare Telehealth bill would allow seniors to “see” a doctor from the convenience of their home via computer or smart phone device.  This could be extremely beneficial for seniors who are less mobile but have minor illnesses and just need a prescription.  Telehealth has been growing over the last few years and now could be extended to cover seniors.  It would be a “win-win” solution as it would save Medicare billions of dollars and provide conveniences to Medicare beneficiaries.  Stay tuned over next few months for progress on this bill.

To read more about this bill, click on the following link to the article:  http://www.bna.com/lawmakers-introduce-medicare-n57982066990/

We here at Choices In Medicare help people transition into Medicare.  If you have questions or need assistance obtaining Medicare Supplemental coverages, contact us at:  David@ChoicesInMedicare.com or go to our website at:  www.ChoicesInMedicare.com