What is Medicare Supplemental Insurance (Medigap)?

Medicare also known as Medigap is a federal health insurance program which pays for a several of health care expenditures. It’s controlled by the Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS).

Medicare is also an entitlement program. Many U.S. citizens have the right to enroll in Medicare by working and paying their taxes for a minimum required period of time.  Medicare beneficiaries are normally senior citizens that are aged between 65 and older. Adults with a particular approved medical and also qualifying permanent disabilities may also be entitled to Medicare benefits.

Medicare Supplemental Insurance (Medigap) plans are provided by private insurance companies and can assist in covering out-of-pocket costs that is not covered by the Original Medicare, such as copayments, coinsurance, and deductibles, With Original Medicare there are no limit to what you may have to spend. A Medicare Supplemental Insurance (Medigap) plan can protect you from having big medical bills (many Medicare copayments or coinsurance amounts) whenever you need extensive medical care. In 47 states, there are up to ten standard Medicare Supplement plans with lettered names (Plans A, B, C, D, F, G, K, L, M, and N) but not all of the  plans are available in all areas.

Who can get a Medicare Supplement plan?

In order to enroll in a Medicare Supplemental Insurance (Medigap) plan, you must have Medicare parts which are Part A and Part B. You are also supposed to be age 65 or even older. While Medicare Part A and Part B may be available to those under the age of 65 with Social Security disability assistances and also a certain health conditions, the federal government does not necessitate that private insurance companies sell Medicare Supplement policies to people under the age of 65. Although, some states requires private insurance companies to sell Medicare Supplement to people under the age of 65 years.

What does Medicare Supplemental Insurance (Medigap) cover?

The 10 standardized lettered Medicare Supplement which available in most states are listed below:

Coinsurance or copayments benefit with different percentage.

  • All Medicare Supplemental Insurance (Medigap) plans mostly and generally cover 100% of Medicare Part A coinsurance and hospital costs up to additional 365 days after Medicare benefits are been used up.
  • All Medicare Supplemental Insurance (Medigap) plans covers Medicare Part B coinsurance or copayments 50%.
  • Plan K covers coinsurance or copayments benefit at 50%
  • Plan L covers coinsurance or copayments at75%.
  • The rest of the plans may cover coinsurance or copayments at 100%.

 

Pints of blood in a medical process at different percentage.

  • All Medicare Supplemental Insurance (Medigap) plans covers the first three pints of blood in a medical process at least 50%.
  • Plan K cover this benefit at 50%.
  • Plan L may cover it at 75%. The rest of the plans typically cover it at 100%.

 

Hospice care coinsurance or copayment.

  • All Medicare Supplemental Insurance (Medigap) plans may covers:
  • Medicare Part A hospice care coinsurance or copayment at least 50%.
  • Plan K covers hospice care coinsurance or copayment at 50%.
  • Plan L covers hospice care coinsurance or copayment at 75%.
  • The remaining plans cover hospice care coinsurance or copayment at 100%.

 

Skilled nursing facility care coinsurance.

  • Eight of the ten plans cover skilled nursing facility care coinsurance at least 50%. Plans A and B does cover skilled nursing facility care coinsurance at all.
  • Plan K covers skilled nursing facility care coinsurance at 50%.
  • Plan L covers skilled nursing facility care coinsurance at 75%.
  • The rest of the plans skilled nursing facility care coinsurance at 100%.

 

Deductible.

  • All Medicare Supplement plans expects plan A to cover the Medicare Part A deductible at least 50%.
  • Plan K and Plan M cover deductible at 50%.
  • Plan L covers deductible at 75%.
  • Plans B, C, D, F, G, and N cover deductible at 100%.
  • Plans C and F cover the Part B deductible at 100%.
  • No other plans cover the Part B deductible.

 

Excess charges

  • Plans F and G cover Part B excess charges.
  • No other plans cover Part B excess charges.

 

Foreign travel emergencies

  • Six plans (C, D, F, G, M and N) cover foreign travel emergencies at 80%, up to plan limits.

 

What Medicare Supplemental Insurance (Medigap) does not cover?

Medicare Supplemental Insurance (Medigap) plans usually do not cover:

 

  • Routine dental care
  • Routine vision care
  • Private-duty nursing
  • Prescription drugs
  • Nursing home care

 

Learn more about Medicare Supplemental Insurance plans, rates and more at http://www.emedicare-supplemental-insurance.com.  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 877-202-9248 today!

Trending Information About Medicare in Texas

In Texas, eligibility for Medicare supplemental plans varies with age – there are rules for each of the plans. However, before we plunge into the rules, you should know that when you first activate Part B, there is a window for open enrollment for a Medigap plan without having to go through any form of health underwriting. As long as you are a Part B holder, you’ll be guaranteed access to any plan for six months beyond the effective date of their Plan B. Everyone is granted this special application window, regardless of when they first obtain Medicare.  The eligibility rules determine which plans each of the two groups can access. There is, however, a limit for the plans offered to those below 65.

How Eligibility Rules Work

For age 65 or older who are on Medicare in Texas, have access to all 10 supplement plans – Plan A through Plan N. Plan F being the most popular is the highest-deductible option available because it includes all deductibles and co-insurance you would have paid. Nonetheless, membership for Plans G and N is on the rise as they are offering a relatively low premium for a little cost-sharing with beneficiaries.

For folks under age 65, there is a clause. A great number of these people have access to just Plan A, and the reason for this is because each insurance company can decide on the supplement plans they want to offer to the public. The only supplement plan they are required by law to offer to all is plan A.

These insurance companies are aware that those under 65 must have got Medicare due to some form of major health issues, so they anticipate these people to use benefits more frequently, and this will cost more money to the company. Thus, since Plan A has fewer benefits and more cost-sharing on the part of the policyholder, most insurance carriers decide to offer just Plan A to individual below 65.

Well, you should also know that Plan A supplement still has many benefits. Just that it doesn’t cover deductibles or skilled nursing co-insurance, but it’s still great as it covers a very important gap – 20% co-insurance for Part B outpatient care that you would have paid. It is really great because Part B covers items such as radiation, chemotherapy, and dialysis and not just doctor regular visits. Without Plan A coverage, thousands of dollars would be spent on a major health condition.

This plan A is still very suitable for those who are uncomfortable with network-based advantage coverage, probably want access to more than one doctor and hospital considering that a standard supplement plan allows the beneficiary to see any doctor that accepts the original Medicare. However, due to the increasing rate of all supplement plans, it may be inconvenient for a younger Medicare beneficiary to keep up with the increasing rate of their Plan A for many years, and their health condition in most cases prevent them from getting access to a lower-priced company because they are unable to pass through health underwriting.

The great news is that when a beneficiary gets to age 65, they will receive another enrollment window which will give them the opportunity to switch to any other supplement plans they wish to obtain. Knowing the eligibility rules of the supplements is almost impossible for the average individual, so it would save much of your time if you consult an independent insurance agent for help in understanding your qualifications and eligibility for the next open enrollment window.

Learn more about Texas Medicare Supplemental Insurance rates, plans, and more at http://www.emedicare-supplemental-insurance.com/medicare-supplement-plans-texas.  Our Texas Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans in Texas.  To talk to an expert in Texas Medicare coverage toll free 888.404.5049 today!

 

Big changes expected in many 2018 Medicare Advantage plans

As if there isn’t enough to worry about when it comes to finding health insurance, add this item to the list: Medicare Advantage.

Changes in plan structures and a dearth of insurers in rural areas may leave consumers with fewer choices and more confusion in the upcoming Medicare open enrollment period, which begins October 15.

Medicare Advantage plans, offered by private insurers, provide traditional Medicare coverage and often offer additional benefits such as dental, vision and Medicare Part D prescription drug coverage. Premiums, deductibles and co-pays vary significantly from plan to plan, so comparing costs and coverage each year — even if you are already enrolled — is critical.

Medicare Advantage is different from Medigap, which is designed to help fill the gaps in traditional Medicare coverage.

In the recent past, some Medicare Advantage plan members have been struggling to find the care they need, especially those who have acute or chronic illnesses. About one-third of people eligible for Medicare enroll in Advantage plans.  A recent Government Accountability Office report found that a large number of Medicare Advantage enrollees, especially those in poor health, drop out of the plans because they have trouble getting access to the care they need. Of the 126 Medicare Advantage plans studied, the GAO found 35 of them had disproportionately high numbers of sick people dropping out.

If you are part of a Medicare Advantage plan or considering Medicare Advantage in the upcoming sign up period, or if you are taking care of a loved one with MA coverage, here’s a preliminary glimpse at what you need to watch out for in the year ahead.

Look for changes in your existing plan. If you’re already enrolled in a Medicare Advantage plan, your insurer will likely send you information soon regarding 2018 plan details. Read this carefully. “Just because a plan works for you this year doesn’t mean it will necessarily work for you next year.” warned David Lipschutz, an attorney at the Center for Medicare Advocacy. Many insurers change their cost-sharing, premiums and prescription drug formularies (the list of drugs covered by the plan) each year, Lipschutz explained. Look closely at any changes your plan is implementing and compare that to other plans available in your area. Existing Medicare enrollees and first-time shoppers can compare Medicare Advantage plans and traditional Medicare on Medicare.gov.

Check your health network. Like all health insurance plans, Medicare Advantage insurers negotiate with hospitals, doctors and other health care providers to find the lowest cost providers each year. Those networks — both health maintenance organizations and preferred provider organizations — are subject to change every year. In recent years, these provider networks have become smaller, with fewer specialists. These changes were among the main reasons Medicare Advantage enrollees dropped out of their plans, according to the GAO report. Always check to make sure the network on your plan or the plans you are considering include the providers you need to stay healthy. And check to see if more of the providers you need are available to you through traditional Medicare.

Rural consumers may be out of luck. Much has been said about rural counties left with only one or no insurance options on the Obamacare exchanges. State insurance commissioners, insurers and others have been working hard to successfully fill those gaps. In the meantime, the real dearth of coverage may exist among Medicare Advantage insurers. According to a recent report from the Kaiser Family Foundation, 147 counties, across 14 states have no Medicare Advantage insurer this year.

If you live in an area with no Medicare Advantage insurer you’ll need to take the time to thoroughly understand traditional Medicare coverage and decide if a Medigap policy is right for you.

Get help while you still can. Your State Health Insurance Assistance Program (SHIP) can help you sort through your Medicare options and compare Medicare Advantage plans. SHIPs are funded through the federal government and provide free health care counseling for Medicare recipients. The Trump Administration’s budget proposal would cut funding for SHIPs entirely, Lipschutz said. He suggested starting your health plan search now while this resource is still available.

Original Source: https://www.cbsnews.com/news/medicare-advantage-plans-2018-finding-health-insurance/

Original Date: Aug 28 2017

Original Author: Walecia Konrad

 

Medicare Is in Deep Trouble: Here’s How to Rescue It

medicare-is-in-trouble

Medicare’s trust fund will run out of money in just over 10 years, according to a new report from the program’s trustees. Once that happens, the federal government won’t collect enough in payroll taxes to cover beneficiaries’ hospital bills.

Congress could hike taxes to cover the shortfall. Or it could ration care to save money.

Or it could modernize and restructure Medicare — by giving beneficiaries means-tested vouchers to buy private insurance. Doing so would protect taxpayers now, preserve the program for future generations and even provide higher-quality care to seniors.

Medicare actually consists of multiple programs that pay for health care for 57 million seniors and people with disabilities.

Beneficiaries don’t pay premiums for Part A, which covers inpatient hospital care. It’s funded primarily by payroll taxes.

For much of the program’s history, the government collected more in payroll taxes than it paid out to hospitals. These surpluses went into a “trust fund,” where they were invested in U.S. government bonds.

But with Part A spending per beneficiary rising 3.5 percent annually — faster than tax revenue is growing — those surpluses have turned into deficits. Since 2010, Part A has spent $105 billion more than it collected in taxes. The trust fund has covered these deficits.

By 2029, the fund will be exhausted. Payroll taxes will only cover about 88 percent of Part A costs.

Costs in Medicare Part B, which pays for doctors’ visits, are also surging. The trustees estimate that Part B spending per beneficiary will increase 5.2 percent annually for the next decade.

Unlike Part A, beneficiaries pay premiums for Part B coverage. But these premiums account for only 23 percent of the program’s costs. The rest comes out of the federal Treasury.

Last year, Medicare cost $349 billion more than it collected in payroll taxes and premiums. This spending squeezes funding for other priorities, like defense and scientific research.

These deficits will explode in the future. Medicare faces $65 trillion in unfunded liabilities.

Despite its astronomical price tag, Medicare actually underpays health care providers. It reimburses hospitals at just 60 percent of private insurers’ reimbursement rates. In 2016, hospitals lost 9 cents for every dollar they spent treating Medicare beneficiaries, according to the Medicare Payments Advisory Commission.

By 2040, half of doctors will lose money treating Medicare patients. Seventy percent of skilled nursing facilities and 80 percent of home health agencies will be in the same position.

That doesn’t bode well for patients. The trustees’ report notes that providers will either have to “withdraw from serving Medicare beneficiaries” or “shift substantial portions of Medicare costs” to other patients — like those with private insurance.

Medicare desperately needs a revamp. Its biggest problem is that seniors have no incentive to control their health care spending, since the government picks up most of the tab.

Vouchers would enable poor and middle-income seniors to pick from a variety of private health plans, with different premiums, deductibles, and co-pays. They’d have an incentive to choose wisely, since they’d be spending their own money on top of whatever they received as a voucher.

And by means-testing the vouchers, the government would no longer waste billions subsidizing health insurance for the rich, who don’t need taxpayer-funded assistance.

This idea has attracted bipartisan support in the past. Indeed, three decades ago, a group of congressmen from both sides of the aisle proposed the concept — but were one vote short of being able to make a recommendation to Congress. The Bipartisan Policy Center and Committee for a Responsible Federal Budget have also voiced support for a voucher system.

Furthermore, it’s already working in another part of Medicare — the Part D prescription drug program. Under Part D, seniors shop for the privately administered drug coverage that meets their needs and budget. Competition among insurers helps keep costs low. The federal government subsidizes the plans to keep them affordable for beneficiaries.

From 2004 to 2013, the program cost $349 billion less than initially projected. Ninety-five percent of seniors report that their Part D coverage meets their needs.

Medicare‘s spending isn’t sustainable. Congress can stave off massive tax hikes and benefit cuts by voucherizing the program — and injecting some much-needed competition into the health care market.

Original Source: https://morningconsult.com/opinions/medicare-deep-trouble-heres-rescue/

Original Date: Aug 23 2017

Original Author: Sally Pipes

Medicare Supplement Insurance – What, Why and Who?

Medicare Supplemental question

The main idea behind Medicare supplement insurance was to offer extra coverage above and beyond regular Medical care parts A & B for qualified people aged 65 and above or folks on disability under the age of 65.

Medicare Parts A & B are really good coverage on their own.

Part A helps pay for medical services while confined in a hospital setting and covers 80% of those services after a deductible is met ($1132 in 2011). The deductible is a “per benefit period” deductible which in most cases means you’ll have to meet the deductible each time you have a hospital stay.

Medicare Part B helps pay for your outpatient medical services. This would include things like primary care and specialist physicians and lab work, x-rays, outpatient surgeries, emergency room visits, and most other medical services in which you don’t have to spend the night in a facility. This works like Part A in that you have a deductible ($162 in 2011) and then Medicare pays 80% of most services. The part B deductible, however, is an annual deductible and only needs to be met once per calendar year. Medicare also has something called excess charges which allow a doctor to charge up to 15% over Medicare’s rates.

What is Medicare Supplement Insurance? This insurance is private coverage that picks up those gaps in coverage left by Medicare and is therefore often called “Medigap” or “Gap insurance”. So, these plans can cover all, or some, of the deductible, coinsurance, and excess charge gaps in regular Medicare.

Why should I buy Medicare supplement insurance? Although it’s not necessary to buy this type of insurance, it can be a very valuable policy in helping protect your assets and also lends a significant amount of “peace of mind” that you won’t be hit with major medical bills. It has been noted that about half of all bankruptcy is related to a person’s inability to pay for medical services received. Medicare supplement insurance can help you avoid that situation.

Who should I buy Medicare supplement insurance from? The great thing about Medicare Supplement Insurance is that they are standardized. So, once you identify which plan is best for you, you can shop the market to see who can offer the best rates.

You can pretty much feel comfortable going with whoever is offering the best rate for the plan you feel most comfortable with. You might use the services of a Medicare supplement insurance agency to identify the rates from several companies and maybe get some experienced details on which companies might be better for the long term.

Shopping for Medicare supplemental insurance can be tough, that’s why we have made a ton of information available to you. Our main website http://www.emedicare-supplemental-insurance.com is a good place to start with not too much information that won’t overwhelm you. After that you can move on to our blog that has a ton of information like general Medicare information to state specific supplemental information. If you are still wondering or just would like to talk to some one you can call us directly at 888-404-5049.

Medicare Scare Tactics

TV ads from a Democratic group warn seniors that “right now, your Medicare coverage is in danger,” claiming “deep, automatic cuts” could be made by “unelected Washington bureaucrats.” But those cuts, according to current estimates, wouldn’t be implemented until 2023, and they would amount to .002 percentage points of Medicare growth that year.

tactics-chess-medicare

It’s true that more automatic cuts to the growth of spending are expected in future years. But like many political messages about Medicare, these ads feature scare tactics — warning of cuts that could “restrict access to doctors” and “deny care” — when we don’t yet know what any cost-cutting would entail.

The ads, from Majority Forward, a 501(c)(4) formed to support Democratic candidates and affiliated with the Senate Majority PAC, are airing in Montana and North Dakota, in support of Democratic Sens. Jon Tester and Heidi Heitkamp. Another ad on this topic — featuring circling sharks to represent the “bureaucrats” who “want to take a bite out of your Medicare” — is airing in Indiana, in support of Democratic Sen. Joe Donnelly. All three ads say these senators are working to stop these cuts, and they have co-sponsored legislation that would do so.

What the ads don’t say is that these reductions to Medicare growth are now several years away.

The TV ads are referring to the Independent Payment Advisory Board, or IPAB, which was created by the Affordable Care Act as a way to slow the growth in Medicare spending. The ACA, signed into law in March 2010, called for a 15-member panel that would be tasked with cutting the growth of Medicare if spending on the program exceeded certain targets.

The IPAB has been the target of criticism. Two months ago, we saw a $2 million ad buy from a group called Healthcare Leadership Council, a coalition of insurers, health clinics, pharmaceutical companies and others, urging a repeal of the board.

The idea was controversial from the start — former Republican vice presidential nominee Sarah Palin called the board a “death panel” in 2010, while Republicans, including House Speaker Paul Ryan, repeatedly said it was made up of “unelected, unaccountable bureaucrats,” language that’s echoed in the ads supporting Democratic senators.

Fiscal groups such as The Concord Coalition and the Committee for a Responsible Federal Budget have supported IPAB, saying that it’s necessary to find ways to control growing health care costs and that the board can operate without the political pressure rampant in Congress. “Ultimately, in a country struggling mightily with unaffordable health care costs now, and destined to struggle even more in the future, IPAB is one of the institutions that gives some hope that if we figure out how to control costs, we just might be able to put that knowledge to use,” Joshua Gordon, policy director at The Concord Coalition, wrote in a guest column for CNN Money in 2011.

But so far, there is no board: It doesn’t have any members and hasn’t done anything. The supposed “bureaucrats” who “want to take a bite out of your Medicare,” as the Majority Forward ad in Indiana says, don’t even exist yet.

If the board is created in the future, the law stipulates that the president must consult with congressional leadership and appoint members with the “advice and consent of the Senate,” a March 2017 Congressional Research Service report on the IPAB says. The IPAB members must “possess recognized expertise in health finance and economics, actuarial science, health facility management, health plans and integrated delivery systems, and reimbursement of health facilities,” the CRS report explains, and include representatives of consumers and the elderly.

The board hasn’t been needed because Medicare spending growth has remained below targets set by the ACA that would trigger IPAB action. And the latest report by the Medicare trustees says the IPAB isn’t expected to be triggered until 2021, with any required cuts implemented two years later.

Here’s how the trigger works: The actuary for the Centers for Medicare & Medicaid Services estimates per capita Medicare growth, and each year those estimates are published in a report from the Medicare trustees. The IPAB determination looks at a five-year projected average — the per capita growth for two years prior, the current year and two years later. Cuts would be required under the law if that rolling average exceeded the target. That target has been tied to inflation and medical care inflation, but next year, the target changes to the growth of per capita gross domestic product plus 1 percentage point.

Once triggered, the IPAB must issue recommendations the following year on how to cut spending to keep growth below the savings target established by the actuary. And if there’s no board, the secretary of health and human services instead would make the recommendations for cuts.

The cuts would then be implemented the year after that, though Congress can choose to implement its own changes to keep spending below the target. Congress can’t change the fiscal targets in other legislation, either, unless a three-fifths majority in the Senate waives that requirement.

Last year, the Medicare trustees report estimated that the IPAB would be triggered in 2017 for the first time, requiring a 0.2 percentage point cut in Medicare spending growth, “a relatively small difference,” CMS Chief Actuary Paul Spitalnic said at a Brookings Institution event last June in explaining that the projection could change. And it did with the 2017 report, released July 13. The IPAB wasn’t triggered, and now isn’t expected to be until 2021, with savings implemented two years later.

The estimated difference between Medicare growth and the IPAB target is even smaller — 0.002 percentage points.

Medicare trustees report, July 13, 2017: As a result of the other savings provisions incorporated into current law, the Trustees estimate that the IPAB provision will reduce Medicare growth rates for the first time in 2023, and by only 0.002 percent in that year. In addition, the Trustees project that rates will be reduced by similar small amounts in 2026, 2027, 2028, 2030, 2033, and 2035

It’s certainly possible that that gap could widen, or go away, or that the IPAB could be triggered sooner.

What Could the IPAB Cut?

How “deep” could these cuts be? And could they “restrict access to doctors … deny care and cost you and your family more,” as the TV ads say? We can’t predict what action the IPAB provision could spark in the future, but the board is limited in what it can do. It can’t increase beneficiaries’ premiums or cost-sharing, or restrict benefits, but it could reduce payments to health care providers.

Medicare spending totaled $678.7 billion in 2016 — about 15 percent of the total federal budget — and the health care program covered 56.8 million people, 84 percent of them age 65 and older and 16 percent people with disabilities. The current projections for IPAB cuts would involve well under 1 percent of Medicare spending. Of course, the cuts could be larger in the future, and accumulate over time. But the IPAB is limiting to cutting no more than 1.5 percent of total Medicare payments in a given year, even if the gap between spending growth and the target is larger, a 2011 analysis by the Kaiser Family Foundation explains.

The Affordable Care Act stipulates that the board “shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums” or “increase Medicare beneficiary costsharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria” (page 490).

The Kaiser Family Foundation analysis says that any recommended reductions would then come from “Medicare Advantage, the Part D prescription drug program, skilled nursing facility, home health, dialysis, ambulance and ambulatory surgical center services, and durable medical equipment.” Payments to health care providers, including hospitals could also be cut, starting in 2020.

Juliette Cubanski, associate director of KFF’s Program on Medicare Policy, told us in a phone interview that beyond “basic guidelines,” the ACA “left a lot of latitude” for the board.

She said it was “a bit of a stretch” to draw conclusions about how any cuts could affect access to doctors and medical care without knowing more specifically what the board or HHS secretary might have in mind. Even small spending reductions can lead to big battles, however, when it comes to Medicare.

“Depending on where those cuts are made, it could affect some providers more than others, if indeed they go for provider cuts to achieve the savings,” said Cubanski, who holds a Ph.D. in health policy from Harvard.

Majority Forward’s support for the ad points to a February letter to Congress from the Healthcare Leadership Council, signed by many health care organizations across the country, warning that cuts to provider payments “would be devastating for patients, affecting access to care and innovative therapies,” as some physicians wouldn’t accept new patients under lower rates.

The 2011 KFF analysis, which Cubanski co-authored, said there was “ambiguity” in the law that could lead to IPAB proposals that could affect Medicare beneficiaries.

Kaiser Family Foundation, “The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending”: Despite efforts to limit the reach of IPAB with respect to beneficiaries, there is some ambiguity in the ACA that could leave room for proposals that could directly or indirectly affect beneficiaries. The statute explicitly takes benefits, premiums, cost sharing, and “rationing” out of the scope of IPAB’s general authority, which appears to remove beneficiary issues from consideration. Yet, it is not entirely clear which proposals would be outside the scope of IPAB’s authority. …

If IPAB recommends policies that squeeze Medicare payment rates without equal pressure being placed on private payment rates, there is some concern that Medicare beneficiaries would be at greater risk of having access problems, as providers become more inclined to serve other patients. While the ACA requires that proposals achieve the savings target “…while maintaining or enhancing beneficiary access to quality care…” there is no further clarification of how this is to be determined.

The law allowed for a joint resolution to abolish the IPAB this year — and such resolutions were introduced in the House and Senate. But they needed to be approved by three-fifths of each House by Aug. 15. There are other pieces of legislation, two in the Senate and one in the House, that would repeal IPAB provisions from the Affordable Care Act. All of these measures were introduced in February and referred to committee.

Tester and Heitkamp are co-sponsors of the Democratic Senate bill and, along with Donnelly, co-sponsors on the joint resolution.

These TV ads warn that “right now, your Medicare coverage is in danger.” Actually, “right now,” we don’t know what will happen if IPAB is triggered and we could be several years away from finding out.

Interestingly, to support that line about Medicare being in “danger,” Majority Forward pointed to the Medicare trustees’ estimate that the trust fund for Part A, which pays hospital expenses, would be depleted in 2029. If Congress doesn’t act to shore up financing, the tax revenue for Part A would cover only 88 percent of costs, the trustees said. But the “automatic cuts” the ad warns about would improve Medicare’s finances.

Original Source: http://www.factcheck.org/2017/08/medicare-scare-tactics/

Original Date: August 11 2017

Original Author: Lori Robertson

How Does Medicare Supplemental Insurance Affect me?

Mеdісаrе Suррlеmеnt Plans аrе utіlіzеd tо support hеаlth саrе соѕtѕ whісh are nоt соvеrеd bу the original Medicare plan. Thе соvеrаgе costs can vеrу a bіt frоm company tо соmраnу and wіth dіffеrеnt рlаnѕ ѕіnсе thе dіffеrеnt оrgаnіzаtіоnѕ charge many different рrеmіumѕ. Thіѕ іnѕurаnсе аlѕо hеlрѕ wіth со-рауmеntѕ аnd dеduсtіblеѕ. Seniors who аrе enrolled іn a Mеdісаrе Benefit Plan do not ԛuаlіfу fоr a Mеdісаrе Supplement Plаn. All Mеdісаrе ѕuррlеmеnt policies ѕhоuld bе сlеаrlу іdеntіfіеd as such. Thеѕе policies are rеԛuіrеd tо hаvе соmраrаblе if not іdеntісаl bеnеfіtѕ.

Medicare-doctor

Advаntаgеѕ lіkе long-term care, eyeglasses, dеntаl саrе, еtс. Arе nоt covered bу these роlісіеѕ. The іnѕurаnсе providers may well determine whісh tуреѕ of policies thеу sell but ѕtаtе lаwѕ affect the policies whісh are оffеrеd. Oссаѕіоnаllу, insurance рrоvіdеrѕ ought tо ѕеll уоu a роlісу rеgаrdlеѕѕ of аnу hеаlth dіffісultіеѕ уоu’vе gоt раrtісulаrlу іf уоu are mаkіng аррlісаtіоn throughout ореn еnrоllmеnt. At tіmеѕ other thаn ореn enrollment, thе insurance оrgаnіzаtіоn саn refuse tо problem уоu a роlісу whеn уоu have рrееxіѕtіng соndіtіоnѕ. Simply bесаuѕе a lоt of people tоdау hаvе mеdісаl іѕѕuеѕ, the very best tіmе to buу a policy іѕ during ореn еnrоllmеnt..

“Medicare Supplemental plans are utilized to support health care costs which are not covered by the original Medicare Plan”

So thаt уоu саn kеер аwау frоm the ѕіtuаtіоn уоu соnѕеԛuеntlу nееd to have tо take ѕеvеrаl асtіоnѕ. It іѕ сrіtісаl fоr уоu tо mаkе ѕurе that аnу рrоvіdеr that you deal wіth is a fully licensed brоkеr who іѕ rеаllу ѕеllіng іnѕurаnсе. You’ll find a соuрlе оf tесhnіԛuеѕ іn whісh уоu саn tell whether or not this is thе саѕе. Fіrѕt of all thеу’ll vіrtuаllу соnѕtаntlу hаvе a toll frее numbеr thаt іt іѕ роѕѕіblе tо саll.

Tо bе able tо uncover thе most еffесtіvе Mеdісаrе Supplement Plаnѕ, соnѕеԛuеntlу, уоu’ll want tо tаkе bеnеfіt оf аn аgеnt аѕ thеу will bе іn the mоѕt beneficial feasible position tо lосаtе the most effective feasible роlісіеѕ thаt wіll bе ѕuіtаblе for you. Typically thіѕ is a muсh fаr better ѕеlесtіоn thаn gоіng ѕtrаіght tо a huge fіrm and via аn іndереndеnt brоkеr уоu may be аblе to fіnd thе very best alternatives оbtаіnаblе.

Whіlе соvеrаgе аnd соѕt оught tо bе significantly thе same from рrоvіdеr to рrоvіdеr, сеrtаіn thіngѕ саn change. Most noticeably іѕ thе flexibility of a plan tо аdарt tо lіfе’ѕ ups and dоwnѕ and, take оn еxtrа еxреnѕе. Idеаllу, a plan ought tо ѕuррlу as muсh flеxіbіlіtу аѕ роѕѕіblе, thоugh іt’ѕ wоrth mеntіоnіng that thе рrеmіumѕ wіll lіkеlу bе higher fоr thіѕ рrіvіlеgе.

Onсе a Mеdіgар рlаn hаѕ bееn dесіdеd uроn, іt’ll bе рrеttу еffоrtlеѕѕ to ѕіgn up; it is thе рrосеѕѕ to acquiring thеrе whісh tаkе thе tіmе. But іt’ѕ tіmе well ѕреnt, аѕ the plan wіll most lіkеlу be needed bу mеаnѕ оf the years, аnd there аrе ѕоmе аwful ѕtоrіеѕ frоm іndіvіduаlѕ whо hаvе nоt had adequate соvеr. Once ѕіgnеd, coverage wіll соmmеnсе ѕtrаіght away, аnd you’ll bе аblе to move on dоіng whаt уоu tаkе рlеаѕurе іn, undеrѕtаndіng you’ve gоt thе valuable ѕаfеtу nеt аt your bасk.

How To Chооѕе Thе Rіght Plаn

Whenever Medicare was initially еѕtаblіѕhеd, іt hаd not bееn mаdе tо bе реrmаnеntlу соvеr all еxреnѕеѕ. Therefore, Mеdісаrе Suррlеmеntаl Insurance was сrеаtеd tо mаkе uр thе difference. Yоu can fіnd currently 12 plans of соvеrаgе. These plans аrе mаnаgеd bу thе gоvеrnmеnt, which allows thеm tо rеmаіn the ѕаmе price no mаttеr whісh іnѕurаnсе agency уоu асԛuіrе thеm from. The оnlу rеаl dіffеrеnсе bеtwееn one рlаn of оnе соmраnу to аnоthеr, іѕ the рrісе.

Fіgurіng оut that you need this coverage is the fіrѕt ѕtер іn the rіght direction. Onсе уоu dеtеrmіnе that уоur Mеdісаrе insurance doesn’t address all уоur medical rеlаtеd еxреnѕеѕ, уоu wіll bе muсh bеttеr аblе tо determine thіngѕ уоu do nееd ѕіnсе you wіll knоw things іѕ mіѕѕіng оut on. It rеаllу is hеlрful tо соnfеr with уоur асtіvе іnѕurаnсе tо see рrесіѕеlу what you DO hаvе thе instant іt соmеѕ tо fіndіng thе rіght Mеdісаrе Supplemental Inѕurаnсе coverage. Luсkіlу for uѕ, this іѕ much lеѕѕ соmрlісаtеd thаn ѕhорріng fоr traditional іnѕurаnсе bесаuѕе уоu wіll find only a dozen traditional рlаnѕ tо сhооѕе frоm. Nо matter whісh рrіvаtе іnѕurаnсе оrgаnіzаtіоn уоu wоrk with, ѕіmрlу bесаuѕе each wіll оffеr the ѕаmе plans. Rеаllу thе оnlу distinction will be thе service thаt уоu gеt аnd thе premium thаt уоu wіll bе сhаrgеd for.

Learn more about Medicare Supplemental Insurance plans, rates and more at http://www.emedicare-supplemental-insurance.com.  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 888.404.5049 today!

Introduction to Medicare Supplement Insurance Plans

Supplemental Insurance

While Medicare pays for many healthcare services, there are still many that are not covered. Traditional, or Original Medicare, does not provide full coverage for medical expenses.  Some expenses such as deductibles, copayments, and co-insurance amounts are not covered under Original Medicare, Medicare Part A and Part B.  In order to offset these expenses Medicare Supplemental Insurance Plans were designed.

What is Medicare Supplemental Insurance and How Does It Work?

Supplemental Insurance is an additional health care plan that is provided by private insurance companies to cover the gaps left in Medicare Part A and Part B.  Federal and State laws regulate Medicare Supplemental Plans to protect you as the beneficiary.  Plans are clearly labeled as Medicare Supplemental Insurance and the policies are standardized.  Supplemental Insurance Plans are all the same and do not vary from state to state.  The only aspect that that changes is the cost and where it is purchased.

Medicare Supplemental Insurance Eligibility Requirements

Supplemental coverage works only in conjunction with Medicare Part A and Part B.  The acceptance of your application is guaranteed if you are 65 or older and apply within six months of the initial enrollment in Medicare Part B.  Under certain circumstances, pre-existing conditions are waived; specific details can be found by working with a Medicare Supplemental Insurance Broker.  A  Medicare policy covers only one person.  Your spouse must have a policy of their own.

Medicare Supplemental Insurance Plans

Participants may select from up to ten standardized policies, Medicare Supplemental Insurance Plans A through Plan N.  Each plan offers a different set of primary benefits with a unique set of benefits. These policies are the same no matter what private insurance company you choose to purchase the insurance from.  Each insurance company can decide which policies they want to sell and set their own prices so research carefully to avoid overpaying.

Medicare Supplemental Plans A through J

Plans A through J have more benefits, higher premiums, and lower out of pocket expenses.  Basic benefits include coverage of Medicare Part A and Part B copayments, co-insurance, and three pints of blood.  Extra benefits may include Skilled Nursing Facility co-insurance, foreign travel emergency services, at-home recovery and preventative care.

Medicare Supplemental Plans K through M

Plans K through M have lower premiums and higher out of pocket expenses.  Basic benefits include Medicare Part A hospital benefits, Medicare Part A and B coinsurance or co-pay, three pints of blood and hospice care.  Extra benefits include skilled nursing facilities coinsurance and Medicare Part A deductibles.

Medicare Supplemental Plan N provides co-insurance payments on hospital expenses for Medicare Part A, as well as a full year of payments once your Medicare benefits have been depleted.  Supplemental Plan N policies pay 100% of Medicare Part B co-insurance.  Doctor visits cost up to twenty dollars and emergency room visits up to fifty dollars.

When selecting a Medicare Supplemental Insurance Plan, carefully compare each plan and compare quotes from insurers. Make sure you choose the coverage that best meets your needs and be sure not to pay more for the benefits than you need to.

Learn more about Medicare Supplemental Insurance plans, rates and more at http://www.emedicare-supplemental-insurance.com.  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 888.404.5049 today!

Read This Before You Take Medicare Benefits

Medicare Supplemental Insurance Chart

Most Americans are eligible for Medicare benefits beginning in the month of their 65th birthday. Although it is the most widely used health insurance plan in the United States, many pre-retirees don’t understand it well. With that in mind, if you’re getting close to turning 65, here’s some basic information about Medicare that you need to know.

The four “parts” of Medicare

There are four different types of Medicare insurance, known as “parts,” designated with letters A through D. Here’s the difference between each one:

  • Medicare Part A is hospital insurance, and covers expenses such as hospital stays and services provided by skilled nursing facilities. (We’ll discuss what Medicare covers in greater depth later on.)
  • Medicare Part B is medical insurance, and this is the part of Medicare you’ll use when you see your doctor or obtain preventative care.

Collectively, Medicare Parts A and B are known as “original Medicare.” These are the parts that nearly all senior citizens have.

  • Medicare Part C is Medicare Advantage, which are plans offered through private insurance companies that are contracted to provide Parts A and B benefits.
  • Medicare Part D is prescription-drug coverage, which can be added on to Medicare coverage. Part D plans are offered through private insurance companies and can be part of a Medicare Advantage plan.

Image Source: Getty Images.

Do you need to sign up for Medicare at 65?

If you’re already collecting Social Security benefits, you will automatically be enrolled in Medicare, starting on the first day of the month in which you turn 65.

If you’re not collecting Social Security benefits, you’ll need to apply for Medicare. You can apply for Medicare only at the Social Security Administration’s website, and your initial enrollment period runs for seven months, beginning three months before the month of your 65th birthday.

There’s a possible exception if you’re covered under an employer’s health plan (not through COBRA or retiree coverage). If your employer has 20 or more employees, it meets the definition of “group coverage” and you don’t need to enroll in Medicare during your initial enrollment period. Instead, you’ll get a special enrollment period when you leave your job or your group coverage ends.

Having said that, it’s still a good idea to sign up for Medicare Part A at 65. It’s free, so there’s really no reason not to. On the other hand, Medicare Part B has a monthly premium you’ll have to pay, so it can be smart to wait if you aren’t required to sign up during your initial enrollment period.

How much does Medicare cost?

Cost of Medicare Supplemental Insurance

For most retirees, Medicare Part A is free, meaning you probably won’t have to pay a premium for your hospital insurance.

Medicare Part B, medical insurance, is another story. The standard Medicare Part B premium is $134 per month in 2017, although beneficiaries who pay their premiums directly through their Social Security benefits pay slightly less, because of cost-of-living adjustment rules.

In addition, high-income retirees pay higher premiums. This is based on the beneficiary’s income from two years ago, so 2015 income was considered for 2017 Medicare Part B premiums. Single taxpayers with adjusted gross income greater than $85,000 and married couples with combined incomes over $170,000 pay Part B premiums of $187.50 to $428.60 per month, depending on their specific income level.

Finally, Medicare advantage and prescription-drug plans have costs that vary widely, depending on variables such as location and scope of coverage.

What original Medicare does (and does not) cover

As I mentioned, “original Medicare” refers to parts A and B. Since virtually all Americans over 65 will have original Medicare, it’s important to know what it covers, and what you’ll still be responsible for paying.

First, of all, Medicare Part A covers hospital service, including meals, drugs, and other services while hospitalized. It also covers skilled nursing facilities for a limited amount of time, nursing home care that is deemed medically necessary, hospice care, and some home health services.

In addition to doctors’ office visits, Medicare Part B covers outpatient surgeries, as well as necessary medical supplies, such as wheelchairs and walkers. It also pays for preventative services such as lab tests, disease screenings, and disease-preventing services, such as an annual flu shot.

However, there are some medical costs that Medicare doesn’t cover, such as:

  • Long-term care.
  • Dental care (for the most part).
  • Eye care.
  • Acupuncture.
  • Hearing aids.

In addition to this list, it’s important to point out that you’ll have some out-of-pocket costs for covered services as well. For starters, Medicare Part A has a $1,316 deductible per benefit period for inpatient hospital stays, and a coinsurance requirement of at least $329 per day for stays longer than 60 days. Skilled nursing facility stays are only fully covered for 20 days, and you’ll pay a $164.50 daily coinsurance payment for longer stays, up to 100 days, at which point Medicare stops paying.

Part B has a lower $183 annual deductible, but after this is met, Medicare generally covers 80% of covered services, leaving you responsible for the other 20%.

How to protect yourself from unexpected costs

medicare-money

These copays, deductibles, and coinsurance requirements are collectively referred to as “Medigaps.” To limit your unexpected healthcare costs, a Medicare Supplemental Insurance Plan, or Medigap plan, can be purchased.

There are 10 different types of Medigap plans, and price and availability depend on your location. You can read the features of all 10 plans at Medicare’s website, but an important point is that Plan F is the most comprehensive, as well as the most popular. While it’s a bit more expensive than other Medigap plans (average monthly cost of $159-$239 for a 65-year-old male), it covers virtually every copay, deductible, or coinsurance payment Medicare Parts A and B could ask you to pay.

The bottom line is that by knowing the basics of Medicare, you’ll know when and how to sign up, how much you’ll pay for it, how much of your costs Medicare will cover, and how to protect yourself from uncertainty.

The $16,122 Social Security bonus most retirees completely overlook

If you’re like most Americans, you’re a few years (or more) behind on your retirement savings. But a handful of little-known “Social Security secrets” could help ensure a boost in your retirement income. For example: one easy trick could pay you as much as $16,122 more… each year! Once you learn how to maximize your Social Security benefits, we think you could retire confidently with the peace of mind we’re all after. Simply click here to discover how to learn more about these strategies.

Original Source: http://host.madison.com/business/investment/markets-and-stocks/read-this-before-you-take-medicare-benefits/article_69d1b2fb-05f7-524f-bdb4-c82b4d4c11b5.html

Original Author: Mathew Frankel

Original Date: Jul 31 2017

4 Things to Look For In Texas Medicare Supplemental Plans

Texas Medicare Supplemental policies cover medical procedures that are approved by Medicare provided by Medicare approved providers.   Below you will find the top four things participants in the Texas Medicare Supplemental Insurance Program should be aware of when buying their plan.

1) Medicare policies in Texas are only available to individuals who are already enrolled in Medicare Part A, hospital services and Part B, doctor’s services. Each plan covers one individual.  This means that you and your spouse will each have to purchase separate policies.

2) The Medicare Supplemental Insurance Plans that are offered are lettered Plan A through N.  Each supplemental plan offers a different package of benefits with its own premium.  Although each insurance company sells the exact same policies, they offer the same benefits.  Not all of the policies will be available in Texas.

3) It is pertinent to save on premiums that you purchase your Medicare Supplemental Insurance Plan during your six month enrollment period.  This period begins on the start of the first day of the month in which you turn 65 and are enrolled in Medicare Part B.

During this time period insurance companies cannot use medical underwriting to deny your policy or raise your premiums due to your health nor may they apply a waiting period.  If you want to get Medicare Supplemental coverage after your open enrollment period there is no guarantee that you will be able to get coverage.  In certain cases you will get coverage but at a higher premium, if you do have a preexisting condition.

4)  In order to have a Medicare Supplemental Plan to cover gaps in your Original Medicare plan you are required to pay a monthly premium to the insurance company that is providing your insurance policy along with paying your Medicare Part B premium.  The cost of your policy is determined by the following:

–  Community-rated polices charge the same premium to everyone within the same are regardless of age.

–  Premiums that are issued based on the age you first bought them do not increase automatically as you age.

–  Attained age rates policies are less expensive at 65 but their rates increase automatically as you age.

Generally, Medicare Supplemental Insurance in Texas companies establishes their own prices and eligibility regulations.  Working with a Medicare Supplemental Insurance Broker allows you to compare different supplemental plans and their costs through a variety of providers.

Learn more about Texas Medicare Supplemental Insurance rates, plans, and more at http://www.emedicare-supplemental-insurance.com/medicare-supplement-plans-texas.  Our Texas Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans in Texas.  To talk to an expert in Texas Medicare coverage toll free 888.404.5049 today!