What Is Medicare Supplement Insurance?

                      *repost: https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html               What's Medicare Supplement Insurance (Medigap)?

A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

8 things to know about Medigap policies 

1. You must have Medicare Part A and Part B.
2. If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
3. You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
4. A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
5. You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
6. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
7. Some Medigap policies sold in the past cover prescription drugs, but Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
8. It's illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.

Medigap policies don't cover everything

Medigap policies generally don't cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

Insurance plans that aren't Medigap

Some types of insurance aren't Medigap plans, they include:

• Medicare Advantage Plans (like an HMO, PPO, or Private Fee-for-Service Plan)
• Medicare Prescription Drug Plans
• Medicaid
• Employer or union plans, including the Federal Employees Health Benefits Program (FEHBP)
• TRICARE
• Veterans' benefits
• Long-term care insurance policies
• Indian Health Service, Tribal, and Urban Indian Health plans

Dropping your entire Medigap policy (not just the drug coverage) 

If you decide to drop your entire Medigap policy, you need to be careful about the timing. For example, you may want a completely different Medigap policy—not just your old Medigap policy without the prescription drug coverage. Or you might decide to switch to a Medicare Advantage Plan that offers prescription drug coverage.

You have to pay a late enrollment penalty when you join a new Medicare drug plan if:

• You drop your entire Medigap policy and the drug coverage wasn't creditable prescription drug coverage, or
• You go 63 days or more in a row before your new Medicare drug coverage begins

To learn more about the costs of MediGap: https://www.medicare.gov/supplement-other-insurance/medigap/costs/medigap-plan-costs.html

Be A Smart Shopper during Open Enrollment

THE MEDICARE BLOG

THE OFFICIAL BLOG FOR THE U.S. MEDICARE PROGRAM. FOR MORE INFORMATION, PLEASE VISIT WWW.MEDICARE.GOV

MEDICARE OPEN ENROLLMENT: BE A SMART SHOPPER

*REPOST* Brought to you by The Medicare Blog:

Whether groceries, health insurance, or anything else, everybody wants to get the best value for their money. And health care is no different—that’s why it’s a good idea to shop around for a plan. Cost is an important factor in any purchase, especially when it comes to health care, but it’s not the only thing to consider.

There may be dozens of Medicare plans in your area, all with different costs and levels of coverage. How much are each plan’s premiums and deductibles? How much will you pay for the benefits and services you’re likely to use? Is there a limit on what you’ll have to pay out-of-pocket for the year? If you’re currently in a plan, how does that plan stack up to the other plans that are available? Thinking about these things will help you make a smart choice to get good value that meets your own health care needs.

Prescription drug coverage is another part of the cost puzzle. How much will your prescriptions cost under each plan? Does the plan cover the drugs you take? Remember, thanks to the Affordable Care Act, everyone who reaches the Part D coverage gap (or “donut hole”) will benefit from a discount of 60% on covered brand-name drugs.

Only you can determine what mix of benefits and costs will work best with your needs and budget, but we can help. The Medicare Plan Finder makes it easy to compare plans so you can pick a plan that meets your needs. After you’ve narrowed your options, you can call the plans you’re interested in to get more details about their benefits and services, or check out their websites.

And lastly, protect yourself from Medicare fraud. Medicare fraud wastes a lot of money each year and results in higher health care costs and taxes for everyone. Con artists commit Medicare fraud by getting people’s Medicare number. You can help fight Medicare fraud by never giving your Medicare number to get a free offer or gift. Protect your Medicare by protecting your Medicare number.

If you believe you or someone you know is a victim of Medicare fraud, you can:

• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
• Report it online to the Office of the Inspector General.
• Call the Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8477). TTY users should call 1-800-377-4950.

Brought to you by: Medicare

Read More @ https://blog.medicare.gov/2016/10/17/medicare-open-enrollment-smart-shopper/?linkId=31022960

Medicare 101: What is Part D?

What Is Medicare Part D and Who Qualifies?

*Repost* Brought to you by: TransAmerica: http://blog.transamerica.com/what-is-medicare-part-d#.V_QNDOUrJhE

Medicare Part A and B together make up what is known as Original Medicare and provide coverage for many things that are typically categorized as hospital insurance and medical insurance, including emergency care. But often, taking care of your daily health comes with medicines prescribed by your doctor. This is where Medicare Part D enters your healthcare picture.

What does Medicare Part D cover?

Simply put, Medicare Part D covers a patient’s prescription drugs. In the Medicare system, drugs are put intotiers based on formularies, which results in different price levels. Medicare Part D plans are generally set up to provide coverage at levels that correspond to the prescription drug tiers. In this guide, you can find a description of some common situations people face, as well as things to consider in each scenario regarding coverage options.

Who qualifies?

Medicare Part D is voluntary for everyone except those enrolled in Medicaid, or Medi-Cal for those in California. Because of that, anyone who is eligible for Medicare can sign up for a Part D coverage during the annual open enrollment period.

When should I enroll?

Enrollment follows the same initial rules as Plans A and B. You can apply three months before the month of your 65th birthday, within your 65th birthday month, and the three months following. Likewise, if you don’t select drug coverage when you first become eligible, and don’t qualify for an exception, you may encounter a late enrollment penalty that stays with you as long as you have Medicare drug coverage.

You don’t have to re-enroll each year, but you will have a chance to review your coverage and change plans if needed. In addition, certain changes in your circumstances throughout the year may prompt the need for aSpecial Enrollment Period (SEP). Rules for what you can change and when you can change it are different for each SEP.

How much does it cost?

The cost for prescription drug coverage isn’t as clear cut as with Parts A and B, since your cost will largely depend on which prescription drugs you take. Other variables include the plan you choose, if you use a pharmacy in your plan’s network, and if your prescriptions are part of the formulary of your chosen plan.

Since coverage for Part D is distributed through independent companies, you have a lot of options to choose from. We can assist you in getting started.

What about Part C?

Original Medicare is enough coverage for some people, but if you feel like you need extra benefits, that’s where Part C comes in. Part C plans are sometimes called Medicare Advantage plans. Medicare Advantage Plans are administered by private insurance providers, but are regulated by the government. They include most Part A and B benefits as well as prescription drug coverage, vision, hearing and dental services. Opting into a Part C plan means that you’ll receive benefits from Medicare Advantage instead of Original Medicare. Costs vary by plan.

For more information on Medicare, Transamerica Center for Health Studies^® has a guide that can help you compare the features of the different parts.

About Transamerica Center for Health Studies^®.
The Transamerica Center for Health Studies^® (TCHS) is a division of the Transamerica Institute^®, a nonprofit, private foundation. TI is funded by contributions from Transamerica Life Insurance Company and its affiliates and may receive funds from unaffiliated third parties. TCHS is dedicated to identifying, researching and analyzing the most relevant health care issues facing consumers and employers nationwide. For more information about TCHS, please visit www.TransamericaCenterforHealthStudies.org.

Benefit Awareness News

Benefit Awareness News | July 2016

Brought to you by: UHC

7 things to bring to your next doctor visit

When you need to see a doctor, it may save time if you already know what you need to bring with you.

Some of these things you'll need to gather right before your visit. But others can be ready to go ahead of time.

What to do in advance

Before your next sick day, make yourself a grab-and-go kit with these four things:

1. Your health plan ID card. You can review your benefits and print a copy of your ID card right from myuhc.com®.

Cool tool: Did you know you can use the UnitedHealthcare Health4Me® mobile app to view and share your ID card information with your doctor?

2. Your health history. Your doctor will want to know about your current medical conditions, as well as any past illnesses or surgeries.

Cool tool: You can use the Health4Me app to collect, track and share your personal health records.

3. A list of all the medications you take. Be sure to include both prescription and over-the-counter products, such as vitamins and supplements. And note how much you take and how often.

Cool tool: Use this prescription checklist any time your doctor prescribes a new medicine. It may help you better understand why you need the medicine — and how to take it safely.

4. A list of your questions. Asking questions may help you make more informed decisions about your health care. Between visits, jot down what’s on your mind so you won’t forget to ask.

Cool tool: Visit uhc.com/checklists to browse questions on a range of health topics.

What to gather on the fly

If you have time before you see your doctor, here are three more things that can help you have a good visit:

5. A cost estimate. Review your benefit plan — and understand what costs you may be responsible for.

Cool tool: You can compare estimated costs for procedures and providers at myuhc.com. Just look for the “Estimate Health Care Costs” button.

6. Online research. If you’ve looked up your symptoms or other information on a website, bring along your findings to discuss with your doctor.

7. A buddy. You can bring a friend or family member to your visit. This person can take notes, act as your advocate or offer other support.

What to do next
Not sure if you need a doctor? With NurseLineSM, you can talk with a registered nurse 24/7 for help with health or medication questions, finding a doctor or hospital, or understanding your treatment options. Choose the “Talk With Us” feature on the Health4Me app. Or call the member number on your health plan ID card.

Read More at:https://pages.unitedhealthcare-hmhb.com/page.aspx?qs=c76003443ff9837d856a4ecdb5606199ab3b8fdc602f72f559be5ce49c12de235f5c20efb4ad5feb3e34fc8158b800a0f9be8f401c14d0b8f536366a9e904fb2a41343590dff6a86f1e36b0de0e72e80ccae5e2c44fb0b36a0542a1870bf18a9 

NurseLine is for informational purposes only. Nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor’s care. NurseLine services are not an insurance program and may be discontinued at any time.

© 2016 United HealthCare Services, Inc. 9700 Health Care Lane, Minnetonka, MN 55343 USA.

Alzheimers: A defining disease for aging baby boomers

Alzheimers: A defining disease for aging baby boomers

*Repost Brought to you by: Aetna

Alzheimer’s disease is the sixth leading cause of death in the United States, killing more than 93,000 people each year. The progressive and fatal brain disorder causes issues with memory, thinking and behavior. Currently without a cure, Alzheimer’s has a good chance of being one of the defining diseases for Baby Boomers as they age.

Age is the greatest risk factor for Alzheimer’s disease. Once someone reaches 65, their risk of developing the disease significantly increases. An estimated one in eight baby boomers will get the disease after they turn 65. At age 85, that risk increases to nearly one in two.

The disease currently affects more than 5 million Americans, according to the Alzheimer’s Association. By 2040, when the Baby Boomer generation will be from 76 to 94 years old, Medicare costs related to Alzheimer’s are projected to account for more than 24 percent of total Medicare spending, or about $328 billion in 2014 dollars, recent analysis has shown.

Alzheimer’s is a family matter

It’s not just the person with Alzheimer’s that suffers, the caregivers — typically family and friends — often take the brunt of the disease. It is particularly hard because Alzheimer’s robs a person of their memories and independence, leading to a steady increase in the need for monitoring.

In 2015, 15.9 million family and friends provided 18.1 billion hours of unpaid care to those with Alzheimer’s and other dementias, according to the Alzheimer’s Association.

Nearly 60 percent of Alzheimer’s and dementia caregivers rate the emotional stress of caregiving as high or very high; about 40 percent suffer from depression.

A majority of caregivers report they are “somewhat” to “very” concerned about maintaining their own health since becoming a caregiver. One in five care contributors cut back on their own doctor visits because of their care responsibilities. Most people survive an average of four to six years after being diagnosed, but many can live for as long as 20 years with the disease.

Family members and friends providing care for someone (other than their children) have to squeeze in an average of more than 24 hours a week to take care of their loved one, according to AARP research. Caregiving is particularly time-intensive for those caring for a spouse or partner, which requires an average of 44 hours a week. That doesn’t leave much time for any of the other priorities you might have in your life. A good game plan can help get things under control.

Where can you find help for Alzheimer’s?

Non-profits like the Alzheimer’s Association and the Alzheimer’s Foundation of America offer good information on resources and support networks for patients and families. You can also search by zip code and/or state to find area resources.

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From the Desk of SBS:

As you read above, "1 in 8 Baby Boomers are susceptible to acquiring Alzheimer's and that increases to 1 in 2 around the age of 85. Along with that, care-giving for this disease requires an average of 44 hours a week." If this were to happen in your family, what would your game plan be? 

Senior Benefit Services has representatives all over the U.S. that would love to sit down with you to help you start planning. We are a brokerage that represents many reputable companies (such as above) and we offer a variety of insurance plans including: 

• Long Term Care
• Short Term Care
• Home Health Care
• Nursing Home Care

When something such as Alzheimer's arises in your life, we want your biggest worry to be enjoying those precious moments with your family - not worrying about the financial side of it.  
We're just one phone call away: 800-627-2768
Visit us Online at: www.sbsteam.net

Unexpected Costs of Medicare

The Unexpected Costs of Medicare

With a little planning, seniors on Medicare can minimize their out-of-pocket expenses.

Seniors can save hundreds – or even thousands – on Medicare costs through careful planning.

By Joseph P. WilliamsOct. 15, 2014, at 8:00 a.m.+ More

​Created in 1965, Medicare was intended to answer growing reports of impoverished seniors languishing or dying because they lacked health insurance. Since then, Medicare has acquired a reputation as the ultimate government entitlement, a system of low-cost, taxpayer subsidized health care provided at the stage in life when retirees need it most.

[Read: What You Need to Know About Medicare Open Enrollment.]

But the broad-reaching health care insurance system comes with costs that many seniors – including those already using the plan – don't see until the bills show up. Those out-of-pocket expenses, according to experts, can range from hundreds of dollars in monthly premiums and office visit copays to six-figure bills for surgery and hospitalization for things like joint-replacement operations, a procedure common among older Americans.

Those costs, which add up quickly, can stress or even break a household budget, particularly for retirees getting by on fixed incomes. Even declining to sign up for Medicare when you first become eligible, experts say, can cause a lot of pain in the wallet later on.

"A lot of people looked at Medicare as this Promised Land – 'Everything is covered, until the end of time,'" says Nicole Duritz​, vice president of health education and outreach for AARP, a nonprofit advocacy group. "I don't think people have a great understanding of how the system works. They're surprised at how much they'll have to contribute."

Compared to individual or group health insurance plans, "Medicare is unique in that it has no out-of-pocket spending limits," says Nancy Metcalfe​, a health policy analyst at Consumer Reports.

That's because Medicare plans are typically private health insurance policies that are government-subsidized. Nothing is completely covered, and no expense is 100 percent paid for. Though the subsidies paid to the insurance companies help keep costs low for seniors, the plans vary and usually require beneficiaries to pay some premiums.

There's good news, however: Metcalfe and others say a little planning, homework and realism can go a long way toward helping Medicare consumers keep more of their hard-earned money in their pockets.

That means seeing past the monthly premium payment to take a hard look at what may be some uncomfortable things – including a realistic assessment of your finances, anticipating how healthy you'll be during your sunset years and choosing what services you might need in a worst-case scenario.

Updated on Oct. 15, 2014: This article was originally published on Oct. 18, 2013 and has been updated to reflect new costs.

Visit Health News to Learn More: http://health.usnews.com/health-news/medicare/articles/2014/10/15/the-unexpected-costs-of-medicare

+ More

Medicare 101: What is Medicare Part A?

Medicare 101: What is Medicare Part A?

TransAmerica Page: Medicare 101: What is Medicare Part A?

Medicare can be confusing, but don’t worry. You aren’t the only one feeling that way. Although there are many benefits to Medicare, with its different components and enrollment periods, it can get a little confusing. In this three-part series, we’ll break down Parts A, B, C and D of Medicare down to their essentials. Here are simple answers to the most-asked questions about Part A:

What does Medicare Part A cover?

Medicare Part A combined with Part B, make up what is known as Original Medicare. Part A covers emergency care, hospital stays, some nursing home care, and other long-term visits such as home health services and hospice care.

Who qualifies?

• Seniors (age 65 and above) who are U.S. citizens and permanent residents.
• Individuals with qualified disabilities (age 64 and below).

When should I enroll?

You can enroll during your Initial Enrollment Period (IEP), which usually lasts 7 months:

• Three months before your 65th birthday or 25th disability check.
• Month of your 65th birthday or 25th disability check.
• Three months after your 65th birthday or 25th disability check.

If you miss your Initial Enrollment Period, you can sign up during the General Enrollment Period, which is from January 1 to March 31. If you sign up during this time, your coverage will start July 1. Please note that if you enroll during the General Enrollment Period you may have to pay a higher premium for late enrollment.

Fall Open Enrollment occurs every year between October 15th and December 7th and allows those who already have Medicare to change their coverage. We recommend you review your coverage every year, as this is the one time when all people with Medicare can make changes to their plans for the next year.

How much does it cost?

Part A plans are provided to you at no cost if you or your spouse have worked and paid taxes for at least 40 quarters (or 10 years).

If this isn’t the case, you will pay a monthly premium of up to $407. The exact amount you’ll pay is determined by different factors such as your income and assets.

If you’re concerned about the costs involved that aren’t covered by Medicare, Medicare Supplement Insurance can help cover expenses that you’ll have to pay out of pocket.

For more info, check out Medicare.gov and this chart published by the Transamerica Center for Health Studies®.

The Transamerica Center for Health Studies® (TCHS) is a division of the Transamerica Institute®, a nonprofit, private foundation. TI is funded by contributions from Transamerica Life Insurance Company and its affiliates and may receive funds from unaffiliated third parties. TCHS is dedicated to identifying, researching and analyzing the most relevant health care issues facing consumers and employers nationwide. For more information about TCHS, please visit www.TransamericaCenterforHealthStudies.org.

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