Medicare 101: What is Part C?

Medicare 101: What is Medicare Part C?

*Repost* Brought to you by: TransAmerica: http://blog.transamerica.com/medicare-101-part-c#.V_QMAuUrJhE

If you’re choosing your Medicare insurance plan, or helping your parents choose theirs, the details can get a little confusing. We already helped lay out Part A and Part B for you, so now it’s time to explain Part C.

Medicare has four parts: A,B,C, and D. Each has a different benefit to offer you, but Part C is a little different than the others. Parts A and B together provide what’s called Original Medicare under the public healthcare system. Part C is different in that it is offered through private companies approved by Medicare.

What does Medicare Part C cover?

Medicare Part C, also called Medicare Advantage plans, are private plans, like Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), and others. These plans must offer the same benefits as Original Medicare. However, the costs associated with your healthcare services will vary depending which plan you choose.

Some people choose these plans over Original Medicare because they can offer additional benefits and cover more services, though that isn’t guaranteed for every plan.

Who qualifies?

Qualifying for Medicare Part C is fairly simple. People who qualify for Medicare Part C are already enrolled in both Medicare Part A and B. A person must also choose a Medicare Advantage plan that’s in the service area he or she lives in.

When should I enroll?

Like with Medicare Parts A and B, you’ll need to enroll when you first become eligible, and can change plans during the Open Enrollment Period (October 15-December 7). To unenroll, you’ll need to do so between January 1-February 14.

Your Initial Enrollment Period is seven months long, and starts three months before your 65th birthday, includes you birthday month, and the following three months after that. After this time, you’ll have to wait for Open Enrollment to sign up.

How much does it cost?

The cost will vary according to which plan you choose for yourself, but since Part C is still a part of Medicare, you’ll have to keep paying your Part B premium. The out-of-pocket costs will also differ, according to your chosen plan.

If you’re looking to add coverage to what Original Medicare offers you, then Part C may be a good option. However, if you still have some questions, you can find the answers on Medicare.gov.

You can also get more information about Medicare from Transamerica Center for Health Studies^®’ helpfulguide.

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.

Medicare Made Clear

10 Key Medicare Facts

Your Medicare journey may be smoother when you understand the rules of the road.

Medicare is a complex subject. Watch this video to get the main ideas behind it. Then you can dig deeper into what’s most important to you

10 Key Medicare Facts Summary

1. There are two main ways to get Medicare.

   • Original Medicare (Parts A and B) which is provided by the federal government
   • A Medicare Advantage plan (Part C) offered by a private insurance company

2. With Original Medicare, you may pay a share of the cost.

   • You contributed to Medicare by paying taxes. That’s why you’re eligible for Medicare when you turn 65.
   • Original Medicare may not pay for everything. You may pay a share of the cost in monthly premiums and copays.

3. Medicare supplement insurance helps with some out-of-pocket costs.

   • Medicare supplement insurance plans help with some of the expenses Medicare Parts A and B don't pay.
   • Medicare supplement insurance plans are offered by private insurance companies

4. Prescription drug coverage may help limit drug costs.

   • Original Medicare does not include prescription drug coverage. However as a Medicare member you can get Medicare Part D prescription drug coverage.
   • Prescription drug plans, also known as PDP, and Medicare Advantage plans are offered by private insurance companies.
   • You can enroll in a stand-alone Part D plan to go with your Original Medicare coverage.
   • You can enroll in a Medicare Advantage plan that includes prescription drug coverage.

5. Coverage choices vary by plan type and state.

   • Original Medicare (Parts A and B) is the same across the United States.
   • Medicare Advantage (Part C) and prescription drug (Part D) plans are offered by private insurance companies and may be available only in certain counties, states or regions.
   • Medicare supplement plans travel with you nationwide. The plans are standardized, but the availability may vary by state.

6. Your initial enrollment in Medicare is time sensitive.

   • The Initial Enrollment Period (IEP) is your first chance to enroll in Medicare. It’s the three months before your 65th birthday month, the month of your birthday, and the three months after your birthday month.
   • If you are eligible for Medicare due to disability, your IEP is based on your disability date.
   • Late enrollment penalties may be incurred for missing certain enrollment periods for Part B and prescription drug coverage.

7. Your health care needs may change over time.

   • After you choose your Medicare coverage, you can make changes once a year during Medicare Open Enrollment, October 15 through December 7.
   • You may change your coverage at certain other times if you qualify for a Special Enrollment Period.
   • Review your coverage each year to see if it still fits your needs.
   • These enrollment period restrictions do not apply to Medicare supplement insurance.

8. Special Enrollment Period (SEP).

   • In some cases you may be able to enroll in or switch plans at times besides your IEP or Medicare Open Enrollment.
   • You may qualify for an SEP if you retire and leave a health care plan sponsored by your employer or union.
   • You can usually use an SEP to change your coverage if you move out of your current plan’s service area.

9. Medicare can work with other health insurance.

   • Group or retiree health insurance sponsored by an employer or union can work with Medicare.
   • Your plan administrator can help you figure out how Medicare could work with your current coverage.
   • Medicare supplement plans work with Original Medicare, but not with Medicare Advantage plans.

10. Help is available.

    • Medicare can be complicated, but help is available.
    • You may qualify for financial help.

Medicare Made Clear: Brought to you by UnitedHealthCare

https://www.medicaremadeclear.com/about/medicare-facts?mrcid=display_fed&utm_source=YouTube&utm_medium=display&utm_content=Top10_3&utm_campaign=MMC+YouTube_TrueViewVID

2016 Best List Of Senior Discounts

FEBRUARY 28, 2016 BY THE SENIOR LIST 27 COMMENTS

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The Best List of Senior Discounts on the web.  Feel free to share it with friends and family!

© The Senior List, 2016. If you plan on recommending any of our discount lists, please do so with appropriate attribution to The Senior List® and a link back to our website. Thanks!  If you’re looking for a printable version of our list you’ll find it in our community library (members only area) located —> HERE.

*Please note: Many of the discounts you’ll see below are offered by franchise owners in local markets.  This means that discounts will vary from location to location.

We had an incredible response to our 2015 senior discount lists published last year.  Many of the service providers on our 2016 senior discounts list have been verified and those that have with be noted with a “verified” flag.  We reached out to all the businesses on our list, but some were unresponsive.  As usual, we’ll  rely on our community (you) to provide updates as you uncover them.  Use the comments section to help verify discount policies and/or note the specific senior discounts in your local area.Be the first to hear about new Discount Lists by joining us on Facebook.  We’re building an online community where people can engage with each other, provide advice, discuss products, and more.

Please understand that discount policies do change.  They change at the national level, and they change at the local level.  Sometimes these changes are published, and sometimes they’re not.  Our best advice for discount shoppers is to ask ahead of time so there are no surprises.

2016 Best List Of Senior Discounts

This master list of senior discounts is meant to be a guide, and with your help we’ll keep it updated throughout the year.  If you’re looking for short versions or printable versions of the individual categories, just navigate to the category “header”, and it will link you to that specific discount list.  You can also click the printer icon below for a printable list.

Senior Discounts at Grocery Stores

ALSO READ: Senior Discounts to Add to Your Repertoire in 2016

Albertsons: 10% off first Wednesday of each month ( 55 +)
American Discount Stores: 10% off every Monday (50 +)
Compare Foods Supermarket: 10% off every Wednesday (60+)
DeCicco Family Markets: 5% off every Wednesday (60+) verified
Fred Meyer senior discount: 10% first Tuesday of each month (55+) verified
Fry’s Food Stores: 10% off on the first Wednesday of every month (55 +) verified
Get free printable coupons now from Coupons.com
Great Valu Food Store: 5% off every Tuesday (60+)

Like Us on Facebook for More Updates

Gristedes Supermarket: 10% off every Tuesday (60+)
Harris Teeter: 5% off every Thursday (60+) verified
Hy-Vee: Says “Yes” (but discount policy varies by locale) verified
Kroger: 10% off (date varies by location) verified
Morton Williams Supermarket: 5% off every Tuesday (60+)
New Seasons: 10% off every Wednesday most items (65+), 10% off every Tuesday for militaryverified
Publix: 5% off every Wednesday ONLY in Tennessee, North Carolina and the northern portions of Alabama, South Carolina and Georgia (60 +) verified
Rogers Marketplace: 5% off every Thursday (60+)
Uncle Guiseppe’s Marketplace: 5% off (62+ on Wednesdays)

ALSO READ: Senior Discounts And Customer Loyalty

Senior Discounts On Prescriptions

AARP:  With the AARP Prescription Discount Card (provided by Catamaran an OptumRx company), AARP members and their families can access an average savings of 38% off prescription drugs (regardless of age or health status).  Must be a member of AARP to access benefits.  AARP boasts acceptance by 64,000 pharmacies nationwide. verified

Rite Aid:  Sign up for the Rite Aid Rx Savings Program.  Save 15% or more on thousands of brand name and generic prescription drugs by signing up for the Rite Aid Rx Savings Program. When you sign up, you’ll receive Rx Savings Card that gives you access to special discounts at Rite Aid pharmacy. verified

Costco Member Prescription Program:  The Costco Member Prescription Program is a prescription savings program for you and your family. It allows Members who have no prescription drug insurance or whose insurance does not cover all of their prescription medications. Save 2% – 40% at time of sale. verified

CVS Pharmacy:  Enroll in the CVS ExtraCare Savings and Rewards program.  You’ll receive “ExtraSavings” through personalized coupons delivered on receipts, and online via theExtraCare Coupon Center. ExtraBucks Rewards are earned by shopping and filling prescriptions.  You can earn up to 2% back in ExtraBucks Rewards from your everyday purchases.  Also, if you fill 10 prescriptions, your can earn $5 ExtraBucks Rewards through the ExtraCare Pharmacy & Health Rewards program.  verified

RELATED READ: PRESCRIPTION DRUG PRICES ON THE RISE

Kmart:  The Prescription Savings Club at Kmart (Pharmacy Savings Plus) is annually $15 per household or $10 per person.  You and the family are then covered  for certain generic drugs (starting at $5 for a 30-day supply and starting at $10 for a 90-day supply). The Drug Price lookup tool is an easy way to see if and how much you can save.   You can even get discounts on pet medications with a prescription from your vet. verified

Target: Target pharmacies are being rebranded to CVS Pharmacy brand.  This change is underway now.  Your Target (CVS) Pharmacy will already have your prescription records on file. You’ll be able to access your records and refill your prescriptions at CVS.com/Target or by visiting CVS Pharmacy inside Target stores.  Target says “As of December 16, 2015, Target Pharmacy guests have automatically moved to CVS Health’s network. Guests are encouraged to call their health-plan provider with any questions. For general pharmacy questions, you can contact your local pharmacy or CVS Customer Relations: 1-800-SHOP-CVS (1-800-746-7287).  The Target Prescription Savings Plan is no longer being offered.  It will be replaced with the CVS pharmacy and CVS rewards plan (which you can review above). verified

Walgreens Prescription Savings Club:  Membership fee required ($20 individual or $35 family per year). Walgreens Prescription Savings Club members get special discounts off the cash price of thousands of brand-name and generic medications as well as other benefits when they use their Prescription Savings Club Card. Additionally, if you don’t save at least the cost of your membership fee in one year, Walgreens will give you the difference. verified

Walmart Pharmacy Services: Walmart pharmacies offer low-cost generic prescription medications that can save you money. Walmart carries both generics (where they boast $4 refills) and branded drugs.  Check out the Walmart drug list to see if you can save on your medications. verified

Narcup.com: Start saving money today with Narcup.com’s prescription discount card for credit union members age 50 plus. However, it is also open to the general public. The program is for families, children and grand children who have no prescription drug insurance or whose insurance does not cover all their medications.

By using their prescription discount card, a person can save up to 50% on FDA approved drugs. In addition to 18,000 independent pharmacies, large chains including Walgreens, Kmart, Target, CVS, Rite Aid, Publix, Winn-Dixie and Safeway also participate in the network.Narcup.com does not charge any membership dues or fees. You can print off a prescription card and use it immediately. You can request a durable card by mail. A nice feature of the program is that you can look up your medication price based on your zip code. You can also compare prices at other pharmacies. verified

Click to read more: https://www.theseniorlist.com/2016/02/2016-best-list-senior-discounts/ 

Conservative lawmakers, Aetna CEO 

suggest Advantage plans could help save 

Medicare

By Shannon Muchmore and Bob Herman  | March 16, 2016

(Story was updated at 4:27 p.m. ET) 

Lawmakers, health policy experts and the chief executive of one of the nation's largest insurers believe Medicare Advantage could help keep the Medicare program solvent.

On Wednesday, the House Ways and Means Committee's Health Subcommittee held a hearing on Medicare's future. The Medicare board of trustees said in its most recent annual report that Medicare will be able to cover its costs until 2030, but suggested congressional action to strengthen the program's future.

Robert Moffit, a senior fellow at the right-leaning Heritage Foundation, suggested increasing the age of eligibility for Medicare, implementing means testing, expanding direct contribution abilities and combining Medicare Parts A and B.

Health Subcommittee Chairman Rep. Pat Tiberi (R-Ohio) said he agreed with many of those proposals and that changes had to be made to account for the increasing elderly population.

“Despite major improvements and innovations in the healthcare sector that have transformed how care is delivered, traditional Medicare has barreled through the last 50 years on the same trajectory of increased costs and little innovation,” he said.

Medicare reforms pop up every year in Congress during budget battles, butlittle is actually done. Conservatives traditionally have supported a premium-support model for Medicare, while liberals have championed a morestreamlined approach. Single-payer, or Medicare-for-all, also has wide support from many left-leaning economists and supporters, although the industry has opposed that model.

Aetna CEO Mark Bertolini said Wednesday he has another idea.

Medicare Advantage, the private managed-care version of traditional Medicare, will be “the solution to entitlement reform around health benefits,” he said at the annual Barclays Global Healthcare Conference.

Aetna has more than 1.36 million Advantage members, according to March figures from the CMS, and it stands to become the largest Medicare insurer in the country through its $37 billion buyout of Humana.

Bertolini's comments came after he was asked his thoughts about last summer's speed-dating among health insurers. If federal and state regulators approve Aetna's acquisition of Medicare powerhouse Humana, which remains a big “if,” the combined company would have a presence in markets that make up more than 90% of the eligible Medicare population. It would allow Aetna to offer a “nationally portable” Medicare Advantage product that the government believes can help slow down the growth of Medicare's costs, he said.

“I think Medicare fee-for-service is a moving target,” Bertolini said, adding that Medicare Advantage would then become “more of a default program.”

Medicare Advantage already enrolls more than 18 million people and has garnered support from Democrats and Republicans alike, although serious issues have been raised about the program.

For instance, some observers have said Advantage plans are acting “unethically” by inflating patient risk scores conducted during home visits to gain higher payments, but then aren't pursuing follow-up care. Federal policy moves to save Medicare revenue at large players also have caused consternation.

At Wednesday's House committee hearing, Katherine Baicker, a health economics professor at the Harvard Chan School of Public Health, said Medicare Advantage plans should be key to keeping Medicare available for future generations.

A "one size fits all" Medicare program will be increasingly difficult to maintain, she said. “A thriving and competitive Medicare Advantage program can be a vital contributor to high quality beneficiary care in a sustainable healthcare system.”

Rep. Jim McDermott (D-Wash.), the ranking member of the subcommittee, pushed back on the ideas brought forth by his Republican counterparts, saying those plans could “have devastating effects.” He also said Medicare Advantage plans are being overpaid and allowed to cherry-pick healthier beneficiaries.

Stuart Guterman, a senior scholar in residence at AcademyHealth, agreed and said the elderly and disabled are the “least prepared to bear that additional burden.”

“Policymakers are confronted, therefore, with the question of how to continue to slow the growth of total Medicare spending when the spending per beneficiary already is increasing so slowly,” he said.

Harvard's Baicker said more radical changes are needed because the system is out of balance.

“I think something fundamental about the system has to change to preserve the viability of the program,” she said.

Want to see more? Visit this link from modern healthcare: http://www.modernhealthcare.com/article/20160316/NEWS/160319921/conservative-lawmakers-aetna-ceo-suggest-advantage-plans-could-help

2016 || Health Insurance Regulations

The Fee for not having health insurance...

Brought to you by: healthcare.gov

If you don't have Health Insurance: How much you'll pay

If you can afford health insurance but choose not to buy it, you must pay a fee called the individual shared responsibility payment. (The fee is sometimes called the "penalty," "fine," or "individual mandate.")

• You owe the fee for any month you, your spouse, or your tax dependents don’t have health insurance that qualifies as minimum essential coverage. See all insurance types that qualify.
• You pay the fee when you file your federal tax return for the year you don’t have coverage.
• In some cases, you may qualify for a health coverage exemption from the requirement to have insurance. If you qualify, you won’t have to pay the fee. Learn about health coverage exemptions.

Learn more about the individual shared responsibility payment from the Internal Revenue Service.

The fee for not having health insurance in 2016

The fee is calculated 2 different ways – as a percentage of your household income, and per person. You’ll pay whichever is higher.

Percentage of income

• 2.5% of household income
• Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace

Per person

• $695 per adult
• $347.50 per child under 18
• Maximum: $2,085

Paying the fee

• Using the percentage method, only the part of your household income that’s above the yearly tax filing threshold ($10,150 for individuals, $20,300 for couples filing jointly in 2014, the most recent year available) is counted.
• Using the per-person method, you pay only for people in your household who don’t have insurance coverage.
• If you have coverage for part of the year, the fee is 1/12 of the annual amount for each month you (or your tax dependents) don’t have coverage. If you’re uncovered only 1 or 2 months, you don’t have to pay the fee at all. Learn about the “short gap” exemption.
• You pay the fee when you file your federal tax return for the year you don’t have coverage.

The fee in previous years

The fee for not having coverage in 2015

The penalty for 2015 is the higher of these:

• 2% of household income
• Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace

OR

• $325 per adult
• $162.50 per child under 18
• Maximum: $975

The fee for not having coverage in 2014

The penalty for 2014 is the higher of these:

• 1% of household income
• Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace

OR

• $95 per adult
• $47.50 per child under 18
• Maximum: $285

More answers: The penalty for not having health insurance

Link: If I'm unemployed, do I have to pay the fee?

What happens if I don't pay the fee?

The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee.

Barnes Insurance Group Reintroduced

We hope this first blog of ours finds you well - and we hope that your 2015 has gotten off to a GREAT start! We wanted to take this opportunity to make a quick announcement and give you some updates.

Barnes Insurance Group/Senior Benefit Services is transitioning to one name:

Senior Benefit Services

(visit the new website: www.sbsteam.net)

Click on the new design above to visit SBS's new website!

We are still the same great company we have been for over 40 years, with the same office address, phone numbers, and great service from our agents & staff.

As always, if you have any questions or concerns, please don’t hesitate to contact us. As part of our consolidation into one company, making sure we have your most current contact information is important so that we can keep you informed of any updates and changes with your insurance coverage. Many of our clients have cancelled their land lines or changed from P.O. Box to 911 addresses, so if you would be so kind as to fill out your updated info (using the link below) we sure would appreciate it!  Our goal is to always provide the top notch service that you have come to expect from us!

Here’s to the rest of the year, with many Happy Returns!

Your Friends at,

Senior Benefit Services