Medicare Supplemental Insurance

Archive for the ‘Medicare Advantage’ Category

The 2010 Medicare supplement Modernization Act will certainly update current Medicare Medigap insurance plans countrywide. Nevertheless, it can not affect any existing Medicare Supplemental coverage which you have.

This exclusively has an effect on individuals that buy a brand new plan with an effective date of coverage on or after June 1, 2010. In case you already possess a Medicare Supplement insurance policy, your own health benefits are not going to change and also you are guaranteed to keep your policy given that you continue paying your payment. You will end up grandfathered in to the old plan benefits, nevertheless could possibly have a chance to go on to a new program if it performs better for you.

In case you are turning 65 on or after June 1, 2010 or considering a Medicare Medigap switch on or perhaps after that date, you’ll want to pay special attention to the brand new insurance plans and the way they’ll have an impact on you. The key modifications are going to be:

The Preventive Care and At Home Recovery features will be removed completely from all policies which bundled them prior to June 1st, 2010. Medicare has made the decision that these kind of benefits, that weren’t used very often will not be worthy of inclusion in the standard Medicare Medigap insurance plans moving forward, consequently they’ve been peeled off all policies which had them.

Together with the removal of those two benefits many of the plans are going to mirror several other policies exactly, therefore in order to reduce multiple policies with the very same coverage, plans E, H, I along with J will not be available to buy.

Yet again, make sure you try to remember for those who have a plan which won’t be available immediately after June 1st, 2010 you’re grandfathered in and get to maintain your current plan, your features cannot change.

For the brand new policies being launched immediately after June 1st, 2010, there will be a new Hospice feature added as a standard benefit within all the plans. This will now be regarded as a core feature and will be an integral part of all of the brand new plans.

The biggest revision is actually the addition of two new plans, Plan M and also Plan N. Those two plans promise to be a very practical choice for all those currently on a Medicare Advantage plan which are either losing their insurance or facing the significant rates increases / benefit decreases which are predicted in these the years to come.

Each plans will certainly use a different cost-sharing to allow for lower prices. Plan M will make the covered responsible for Half of the Part A deductible, while Plan N will have a $20 doctor’s office co-pay and a $50 emergency room co-pay. Both plans estimate to have 15-30% lower monthly premiums as compared to existing Medicare Supplement Plan F.

At the time of the witting of this article, there has not been virtually any details released with who will likely be selling these brand new plans or the exact costs. I highly recommend you subscribe to our site at www.medicaresupplementdirect.com with regard to up-to-date info as it is published.

For those of you on a Medicare Advantage plan, if you have not taken a look at the benefits that are being offered for next year, we recommend that you take a look and compare them to what your benefits were last year.  What we have noticed for a lot of the plans is that they are keeping the monthly premium and Doctor office co-pays pretty close to what they were last year, its the hospital copay and out of pocket maximum is where the biggest change is.

A lot of the plans now follow the per day copay for each visit to the hospital which could be somewhere in the neighborhood of $200 on up to $250 per day for the first 7 days or more.  This per day charge can add up pretty fast considering the average stay is somewhere between 5 and 7 days.

The other major change so a lot of the Medicare Advantage plans is that your exposure our out of pocket maximum has jumped.  Depending on the plan you could be responsible for $5000, $8500 or more if you are getting benefits out of the network.

Yes these plans work great for some people, however the most important factor is that you know what your responsible for with any plan you choose.

I have to start by saying the reason for this post has made me said, not because we were able to review an move a new client to a better program, but because she was paying over $6000 a year for just her prescriptions.

For every person there is a program that fits their needs, however when you are not placed into the proper program, you spend much more than you need to.  In an earlier post I noted that depending on the Part D prescription program that you were enrolled in, the difference in cost from the lowest cost to the highest cost averaged $3000 for the year.

Now to get to the point of my post.  A new client walked into my office this past week with her current plan details and a list of her prescriptions.  She was currently on a Medicare Advantage HMO plan which included prescription coverage.  Over the course of 2009 she spend $5980 some dollars on just her prescriptions, not to mention her co-pays and deductibles she was responsible for through her medical side of the plan.

When it was all said and done, to make a long story short, we moved her to an individual Part D prescription plan and saved her $900 dollars this coming year just on her prescription program.  (The $900 savings for the year already factors in the monthly cost of the Part D prescription program and all out of pocket cost including copays)

That $900 savings for the year broke down to $75 savings per month.

Her Medicare Supplement Plan J was going to run her $147 per month.  So $147 – the $75 savings means the net cost of her Medicare Supplement is now $72 per month

Her prior Medicare Advantage plan was charging her $20 per month just to be on the plan, plus the co pays and deductibles.

So now you take the $72 additional dollars she is spending and subtract the $20 that she was going to pay for her Medicare Advantage plan and she  is only spending $52 more per month.

THATS NOT ALL!  I must also point out that her Medicare Supplement Plan J does not have any of the hidden expenses such as co-pays or deductibles like her Medicare Advantage had.  So when we factor in the co-pays that she spent with her Medicare Advantage, she saved WAY more by moving to the individual Medicare Supplement and Part D prescription program.

The point I am trying to make here along with everyone of my post is: Just because an agent says they can get you a Medicare plan, does not mean they have access to the proper products for your needs.  Make sure you get with someone who will educate you on all your options so you can make a good decision.

Best Luck,

Travis

November 15th through December 31st 2009 is the Annual Open Enrollment for Medicare Advantage and Medicare Part D plans.

What does this mean?  You can elect to make a change to your Medicare Advantage or Medicare Part D plan if you need to.  If you make a change, the last change you make will be the one that goes into effect on January 1st 2010.

If you have a Medicare Supplement, this does not apply to that plan.  With a Medicare Supplement, if you are healthy and can answer the qualification questions, you can make a change at any time.  If you have had some health challenges, there might be some opportunity on changing your Medicare supplement options, just give us a call so we can help determine the best options for you.  Call 816-254-6100 or toll free 1-888-535-0999

For those with a Medicare Advantage plan or a Medicare Part D (prescription) plan, starting on November 15th and going through December 31st you can make a change to your current program which will take effect on Jan 1st, 2010.

This Annual enrollment period does not allow you to make a change to your medicare supplement since those are a different type of insurance policies and do not follow the Annual / Open Enrollment periods set by Medicare for the Advantage and Part D programs.

The reason that the Medicare Advantage and Part D programs have Annual and Open Enrollment periods is because they are a contract between Medicare and private insurers for those benefits and the enrollment periods are set around the fact that the contracts follow the calendar year.

Medicare Supplements are not direct contracts with Medicare and therefore do not follow the Annual / Open enrollment periods that Medicare Advantage and Medicare Part D follow.  Medicare Supplements have their own open enrollment periods and guarantee issue periods that may have special options for you depending on what state you live in.  Contact an agent for more information.