Medicare Questions – FAQ

Your Medicare questions answered. Review popular Medicare questions and answers. Where are the BEST Medigap rates? Does my doctor take Medicare? How do I find the RIGHT plan for my needs and budget? What are Medicare Advantage plans?

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Turning 65 – Medicare Questions

Most people turning 65 will be eligible for Medicare. What are my options? You should enroll in Medicare Part A and Part B if you are losing current health insurance. If you will continue receiving employer group health insurance coverage you may not need Part B.

Category: Turning 65
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Most people will enroll in Medicare Part A and Part B before turning 65. How do I choose the right plan? If you are currently receiving Social Security, you will be automatically enrolled effective the month you turn 65. If you need to apply direct you may do so no sooner than 3 months before your 65th birthday.  Use this link to apply online.

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Medicare premium costs for Part A are “prepaid” for most people who have qualified based on past Social Security earnings. Medicare Part B standard premiums in 2018 are $134. If your MAGI is above the threshold you may owe a tax in addition to your Part B Medicare premiums. Are Medicare premiums tax deductible?

Medicare Premium Costs

In addition to your Medicare premiums, you may incur additional costs for supplemental coverage, prescription drug plan or a Medicare Advantage plan.

Most people pay nothing for Medicare Part A if they have at least 30 quarters of earned income and paid Medicare taxes on those earnings.

Popular Georgia Medicare supplement plan premiums start around $100 per month in 2018. Popular GA Medigap plans limit your out of pocket expenses to the Medicare Part B deductible ($183 in 2018).

Medicare Part D monthly premiums are as low as $12 in 2018.

Many people do not pay a monthly premium for Advantage plans but that does not mean they are “free”. If you select an Advantage plan you will need to budget for planned and unplanned out of pocket health care expenses. Outpatient care may incur copay’s starting at $10 while some procedures may run $100 or more. Hospital inpatient care imposes a daily copay of several hundred dollars for a specific number of days.

Most GA Advantage plans are HMO models (2018) with small networks. HMO plans reserve the right to deny payment for claims incurred outside of your network.

Currently, many Advantage plans limit your annual out of pocket expenses for health care to $6,700 per year. These amounts do not include prescription drugs. If you use non-par providers your out of pocket expenses could be considerably higher.

 

#MedicarePartAPremium #MedicarePartBPremium #MedicarePartDPremium #MedicarePartCPremium

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Does original Medicare include dental coverage? Will Medicare pay for dentures? What kind of dental plans are available for folks over age 65? Are dentist discount plans good to have? How do they differ from dental insurance? Where do I find a good dental plan if I am on Medicare?

Medicare doesn’t cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you’re in a hospital.

Some employer plans allow retirees to continue their dental insurance plan. If you like your plan and can keep it into retirement, consider that option.

Senior Dental Insurance

Do Dentures Cause Dementia?

 

 

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Medicare Open Enrollment

Medicare Open Enrollment 2019. Shop Medicare supplement plans and Part D. New, lower Medigap premiums. Are higher drug costs coming in 2019?

Who is invited? Who should stay home?

Can anyone help navigate the Medicare maze?

So much information. So much confusion. Medicare Open Enrollment is not for everyone, and certainly not for the faint of heat.

If you think you already have all the answers, don’t read this post. If you believe Medicare open enrollment is for everyone you will probably learn something.

Medicare AEP is not a casual stroll. For most people, this is the only time you can change your Part D drug plan or Medicare Advantage plan.

Make a mistake and you will have to live with that decision for a year.

Medicare Open Enrollment 2019

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Finding the RIGHT plan

Finding the RIGHT Medicare plan. Medicare Advantage or Medicare supplement? Which is better? What is the difference. Which one is right for me? Are you turning 65? Where do I get honest information without sales pressure? Is there anyone out there who will just answer my questions?

The Right Medicare Plan for You

Finding the best Medicare plan that is right for you is easy . . . as long as you know the right questions to ask. For instance.

  • Do you travel in the United States?
  • Would you like to keep your doctor?
  • How much per year do you normally spend on health care?
  • Would you prefer budget your health care expenses or pay as you go?

Do you want to see all the Medigap rates in your area or are you content with reviewing plans from just a couple of carriers? Some agents will only show you one or two carriers, telling you both are the best, and say pick one. At least one of those carriers may be paying a bonus for each application. One carrier is currently (May 2018) paying as much as $150 per application for new business.

If you are about to turn 65 and enroll in Medicare you need good information to make the right decision. Find the plan that fits your needs and budget.

You have questions. We have answers. No selling, ever. Get instant GA Medigap quotes.

 

#BestMedicarePlan #BestMedigapRates #Turning65 #HonestAnswers

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Medicare Part D

Medicare Part D. What is it? How does it work? Do I need to buy a drug plan?

Turning 65? Enrolling in Medicare? How do I navigate the Medicare maze and find the best Medicare Part D prescription drug plan for my needs and budget?

Drug Plans Fail When You Least Expect It

Medicare Part D

Part D can be a snake pit if you don’t understand how it works. Medicare Part D can be a blessing for some but a nightmare for others. Seniors age 65 and older are not required to buy a Medicare Part D plan, but if you don’t and then later change your mind, you will be subject to a Late Enrollment Penalty (LEP) of 1% per month.

What is the Medicare Prescription Drug plan? How does the donut hole work? How can I avoid the donut hole? What if I can’t afford my prescription drug? Does Medicare cover vaccines? Doesn’t Medicare Part B cover prescription drugs? Why do I have to pay more because of my income? When is open enrollment?

Do you have questions like these?

I can help!

#MedicarePartD #MedicareDrugPlan #MedicarePrescriptionDrugInsurance

 

 

 

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Medicare Advantage Plans

Medicare Advantage plans seem to be popular. But why? What is the appeal? What is so attractive about these managed care plans? Are they really free?

 

Medicare Advantage – Why or Why Not?

Are you turning 65 and confused about the Medicare process? Why is it so difficult? Why do my friends, and many agents as well, want to push me in the direction of an Advantage plan? Low premiums are attractive. So is “free”. Is there really such a thing as a free lunch?Confused about Medicare Advantage plans?

Medicare Advantage plans are like the Hotel California. You can check in but you may never leave.

Some people turn to Advantage plans when they first go on Medicare at age 65. Low premiums, many are $0. Extra benefits like dental, vision and some have gym memberships. Drug plans are often included in the plan. “One stop shopping”.

What’s not to love?

 

Where are the traps?

Have you ever bought something and later realized you had no idea how it works? Maybe the sales person forgot to mention key details that might have changed your decision.

If something is too good to be true it probably is.

There is nothing inherently wrong with Advantage plans. You just need to understand what you have signed on for. Here are a few questions you need to ask.

Preferably BEFORE you enroll.

  • Is the plan a PPO or HMO?
  • Do I need a referral to see a specialist?
  • Will my doctor take my Medicare Advantage plan?
  • Are there any out of network penalties?
  • Can I change plans at any time?
  • Can I return to original Medicare and a supplement plan if I want?
  • Does the out of pocket limit include prescription medication?
  • What will my health care really cost if I use an out-of-network doctor?
  • Will my claims be paid if I use a non-par provider?

If you ask the right questions and are satisfied with the responses, the Medicare Advantage plan could be just what you need.

When you enroll in a managed care Advantage plan, the insurance carrier, not Medicare, provides your benefits then reviews, adjudicates and pays your claims.

“No premium” plans are not free. You still have to pay for health care and prescription drugs.

There is no free lunch.

Health care is not free. SOMEBODY pays the bill. Either you or the insurance carrier.

But you knew that all along, didn’t you?

 

This Doesn’t Look Like Kansas Anymore

Managed care plans often have small provider networks. Fewer doctors. Fewer hospitals. The question is, how much smaller?

A Kaiser Foundation survey found that on average “Medicare Advantage plan networks included 46% of all physicians in a county.” Some plans had fewer than 5 thoracic surgeons, fewer than 5 neurosurgeons and fewer than 5 radiation oncologists.

This isn’t JUST about dollars. It is also about access to health CARE.

Each calendar year brings a new list of approved providers. Will your doctors be included or will they disappear into a dark hole?

Are you willing to change doctors to save money or pay more to keep your doctor?

Are claims submitted by non-par providers covered by your plan?

A recent government report says seniors are more likely to LEAVE managed care plans when they get sicker.

Managed care is great when you enjoy good health. But how much will your plan cost when your health changes dramatically? Can you really afford to be sick?

 

Final Exam Time

Many who enroll in a managed care plan never really understood how the plans work . . . until they had large claims. Don’t be one of them!

Do you like your current doctor(s)? Would you like to keep him or her?

Can my doctor refuse to treat me if I have a Medicare Advantage plan?

Do you want to direct your own health care, pick your own doctors and hospitals, or would you rather let an insurance carrier do that for you?

Is it easier for you to budget $120 per month to cover almost all of your health care costs or are you OK paying for your health care only as needed?

Could you budget $6,000 per year or more for your health care (not including drugs) if you had to?

How long could you afford to pay that much? One year? Two years? Longer?

Would you trade places with Marsha’s husband?

You can change your Advantage plan every year. Same is true for your drug plan. You can also enroll in original Medicare any time you want without answering health questions.

But if you want to change to a Medicare supplement plan you may need to prove you are healthy. Your best shot at getting a Medicare supplement plan is when you first enroll in Medicare Part B. If you wait until you NEED a Medigap plan you may not be able to get one. That is Catch-22.

Many will only have one chance to enroll in a Medigap plan. Will you be one of them?

Medicare.

You have questions.

We have answers.

 

#MedicareAdvantagePlans #FreeMedicarePlans  #MedicareHMO  #MedicarePPO

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Medicare Myths

Does my doctor take Medicare? How much does Medicare pay doctors? What percent of doctors do not take Medicare? Do all doctors accept Medicare? How do I find Medicare providers? If you are about to turn 65 and enroll in Medicare, you need answers to these questions.

Medicare Doctor

Ask your doctor if they take Medicare assignment or use Physician Compare. Medicare providers will be paid by EFT. More than 90% of PCP’s accept Medicare. 

If you currently have a regular doctor there is a good chance you can continue to see your doctor as long as you opt for original Medicare and a supplement plan. However, many doctors do not participate in at least some Advantage plans. Ask your doctor before enrolling in Medicare.

Medicare participating doctors are paid a fee for services rendered. Congress sets payment guidelines for Medicare participating doctors.

Most primary care doctors participate in Medicare and accept assignment of benefits. On the other hand, many psychotherapists and gynecologists often choose to opt out of Medicare. In this case you are expected to pay cash at the time of service.

 

#MedicareDoctor #MedicareAssignment #MedicarePhysicianFinder

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  • Jessica Jones says:

    Bob, you are the best. Your information is so helpful. This is a new area to me and it is now the time for me to look at this and find the answers I need to help me decide which is the best way to go, the best plans to take. Thank you so much and we will be in touch.

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