Georgia Medicare Plans

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Welcome to Medicare – What’s Covered?

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Welcome to Medicare. What’s covered, what isn’t?  In the exam room I notice a sign. “Lab work is not covered by Medicare“. You owe $289. Do not pass go. Do not collect $200.

Welcome to Medicare physical exam? Covered. Lab work? Not covered.  Really? You turned 65 and signed up for Medicare. What happens next?

Here is a short introduction to Medicare. What’s covered, what isn’t,  and what to expect

  • Medicare’s definition of preventive care has surprises
  • Lab work may not be covered
  • Medical necessity is the rule
  • Free exams aren’t always free

Whether you have original Medicare and a supplement or you enrolled in an Advantage plan, the underlying rules of what is covered and what isn’t are the same. The difference is in how you pay for it.

You might want to view our Medicare Exam video on YouTube

Turning 65 – Welcome to Medicare 2019 – What’s Covered?

dr kildare

By the time you reach 65 and enroll in Medicare, most people have a doctor (or doctors) they like and trust. They want to continue that relationship and are not interested in picking a doctor from a list provided by an insurance company.

Georgia Medicare Plans specialize in helping you keep your doctor(s) and finding a Medicare supplement plan that fits your needs and budget. We have rates and information on more than 230 different Medigap plans and will provide a FREE REPORT on all plans based on your age, gender and zip.

You can start your research by comparing rates and benefits for roughly 30 plans by getting an INSTANT GA Medigap quote.

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I understand your confusion. Most people want information so they can understand what lies ahead. They want the time to read, make notes and ask questions.

Most of the insurance agents you will talk to are not old enough to enroll in Medicare and have not experienced it first hand. Bob Vineyard turned 65 in September, 2015 and enrolled in Medicare. In spite of 40 years in the health insurance business and over 400 Medicare clients, I am still learning things every day about how Medicare works.

Ask me anything. Others talk, we listen.

Welcome to Medicare Surprises

When I turned 65 and signed up for Medicare, one of the first things I did was schedule my Welcome to Medicare physical.

Because I chose original Medicare and a supplement plan, I was able to keep my doctor. My group insurance plan required me to have an annual exam and wellness interview so there should not have been any surprises with my Welcome to Medicare exam.

That was the wrong assumption.

While waiting in the exam room I saw a notice on the bulletin board.

Lab work is not covered by Medicare

Seriously? What’s that all about?

Preventive screenings are covered by Medicare in the following situations

  • Abdominal aortic aneurysm scan – Men only, if you smoked 100 cigarettes in your lifetime
  • Bone density – Mostly women, if you are estrogen deficient or have osteoporosis
  • Lab tests – Only if considered medically necessary by Medicare

What is considered medically necessary?

Medicare defines medically necessary as tests or treatment needed to diagnose or treat an illness, injury, condition, disease or symptoms that meet accepted standards of care.

Preventive lab work may not be covered by Medicare.

Congratulations! You are healthy. Your test is not covered!

not covered

I take no medications. For the last few years my doctor has run routine lab work to make sure my body is doing what it is supposed to. As much as it galls me to say, my Obamacare plan covered routine tests like CBC, Lipid Panel, CMP, etc. at no charge to me.

These tests were not free. The labs and technicians do not volunteer their time. The costs associated with the lab tests were absorbed by the health insurance carrier and baked into the premiums.

Not so with Medicare.

Those under age 65 pay nothing.

If you are 65 and older, there is no more free lunch.

When I asked about the sign on the wall. The one that said “Lab work is not covered by Medicare” her response took me aback.

Medicare generally doesn’t cover those tests if you are healthy. But if you were sick, they would pay for them.

Sign this ABN form. If Medicare denies the claim you will have to pay the cost of your lab work. You will owe $289.

So much for my “free” Welcome to Medicare exam.

Medicare physical exam.

Is it covered? Is it free? How much will I have to pay?

Original Medicare is quite good in most respects. No more doctor networks. Forget about balance billing (when you use Medicare providers that accept assignment).  Huge bills for health care are a thing of the past.

So exactly what is covered, and what isn’t? Check out this free Guide to Medicare Preventive Services. And yes, it really is free. Click to download.

More ways to save money.

Most of the retirees we talk to are paying too much for their Medicare supplement plan. Many are facing rate increases. One large Mutual company has increased rates 10 times since 2012!

Medigap plan F will be retired in 2020. Switch now if you can. Plan G is popular with over 90% of our clients. Some have not had a rate increase in two years.

Get a free GA Medigap quote.  FREE report listing rates for all plans based on your age, gender and zip code  sent by email once we confirm your information.

GA Medigap quote

You need to be informed. The more you know and understand the better it will be for your bank account.

#MedicareLab #WelcometoMedicare #GAMedicareExpert #GAMedigapRates

Going on Medicare Age 65

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Going on Medicare at age 65. Can I sign up online? What if I am still working? When is the best time to enroll? How much does Medicare cost? Where can I get help?

Going on Medicare Age 65
Age 65 – Enroll in Medicare

If you are turning 65 you have a lot of going on Medicare questions. You will have a lot of people sending you information by mail, each piece claiming their plan is better. And your phone will ring off the hook. With people calling to SELL you something you don’t want, you don’t need and can’t afford.

Where do you turn?

Consider talking to a Georgia Medicare Expert.

Ready for Medicare?

When you are ready to sign up for Medicare the process is fairly easy. You can go online to sign up. Or maybe you would rather do it by phone. Another way is to visit your local Social Security office.

You can enroll in Medicare Part A and/or Medicare Part B online at www.SocialSecurity.gov. By calling Social Security at 1-800-772-1213 Monday through Friday, from 7AM to 7PM. Or In person at your local Social Security office.

How easy is that?

Where Can I Learn About Medicare?

You can waste a lot of time searching for Medicare information online. But it seems so easy. You just Google “How to go on Medicare”. Or “Where do I sign up for Medicare”. If you know how to enroll then you ask “Who has the BEST Medicare rates“.

Turning 65 – Enroll in Medicare

Those steps will give you a lot of results. Some information is readily available.

But if you just want to know how much Medicare costs. You only want to see Medicare supplement rates WITHOUT talking to a pushy agent. That is a bit more challenging.

About to enroll in Medicare? Every time you fill in your name, email address and phone this is what happens. Almost immediately your phone rings. Someone calling to SELL you something when all you want is INFORMATION.

And your email box will be flooded with offers. Just click this link and all your questions will be answered.

By now you know this is NOT how you want to learn about going on Medicare.

You are like Charlie Brown asking “Why won’t someone just help me?“!

Going on Medicare Age 65 1
Why Won’t Someone Help Me?

Medicare Help? Try This

Why search the web when all your going on Medicare questions can be answered here? Medigap rates. Advantage plan information. GA Medicare Expert Bob Vineyard can help.

When you are ready to sign up for Medicare, who would you rather talk to? A stranger on the phone whose last job was asking if you want fries with your meal? Or would you rather invest 10 minutes talking with someone who has over 45 years working in health insurance and is also on Medicare themselves?

You choose.

Here is my offer.

Give me a call. Invest 10 minutes by phone. Ask any question you want about Medicare. ANY question. Then you decide if my information is valuable or not.

If you like what you are getting, we move forward at your pace. If you don’t like what you hear, move on and we part as friends. It’s not personal, it’s just business.

I call this my offer you can’t refuse.

#GAMedicareExpert #GoingOnMedicare #Turning65

New to Medicare – What Do I Need to Know?

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When you are new to Medicare you will have questions. But you probably don’t know who can help. Even if you did, what questions will you ask?

You don’t know what you don’t know.

new to medicare
New to Medicare – What Questions to Ask?

About the time you think you have it all figured out they change the rules.

Turning 65?

If you are turning 65 and new to Medicare you are about to enter the state of confusion.

Medicare may SEEM simple, but it is not. It is easy until you have a claim. Then it becomes complicated. Where will you turn then? Will you go to the friend that told you to buy the plan they have? Maybe you will call the agent that SOLD you the plan? Good luck with that. They may not even be in the business by now.

You could call the carrier where you went direct to avoid talking to agents. You call an 800 number, press 1 for English then get routed to voice mail. Someone will call you back in a few days while you are in the shower.

How well does that work for you?

Maybe your best choice is to find a GA Medicare expert.

New to Medicare?

Enrolling in Medicare

If you are approaching age 65 and new to Medicare you know the drill. For the last year your phone has been ringing. Pushy insurance agents calling to SELL you a plan you don’t want, you don’t need and can’t afford.

Your mailman hates you because of all the junk mail that arrives at your door every day.

What do you keep? What do you throw away? Where do you turn for answers to your Medicare questions? Check out Medicare plans in Georgia.

Who Can Help Me?

There is nothing wrong with buying a Medicare plan online as long as you are prepared for a LOT of phone calls from agents wanting to SELL you something you don’t need, don’t want and can’t afford.

When you are new to Medicare how do you find the RIGHT plan?

All I ask is for you to give me 10 minutes by phone. Time to answer YOUR questions. You will NEVER be pressured to buy anything. This is your opportunity to ask ANY Medicare related question, then decide if you want to work with me or not.

It’s that simple.

It’s an offer you can’t refuse.

Why Are Medicare Advantage Plans Popular?

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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? GA Medicare expert Bob Vineyard explains.

medicare advantage popular
Why are Medicare Advantage plans popular?

Why are GA Medicare Advantage Plans Popular

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?

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?

Why do sick people leave Medicare Advantage plans?

Georgia Advantage Plan 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 GA Medicare 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?

Medicare Advantage Final Exam

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?

Shop GA Medicare rates.

Medicare.

You have questions.

We have answers.

$GAMedicareExpert #MedicareAdvantagePlans #FreeMedicarePlans  #MedicareHMO  #MedicarePPO

Georgia Medicare Gives Thanks

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Georgia Medicare Looks at 2018

As Dickens said, “This is the best of times and the worst of times.” Like all years, there are times when things are good and times when things are not so good. From a business perspective I would give this year a 9 on a scale of 10. Georgia Medicare expert reflects on 2018.

Georgia Medicare expert
Turning 65 Medicare Options

The Good News

Georgia Medicare supplement clients continue to bless me with referrals. My business grows mostly by word of mouth. When my advice is useful clients remember and pass my name along to their friends.

Like that old shampoo commercial where Heather Locklear told two friends about Faberge, and they told two friends, and so on.

Good new spreads like wildfire, and it is appreciated. With more than 500 GA Medicare clients, new referrals come in almost every month.

Thank you for being generous and sharing my name with your friends.

Georgia Medicare YouTube Channel

After years of planning and hoping it would happen, I finally implemented my Georgia Medicare YouTube channel in early summer. With the help of Christy Sanchez this labor of love is now a reality.

The videos are not fancy or technically complicated. It’s just me talking to the camera the same way I speak to you on the phone. Feel free to like, share and comment on any of the videos.

Of course you can also ask questions.

Say Hello to New Medigap Carriers

I currently count almost 60 insurance carriers offering Medicare supplement plans in Georgia. Many are brand new to the Medigap business. Others are new to Georgia.

At least 6 carriers are new to the Georgia Medicare market. Each one has cut rates to the bone in an attempt to gain market share.

It’s a race to see who can offer the lowest Medigap rate.

For at least a year.

New carriers include Lumico, Western United (late 2017), Everest (late 2016), American Continental, Prosperity (gotta love that name), Mass Mutual, Unified and Pan American. I might have missed a few but that’s a mouthful.

I generally don’t recommend a carrier until they have been here at least 3 years. In the past carriers (like AFLAC) have either disappeared from the market or blew up their rates on renewal in the first 3 years.

I don’t need that kind of drama in my life and neither do you.

Say Hello to a New Name for an Old Friend

One shining star is Anthem Blue Cross. BCBSGA has been co-branded with parent Anthem for a few years now. As of July 2018 the Anthem name is on all new Medicare plans in Georgia.

Of course you can call them direct or use an agent like myself. When you go direct you are a “house account”. You will never know who will answer the phone or anything about them. 

Last week they could have been asking if you wanted fries with your meal.

When you call me you will never hear “Press 1 for English”. You get me or voice mail. Leave a message and I will call you back.

No extra charge for my 40+ years experience.

You can enroll in an Anthem Medigap plan using my link . . . if you have an hour or so to kill. 

https://brokerportal.anthem.com/ac/BobVineyardAnthemGA

Or call me direct. I can take your information in about 10 minutes.

You choose.

The Bad News

A few carriers like Equitable, Manhattan and Aetna Health and Life stopped writing new Medigap business in Georgia. If you have a plan with them you can keep it as long as you pay your premiums.

I hope to move as many as possible away from these carriers in hopes of seeing fewer and smaller rate increases at renewal.

Thank You!

Thank you for all your support, for passing my name along and especially the kind words for my Georgia Medicare YouTube Channel.

I look foward to helping as many people as possible to navigate the Georgia  Medicare maze.

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