Today we are going to quickly discuss whether or not you have to enroll in a Medicare Part D Prescription Drug Plan. While the answer to this question is easy to answer, there is a big reason why you might just not want to go along with it.
Do I have to enroll in a Medicare Part D Prescription Drug Plan?
No! There is no law that says you MUST enroll in a Part D Plan, but the penalties for not doing so will hit you squarely in the wallet. First you must understand that for Medicare Part D to actually work, it must have a balance of folks who take little to no prescription drugs to offset all the folks taking large amounts of prescriptions. If you could simply start Medicare Part D at any time, most people would simply wait until they were on a number of expensive prescriptions to go and sign up for the benefit.
What are the penalties for waiting?
The Medicare Part D late enrollment penalty is 1% ‘simple interest’ per month that you do not have a Part D plan or other credible coverage. Credible coverage can be prescription drug benefits provided thru a group health plan that you are covered under at your place of employment or thru your spouse. While 1% does not sound like much, keep in mind that it is per month you were without coverage when you were eligible. In the sample below you will see how quickly the penalty adds up when a person does not sign up for a Part D plan when first eligible. In this example the individual waited 34 months before finally deciding that they needed to get coverage. We are also going to say that the Part D plan they want to now enroll in has a monthly premium of $18.00 per month. It would be great if the penalty was based off of whatever plan premium you selected, but it doesn’t work that way. The penalty is based off of what CMS announces as the national average (and that typically goes up each year). For year 2022 the national average is $33.00 per month.
Based on the example above, this individual who could of been paying only $18.00 per month for their Part D Prescription Drug Plan must now pay $29.20 per month in 2022. Each year for the rest of the time this individual is enrolled in Medicare Part D the penalty amount will have to be re-worked. So this means that if in 2023 the national average is $35 per month, and the consumer stays in the exact same priced plan of $18 per month, then they will have to now pay $29.90 per month. If they needed to move to another plan due to prescription no longer being covered in their old plan, the $11.90 penalty amount would be applied to the new plan premium.
Why should I enroll in a Medicare Part D Prescription Plan when I am not taking any prescriptions?
The short answer is that you will not face the late enrollment penalty. Keep in mind that the late enrollment penalty percentage will follow you each year no matter which plan you are enrolled in. The next reason why you should at least be enrolled in the cheapest premium plan is that you never know when your doctor may have to prescribe a prescription and you want to have coverage to help pay for it. In reality, we never know what kind of prescription we might need or how expensive it will be.
Have additional questions?
Contact Senior Benefit Services to get guidance on what to do if you did not sign up for a Medicare Part D prescription drug plan when first eligible. We are here to help (800)924-4727
Have you heard the big news that there is going to be a large Social Security Increase (COLA) in 2023? It is estimated that it could come in around 10.5% due to rising inflation. What does this mean for the average retiree?
The average retired worker receives about $1,665.00 each month. If the full 10.5% increase takes place, then that same retiree will start receiving an extra $174.83 each month. This would bring their payment to around $1,839.83. As you can imagine this will be very beneficial in helping offset the rising costs of goods due to inflation. This increase will be the largest increase since 1981 which was 11.2%.
To view the Automatic Cost of Living Adjustments since 1975 click here and scroll to the bottom of the page.
If you are like me and really enjoy the old Clint Eastwood cowboy movies, you will remember the classic…The Good, The Bad, and The Ugly. While we have just discussed The Good about the increase, now we must take a look at the other areas.
The Bad
For those retirees that receive lower than the average Social Security payment each month and qualify for other benefits due to having a lower income, could be pushed out of those programs with a large Social Security increase to their check. Here are just a few income based programs that could be impacted:
The Supplemental Nutrition Assistance Program (SNAP) which provides benefits for seniors to purchase needed food items.
The Home Energy Assistance Program (HEAP) which provides money to senior to help offset the cost of their monthly utilities.
Property Tax Exemptions are offered in many states for low-income retirees.
Prescription Assistance Programs thru the state to help pay for Part D prescription drug plans.
Finally, many states also have pharmaceutic assistance programs along with programs from drug manufacturers that offer assistance as well based on income.
The Ugly
The amount of Social Security benefits that are exempt from taxes is still the same since 1984. This means that any increase above the payment threshold is going to end up being taxable. So if the monthly payment increase pushes an individual above $25,000 or a married couple above $32,000 for the year then this will trigger a taxable event on the income above these thresholds.
While such a large increase (if the full amount goes thru) seems like there is going to be so much extra money going into a retiree’s pocket, that simply is not the case. With the current inflation rate being around 8.6%, the increase is pretty much a wash. In addition, while inflation is coming in at 8.6%, certain primary goods such as food costs have climbed at a much higher rate, so there really will not be any ‘extra’ money going into anyone’s pocket.
What Can You Do?
Maybe your concern is simply having as much money in your pocket at the end of the month as possible. With the rise of inflation we have also started seeing the rise of interest rates. While savings account interest rates are still extremely low, there are CD type annuities that are paying much higher interest rates. Many of our 5 year multi year guaranteed annuities are paying out over 4.00% which can help bring in additional income if needed. To get a personalized annuity quote click below.
Another way to increase your monthly income is by seeing if you can lower your current Medicare Supplement rates. Many of our clients have been able to lower their older Medicare Supplement plan rates by a substantial amount. As always with Senior Benefit Services there is no cost or obligation to get a quote from us. It’s FREE and you have absolutely nothing to lose.
Heartland National Medicare Supplement Plan Review
With all the Medicare Supplement insurance offers you receive as you near the age of 65, the hope is that you can pick one that you can count on and trust.
Heartland does NOT always have the best rates in each state. For the best rates in your state, start by getting a quote below:
Heartland National Medigap Plans Offered
Remember, the plans offered by Heartland National are identical to any other supplemental insurance carrier, including; AARP or Aetna Medicare supplement plans .
Heartland National only offers four of the 10 Medicare Supplement Plans approved by the Federal government.
Don’t worry though, the majority of people purchasing Medicare supplemental insurance will choose one of three plans and Heartland offers all three of those plans.
The three most often purchased Medicare Supplement health insurance plans are Plan F, Plan G and Plan N.
Heartland refers to these three options as their premium plans.
Premium Plan Features:
Portable coverage
Guaranteed renewable for life
12-month rate lock-in
Get A Free Quote Today
Understand, each plan is different. Heartland National checks off the major plan differences between the three most popular Medicare supplemental insurance plans below.
Heartland Medicare Supplement Plan F
Covers 100% of all costs that Medicare doesn’t cover in full
Pay more in premium each month and not have any hospital or doctor bills
Something to keep in mind about Medigap Plan F, is that it will no longer be availableafter the end of 2019.
This plan has been discontinued by Congress.
The discontinuing of plans isn’t unusual as there have been multiple Medsup plans that are no longer offered for various reasons.
What is important is that when the plan is no longer able to add new younger members, the premiums will increase at a higher rate than open plans because they are able to attract the younger and healthier 65-yearold’s keeping plan costs lower.
Speak with a Senior Benefits agent today to discuss if this plan is the right choice for you long term.
Heartland Medicare Supplement Plan G – Top Recommended Plan
More rate stability than Plan F
Must pay Medicare Part B annual deductible
Part B deductible is associated with doctor visits and outpatient services
There are only two things that are different about Plan F and Plan G. With Plan G, you are responsible for paying your Medicare Part B deductible and Plan G will not be discontinued at the end of the year.
In fact, congress is expecting Plan G to be the most popular and chosen plan of them all.
It offers everything that Plan F offers, less the Part B deductible.
Many Medicare Supplement experts believe that with the large influx of new Medicare supplemental insurance recipients choosing this plan, the premiums may become the most stable of all of your options.
Heartland Medicare Supplement Plan N – Most Popular
$0-$20 co-pay at an office visit
Must pay Medicare Part B annual deductible
Part B doctor’s excess charges are not covered
$50 co-pay at the E.R. (waived if admitted)
The cost of Plan N is much less than Plan G but for the reduced premium, you receive a reduced amount of services.
You will have to pay your Medicare Part B deductible and will have to also pay any doctor’s excess charges that are not covered by Part B.
In addition, you will be responsible for a co-pay when you visit the doctor or the E.R.
If you are a in great health and are not on a tight fixed income, this plan can make a lot of sense.
Keep in mind though, if your health deteriorates or you have problems as you get older, the out of pocket expenses with Plan N will be much higher than with Plan G.
Don’t just think about today, you must think about long term when choosing a Medigap plan.
Why Choose Heartland National Medicare Supplement Plans?
Senior Benefit Services works with Heartland National Insurance because they are a leader in the Medicare Supplement market and their rates tend to be lower than many of their competitors.
Heartland offers top quality health insurance plans, including:
They offer a wide range of services and are known for their personal customer service.
While their Medicare Supplement plan offerings are near the minimum, they do offer the top three choices at much lower rates than most of their competitors.
Their great rates and customer service are why Senior Benefit Services has such a strong partnership with Heartland.
Heartland National Medigap Plans
Heartland National Life is a subsidiary company of Heartland Holding Company.
Heartland currently offers Medicare Supplement, Hospital Indemnity, and Cancer plans.
Heartland National is licensed in 50 states and has a solid financial rating.
Product Features
covers some costs that Original Medicare doesn’t.
See any doctor who accepts Medicare.
No referrals needed to see a specialist.
Coverage that goes with you anywhere in the U.S.
Guaranteed coverage for life; Just pay your premiums
Plans Offered By Heartland National
Plan F, Plan G,
Plan N, Plan A
Senior Benefit Services thinks Heartland is best known for having some of the most competitive rates.
It will be hard to go wrong with this option if it is available in your state.
Take Action!
Senior Benefit Services will be able to help guide you through choosing a Medicare Supplement Plan.
There are many factors that determine the Best Medicare Supplement Plan for you.
The Experts at Senior Benefit Services have been specializing in helping seniors make the best Medigap insurance choices for over 50 years!
Call now at 1-800-924-4727 or fill out the easy and convenient ‘Start Free Comparison’ form in this article.
Beyond Basic Medicare: Top-Tier Dental Insurance For Seniors
After retiring and going on Medicare, many seniors are shocked to find out that traditional Medicare does not cover routine dental expenses.
Thankfully, you will read about some popular dental insurance plans tailored for seniors that are available to address this need.
These plans ensure your teeth stay healthy without causing financial stress in your golden years.
With supplemental dental insurance, you can protect both your smile and your savings. In this article, you will discover how you can enjoy dental insurance for seniors with Medicare.
Senior Dental plans to fit all needs and budgets.
Additionally, Senior Benefit Services offers many dental insurance plans for seniors on Medicare to ensure you can pick a plan that best fits your needs and budget.
Many of our plans use no network of providers, so you are free to use your current dentist.
Of course, if you wish to save even more money on your plan, you can opt to go with one that uses a network of dentists and choose from that list.
The great news is that by us offering so many different plans, the choice is yours!
Get Your FREE Customized Quote
Senior Dental Plan Benefits
Looking for the best dental insurance for seniors on Medicare? As a senior, taking care of your teeth is crucial for both your oral and overall health.
However, with so many dental plans and insurance options available, finding the right coverage for your needs can be tricky.
Whether you’re wondering if Medicare covers dental care or if there are any free dental care options available, this blog post has got you covered.
Here, we’ll discuss everything you need to know about the best dental insurance for seniors on Medicare, so you can make an informed decision about your oral health.
Check out the benefits that many of our plans offer:
Up to $5,000 in annual coverage
Choose your own dentist
No underwriting (this means there are no health questions and you are guaranteed to get the plan)
Preventive and Basic services are covered immediately with no waiting periods
Does Medicare Pay Anything on Teeth?
Firstly, let’s address the most pressing question: Does Medicare pay anything on teeth? Unfortunately, no. Original Medicare (Part A and Part B) does not cover routine dental care, such as cleanings, fillings, extractions, and dentures.
However, there are some exceptions. For instance, if you require a dental procedure due to an injury, a medical condition, or hospitalization, Medicare may cover it as part of your inpatient or outpatient treatment.
Additionally, some Medicare Advantage (Part C) plans offer dental coverage, although the benefits and costs vary widely by plan and location.
Do Seniors Get Free Dental Care in the USA?
In general, no. While there are some government-funded dental clinics, such as those run by the Department of Health and Human Services or the National Association of Free & Charitable Clinics, they have limited availability, eligibility requirements, and services.
Some states also offer dental coverage under Medicaid, but again, the benefits and criteria vary by state. Your best bet for affordable dental care as a senior is to shop around, negotiate rates, and ask for discounts or payment plans from your providers.
You can also consider joining a dental savings club, which typically offers discounts on a wide range of dental procedures with no waiting periods, annual limits, or paperwork.
The option that gives you the flexibility to get the benefits you need at the price you can afford is a stand-alone dental plan.
What Is A Discount Dental Plan?
The key point to understand is that a discount dental plan is NOT insurance. You are basically paying an annual fee to receive ‘discounted’ dental services.
You are required to use a dentist that is part of the discount plan’s network. Before signing up for a discount dental plan it is wise to first make sure that your current dentist is in their network.
Best Dental Plan
The best dental plan is one that your dentist takes. Make no mistake, this is the first priority since most plans use a network of dentists.
If your dentist is not in that plan’s network, you could be looking at either bills not being covered at all, or a reduced amount being paid out for being out-of-network.
The next thing you want to make sure is that the dental insurance for seniors plan covers more key procedures than it excludes.
Case in point, some dental plans will not cover implants, while others will.
If the plan covers implants or another major procedure, does this mean that you can simply wait until the dentist tells you that you need this service and then go get a policy to immediately pay for it? This is a resounding No!
We would all love to be able to pay a monthly premium of around $40 to have $5,000 of expenses paid. The reality is that insurance doesn’t work this way.
Most dental plans have waiting periods for major services that can be up to 12 months.
This protects the insurance company from having someone simply sign up, pay $40 and then get the expensive procedure done (and then maybe cancel their policy afterwards).
Last but not least, the dental plan you choose should be within your budget. Plan premiums can vary based upon the carrier and the benefits they will pay out in a given year.
This doesn’t mean you should simply shop for the lowest premium plan.
The reality is that one of the lowest priced plans on the market also offers the most basic of benefits and has a low annual maximum benefit.
Read our article on Best Dental Insurance for Seniors on Medicare to see our top picks.
Who Has The Best Dental Insurance Plan for Seniors on Medicare?
While there is no one-size-fits-all answer, some dental insurance for seniors can offer comprehensive coverage including APEX Dental, Cigna, Mutual of Omaha, Manhattan Life, and Humana.
These plans typically cover preventive care, basic and major services, with options to customize your deductible, coinsurance, and premiums.
However, be aware that some plans may exclude certain procedures or providers, have waiting periods or limitations on coverage, or require preauthorization for specific treatments.
Breaking Down The Plans
Manhattan Life
The Manhattan Life dental, vision, and hearing plan has been on the market for a number of years and continues to be a client favorite.
While you can choose your dentist, you will get the most bang for your buck by using one that is in their network. The plan uses the Careington network which is quite robust.
What we like about it:
Built in hearing benefit
Built in vision benefit
Monthly premiums as low as $40.23 for individual
Guaranteed Issue (no health questions)
Mutual of Omaha
If you seek a budget-friendly, no-frills dental plan, this might suit your needs. The plan works best for folks whose dentist is in the network. This plan does not offer any hearing or vision benefits.
What we like about it:
Large network of dentists
Issued up to age 99
Monthly premiums as low as $25.76 for individual
Guaranteed Issue (no health questions)
APEX
The APEX dental plan is a newer plan that came onto the market in recent years. It uses one of the largest PPO networks of dentists and is currently available in 13 states with more being added almost each month.
What we like about it:
Up to $5,000 in annual benefits
Coverage for implants
Waiting period waiver for major services if coming from another dental plan that has been effect.*
Built in hearing benefit
Optional stand-alone vision plan can be added.
Monthly premiums as low as $44.01 for individual
Discounted rate for spouse
Guaranteed Issue (no health questions)
Guarantee Trust Life (GTL)
The dental plan from GTL is one of the only plans on the market that does NOT use a network of dentists. This means you can literally go see any dentist that you want. While your chosen dentist may not file the claim, this plan still permits you to see them. Simply pay the dentist upfront, then provide your agent with the itemized billing to file the claim.
What we like about it:
See any dentist that you want.
Built in hearing benefit
Built in vision benefit
Monthly premiums as low as $46.25 for individual
Guaranteed Issue (no health questions)
Finding the right dental insurance for seniors on Medicare can be challenging, but not impossible. By understanding your dental needs, budget, and preferences, and comparing various plans and options, you can make an informed decision that suits you best.
While we have outlined some great plans above, be sure to contact us at (800)924-4727 to see what other plans we have available in your state.
Does Medicare cover all dental Issues?
That is a Yes & No question.
Fortunately, Medicare provides coverage for quite a bit of our healthcare, and even some dental when it is truly health related.
Medicare covers dental services such as routine dental care, emergency dental, dentures and much more.
Medicare and Dental Implants
Is it true that Medicare now pays for dental implants? Unfortunately, no. Original Medicare (Part A and Part B) does not cover routine dental care or dental implants.
However, some Medicare Advantage plans (Part C) might offer dental benefits, including coverage for dental implants.
To find out if your Medicare Advantage plan covers dental implants, check your plan summary of benefits or call your plan provider.
Keep in mind that even if your plan covers dental implants, you might still have to pay a portion of the cost as a copayment, coinsurance, or deductible.
Besides dentures, dental implants are one of the other concerns that many retirees are concerned about. While dental implants permanently anchor prosthetic teeth into the gum line, this procedure is also NOT covered by original Medicare
Private Dental Insurance For Seniors
Some stand-alone dental insurance plans for seniors on Medicare actually provide benefits for dental implants. These benefits typically range anywhere from $1,000 – $5,000 per year.
The cost for these plans are very affordable, but the pricing will be directly related to the amount of annual benefits the plan will pay out each year. In other words, the higher the annual maximum of benefits equates to a higher monthly plan premium.
Does a Medicare Advantage Plan cover dental benefits?
Yes. Many Medicare Advantage plans offer a limited benefit for dental coverage. Typically these services must be provided by a dentist that is in their network.
What is the best dental plan for seniors on Medicare?
There is no one-size-fits-all answer to this question, as the best dental plan for seniors depends on various factors, such as your budget, oral health needs, and personal preferences. Before choosing a dental plan, do your research, compare costs and review benefits.
Can I get additional dental coverage if I have a Medicare Advantage plan?
Yes! Many times the amount of coverage a person may have with a Medicare Advantage plan is less than what they desire.
An example of this would be a person who has dental benefits with their Medicare Advantage plan, but it only provides up to $1,000 in annual benefits.
This individual could purchase a stand-alone dental plan that provides them with an additional $1,000 of benefits each year for a minimal monthly expense. Of course they could also choose to add up to an additional $5,000 per year in benefits if it is affordable to them.
Are dental implants worth the expense?
The answer to this question depends on individual circumstances and preferences. While dental implants are usually more expensive than other tooth replacement options, such as dentures or bridges, they also offer several advantages, such as improved comfort, function, and aesthetics.
In addition, some seniors on Medicare do not like the feeling of dentures. Moreover, dental implants can last for decades, which can make them a cost-effective long-term investment.
Why do full mouth dental implants cost so much?
Full mouth dental implants refer to the replacement of all teeth with implants. This procedure is more complex and time-consuming than single tooth implants and may require additional treatments, such as bone grafting or sinus lift.
The cost of full mouth dental implants can vary depending on many factors, such as the number and type of implants, the surgeon’s skill and experience, the geographic location, and any associated fees. It’s important to ask for a detailed treatment plan and cost estimate from your dentist.
Does Medicare Part B cover any dental services?
Medicare Part B may pay for a dental exam if it is required to be completed before a procedure is able to be performed such as open heart surgery. In addition, for these services to be covered you must have an underlying health condition. Our advice is to always ask if the service will be covered by Medicare prior to having services performed.
What are my coverage options for dental care?
Private dental plans are one of the most popular options that we see people use to cover dental care. Many of these plans also offer additional benefits to help cover vision and hearing as well.
If you are enrolled in a Medicare Advantage plan you can check your plan benefits to see if dental is a benefit, or if you can add additional coverage for these benefits. Since Medicare Advantage plans typically are network driven you will most likely have to use a dental provider who is in that plan’s network. Some other key points to keep in mind:
Most dental coverage under Medicare Advantage Plans have a coverage limit which may be lower than a private dental plan.
Most costs incurred will require you to pay a co-insurance rather than a small co-pay.
May restrict how often they cover a particular dental benefit.
Does Medicare cover teeth cleanings?
No. Traditional Medicare nor Medicare Supplement plans cover teeth cleanings. This is another reason why it is advisable for seniors to look at dental insurance plans.
Do Veterans receive any dental benefits?
Veterans may be eligible for reduced cost dental care or insurance. If you are a veteran, then you can start here to see if you qualify for those benefits. The VA does have clinics that provide dental care and those locations can be found here.
Take Action!
Hopefully, this article helped to alleviate some of your fears about who would end up paying for dental care, implants, and dentures.
Medicare coverage of dental services can sometimes be a bit confusing.
Senior Benefit Services has been in the Medicare business for decades and understands your concerns.
To make sure everything is understood correctly, give a Senior Benefit Services Expert a call today at (800)924-4727.
How To Get A Dental Insurance Plan
It is really simple. All you need to do is either call us at (800)924-4727 or complete the form below to request a FREE…No obligation quote.
Get Your FREE Quote Today!
*Not all plans are available in all states.
Contact To Us To Discuss Your Dental Insurance Options
Don’t panic, you still have about 3 months left before we enter the Medicare Annual Election Period. How will you know it is getting closer? Well, you will see an increase of Joe Namath and Jimmie Walker telling you all about the benefits you could be getting from Medicare. Don’t worry, in one of the later parts of this series I will touch a little bit more on the commercials and how they are not really what they appear to be.
What You Can Do During the Annual Election Period (AEP)
You can leave traditional Medicare and enroll into a Medicare Advantage Plan
You can disenroll from a Medicare Advantage Plan and return to traditional Medicare and get a stand-alone Part D Prescription Drug plan.
You can change your stand-alone Part D Prescription Drug plan to another stand-alone Part D Prescription Drug plan.
You can change your Medicare Advantage Plan to another Medicare Advantage Plan.
FREE Medicare Benefit Quote – Perfectly Customized for You!
For a full list of what you can do during the different enrollment periods check out our article here.
Your Window of Opportunity to Make a Change
The dates for the Medicare Annual Election Period are set in stone. You can make any of the changes discussed above from October 15th until December 7th. If you decide on December 12th that you need to change your stand-alone Part D prescription drug plan because a prescription you are taking will no longer be covered, then you will basically be stuck in that plan for another year
How do you know if there are going to be changes to your existing plan?
Medicare Advantage and Part D carriers are required to send out each year what is called an Annual Notice of Change (ANOC) packet to all their policyholders. The carriers must send the ANOC package in the mail to you by September 30th.
I can’t tell you how many times we hear about folks either throwing these away or simply not even opening them. Don’t do this! While there is quite a bit of information in the packet, most of the major changes are listed on the first page. It is vitally important that you read over this prior to October 15th so you will have time to contact your agent and book time to review any changes that need to be made to your current coverage when the Medicare Annual Election Period rolls around.
Start Preparing Now
Yes, even though we are 3 months away from the Medicare Annual Election, there are things that you can do now.
Make a complete list of your current medications. Be sure to include the full name of the prescription along with the dosage, quantity and strength on your list.
Make a note beside any prescription that your doctor has informed you that could be changing in the future.
Have this list with you when you meet with your agent during the Annual Enrollment Period.In Part 2 we will discuss what you should do if you have a Medicare Advantage plan or a Medicare Supplement plan during the Medicare Annual Enrollment Period. As promised we will also dive a bit into the commercials, we all see and how they can be a bit misleading.
What if I have questions now?
If you are already a client of Senior Benefit Services, then please contact your personal agent immediately. For those folks who are not a current client but wish to start receiving the personalized attention they deserve, simply call (800)924-4727 or click here and one of our friendly staff members will connect you with your own personal advisor.
If you have spent any time in front of the television, you have likely seen a commercial or two about a Medicare Flex Card. While you might not remember the actual term being used, you likely do remember the advertisement of getting around $2,800 pre-loaded on a ‘debit’ type of card that can be used to pay for certain medical expenses. While this sounds like a windfall of money for seniors, the advertisements gloss over quite a bit of important information.
So…what the heck is a Medicare Flex Card anyway? To make this as easy as possible to understand, this money does not come from the federal government. The money is part of a benefit that can be paid out by a private insurance company. Furthermore, the card is not available to folks on a Medicare Supplement plan, but rather must be enrolled in a Medicare Advantage plan. That caveat alone knocks out the majority of seniors who could qualify for the money. On a Medicare Advantage plan that offers a flex card, the funds can be used for such things as:
Prescriptions
Durable Medical Equipment
Other medical expenses such as dental, vision, and hearing
Plan Deductibles and Copayments
You may be saying to yourself, “I am already on a Medicare Advantage plan, so how do I get a flex card?” This is where it gets even a bit more interesting. Not all Medicare Advantage plans offer a flex card as a benefit. While the commercials don’t point this out, the reality is that even if a carrier does offer a flex card as a benefit, they don’t have to offer it on all their Advantage plans and can even limit it to plans in specific zip codes. In addition, a number of insurance companies limit this benefit to those individuals who qualify for a Dual Eligible plan, which means that you must have a low enough income to qualify for both Medicare and Medicaid.
Even When Things Fall Into Place….There Is Still No Guarantee
Let us play devil’s advocate here and say that an individual happens to live in a zip code that has one of these plans available and it is not a Dual Eligible plan. This means that you could sign up for this plan and get a quick extra $2,800!? Not necessarily. You have to understand that since it is not Medicare providing this benefit but rather the private insurance company, the amounts can be up to $2,800. Don’t you just hate that phrase…’up to’? One insurance company might offer $300 while another offers $400, and then another might offer $500.
Should You Enroll in a Medicare Flex Card plan?
First things first. Do you understand the difference between a Medicare Advantage Plan vs a Medicare Supplement plan? If not, then the answer is definitely hold off until you do. Let’s say you do know the difference between these types of plans, then the next thing you need to do is look at the plan’s prescription drug formulary. A formulary is the complete list of covered prescriptions and also what tier they will fall into (the tier determines how much your co-pay or coinsurance will be). If the plan does not cover all your prescriptions, then it might very well be a bad choice. After checking your prescriptions, you are going to want and make sure your doctors are part of the plan’s network. If not, you might have to make the decision to switch doctors or pay the full bill out of your own pocket. Last but not least, you are going to want to compare the plan’s other benefits to determine how much your different co-pays, co-insurance, and even maximum out of pocket costs are going to be.
The Final Word
Instead of trying to figure this out all on your own or take the word of a possible misleading commercial, you can simply reach out to Senior Benefit Services where we will put you with your own personal advisor that can give you all the information that you need to make an informed decision. Feel free to call us at (800)924-4727 or click here to request an advisor to contact you directly.
Are you a diabetic who is turning 65 and going onto Medicare? You may want to rethink getting a Medicare Advantage plan. A recent study found that Medicare beneficiaries who were enrolled in a Medicare Advantage plan were more likely to receive older generic diabetes medications rather than newer and more expensive medications.
What Are Your Options
If you are a diabetic and looking at a Medicare Advantage plan, then the first thing you will want to do is make sure that your current prescriptions are covered in the plan’s formulary. If the prescription is covered, then you want to make sure that there are no additional conditions that would impede the prescription being covered immediately. Some plans require that you do what is called step therapy. This basically means that the plan wants you to try other lower costing drugs before they approve the more costly one that you are on. If this is the case, you may want to look at another option.
A Medicare Supplement plan with a separate Part D prescription drug plan might just be a better option for you. By going this particular route, you are able to be covered under traditional Medicare and select a Prescription drug plan that covers all of your current prescriptions if one is available. In addition, there may be multiple plans that cover your current prescriptions, so you will want to make sure that you select one with not only solid star ratings, but also that do not require step therapy.
To do all this research on your own can be quite daunting. Instead of putting yourself through all of this aggravation, you can simply contact Senior Benefit Services, Inc. and let us do all of the work for you! Our advisors will show you all of the best options to fit not only your medical needs, but also your budget. Feel free to give us a call today at (800)924-4727.
There are many factors to consider when choosing a Medicare Supplement. There are many plans available (most popularly Plan F and Plan G) and there is no such thing as one plan fits all approach. In addition to Medicare Supplement plans there are Medicare Advantage plans that may or may not fit a retiree’s needs.
As you reach retirement age, you will need to focus on staying healthy so you can thoroughly enjoy your golden years. During this time of your life, you will need to receive routine medical care to address any health problems you might have. Getting this care without jeopardizing your financial future will require the right insurance policy. If you get approved for Medicare insurance, you need to realize that there are financial gaps you need to prepare for.
Over 81% of Medicare policy holders have supplemental coverage to help pay for the financial gaps in traditional Medicare. If you are trying to find the right Medicare supplement insurance, you need to consider some of the factors covered below.
Get Familiar With What Supplement Insurance Covers
Medicare supplement insurance, or Medigap insurance as it is commonly referred to, was designed to help seniors better manage their healthcare costs. When serious medical problems arise, large bills can be created. Instead of trying to figure out how to pay these bills out of pocket, you need to think about getting a Medigap policy. While these policies won’t cover every out-of-pocket cost, they can reduce the amount of money you have to pay for healthcare.
When trying to figure out what type of Medigap policy to choose, you need to consider the out-of-pocket expenses you are having trouble paying. The deductible on your Medicare policy is the amount of money you have to pay before the insurance kicks in.
The co-payment on your policy refers to the money you have to pay when going to doctor visits. Coinsurance is a term used to describe the percentage of a healthcare claim you are responsible for. The more you know about the costs associated with your Medicare policy, the easier it will be to narrow down the Medigap policies at your disposal.
Check The Medicare Supplement Plans Offered In Your Area
For the most part, you will have to deal with a private insurance company to get a Medicare supplement policy. While Medigap plans are standardized, private insurance companies put restrictions on which policies are offered to a customer based on their location. This is why you need to do some research to find out what Medigap policies are available where you live.
You need to realize that private insurers set their premium rates for Medicare supplement insurance. This is why you need to work with a company like Senior Benefit Services, Inc. to find the best deal on the Medicare insurance products you need.
Plan For Open Enrollment
If you want to make changes to your existing Medicare Advantage or Part D prescription drug policy, you will have to do so during the open enrollment period. In 2022, this open enrollment will start on October 15th and end on December 7th. By working with professionals, you can make a plan of action regarding how to get the supplement insurance you need during this period.
Medicare cost for 2024? Once again, as in previous years, this is one of the biggest questions that Medicare beneficiaries ask us.
Each year your basic costs change due to increases in Part B premium, deductibles, and co-insurance. To see the current Medicare cost for 2024 please refer to the image below. Have questions? Call us today at (800)924-4727.
Keep in mind that if you worked 40 quarters during your lifetime, you will not be charged the Part A premium. During your working years, the Part A premium was funded thru your Medicare taxes paid each pay period. The deductible for Part A increased from $1600 in 2023 to $1632 in 2024. The daily co-insurance for days 61-90 increased from $400 per day in 2023 to $408 per day in 2024. In addition, the lifetime reserve days which run from days 91-150 rose from $800 per day in 2023 to $816 per day in 2024. The co-payment for skilled nursing facility increased from $200 per day from days 20-100 to $204 per day in 2024.
The standard Medicare Part B premium rose from $164.90 per month in. 2023 to is now $174.70 per month in 2024.
The increases from from 2023 to 2024 are located here .
Wondering if you are paying to much for your current Medicare Supplement plan? Get a FREE, NO OBLIGATION quote by clicking here.
What factors influence Medicare Supplement Plan costs? It’s a question that we hear often, and we think that even medical providers do, too. At least, that’s what we’re hearing, in an age where figuring out your own health coverage is often even more difficult than ever.
Seniors are simply asking how much Medicare Supplement Plans cost. Or they’re asking how they can possibly lower what they are paying in premium for their current plan.
It’s complicated algebra, and it’s very obscure to a lot of average people. That’s why they get help selecting the Medicare Advantage and Medicare Supplement plans that are going to protect them financially as they age.
Here are some common things to think about as you select insurance of this kind. Be sure to cover these principles to be best served by a Medicare and supplement policy set.
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Coverage and Cost
One of the most simple building blocks of this process is understanding the interaction between coverage and costs.
A simple way to do that is to look at the deductible. A higher deductible reduces the Medicare Supplement plan costs, however, it raises the out of pocket cost on initial claims to the policyholder.
On the other hand, a lower deductible pushes premium cost up, but the insurance company covers more if there is a claim – if you have a registered date of service and an EOB to go with it. That’s worth thinking about as you make these important policy choices.
Insurance Ratings
Then, also, think about insurance ratings and how they apply to your coverage and cost.
You have community ratings around where you are living, and what type of facility you’re living in – whether you’re in your own home or a community home, for example.
Then you have age-based insurance ratings, too, and other factors. The insurance company is doing its homework!
Enrollment Windows
This one will come as a shock to a lot of people, but in many cases, you’re paying partially due to when you sign up.
Insurers and government offices have created enrollment windows that are special time frames for people to sign up for Medicare and supplemental plans.
Simply put, you save by selecting plans during an enrollment window, where you may pay more if you have to join after that enrollment window is over.
These three things can affect your coverage and your costs. Each of them you can explore in more detail to know more about Medicare and supplement coverage and how it works. We can help. We are not an insurance company, but we can provide you with helpful information about all of this. Get the data that you need to make good decisions!
What’s involved in seeking a long term care insurance policy? Many people, as they move toward Medicare age, still don’t understand why this type of insurance would be important. In fact many Medicare beneficiaries are quite shocked to find out that Medicare does not provide benefits for custodial or even intermediate care in a nursing home or assisted living facility.
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However, long-term care insurance represents some of the realities around evolving medicine and longer life spans. In the old days, a lot of the focus was on life insurance. If the wage earner were to die prematurely, then the financial burden left on the surviving spouse could be immense. Life insurance protected the income for the surviving spouse.
But in retirement, life insurance is less of a necessity. Long term care insurance addresses a more prevalent risk – that instead of suddenly passing away, someone might spend months or even years in a nursing home. Most nursing home stays are not covered by Medicare, so it falls on the consumer to either private pay or have insurance to cover the costs.
Long-term care insurance also addresses the risk of depleting a person’s nest egg and retirement resources due to the need for extended care.
Considerations for a Long-Term Care Insurance Policy
Those approaching Medicare age should think about how they will handle covering the costs for an extended nursing home stay or even needing home health care for an extended period of time.
This approach holds true whether consumers are wanting to remain in their own home, need to enter an assisted living facility, or a nursing home during their remaining years. Keep in mind that many of the more reputable assisted living facilities and nursing homes have a wait list. Many times an individual who has a well put together long term care insurance policy will move up thru the wait list faster than someone who doesn’t.
Additional Considerations
Deciding on the right long term care policy takes time, energy, and specific research. There is no need to do this alone.
In past blog posts, we wrote quite a bit about Medicare Supplement and Medicare Advantage plans, and why they are necessary. Long-term care insurance plans are necessary for a different reason. They are very much focused on the idea that a increased percentage of retirees at some point either need extended home health care, or will enter a nursing home.
We aim to be a comprehensive resource for those with questions about this type of insurance and related needs. Our advisors do the work so that retirees won’t be overwhelmed by all of the research and complexities that goes into proper insurance planning in retirement.
When we are in our very young years, we have the notion that we are invincible. As we age, it becomes quite clear that we are not. Once we are approaching our golden years it is imperative to understand how frequent doctor visits can benefit senior citizens.
As you reach retirement age, several changes will happen in your life. As you get older, you will have to work harder to maintain good health. Establishing a good relationship with a doctor you trust is crucial when trying to remain healthy as you get older.
The average senior citizen will visit the doctor around four times a year. One of the main things you need to focus on when trying to stay healthy is scheduling frequent appointments with your doctor. These appointments provide you with an opportunity to express concerns about health changes and get some information about your existing health problems. Scheduling frequent doctor visits is beneficial as you get older and here are some reasons why.
Get Help With Pain Management
As you get older, you might start to experience problems with things like degenerative joint disease or arthritis. When left unmanaged, these common health problems can cause lots of pain and discomfort. Living your life in severe pain can limit mobility and rob you of your joy. Instead of suffering in silence, you need to visit your doctor regularly to get help.
During an appointment, your doctor will review the conditions that are causing you pain. Once they have an idea of what your ailments are, they can review a few different treatment options. Severe pain can also be an early warning sign of things like herniated discs, gallbladder disease and even spinal tumors. If these problems are diagnosed early on, you have a better chance of beating them and returning to a sense of normalcy.
Your Doctor Can Help Monitor Your Blood Pressure
Every time you visit your doctor, they will check a few basic things. One of the first things most doctors will check during your visit is your blood pressure. The older you get, the more common high blood pressure issues will become. High blood pressure can be life-threatening if it is coupled with other serious ailments like heart disease or diabetes.
The only way to have this condition identified is by routinely checking it. If your doctor discovers that your blood pressure is high during a check-up, they can prescribe medications to help you control it. However, if you skip an appointment with your doctor, this condition will only get worse. This is why you need to view attending these appointments as a priority.
Addressing Cognitive Issues
Having cognitive problems can severely diminish a senior citizen’s quality of life. In most cases, cognitive problems will be caused by underlying problems like elevated blood sugar levels, infections and even brain lesions. The only way to find out the cause of your cognitive issues and get the appropriate treatments is to work with a trusted medical professional. If your doctor feels like your issues are something they can’t diagnose or treat, they may refer you to a mental health professional.
Instead of trying to pay for the cost of doctor visits on your own, you need to find the right Medicare policy. With this insurance policy, you can get the care you need without going broke.