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    Turning 65 This Year?

    Are you turning 65 this year? Well let us be the first to wish you a Happy Birthday and provide a Welcome To Medicare! Believe it or not, this particular birthday will require you to make a few decisions that could impact you for years to come.

    Hopefully you are reading this and have at least 3-6 months before becoming eligible for Medicare. The sooner you get started, the better off you will be. The last thing you want to do is procrastinate and wait until the last minute. Making a major decision in a rush is never a good thing.

    Getting Ready

    As you can see from the Enrollment Timeline chart that you can take advantage of enrolling into Medicare up to 3 months prior to the month you turn 65 in. Unless you were born on the first day of the month, your Medicare coverage will be effective the first day of your birth month.

    If you were actually born on the first day of the month, then your Medicare coverage will be effective the first day of the prior month. To make this easier to understand, lets just say that you turn 65 on the first day of September. This means that your Medicare coverage will actually be effective on the first day of August (the month before).

    Turning 65

    Choices and More Choices

    There are a number of choices that you are going to have to make when it comes to your Medicare coverage. Here are the most common choice folks going onto Medicare have to make:

    • Choice 1: Go with just traditional Medicare Parts A and B with a Part D plan.
    • Choice 2: Go with traditional Medicare Parts A and B. Enroll in a Medicare Supplement plan and a Part D prescription drug plan.
    • Choice 3: Go with a Medicare Advantage plan with integrated prescription benefits.

    What’s Your Personality?

    We are sure that you have a great personality! What we are really wondering is, are you the type that prefers to sift thru a ton of junk mail (which you will be inundated with), go online and try to learn everything on your own, and then do everything by yourself? There’s nothing wrong with that. In fact, you can find quite a bit of information on Medicare right here on our website. In addition, you can get a jump on reading all about Medicare by reviewing the current copy of Medicare & You by clicking here.

    Now if your personality is that you prefer to get information that is 100% dedicated to your specific needs and wants, then Senior Benefit Services makes it easy for you. We will assign you your own personal advisor, who will review your exact situation and needs, when you work with us. This information will be provided to you at no charge. That’s right, there is no cost for this information and guidance.

    What To Do Next

    Instead of taking any chances, simply contact Senior Benefit Services, Inc at (800)924-4727 and ask to speak to an advisor. Just let your advisor know that you are going to be turning 65 and want to know what your options are. If you would prefer to have one of our advisors reach out to you directly simply click on the box below and provide a little bit of information and we will take it from there.

    Get Help From Senior Benefit Services

    Medicare Donut Hole Part D: Your Guide to Changes in 2023-2025

    The Inflation Reduction Act has lots of parts that help make prescription drugs more affordable, including closing the “Medicare donut hole” and changing how much money you have to pay when getting your prescriptions through the Medicare Part D drug benefit. “By 2025, Part D will expand its coverage to include more prescription drugs than today, reducing your out-of-pocket expenses.”

    So if you’re on Medicare or know someone who is, now you know a bit more about how the Inflation Reduction Act helps people save money when it comes to prescriptions – including closing the dreaded “Medicare donut hole” and making sure there’s coverage with Medicare Part D. This way, people on Medicare can get the medicines they need without breaking the bank. So if you’re dealing with the “Medicare donut hole” or using Medicare Part D, now you know a bit more about how the Inflation Reduction Act can help.

    Part 1: Overview of the Medicare Part D Benefit in 2023

    To comprehend the changes, let’s first understand how the Medicare Part D benefit works. The benefit has four distinct phases, determining the share of drug costs paid by Part D enrollees, Part D plans, drug manufacturers, and Medicare. Here’s a breakdown of each phase:

    1. Deductible Phase: Enrollees pay 100% of their drug costs, up to $505 in 2023. Some plans don’t charge a deductible, but most stand-alone plans do.

    2. Initial Coverage Phase: Enrollees pay 25% of total drug costs, while Part D plans cover the remaining 75%, up to $4,660 in 2023. People commonly use copayments and coinsurance in this phase.

    3. Coverage Gap Phase (Donut Hole): Enrollees pay 25% of total drug costs, including both brand-name and generic drugs. Part D plans pay 75% of generic drug costs, 5% of brand-name drug costs, and drug manufacturers provide a 70% price discount on brands.

    4. Catastrophic Phase: Medicare pays 80%, while the Part D plan pays 15%. You will be responsible for paying 5% of the total cost. If your out-of-pocket expenses, plus any discounts on brand-name drugs offered by the manufacturer, add up to more than a certain amount, you may qualify for catastrophic coverage. This means that you won’t have to pay as much and your coverage can help cover some or all of your remaining costs.

    Medicare donut hole part d
    Medicare Donut Hole for Part D in 2023

    Part 2: Changes Coming in 2024

    In 2024, several modifications will be implemented to improve the Medicare Part D benefit:

    1. Elimination of 5% Coinsurance: In Part D coverage enrollment, specific thresholds determine the amount of money you will have to pay out of pocket for your prescription drugs. Beginning in 2024, the threshold for reaching catastrophic coverage is $8,000. This means that if your total drug costs for a single year hit or exceed this amount, you essentially cap them at $8,000, and you don’t need to pay any additional amount. Additionally, before reaching the catastrophic coverage phase, enrollees no longer need to cover 5% of their drug costs as they previously did – they have eliminated this requirement. This change ensures that no one enrolled in Part D has to worry about paying too much for their medications during a single year.

    2. Increased Plan Contribution: Part D plans will now be required to pay 20% of total drug costs in the catastrophic phase, up from 15% in previous years.

    Part 3: Changes Coming in 2025

    Medicare Part D benefit will introduce the following changes in 2025:

    1. Out-of-Pocket Spending Cap: When you enroll in Part D, the amount of money that you will have to pay for your medications out of your own pocket each year is limited to $2,000. This means that no matter how much your medicines cost, you will never have to pay more than $2,000. Every year, this limit might change based on the average cost of Part D medicines for everyone. That way, the limit stays up to date with how much medications cost and you can still get the help that you need.

    2. Elimination of Coverage Gap Phase: The coverage gap phase, where enrollees faced 100% of their drug costs, will be eliminated in 2025. Enrollees will no longer experience a change in their cost sharing when transitioning from the initial coverage phase.

    3. Adjustments in Cost Sharing: Medicare Donut Hole Part D plans will help cover the costs of your prescription drugs when they reach a certain amount. When your costs get very high, Part D plans will pay 60% of what you owe, and the drug companies will reduce the cost of their brand-name medicines by 20%. Before your costs get too high, Part D plans will still help out – they’ll pay 65% of the cost, and drug companies will reduce the price of their brand-name drugs by 10%. That way, you can get the medicine you need without spending too much.

    Part 4: Additional Changes to Part D

    Medicare Part D Changes

    Apart from the significant changes mentioned above, several additional modifications will be made to Medicare Donut Hole Part D:

    1. Affordable Insulin: Starting in 2023, the cost of insulin products will be capped at $35 per month for all Part D plans.

    2. Vaccination Coverage: Part D will cover adult vaccines, such as the shingles vaccine, without any cost sharing.

    3. Full Benefits for Low-Income Individuals: Beginning in 2024, individuals with incomes up to 150% of the poverty level will be eligible for full benefits under the Part D Low-Income Subsidy (LIS) Program. The act will eliminate the partial LIS benefit for individuals with incomes between 135% and 150% of the poverty level.

    4. Premium Adjustments: Starting in 2024, the amount of money that people on Medicare have to pay each year will not be allowed to go up by more than 6%. This means if it goes up at all, it can only go up by a maximum of 6%.

    Part 5: Medicare Part D Improved Out-of-Pocket Costs

    Starting in 2025, Part D enrollees will have the option to spread out their out-of-pocket costs over the year instead of facing high expenses in a particular month.

    Conclusion:

    The Inflation Reduction Act of 2022 is making changes to Medicare Part D that will help make prescription drugs more affordable for people with Medicare and prevent them from falling into the notorious ‘medicare donut hole part d’. It sets a limit on how much you can have to pay out-of-pocket, ensuring your costs won’t be as high. Additionally, it eliminates the gap in coverage, so you won’t have to put up with full price for medications when they are most needed. Finally, they are changing the way we share the cost of medicines. This means both Medicare and you will contribute less money towards medicine costs, providing relief all around. By implementing these changes, the Act aims to reduce healthcare disparities and ensure access for everyone.

    The Medicare donut hole part d is an issue that the Inflation Reduction Act of 2022 seeks to mitigate. People with Medicare donut hole will find prescription drugs more affordable due to its changes, and they won’t have to worry about falling into the ‘Medicare donut hole part d’.

    Is the Medicare Donut Hole Closing? What You Need To Know

    Is the Medicare Donut Hole closing? Here we are almost 17 years later and the donut hole still strikes fear into most retiree’s wallets. Is it the actual donut hole that worries most, or is it the unknown? I am willing to bet it is the unknown! Most retirees never receive the necessary information to properly understand the donut hole, determine if their current prescriptions would place them in it, and comprehend how their Part D prescription coverage functions. Let’s take the mystery out of it.

    donut hole

    What is the donut hole?

    Before we discuss the infamous Medicare donut hole and its closing, lets go back to the beginning.  In 2006 the Medicare Part D program went into effect.  This was the likely one of the biggest changes to the Medicare program in almost 4 decades.  Prior to Medicare Part D, seniors had very limited options for having any prescription drug coverage.

    While the introduction of Medicare Part D was a financial lifesaver to many seniors, there were a number of Medicare beneficiaries that would use all their initial coverage benefits and enter the coverage gap, which many folks and the media started calling the ‘donut hole’.  In 2007 (the first full year of the Medicare Part D program), a Medicare beneficiary would enter the donut hole after their drug costs of $2,400 was met (the amount paid by the beneficiary and the insurance company).  At this point you were on the hook for 100% of the drug costs until you reached a total of $3,850 in out-of-pocket costs for the calendar year.

    It wasn’t until you exceeded spending $3,850 of your own money that you would enter the catastrophic phase which reduced your costs down significantly.

    medicare donut hole closing
    Medicare Donut Hole Closing

    When is the donut hole closing?

    The donut hole actually has been shrinking over the years and finally closed in 2020.  Now seniors pay a percentage of the cost of brand-name and generic drugs during the coverage gap.  A Medicare beneficiary does not enter the coverage gap until they along with their insurance plan have paid out a total of $4,660 in prescription costs.

    Right now, you are likely saying to yourself “Whoa…wait a minute, you said the donut hole closed, but I am still paying 25%.”  This can be a bit confusing but let me explain it a bit simpler.  Prior to the donut hole closing you would pay 100% of the costs for the prescriptions during the coverage gap phase, but now you only pay 25%.  That is a 75% reduction in your overall costs.  The donut hole was just a way that folks described having to pay all the costs during the coverage gap.

    What else has changed with the donut hole closing?

    While the total amount of out-of-pocket spending during the coverage gap has increased over the years, the amount of your out-of-pocket expense being credited has increased.  What this means is that while you might be paying 25% of the costs for a prescription, you are being credited with up to 95% of the actual costs towards getting out of the coverage gap.

    Here is an example that will better illustrate the expenses in the coverage gap.

    Let’s say that when you enter the coverage gap the retail price for one of your brand-name prescription drugs is $100.  During the coverage gap the insurance plan you have may only pay $5, but you are only charged $25.  The other $70 will be covered by the drug manufacturer’s discount they are required to pay during the coverage gap phase.

    Tracking medicare prescriptions

    How do you track all of your drug coverage phases?

    The good news is that you as an individual do not have to track when you enter any of the 4 phases.

    • Phase 1 – Deductible
    • Phase 2 – Initial Coverage
    • Phase 3 – Coverage Gap
    • Phase 4 – Catastrophic Coverage

    The Medicare Part D prescription drug plan you enrolled in for that calendar year must track this mandatory requirement for you.

    What if I get my prescriptions through a Medicare Advantage plan?

    The Medicare Advantage plan will track the same information for you as listed above.  Just like a stand-alone prescription drug plan, these plans have a coverage gap but with the closed Medicare donut hole. Remember, you cannot combine a Medicare Advantage plan with integrated drug benefits and a separate Medicare Part D drug plan.

    Medicaid for prescription drugs

    What if I get extra help for Part D?

    The Part D low-income subsidy program can reduce or even eliminate out-of-pocket costs.  This of course depends on what level of extra help you qualify for.

    If you qualify for full extra help, then:

    • There will be no deductible in your plan, nor will you pay a premium for your coverage.
    • You will not be paying the 25% in the Coverage Gap phase or commonly referred to as the Medicare donut hole.
    • Your co-payments for generic drugs will be up to a maximum of $4.15 and $10.35 for brand-name drugs.
    • If you receive Medicaid and your individual income is lower than $14,820 your co-payment for generic drugs will be reduced to a maximum of $1.45 and $4.30 for brand-name drugs.  For those who are married, the income threshold is $19,956 in 2023.
    • Once you enter the catastrophic phase you will have no co-pays for your medication refills.

    If you qualify for partial extra help, then:

    • The monthly premium you pay will be based on your income.
    • The maximum deductible your plan can charge is $104
    • You will pay a co-insurance for your prescriptions that will be no more than 15% of the price.
    • You can qualify for partial extra help if your individual income is less than $22,116 and you have assets that do not exceed $16,660.  For married couples the income threshold is $29,820 and assets cannot exceed $33,240 in 2023.

    Starting in 2024 more folks will qualify for full extra help.  If you meet the partial extra help income caps you’ll likely qualify for full extra help starting in 2024.  Additionally in certain states there may be a premium subsidy for Medicare Part D plans.

    Takeaway Points

    • Technically, the closure of the Medicare donut hole occurred in 2020.
    • You are only responsible for 25% of the drug costs in the coverage gap but receive 95% credit towards getting out of the coverage gap.
    • You may qualify for extra help.

    When you are a Medicare Supplement client through us, our advisors happily assist with Medicare Part D plans each year.  Not a Medicare Supplement client with us yet?  Give us a call at (800)924-4727 to see if we can lower your current Medicare Supplement/Medigap monthly premiums. Want a quote now? Simply click on the button below to get a NO COST or obligation quote.

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    Medicare Donut Hole

    This article will focus primarily on the Medicare donut hole, but we will also show how you will move thru each phase of a Medicare Part D prescription drug plan. Every year, from October 15 to December 7, during the Medicare open enrollment period, beneficiaries have the opportunity to enroll in a plan that offers Part D prescription drug coverage. This can either be a stand-alone prescription drug plan (PDP) for those in traditional Medicare or a Medicare Advantage plan which includes all Medicare benefits, prescription drugs inclusive (MA-PD). In 2022, out of the 65 million people Medicare covers, 49 million are enrolled in Part D plans. More than half of these (53%) have enrolled in MA-PDs and 47% in PDPs.

    Medicare Supplement Comparison

    Understanding The 4 Phases of Part D Prescription Plans

    Phases that includes Medicare Donut Hole

    Prescription drug coverage operates through several stages. The initial phase begins with the effective date of your prescription drug plan, which is often January 1.

    During this first phase, you must reach your deductible, which can be up to $505. You must pay this amount entirely.

    Once you’ve satisfied the deductible, you progress to the initial coverage phase. Here, you’re only responsible for making copayments. When your drug costs escalate to $4,660, you transition into the donut hole stage.

    While residing in the donut hole stage, you are obligated to pay 25% of the cost for both generic and brand-name drugs, until your out-of-pocket expenses total $7,400. As soon as you exit this gap, the final phase known as catastrophic coverage begins.

    It is also important to keep in mind that your plan premiums do not count towards these phases. To understand a bit more about Medicare Part D plans and also penalties that can be incurred click here.

    How have the Medicare donut hole regulations changed for 2023?

    The designers of the Medicare Part D program intentionally included a coverage gap, commonly referred to as the “donut hole.” Prior to the Affordable Care Act, the program provided coverage for beneficiaries’ drug expenses up to a specific dollar amount after the deductible. On standard plan designs, beneficiaries paid 25% of the cost during this phase. Coverage then ceased completely until beneficiaries reached another expenditure level, after which more robust coverage kicked in. Beneficiaries then paid 5% of the cost or a nominal copay at this point.

    What the heck is the Medicare donut hole?

    The designers of the Medicare Part D program incorporated a coverage gap, commonly referred to as the “donut hole.” Before the Affordable Care Act, the program covered beneficiaries’ drug expenses up to a specific dollar amount after the deductible. On standard plan designs, beneficiaries paid 25% of the cost during this phase. Coverage then ceased completely until beneficiaries reached another expenditure level, after which more robust coverage kicked in. Beneficiaries then paid 5% of the cost or a nominal copay at this point.

    Is the Medicare donut hole something I will encounter?

    Over the last few years, the donut hole has actually closed.  Beginning in 2020, Medicare beneficiaries no longer had to pay the full cost of their medications while in the donut hole. Instead, they would now pay 25% of the cost during this period. That 25% cost share is what you still would pay during this phase. Depending on their plan design, however, there may still be differences in costs before and during the donut hole.

    If my drug costs are high and I enter the donut hole, what will I be paying?

    Once you reach the donut hole after spending $4,660 on your medications (in 2023), you will pay 25% of the cost of drugs. If your plan is designed with a copay instead of coinsurance before the donut hole, then your costs may change once you enter the donut hole. However, if you reach the catastrophic coverage stage, out-of-pocket costs decrease significantly.

    Navigating the world of Medicare can be daunting. One of the most confusing aspects is the infamous “Medicare donut hole.” Before reaching this point in your Part D plan, your out-of-pocket costs are primarily covered by your copay or coinsurance. However, once you enter the donut hole, things change. Suddenly, the drug manufacturer provides a discount that mostly covers the cost of your brand-name drugs, while your coinsurance and Part D plan continue to cover generic drugs. It’s important to be aware of this shift and to educate yourself on the ins and outs of this notorious Medicare donut hole.

    Exiting The Medicare Donut Hole and Entering Catastrophic Phase

    If you’re enrolled in Medicare and regularly take prescription drugs, you might have encountered the term “donut hole.” It’s the coverage gap where you’re responsible for a portion of your drug costs until you reach the catastrophic coverage level. Unfortunately, the spending required to get there has been increasing over the years. In 2023, you’ll need to spend $7,400 before your coverage reaches the catastrophic level. Any discounts you receive from drug manufacturers for brand-name drugs will count towards reaching the threshold. Once you reach the catastrophic level, your drug costs will be significantly reduced. In fact, starting in 2024, there will be no out-of-pocket costs during that coverage level.

    There’s more good news. With each prescription refill, you accumulate a higher amount in your out-of-pocket expenses. This means you will transition into the catastrophic coverage phase earlier.  Starting in 2024 the Inflation Reduction Act will eliminate the 5% coinsurance requirement in the catastrophic phase. You can read very informative article from the Kaiser Family Foundation that takes a very deep dive into Medicare Part D here.

    What You Will Encounter in 2023 for the Medicare donut hole!

    While each year looks to enhance the Medicare Part D program, lets focus back in on this current year.  Once again, if the total amount of expense paid out of your pocket combined with the expenses paid by your drug plan reaches $4,660 then you will move from the Initial Coverage phase into the Coverage Gap/Donut Hole.  After you enter the donut hole, your out-of-pocket spending combined with manufacturer discounts will count towards your $7,400 maximum in this phase.  Once you reach this maximum then you move into the catastrophic phase.  For year 2023 your out-of-pocket costs while in the catastrophic phase would be as follows:

    • $9.20 co-payment or 5% coinsurance (whichever is greater) for Brand Name drugs
    • $3.70 co-payment or 5% coinsurance (whichever is greater) for Generic drugs

    Final Note

    Though the out-of-pocket expenses may appear daunting and somewhat intimidating, estimates suggest that only about 12% of Medicare Beneficiaries will progress to the donut hole phase. Additionally, projections indicate that a mere 4% of Medicare Beneficiaries will advance to the catastrophic phase. Still need more help with your Medicare Part D prescription drug plan, then feel free to reach out to us at (800)924-4727.

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    Maryland Medicare Advantage Plans

    Are you a senior citizen in Maryland looking to better understand Medicare Advantage plans and what they can do for you? If so, then this blog post is meant just for you! We’ll be covering the basics of Medicare Advantage plans available in Maryland, including their coverage levels, costs, and eligibility requirements. Stick with us until the end of this post and you’ll leave feeling more knowledgeable about how these plans work – so that you can decide if one is right for your medical needs. Let’s get started!

    Find Out More About Medicare Advantage Plans in Maryland

    Explaining What Medicare Advantage Plans Are

    Medicare Advantage plans are a popular choice for seniors these days, but many folks just don’t understand them. Essentially, Medicare Advantage plans are an alternative option to traditional Medicare. Enjoy the convenience of having all your Medicare benefits in one package with Medicare Advantage – including Original Medicare Parts A and B, plus vision, hearing, and dental. In addition, Medicare Advantage plans can offer integrated coverage for prescription drug costs. These plans are offered by private insurance companies and can have different costs, and restrictions depending on exactly where you live and which plan you want. It’s important to do your research and compare options before making a decision. If you’re looking for an all-in-one healthcare solution, Medicare Advantage plans might be the way to go.

    Overview of Benefits Offered by Maryland’s Medicare Advantage Plans

    Maryland’s Medicare Advantage plans have become increasingly popular and for good reason. Retirees can take advantage of benefits offered by these plans to get the care they need at an affordable cost. One of the main advantages of these plans is that they provide comprehensive coverage, which includes all of the benefits offered by Original Medicare plus additional services such as prescription drug coverage, vision and dental care, and wellness programs. Additionally, many of these plans offer low premiums and low copays for doctor visits, making them a cost-effective option for seniors on a budget.

    There are mainly three types of Medicare Advantage plans available in Maryland.

    • Health Maintenance Organization (HMO)
    • Preferred Provider Organization (PPO)
    • Special Needs Plans (SNPs)

    In the chart below we break down how these plans differ.

    Plan Network Type

    With so many benefits available, it’s no wonder that Maryland’s Medicare Advantage plans have become a favorite option among seniors seeking quality healthcare coverage.

    Comparing the Different Plan Types and Prices

    When it comes to choosing a plan the options can seem overwhelming. It’s important to compare the different plan types (type of network they offer) and prices to determine what will work best for your needs and budget. Several carriers offer plans at different price points. Typically the lower monthly premium plans are offset by higher co-payments, whereas the higher monthly premium plans offer lower co-payments.

    In the state of Maryland, there are not as many plans available that you might see in another state. This is mainly due to the reimbursement rates that the plans receive from Medicare for the state of Maryland (less than others). Another issue that you might run into is that the networks in Maryland are smaller (especially in the rural areas) which means that your doctors may not participate in the plan. Currently the most popular Medicare Advantage plans in Maryland come from the following insurance carriers (not in any specific order):

    • Humana
    • UnitedHealthcare
    • Johns Hopkins
    • Carefirst

    Humana

    Currently Humana offer 3 plans in the state of Maryland. While all the plans use a PPO network, only 2 of them have integrated prescription drug coverage. These plans range in price from $0.00 – $69.00 per month.

    UnitedHealthcare

    Currently UnitedHealthcare offers up to 4 plans in Maryland. For 2 of the plans a PPO network is used and for the other 2 an HMO network is used. Only 1 plan does NOT have integrated prescription drug coverage. The plans range in price from $0.00 – $26.00 per month.

    In addition to their standard Medicare Advantage plans, UnitedHealthcare offers 2 Dual Eligible SNP plan for those on both Medicare and Medicaid.

    Johns Hopkins

    At the moment Johns Hopkins offers up to 5 plans in Maryland. The HMO network is used for 2 of the plans while the other 3 use a PPO network. All but 1 plan has integrated prescription drug coverage. The plans range in price from $0.00 – $130.00 per month.

    Carefirst

    Currently Carefirst offers 2 plans in Maryland. Both plans use an HMO network and have integrated prescription drug coverage. The plans range in price from $18.00 – $75.00 per month.

    In addition to their standard Medicare Advantage plans, Carefirst also offers a Dual Eligible SNP plan for those on both Medicare and Medicaid.

    Tips for Shopping Around for the Best Plan Option For You

    Are you tired of feeling overwhelmed and confused when it comes to choosing the best plan option for your needs? Senior Benefit Services assists you in locating the right plan to suit your lifestyle – no daunting task here! Start by contacting us so we can help identifying your specific needs and then compare plans from several different providers. Remember, the best plan option for you might not be the same as someone else’s, so you will want to take the time to find the one that works best for you.

    When Can You Join A Medicare Advantage Plan?

    So when can you actually sign up for a Medicare Advantage plan in Maryland? Let’s look four different enrollment periods that you can take advantage of:

    During the Initial Coverage Election Period (IEP), you are eligible to enroll in Medicare when you turn 65 or when you receive benefits due to disability. This enrollment period includes three months before your 65th birthday, the month of your birthday and three months after.

    Initial Election Period enrollment timeline for Medicare Advantage plans
    Medicare Advantage Initial Election Period Chart

    During the Annual Election Period (AEP), you can switch from Original Medicare to a Medicare Advantage Plan from October 15 to December 7. If you are already enrolled in a Medicare Advantage Plan, you have the option to switch between plans during this period.

    Medicare Advantage plan annual enrollment period timeline
    Medicare Advantage Annual Enrollment Period

    During the Open Enrollment Period (OEP) between January 1 and March 31, you can switch between Medicare Advantage Plans or return to Original Medicare.

    Open Enrollment Period for Medicare Advantage plans
    Medicare Advantage Open Enrollment Period

    People who experience unusual life circumstances, such as losing a job and its accompanying health coverage or moving out of an area serviced by their current Medicare Advantage plan, can take advantage of special enrollment periods (SEP) offered by Medicare.

    What can you do about expensive copays with a Medicare Advantage plan?

    Dealing with expensive copays with a Medicare Advantage plan can be frustrating, but there are steps you can take to eliminate the big ones. Start by reviewing your plan’s benefits and looking for areas where copays may be particularly high. Explore options like a hospital indemnity plan that allows you to shift the higher costing co-pays onto the insurance company for a small monthly premium.

    Using a Hospital Indemnity plan to cover hospital copays with a Medicare Advantage plan.

    Takeaway

    You now have the knowledge to confidently choose a Medicare Advantage Plan in Maryland. First we need to explore your location to find the most suitable benefits, plans and prices for you. Here at Senior Benefit Services, Inc., we understand the importance of these factors, as well as how complicated choosing a plan can be. We offers senior citizens of Maryland unbiased information regarding all their Medicare needs. If you have any questions or concerns about joining a particular advantage plan in Maryland, contact us today. Our experienced advisors will help you select the most suitable insurance plan for your needs and budget.

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    Medicare Supplement Plans Maryland

    Are you a senior/retiree living in Maryland searching for the best Medicare Supplement plan? Medicare Supplement Plans are great for extra coverage of costs not covered by original Medicare. You can customize the plan that best suites you, but it’s important to have a good understanding of the plans. Here we’ll provide all the information necessary on how to get started with supplement plans in Maryland.  

    Medicare Supplement Quote Request for Maryland

    What is a Medigap Plan and How Can It Help with Medical Expenses in Maryland

    A Medicare Supplement Plan, also known as Medigap insurance provides coverage for expenses not covered by Original Medicare. Some of the gaps in Medicare are deductibles, co-payments, and coinsurance. Marylanders can select from Medigap plans offered by private insurers, that vary in coverage and costs. Seniors in the state of Maryland can gain financial security with a Medicare Supplement plan. A Medigap policy offers peace of mind with no network worries. Use your own doctors and hospitals!

    Many Choices Available in Maryland

    Already enrolled in Medicare? Residents of Maryland enrolled in Medicare may know Medigap plans help cover gaps in coverage. There are multiple types of plans available depending on your personal needs. Each plan offers different benefits and varying coverage levels, so it’s important to explore all your options before choosing one. With up to 12 different plans to choose from, it may seem overwhelming, but don’t worry, our advisors make it easy.

    Best Medicare Supplement Plans Available in Maryland

    First things first!  Just like other states, the Medigap plans in Maryland are all standardized, so the benefits for a Plan N are the same for every insurance company.  Currently the most popular Medicare Supplement plans in Maryland are Plan F, Plan G, and Plan N.

    While Plan F is the most comprehensive when it comes to benefits, not all Marylanders are eligible to enroll.  Only those individuals who went onto Medicare prior to January 1, 2020 are eligible.  If you went onto Medicare after this date, then don’t despair.  Medicare Supplement Plan G is almost identical to Plan F when it comes to benefits.  The only difference is that Plan G does not cover the annual Part B deductible.

    So how does Plan N fit in?  Medicare Supplement Plan N offers solid benefits with typically a lower premium.  Plan N may be ideal for Marylanders with tight budgets. With Medigap Plan N you get all the same benefits as Plan G, except for excess charge coverage.  For many this is not a big issue since over 96% of the providers in Maryland participate in the Medicare Assignment program and do not balance bill for excess charges.

    Medicare Supplement Plan F vs Plan G vs Plan N

    How Much Does A Medicare Supplement Plan Cost In Maryland

    In Maryland? Curious what a Medicare Supplement plan costs? The charts below outline some of the current pricing for both males and females. You may see rates less than these listed on other websites, but many of those rates include discounts such as household or active wear.  We prefer not to list those since not all folks qualify for them.  Our advisors will of course look for each and every discount to help you get the best pricing for your Medigap plan.  Once again it is important to remember that if you went onto Medicare January 1, 2020 or later, you are not eligible to enroll in Plan F.

    Medigap Rates in Maryland for female
    Medigap Rates in Maryland for male

    How to Determine Which MD Medicare Supplement Is Right for You

    Are you confused about which MD Medicare supplement plan is suitable for you? Don’t panic! First, evaluate your medical needs and budget. Consider the doctors you visit frequently and ask them if they participate in the Medicare Assignment program.  This is making sure that they do not balance bill for an additional 15% over what Medicare approves.

    Then, take a look at the prescriptions you are currently taking and make sure that your stand-alone Part D plan covers those at the lowest possible costs.  When it comes to getting help with your Part D plan premiums, there is a state program that is based off income and not assets.  Many seniors in Maryland qualify for this benefit. 

    Lastly, while many folks are turning to Medicare Advantage plans due to the low monthly premiums, it is important to remember that plan networks in Maryland are much smaller in the rural areas than in the larger cities.

    Medicare Supplement Quote Request for Maryland

    Medicare Advantage Plans in Maryland

    Are you feeling overwhelmed about choosing a Medicare supplement plan in Maryland?  Depending on your budget, you may feel that a Medicare Supplement plan may simply cost too much.  The commercials on TV touting little to no premium Medicare Advantage plans may seem like a no-brainer.  While a Medicare Advantage plan might seem appealing, it is important to understand that it is not the same as a Medicare Supplement plan. 

    Many of our clients do opt to get a Medicare Advantage plan from us, but our advisors make sure that you completely understand that these plans use a cost-sharing approach.  This means that you will have co-pays and even co-insurance payments that you will need to pay when receiving care.  Some examples of these co-pays include small ones when visiting your primary care physician, but large ones when there is a hospital stay. 

    How to Sign Up or Make Changes to Your Existing MD Medicare Supplement Plan

    Signing up or making changes to your existing MD Medicare Supplement Plan may seem like a daunting task, but it doesn’t have to be. At Senior Benefit Services we make it EASY! Fortunately, we make the process simple and straightforward. We will help you understand what Medicare Supplement plans available and which ones you should consider.  If you already have a Medicare Supplement plan it is always in your best interest to get a comparison quote.  To review your current Medigap policy and pricing, you can either call us at (800)924-4727 or complete our online quote request.

    Medicare Supplement Quote Request for Maryland

    Medicare Plan N Review

    We are going to review the benefits of Medicare Plan N and how it might be a good choice for you. Navigating Medicare plans can be confusing, especially for those approaching retirement. Retirees often feel confused about selecting the best coverage option due to the overwhelming number of choices. One option that may work well for certain people is Medicare Plan N. This plan offers solid benefits and lower premiums without the requirements of using doctors and hospitals in a network.

    Discover this coverage’s benefits with our in-depth review. Before we get started, keep in mind that sometimes this plan is referred to as Medigap Plan N, Medicare Supplement Plan N, and even Medicare Plan N. Plan N is standardized so no matter which carrier you get your coverage through, the benefits are the same.

    Difference between Part and Plan

    What is Medicare Plan N and who is eligible for it

    Medicare provides health coverage to those over 65, ensuring peace of mind. However, there are many different plans within Medicare, and choosing the right one can be confusing. One option is Medicare Plan N. The plan covers services offered by Medicare Plan G, but excludes excess charges and has lower co-payments. Enrollment in both Medicare Part A and Part B makes you eligible to participate in this plan. It’s important to carefully review all the specifics of Medicare Plan N and its benefits.

    Medicare Supplement Comparison

    The benefits – what does Medicare Supplement Plan N cover

    Plan N may not be the most well-known Medicare Supplement plan, but it’s popularity is increasing each year. The plan covers most out-of-pocket healthcare expenses, minimizing financial worries for you. However, it’s important to note that Plan N does require you to pay a small copay for some services, such as emergency room visits and doctor’s office visits. Understand the plan before signing up, as it excludes excess charges and specific costs. Overall, if you’re looking for a reliable and lower costing Medicare Supplement plan, Plan N might just be the answer.

    Medicare Plan N Benefits
    Medicare Supplement Plan N Benefits At A Glance

    Coverage differences between Plans F, G, and N

    When it comes to choosing the right Medicare supplement plan, it’s important to understand the coverage differences between Plans F, G, and N. While Plan F is the most comprehensive, covering all of the out-of-pocket costs that Medicare doesn’t cover it is the most expensive. Plan G is similar, but doesn’t cover the Medicare Part B deductible. The Plan N covers even less, but is a more affordable option. It’s important to carefully consider your healthcare needs and budget when selecting a plan.

    Medicare Supplement Plan N Comparison to Plan G and Plan F

    The above graphic shows a comparison for a 70 year old male, non-tobacco user for the state of Maryland in 2023. It is important to note that since January 1, 2020 folks that are new to Medicare cannot purchase Plan F.

    Understanding out of pocket costs with Plan N

    While it is great to review the benefits of Medicare Plan N, it is also important to understand what it does not cover.

    • Part B Deductible – for 2023 the annual deductible is $226
    • Part B Excess Charges – keep in mind that roughly 96% of doctors do NOT balance bill for excess charges. Example of an excess charge would be someone who goes to see their doctor who doesn’t participate in the Medicare Assignment program. The doctor is billing Medicare $200, but Medicare is only approving $120. This doctor can balance bill for a maximum of 15% above the Medicare Approved amount. The patient would owe the doctor $18 as the excess charge amount.
    • Doctor Copays – the copays are somewhat of a hybrid model. The way that it works is that it is a 20% co-insurance up to a $20 maximum co-pay. If Medicare approves the doctor’s office visit billing for $200, then 20% of that amount would be $40. The plan can can charge the policyholder no more than $20, which is the maximum capped amount permitted under the policy.
    • Emergency Room Copays – the copay for this item is the basically the same, but is capped out at $50. When the hospital admits you from the emergency room, your expenses come under Part A of Medicare. If you meet the eligibility criteria, they will waive $50 charge.

    Using the comparison chart above you will see the savings are quite noticeable when comparing Plan N to Plan G and Plan F. For folks whose doctors accept Medicare Assignment (don’t balance bill for excess charges) Plan N could be a great choice. If you regularly visit multiple doctors throughout the year, then Plan G may be a more suitable option for you.

    Tips on selecting the right plan for your needs

    Picking the perfect plan can be overwhelming, but it’s essential to find one that fits your unique needs. As you try to determine the plan that perfectly suits your unique requirements, the overwhelming availability of twelve standardized plans can easily cause confusion and frustration. This is exactly why we do reviews such as this one for Medicare Plan N.

    Medicare Supplement Plan Chart

    Though most consider Medicare Plan N as a cost-saving option, it is important to weight the benefits of Plan N against Plans F and G and determine which one best meets your specific needs. Consider if you are comfortable with paying costs like the Part B deductible and coinsurance – if so, then Plan N may be an excellent choice. It is a good idea to work closely with a qualified health insurance expert who can guide you through this assessment process. Call Senior Benefit Services, Inc at (800)924-4727 to get the help you need.

    Get a Medicare Supplement plan quote
    Click Here To Get a FREE – No Obligation Quote

    Aetna Senior Products Plan G

    Are you a senior looking for the peace of mind that comes with having comprehensive health coverage? If so, you should consider Aetna’s Senior Products Plan G. As one of the most popular supplemental healthcare options, this plan gives seniors reliable coverage and affordable costs.

    While many seniors are very familiar with Aetna’s Medicare Supplement Plan F as being their most comprehensive benefits plan, the Aetna Medicare Supplement Plan G is almost identical in coverage except that it does not provide coverage for the annual Medicare Part B deductible. Read on to learn more about what makes Aetna’s senior products plan G one of the best options out there for older Americans.

    Overview of Aetna’s Senior Products Plans

    Many retirees prefer to have a comprehensive healthcare plan that meets all their needs. Aetna’s Senior Products Plan G is designed to provide coverage for a wide range of healthcare services, including hospitalization, skilled nursing care, and physician services. With Plan G, seniors have the freedom to choose their healthcare providers without worrying about the restrictions of a network.

    In addition, the plan offers coverage for excess charges beyond what Medicare pays, ensuring that seniors have the protection they need against unexpected medical expenses. Overall, Aetna’s Senior Products Plan G is an excellent option for seniors who want comprehensive coverage and flexibility in their healthcare plan.

    Benefits and Coverage of Plan G

    If you’re in the market for a new Medicare supplement plan, Plan G might be just what you’re looking for. This plan offers comprehensive coverage that can give you peace of mind in your healthcare decisions. With Plan G, you’ll have coverage for your Medicare Part A deductible, which can save you money in the long run. You’ll also have coverage for skilled nursing facility care and a full year of foreign travel emergency coverage.

    Another great benefit of Plan G is that it doesn’t require you to pay any out-of-pocket costs other than your annual Part B deductible for Medicare-covered services, which can be a huge relief for those on a fixed income. Overall, Plan G is a great option for those who want comprehensive coverage without breaking the bank. The chart below shows just how comprehensive the Medicare Supplement Plan G is with Aetna and other carriers.

    Aetna Senior Products Plan G

    Eligibility for this Plan

    Medicare Supplement Plan G is a comprehensive coverage option that offers seniors extra benefits beyond Original Medicare, such as coverage for foreign travel. However, not everyone is eligible for this plan. To enroll in Plan G, individuals must first be enrolled in Medicare Part A and Part B. They must also live in the U.S. and be at least 65 years old. Individuals under 65 may be eligible for this plan if they have a qualifying disability or end-stage renal disease and the state they live in mandates that a Plan G be offered to them the same as to those individuals who are 65 and older. If you meet these qualifications, this supplement plan could be the right choice for you. It offers robust coverage, including coverage for excess charges and skilled nursing facility care, and could help reduce out-of-pocket expenses.

    Compare Medicare Supplement Plans

    Medicare Supplement Plan G vs Plan F

    Choosing the right Medicare Supplement plan can be confusing, especially when it comes to deciding between Plan G and Plan F. While both plans provide coverage for the same basic benefits, Plan G does not cover the Medicare Part B deductible like Plan F does.

    In the long run, choosing Plan G can be a more cost-effective option since it typically offers lower premiums than Plan F. The comparison chart below shows the difference between Plan G and Plan F in benefits provided.

    Medicare Supplement Plan G vs Plan F
    The only difference between Medicare Supplement Plan F and Plan G is the Part B annual deductible.

    Related Article: Best Alternatives to Medicare Plan F

    How to Enroll

    If you’re looking to enroll in Plan G, there are a few important things you should know. Plan G is a Medigap policy that provides comprehensive coverage for Medicare beneficiaries. To enroll, you’ll need to be eligible for Medicare and have an active Medicare Part A and Part B plan. You’ll also need to find a licensed insurance agent or broker who sells Medigap policies in your state. They can help you compare Plan G plans and choose one that best fits your needs and budget. Aetna’s Plan G affordability can vary by state for seniors.

    This is where speaking with one of our advisors really benefits you. They can provide you with not only premium pricing on Aetna, but also on other carriers that might offer the same Plan G but at an even lower monthly premium. Once you’ve selected a plan, you’ll need to provide your advisor with some personal medical information and other basic information about yourself. From there, the insurance company will review your application and determine whether you qualify for coverage.

    Why Aetna Senior Products Might Be Right For You

    If you are a senior citizen, finding the right healthcare plan can be a daunting task. After all, there are various factors you need to consider. Things like:

    • What services are covered?
    • What your out-of-pocket expenses will be?
    • Which provider offers the most value for your money?

    Aetna Senior Products Plan G may be the ideal plan for you if you want broad coverage. It’s also great for low out-of-pocket costs, and access to top-notch medical care (no networks to navigate). With Plan G, you can enjoy all the benefits of Plan F, but at a lower cost.

    That means you won’t have to worry about paying for services that you may not need. It also means you can still get the coverage you need at an affordable price. Whether you’re looking for hospital insurance, doctor’s visits, or even foreign travel coverage, Aetna has got you covered.

    So why wait? Find out if Aetna Senior Products Plan G is a good match for you today. Shouldn’t you enjoy the peace of mind that comes with knowing you’re covered. Check out the case study below on one of our existing clients.

    Senior Products Plan G Case Study

    Why Is This A Great Option For Many Seniors?

    Aetna Senior Products Plan G is a great choice for individuals looking to supplement their Medicare coverage. The debate over which plan is best – Supplement Plan G or Plan F – is ultimately up to you to decide, depending on your individual needs.

    Aetna’s Plan G offers a comprehensive range of benefits at an affordable price, providing you with the peace of mind that comes along with knowing that it covers medical expenses well into later retirement years.

    So if Plan G sounds like the right fit for you, call Senior Benefit Services, Inc today to talk with one of our knowledgeable representatives who can help guide you towards making the best decision for your desired coverage.

    Don’t Need Comprehensive Coverage? Read our related article: Aetna Medicare Supplement Plan Review|Medicare Plan N Reviews

    Get Free Medicare Supplement Quote
    Get Help Now With Your Medicare Supplement Quote

    Is Cancer Insurance Worth It?

    Is Cancer Insurance Worth It?  In our opinion it is!  Now keep in mind as my grandfather used to say “Opinions are like rear-ends…everyone has one and they usually all stink.”  Now with that being the case, what makes our opinion different.  Well, we are going to back that opinion up with data.

    How Prevalent is Cancer?

    Cancer is a disease that affects millions of people each year, and the cost of treatment can be significant. While traditional health insurance for those under the age of 65, Medicare, and Medicare Advantage plans can help cover the cost of cancer treatment, it may not cover everything. That’s where cancer insurance comes in. Cancer insurance is a type of supplemental insurance that can provide additional financial support to help cover the cost of cancer treatment.

    One of the main reasons to buy cancer insurance is to help cover the cost of treatment. Cancer treatment can be expensive, and the cost of chemotherapy, radiation, and other treatments can add up quickly.  According to The Agency for Healthcare Research & Quality (AHRQ) it is estimated that direct medical costs for cancer in the US back in 2015 were a staggering $80.2 BILLION (while 52% of this amount was for outpatient hospital and doctor office visits).  The National Cancer Institute estimated that cancer-related medical costs in the US were $208.9 BILLION in 2020.

    According to the American Cancer Society it is estimated that there will be over 1,900,000 new cancer cases diagnosed in the US during 2023.  The risks of developing cancer are extremely high.  In fact the older that you get the chances increase.  Research shows that 88% of those diagnosed with cancer are over the age of 50.  The chances of cancer increase even more in each individual’s case based on their lifestyle (such as smoking, heavier body weights, drinking alcohol, and their diet).  Keep in mind that if an individual has a family history of cancer, their chances of being diagnosed with cancer during their lifetime can increase even more.

    The Costs For Treatment

    The list price for many of the needed prescription medicines are now more than $100,000 annually.  According to an article by GoodRx one of the most expensive drugs in the US is Kimmtrak which retails at $18,760 for a single vial.  Annual treatment costs would be $975,520.  Now keep in mind that this is not traditional radiation or chemotherapy treatment.  According to an article published by the American College of Radiology states that the cost to treat prostate cancer with proton therapy radiation can reach $40,000.  Individuals and their families can use cancer insurance to obtain a lump sum of money that helps cover these costs and alleviates the financial burden. While insurance may cover a large portion of the costs of these drugs, there will still be high amounts of out of pocket spending by the consumer. Cancer insurance is worth having because it provides extra money directly to you to help pay for these expenses.

    Popular cancer drugs show why cancer insurance is worth it

    What Else Can Cancer Insurance Help With?

    Another reason to buy cancer insurance is to help cover the cost of non-medical expenses. Cancer treatment can also include additional expenses such as transportation to and from treatment, lodging for out-of-town treatment, and even loss of income due to time off work. Cancer insurance can ease the financial burden on the individual and their family by providing a lump sum of money that they can use to cover these expenses. Covering these expenses also helps make cancer insurance worth looking at.

    How Can It Help If You Have Other Insurance Already?

    Cancer insurance can also provide a sense of peace of mind. Knowing that you have additional financial support in the event of a cancer diagnosis can provide a sense of security. This helps individuals and their families focus on recovery and treatment, rather than worrying about financial stress.

    It’s also important to keep in mind that cancer insurance can complement traditional health insurance. Cancer insurance can help fill in the gaps that traditional health insurance may not cover and provide additional financial support.  So, let’s take a look at some of these gaps in different types of insurance:

    • Group Health/Individual Health Plans (under age 65 and not on Medicare)
      • Many of these plans now have very large deductibles to make the premiums more affordable to individuals.  In fact many of the individual plans sold through the Affordable Care Act (ACA) have deductibles of $7,500 – $10,000.
      • The average American has saved less money than they need for an emergency situation. According to the data available from the Federal Reserve’s Board Survey of Consumer Finances the median savings balance (not including retirement funds) are as follows:
        • Under 35 = $3,240
        • Age 35-44 = $4,710
        • Age 45-54 = $5,620
        • Age 55-64 = $6,400

    While these numbers alone are alarming, according to data provided by Bankrate in early 2022, a whopping 56% of Americans would not be able to pay an unexpected bill of $1,000 with their savings.

    Even though health plans typically set a limit on the amount a policyholder must pay for medical expenses out of pocket in a calendar year, they do not cover additional expenses that individuals often incur when being treated for cancer, such as:

    • Travel Expenses
      • Gas expense to and from treatment centers
      • Hotel accommodations for spouse/partner while policyholder is undergoing surgery and follow-ups
      • Meals for spouse/partner while traveling with policyholder
      • Possible loss of income for either policyholder or spouse/partner during time of treatment and recovery.

    How Does Cancer Insurance Work With Traditional Medicare?

    • Traditional Medicare with a Medicare Supplement Plan
      • If you only have traditional Medicare parts A & B then you will be exposed to such out-of-pocket expenses as the Part A deductible ($1,600 in 2023), Part B deductible ($226 in 2023), Part B coinsurance (20%), any additional excess charge expenses, and all travel expenses. This can add up to a very large sum of money coming out of the retiree’s pocket/savings.
      • Depending on the Medicare Supplement plan that you have, Medicare could cover a portion or all of these medical expenses. Of course, any and all travel expenses would still come directly out of pocket since these plans do not cover those expenses as medical.

    How Does Cancer Insurance Work with Medicare Advantage?

    • Medicare Advantage Plan
      • Many of these plans do not have a deductible but have large annual maximum out of pocket exposure (MOOP).  Since many of these plans use a Preferred Provider Network (PPO), we are seeing MOOPs from $7,500 in network and $11,000 out of network.
      • Chemotherapy and Radiation treatment is usually covered at 80% which leaves a 20% obligation to the insured.  This means that the $7,500 in expenses would be easily reached and could cause financial distress to that policyholder.
      • Medicare Advantage plans do not cover travel expenses

    The Final Thought

    Those diagnosed with cancer will receive additional financial support from cancer insurance. It can help cover the cost of treatment, non-medical expenses, and provide a sense of peace of mind. It’s important to speak to an insurance agent to understand the coverage and options that are available. You can then make an informed decision about whether cancer insurance is the right choice for you. Understanding that cancer insurance is a compliment to traditional health insurance is very important. To find out if a cancer insurance is worth it and right for you. Contact Senior Benefit Services, Inc at (800)924-4727.

    Request more information about whether cancer insurance is worth it
    Click above to request more information on cancer insurance plans available in your area.

    Mutual of Omaha Medicare Supplement Review

    Our company has had a long-standing relationship with Mutual of Omaha Medicare Supplements for decades.  While this review focuses on the Medicare Supplement offered by Mutual of Omaha, keep in mind that the company has a broad portfolio of products. Mutual of Omaha continues to rank in our Top 10 Medicare Supplement carriers year after year.

    Mutual of Omaha Medicare Supplement Review

    Mutual of Omaha was founded in 1909 and is one of the most recognized names in the insurance industry.  For over 100 years the company has remained strong and continues to be a carrier that pays its claims quickly.

    One of the key reasons why Senior Benefit Services, Inc. has continued to work with Mutual of Omaha Medicare Supplements for so many years is their financial strength.  In addition to having over $4.0 Billion in statutory surplus, the company has more than 5.3 million individual product customers, and 14.6 million members in their 48,000 employer groups.

    Financial Ratings

    • A.M. Best Company, Inc = A+ (Superior)
    • Moody’s Investors Service = A1 (Good)
    • S&P Global = A+ (Strong)
    • Better Business Bureau = A+

    While financial strength is great, it is also good to know that the company paid out in 2021 over $6.4 billion in benefits.

    FUN FACT:  Mutual of Omaha’s Wild Kingdom first premiered in 1963, and to this day continues to provide education.  Feeling nostalgic and want to see original footage of episodes with Marlin Perkins and Jim Fowler, visit the Wild Kingdom website.

    Mutual of Omaha Medicare Supplement plans are not available in all states. 

    It is important to keep in mind that in some states you will find the Mutual of Omaha Medicare Supplement underwritten by one of their subsidiary companies that include:

    • United of Omaha
    • United World
    • Companion Life

    Here’s the great news, all 3 of the subsidiary companies are A+ rated by A.M. Best as well.

    So, let’s get into the meat and potatoes of this review.  Let’s first look at the pros and cons of Mutual of Omaha Medicare Supplement Plans.

    PROSCONS
    Very large customer base which shows its dedication to the Medicare Supplement market.Not approved in the state of Massachusetts.
    Friendly and helpful customer serviceMultiple subsidiary companies sometimes cause confusion.
    Been selling Medicare Supplements since 1966 

    Other things that we really like about Mutual of Omaha Medicare Supplements

    • Up to a 12 percent household discount
    • 12 month rate lock

    How To Purchase a Mutual of Omaha Medicare Supplement

    Like many companies, you can purchase a policy directly thru their call center.  The other way is to purchase your policy thru a licensed insurance agent.  Which way should you go?

    Believe it or not the answer is very simple.  If you purchase directly from the carrier you receive no discount.  If you purchase from a licensed insurance agency like Senior Benefit Services, Inc. you pay the same cost for your policy, but you get the added value of having your own dedicated agent.  Why does this matter?  The turnover in call centers is extremely high and the chances of you being able to talk with the same person you enrolled thru is very low.  Working with Senior Benefit Services, Inc. allows you to have a dedicated agent who knows you, has a complete support team standing behind them to get any claim problems resolved, and provides service after the sale.

    Speaking of service, each client of Senior Benefit Services gets an annual review of not only their medical insurance, but also their prescription drug coverage.  This means that you will always be getting the most benefits for your premium dollars.

    Next Steps

    We hope that you found our Mutual of Omaha Medicare Supplement review to be of great value. To get a quote for a Mutual of Omaha Medicare Supplement plan or a full comparison of the top priced plans in your area contact us today at (800)924-4727.

    Get Free Medicare Supplement Quote
    Get Help Now With Your Medicare Supplement Quote

    Medicare Advantage Hospital Coverage

    Person laying in hospital bed
    Medicare Advantage hospital coverage can leave you with surprise bills.

    Many folks wonder about how Medicare Advantage plan’s hospital coverage works.

    Medicare Advantage plans are a great way to get health coverage for senior individuals and those on Medicare due to disability who qualify. But did you know that supplementing your Medicare Advantage plan with a hospital indemnity plan can provide even more comprehensive coverage? Let’s look at how this works and why it may be beneficial to you.

    What is a Hospital Indemnity Plan?

    A hospital indemnity plan is an insurance policy that pays out cash benefits for covered medical expenses due to illness or injury. This type of policy provides financial assistance for the costs associated with inpatient care and can also cover other related expenses such as medications, outpatient services, doctors’ visits, and more. It is important to note that these plans do not cover all medical expenses—that’s where Medicare Advantage comes in.

    How Does a Hospital Indemnity Plan Supplement Medicare Advantage?

    Medicare Advantage plans are designed to cover most of the same things as traditional Medicare Part A and Part B, but sometimes there are gaps in coverage. These gaps can include deductibles, copayments, coinsurance, or other out-of-pocket costs associated with health care services. That’s where a hospital indemnity plan comes in—it helps to fill those gaps in coverage by providing additional financial protection against unforeseen medical expenses.

    For example, if you were hospitalized due to an unexpected illness or injury, your hospital indemnity plan would pay out cash benefits to help cover any out-of-pocket costs that your Medicare Advantage plan doesn’t cover.  To better understand this, let’s take a look at the following case study combining a hospital indemnity plan with Medicare Advantage hospital coverage:

    Medicare Advantage hospital coverage co-pay covered by hospital indemnity plan.

    Jane is a 67-year-old female who has a Medicare Advantage plan that requires her to pay the first $300 per day that she is in the hospital.  She must pay the $300 co-payment for the first 5 days she is an inpatient.

    Jane is admitted into the hospital on March 2nd due to an accident that has damaged her knee and shoulder.  It is determined that Jane needs to have a full knee replacement done and will also need physical therapy for her shoulder.  Jane spends 4 nights in the hospital before being sent to a skilled nursing facility to get rehab for her knee and shoulder.

    Jane will owe the hospital $1,200 for her stay ($300 x 4 days = $1,200).  The good news for Jane is that her insurance agent helped her obtain a hospital indemnity plan that will cover $300 per day for up to 10 days each calendar year for only $29.00 per month.  This means that Jane will receive a cash payment of $1,200 that she can in turn use to pay for her hospital bill.

    It Gets Even Better!

    Here’s the great news…if Jane were to go back into the hospital during the same calendar year, she would still have 6 days of benefits left on her hospital indemnity plan.  So even if her Medicare Advantage plan covered all the hospital expenses, her hospital indemnity plan would continue to pay cash benefits directly to her.  That extra money could be used anyway that Jane wants.

    Why Should You Consider Adding a Hospital Indemnity Plan?

    Adding a hospital indemnity plan to your existing Medicare Advantage plan can provide peace of mind and greater financial security for a very small monthly premium. Having both types of coverage means that you will have more comprehensive protection against unexpected hospital expenses due to illness or injury—which can help save money in the long run. Plus, many hospital indemnity plans come with additional options such as ambulance trip coverage, skilled nursing facility coverage, and even outpatient surgical expense coverage—so adding one could be well worth the cost!

    Conclusion:

    Hospital indemnity plans can be an excellent way for individuals who qualify for Medicare Advantage to further protect their finances from unexpected medical costs due to illness or injury. If you are looking for additional peace of mind and financial security when it comes to health care costs and Medicare Advantage hospital coverage, then consider adding a hospital indemnity plan today! With its cash benefits, it could prove invaluable over time.  To find out more about how a hospital indemnity plan could benefit you personally, call Senior Benefit Services at (800)924-4727.

    Best Alternative For Medicare Supplement Plan F

    If you went on Medicare after January 1st of 2020 then you cannot buy a Medicare Supplement Plan F. What is the best alternative for Medicare Supplement Plan F? Research you may have conducted on your own has likely returned results on Medicare Supplement Plan G. 

    Prior to January 1, 2020 the most popular Medicare Supplement plan being sold was Plan F.  This plan was considered by many to be ‘Cadillac Coverage’ since the policyholder had no deductibles, co-pays, or co-insurance payments that they would be paying out of pocket.

    If you went onto Medicare prior to January 1, 2020 you can still get a Plan F, but many choose to switch to a Plan G since it is typically lower priced than Plan F.  If you went onto Medicare January 1, 2020 or later, then you are not allowed to purchase a Plan F so this is another reason why the Plan G has risen to be the most popular Medicare Supplement right now.

    Best Alternatives to Medicare Supplement Plan F
    Find out why a Medicare Supplement Plan G is a great alternative to Plan F

    So, what does a Medicare Supplement Plan G cover?

    Let’s start with Part A of Medicare and how the Plan G works with this part.

    If you go into the hospital as an inpatient Medicare says that you will be responsible for the first $1600. This amount is the Part A deductible for 2023.  After you meet the deductible, Medicare will cover for the first 60 days of your semi-private room and board, general nursing and miscellaneous services and supplies.  Medicare Supplement Plan G will cover that Part A deductible for you.  Keep in mind that the Part A deductible is not a calendar year deductible. It is very possible to incur that same deductible again if you were to go back into the hospital during the same calendar year.  If this happens, then the Plan G will cover the Part A deductible again.

    Blood

    If you were to need pints of blood while in the hospital, Medicare says that you are responsible for the costs of the first 3 pints. Keep in mind that you can have blood donated directly to you.  The Plan G will pay for those first 3 pints and Medicare will cover all amounts above that.

    Skilled Nursing Facility Care

    Many folks become a bit confused when it comes to receiving Skilled Nursing Facility benefits.  Medicare says that if you spend 3 days in the hospital then need rehab that they will cover the first 20 days in a Skilled Nursing Facility.  It is important to keep in mind that your date of discharge does not count towards the 3-day minimum requirement.  The easiest way to keep track of this is to understand you really need to spend at least 3 nights in the hospital as an inpatient.  After Medicare covers the first 20 days, it will now pay all but the first $200 per day for days 21 through 100.  The Medicare Supplement Plan G will cover those 80 days of co-pays in full for the policyholder.

    What About Medicare Excess Charges?

    Another area that sets the Plan G apart from other Medicare Supplement plans is that it covers excess charges.  In fact, with Plan G covering 100% of the excess charges, it is a perfect alternative for Medicare Supplement Plan F. So, what are excess charges?  Excess charges are amounts that a provider can charge you in addition to what Medicare approves. They can only do this if they don’t participate in the Medicare Assignment program. 

    “A non-participating physician does NOT accept what Medicare approves as full payment.”

    Let us look at an example of this.  You go to a physician who does not participate in the Medicare Assignment program. He/She bills you $500 for a specific service and Medicare only approves $400 for this.  Years ago, the physician could bill you for the full $100 that Medicare did not approve, but that is no longer the case. 

    Excess Charge Limits

    The maximum a provider can bill you for can be no more than 15% above the amount that Medicare approves.  This means that the physician could charge an additional $60.  Medicare Supplement Plan G will cover 100% of the excess charge amount.   It is important to keep in mind that around 95% of today’s providers participate in the Medicare Assignment program. This means they do NOT charge excess charges.

    What’s Not Covered

    The final area of benefits that we are going to touch on is the Part B deductible.  Currently in 2023 the Part B deductible is $226.  This amount is a calendar year deductible. Medicare Supplement Plan G does not cover the Part B deductible.  This one area is the only difference between Plan F and Plan G.  The Plan F covers the Part B deductible whereas the Plan G does not.

    Comparison Chart of Medicare Supplement Plan F vs Plan G
    The above chart shows the only difference between Medicare Supplement Plan F and Plan G is the Part B annual deductible.

    The good news is that with current policy pricing the Plan G is typically at least $226 per year less in cost than the Plan F.  This means that your premium savings are more than enough to cover the Part B deductible for the year.

    When you see how close in benefits the Plan G and Plan F are to one another, it is easy to see why the Plan G has now become the most popular Medicare Supplement for complete coverage.

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