Boomer's and Medicare cont...(MED Supp)

Welcome back...I hope everyone had a nice Memorial Day weekend :)

Following up to the prior blog on Medicare Parts (Part A, Part B and Part D), this email will go over Medicare Supplement plans that pay for expenses Medicare leaves a beneficiary to pay.

As stated prior, Medicare leaves the following for a beneficiary to pay:

Part A :  $1,162 deductible for days 1-60 in the hospital then moving to a fixed dollar amount per additional day

Part B:  $162 deductible to then pay 20% on all Medicare approved amounts with excess charges not covered

To help beneficiaries cover these expenses, private insurance carriers offer Medicare Supplement plans that either;

• pay 100% of above amounts, including excess  (Plan F)
• pay 75% of above amounts (Plan K)
• pay 50% of above amounts  (Plan L)
• pay 100% of above and require beneficiary to pay copays for office visits  (Plan N)
• require the beneficiary to pay the first $2,000 before plans pays 100% including excess  (Plan F High Deductible)

In order to be eligible for a Medicare Supplement a beneficiary must currently have Medicare Part A and Part B.  Medicare Supplements do not cover prescription drugs.

If you currently have private coverage while being eligible for Medicare, please make sure to check with your current providers to see if they accept Medicare.  If not, then it will be best for you to stay current if possible.

For more information on Medicare and Medicare Supplements please contact the shoppe.

Thanks,

Jordan

Boomer's and Medicare

Do you know much about Medicare?  Are you turning 65 soon?

Medicare can be difficult to understand and The Health Insurance Shoppe is here to help.

The only part of Medicare that is free is Part A, which is either entitled to a beneficiary at age 65 or requires a premium if the beneficiary has not paid Social Security Taxes.

Part A covers hospital services and leaves the beneficiary to pay up to the $1,162  deductible for days 1-60 in the hospital.  This covers all facility services that are covered by Medicare.  After 60 days the beneficiary is responsible to pay a fixed dollar amount for the remainder of the year.

Medicare Part B, covering physician services is not entitled and requires a monthly premium that can be deducted from a beneficiaries Social Security check.  The standard monthly Part B premium if you are single and filed an individual tax return with a Modified Adjusted Gross Income (MAGI) $85,000 or less, or married and filed a joint tax return with a MAGI less than $170,000 is $115.40.  For incomes that are above there will be an increase in premium up to $253.70, bringing the highest monthly total to $369.10 per beneficiary.


Part B benefits require the beneficiary to pay the first $162 (deductible) in Medicare approved amounts before paying 20%, leaving Medicare to pay 80% with no out-of-pocket maximum.  Part B does not cover the excess charges physicians charge above Medicare, leaving this expense to the beneficiary.


Now, when a beneficiary turns 65 and current private coverage (employer provided, individual) is in place, Medicare Part B does not need to be elected as current coverage is considered credible for Part B.  At this time the beneficiary will want to compare the cost of Medicare Part B premiums to their current, making sure that current coverage is considered credible.  If credible coverage is not in place a penalty will be imposed for each month that goes by and the beneficiary did not enroll when eligible for Part B.


***Both Medicare Part A and Part B are provided by the Center of Medicare and Medicaid Services (CMS).


Lastly, there is Medicare Part D, providing coverage for prescription drugs that is obtained in the private market.  A penalty fee can be implied when a beneficiary does not enroll when eligible, provided there is no credible prescription drug coverage.  Part D premiums begin can start at $30/m and be as high as $90/m, still leaving the beneficiary with out-of-pocket costs.  ***As with Part B, additional premium is required dependent on the beneficiaries MAGI.  At the most, $69.10 can be added to the monthly Part D premiums.


So....When a boomer hits 65 they can be expected to pay at least $145/m for Part B and Part D coverage, with $468/m on the high end.


All of the above was discussion on parts of Medicare.  Please look for the next blog on Medicare Supplements, also known as plans.


I hope that this was informative and all questions can be directed to the shoppe.


-Jordan

Vail

Enjoy :-)

Emergency Room Coverage

This blog will detail ER coverage amongst the 6 carriers marketed.

Emergency Services are covered with all plans and are considered  a plan deductible expense unless noted otherwise.

Blue Cross and Blue Shield of Illinois (BCBSIL) is the only carrier that offers 100% coverage (you owe nothing) at the ER or waives the plan deductible, requiring the insured to pay 20% of the bill towards the plans out-of-pocket expense limit...dependent on plan with 6 out of 8 including this benefit.

All other carriers will slap the insured on the wrist with a copay or access fee before subjecting the bill to the plans deductible.

Certain carriers offer a Supplemental Accident Benefit (SAB) rider that can be purchased for additional premium for benefit amounts of $1,000, $2,500, $5,000 and $10,000.  This benefit will reduce the bill on an accident by the benefit amount selected.  Dependent on the carrier, the amount that paid out by the SAB does not apply towards the plan deductible or out-of-pocket.

Unfortunately with private plans you can not walk into the ER and only owe a copayment.

For further information on benefits please contact The Shoppe.

Thanks,

Jordan

The Importance of The Shoppe

When it comes to choosing a health insurance plan you have 2 choices to make, choosing a benefit package and an Insurance Carrier.  All premiums that are presented by the carrier are subject to change at time of application based on the following factors:

• height and weight
• smoking status
• was their prior coverage in the past without a break greater than 63 days
• some carriers have different rating tiers based on prior coverage
• quotes are presented at preferred rates and then change when answering medical questions YES and to how the prior coverage section is answered
• medical conditions (ongoing or within past 5 years)
• current treatment
• cost of prescription drugs being taken

In order to find out where you fall in eligibility you would need to inquire within each carrier you are interested in.  This can be a dreadful process and being declined coverage after application will take away time from desired coverage and leave you further stressed on what to do next.

Working with The Shoppe (free) will provide you access to 6 private carriers in the Illinois market with one personal contact providing you with information.  The Shoppe knows the ins and outs of the health insurance market and will be able to place you in the most appropriate coverage needed based on your current medical needs and hopefully budget.

Please stop in or call for further information.

Thanks,

Jordan

Blue Cross's 2 most popular plans

BCBSIL announced their 2 plans that are sold the most in Illinois...For those that are clients about 95% are in the HSA plan!

Sales Tip: Most Popular Individual Under 65 Plans
The most popular Under 65 health plans sold in 2010 were BlueEdge^SM HSA and SelectBlue Advantage^SM. The two products that had the highest percent change in sales from 2009 to 2010 were BlueEdge HSA and BlueChoice^SM Value.