Medicare and You
Many people confuse the term “Medicare Supplement Plans” with “Medigap Plans”. It should be noted that Medicare supplement plans fill in some gaps in coverage in original Medicare which is known as “Medigap”.
There are 10 standardized Medigap plans available for senior citizens, each marked with the letters A to N. And these plans are only available through private insurance companies, and it is not necessary for the insurance companies to sell all the 10 Medicare supplement plans. Every insurance company selling Medicare Supplement policy have to offer at least Plan A and if they offer any other policy than they must also offer either Plan C or Plan F.
Please note that Medicare Supplement plans can be used only to pay Original Medicare expenses. These plans can be used to cover expenses that you may have in Part C Medicare. If you enroll in Medicare Advantage plan, you can keep your Medigap plan as long as you keep paying the monthly fee, but you will not be allowed to enjoy Medigap plans on the cost of Medicare advantage plans. There are few things that you need to keep in mind before going for Medigap plans.
First and foremost, the beneficiaries must be enrolled in Medicare Plan A and Plan B. Secondly, if the beneficiary has a Medicare advantage plan than they can apply for Medicare policy and you will have to leave Medicare Advantage plan before you can enroll in Medigap. These Medigap policies are only able to cover one person. If anyone from your family want to avail then they will have to enroll themselves.
Monthly premiums will have to be paid to private insurance companies in addition to monthly Plan B premium. You are not bound by any insurance company, you can select any insurance company you like that is licensed in your state. Each standardized Medigap policy is guaranteed renewable, even when suffering from health problems. This means that the company cannot cancel Medicare Supplement insurance contracts as long as you pay the premiums. Medicare supplement plans allow you to use any provider that can accept Medicare. Among all the states of America, Arizona is considered as one of the best places to live after retirement. Arizona provides the best Medicare and Medigap help to senior citizens.
There are two specific Medigap plans (Plan k and Plan L) which are capable of covering out of pocket limits, because once your basic health care costs reaches the limit, your Medigap plan will cover 100% of all the expenses for the rest of your year. It is worth mentioning that original Medicare don’t have the ability to include a yearly out of pocket limit. Remember, Medicare supplement plan is meant to work side by side with your original Medicare coverage. You only need to remain enrolled in original Medicare to take the benefits of Medigap.
Although private insurers are required to offer the same benefits for each Medicare plan, these companies can change the costs of premiums they charge for this coverage. So if you are looking for Medigap coverage, you must contact different insurance companies to find a Medicare Supplement plan that is appropriate for your medical and financial needs. Remember that insurance companies use different methods to price their Medigap plans. Pricing method that company uses may affect the amount of premium you pay when you first enroll in a Medicare Supplement plan, as well as your long-term costs.
Medigap can be used only by people enrolled in traditional Medicare only. It is not a Government-run program but you can buy private insurance to cover some or most of your expenses in traditional Medicare. Medicare advantage plans consist of variety of private health plans for every type of needs. HMOs and PPOs are the most commonly used among the beneficiaries. Most of the plans include drug prescription coverage at no extra cost. Some plans are capable of covering routine hearing and vision services but not all. By law, all plans have annual limits for out-of-pocket costs.
Another difference from the traditional program is that most plans require you to go to the doctors and hospitals within their network and if you want to go out of the network, you will have to pay extra.
If you enroll in Medicare Advantage health plan, you can’t use a Medigap policy to cover your expenses, and it is illegal to sell insurance Medigap policy if you are enrolled in a Medicare Advantage plan. If you want to stay in traditional Medicare, you will need a separate Part D plan to get prescription drug coverage and pay an extra premium for it. A Medigap does not cover drugs outputs of- pocket.
Some states even offer Medigap plans for beneficiaries under 65 years of age who are eligible for Medicare because of disability or under certain conditions. Federal law doesn’t allow states to sell Medicare Supplement insurance for under 65 years, but depending on where you live, some states offer Medigap coverage for beneficiaries under 65 years of age. Every state can have its own eligibility criteria and terms. If you are a Medicare beneficiary under 65 years of age and interested in purchasing a Medicare Supplement insurance, contact your state insurance department to find out if you qualify for Medigap coverage in your state or not.
- July 30, 2016
- azmedicare, centers for medicare and medicaid services, health insurance, Medicare Advantage Plans, Medicare coverage, Medicare Part A, Medicare Part B, Medicare Part D plans, medicare supplement plans, Medicare Supplemental Insurance, medicare supplements in 2015, medicare supplements in phoenix az, prescription drug plans, private insurance plan
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Many of us spend a lot of time trying to understanding the difference between Medicare and Medigap plans. Today, you will clearly get to know the difference between these two. This article will also help you to wisely select your plan.
Basically, Medicare supplement plans are also known as Medigap plans or policies and they can cover some of the costs that original Medicare coverage doesn’t include. Originally, the government provides Part A and Part B of Medicare coverage to all the eligible individuals. However, this Medicare coverage might not fulfill your demands at later stage so you will need to decide at some point whether the traditional coverage is enough for you which is provided by the government or you need some other Medicare supplement plans.
Medicare and Medigap plans are federal healthcare programs which is designed to fulfill the needs and to help senior citizens during their golden years. According to the law, any senior citizen who is 65+ and currently enrolled in Medicare can apply for a Medigap plan. There are about 10 Medigap plans available to choose from. According to the Centers for Medicare and Medicaid Services (CMS), all the Medigap plans have to offer the same coverage plans, regardless of the company which is selling it or where they are located. It means that Plan A and Plan B is exactly the same in all 50 states of America.
In recent years, private Medicare plans have become more popular than the traditional plans. It has been observed that more than 10 million senior citizens has enrolled in the Medicare advantage plans. These plans actually help to combine the physician and hospital services into one package. Before selecting the perfect plan for yourself or your loved one, you need to keep in mind few things.
First of all, if there are no Medicare advantage or supplement plans are available in your region than you will be in traditional Medicare, which is administered by federal government. You can select any doctor who accepts Medicare in the traditional Medicare and you will have to pay deductibles of the cost of care. If you had a Medigap policy, those expenses would have been covered by your Medigap plan. So, a Medigap plan covers a vast variety of treatments which Medicare wouldn’t cover. There are multiple types of Medicare supplement plans.
Most plans such as health maintenance organizations and preferred provider organizations, manage to control costs. Other like HMOs and PPO, which is based on a network of doctors, so you want to make sure that your doctor and the hospital of your choice are involved in the network. You can also ask about the policy for referrals, In case of a PPO, you may want to know how much you have to pay to see doctors who are not on the network. Private plans fee-for-service provides more choice because they are not allowed to have a network of doctors and hospitals.
Sometimes, Medicare supplement plans have extra benefits like eye exams, dental care and hearing coverage. For many people, this coverage doesn’t seem to be enough, and this is where private insurance, such as Medicare Supplement plans come in. These plans may offer coverage of health services not covered for Part A and Part B. To participate in a Medicare Supplement plan a beneficiary must be enrolled in Part A and Part B, live in the state where it is offered, and generally be over 65 years. But you must make sure you understand each and every point of the Medicare advantage plan you will be selecting.
One benefit of Medigap plans is that Medigap policies are renewable, as long as you pay your monthly fees and your insurance company doesn’t go bankrupt, you cannot be dropped from your plan. Medicare has a small network of doctors, but Medigap provides access to an extensive network of doctors. In short, Medicare is designed for those on a tight budget and if your pocket allows you then you have to go Medigap.
According to the latest research, Medigap plans are usually more expensive than Medicare Advantage plans. Medigap offers a variety of supplemental insurance to Medicare, while Medicare coverage and Medicare Advantage are almost identical. Furthermore, you also need to keep in mind that if you travel a lot or migrate yearly as per job requirements or you live in an area where there are lack of medical facilities, then you must go for a Medigap policy. No doubt, there are other ways to supplement your Medicare coverage but Medigap offers the best flexibility.
With Medigap, you are free to receive care from any hospital and any doctor which accepts Medicare. If you have a need for vision or dental benefits, then you will also have to buy Medicare supplement plans for that which will be covered by your Medigap policies. Now that Medicare Part D is also here, so all Medigap plans which used to offer prescription drugs are being phased out.
Last but not the least, if you have signed up for a Medigap plan but you later realized that it wasn’t right for you, there’s no need to worry because as long as you make that discovery within a month of coverage, you can cancel the coverage for a full refund.
For Arizona residents who are confused about which plan to choose, visit www.azmedicare.info for all the details and help on Arizona Medicare Supplement plans.
- July 30, 2016
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One of the benefits of our medicine system is there are tools the elderly can use to take better care of themselves. The main thing which confuses seniors is the difference between Medigap and Medicare and which plan is the best for them.
It is extremely important to realize the fact that Medicare is not sufficient to cover all your medical expenses. This is the reason why Medicare supplements are created to fill the gaps in between the original Medicare coverage. These Medicare supplements are also known as Medigap insurance. Every state can differ in terms of Medigap policies, the Medigap plans in Arizona are regulated by the State of Arizona and the federal government.
There are basically twelve (12) standardized Medicare Supplement plans naming from (A to L) that is covering the entire United States. These 12 Medicare supplements plans have their own set of basic and extra benefits. All insurance companies are obliged to sell Plan A and B as a rule of law. One thing which is common among the Medigap plans is that you cannot be charged differently from others in a particular state for a Medigap insurance plan. For example, if you pay $200 amount for Plan D in Miami, everyone will be paying the exact same amount everywhere in United States. Your Medicare supplements can only cover your expenses, you will have to buy separate policy even for your spouse.
One thing should be kept in mind is you don’t need to buy Medigap insurance policy if you are covered under a group of health insurance plan. And it is not necessary that all 12 plans may be available in all the areas.
Differences between Medigap and Medicare
Many people confuse themselves with the Medicare and Medigap advantages. Basically, Medigap refers to a bunch of supplemental insurance plans that works with the combination of regular medical benefits. Many medical options such as hospital accommodation or international transport are usually not covered in Medicare plans however they are covered in Medigap plans.
Expensive payments are also often covered in Medigap that are charged to Medicare patients without Medigap. Different insurance companies which sell Medigap plans give the same benefits all over the country. Insurance companies can be different but the policies, terms and conditions and the benefits will be same all across the United States. Another thing to keep in mind is that Medicare advantage plans replaces the original Medicare because these Medicare plans are run by private companies and must be able to provide the same coverage as Medicare A and Medicare B.
Some Medicare advantage plans also offer dental, vision, ENT or prescription coverage. Medicare plans are usually much cheaper than Medigap plans, if you are short on funds or you have planned to settle at one place, than Medicare is the best choice for you.
According to the latest research, Medigap plans are typically more expensive than the Medicare advantage plans. Medigap offers a variety of additional coverage to Medicare whereas the coverage of Medicare and Medicare advantage is almost same. Medicare offers a smaller network of doctors but Medigap allows the access to a larger network of doctors. In short, Medicare is recommended for those who are on a tight budget and if your pocket allows you than you must go for Medigap.
Medigap and Medicare plans have same prices almost across whole of the United States and these prices are set using the below mentioned three methods:
Community-Rated method: This method charges everyone the same premium regardless of their age or sex.
Age-Rated method: This method sets the price based on your age when you purchase the plan.
Attained-Age-Rated method: This method will increase the cost each year as you age.
Before buying any plan for yourself, you should understand the levels of coverage from (A-L). Plan F covers everything that Medicare fails to cover, so you do not have to pay any extra costs for doctor/hospital. Lower levels of coverage involve a corresponding lower premiums but doesn’t fill like the Plan F. Another thing to remember is that only you can determine which is the best plan for you as there several type of “pay now or pay later” plans. For example, Pay Now Medigap plans are the most expensive each month. however they will save you a great portion of money if you need extensive medical treatment or service. If you think that your budget can afford a Medigap plan, than they are the best way to protect your health. Pay Later Medicare will always seem to be less expensive in short run because of their lower monthly premiums. Extra services including hospital accommodation, transport or other prescriptions are much more expensive with Medicare plans than with the Medigap plans.
If you are interested in any of the Medicare or Medigap plans, visit AZ Medicare, the best Medicare insurance for Arizona residents. For senior citizens, Medicare only covers 80% after your deductibles have been paid. Medicare plans usually don’t include Plan D which is the drug plan, but it may be included in your Medigap plans.
Medicare advantage plans further include several types of plans, some of which are:
Health maintenance Organization (HMO) plan: Your choice is restricted for hospitals and doctors in this plan, except for emergencies.
Preferred Provider Organization (PPO) plan: You can choose doctors or hospitals outside the scope but it will cost you more in addition to the medical care within PPO.
Private Fee-for-Service (PFFS) plan: You are free to select your hospital or doctor in any way you want. The plan will determine the sharing of expenses.
- July 30, 2016
- AARP, az medicare, azmedicare, centers for medicare and medicaid services, gap, Kaiser Family Foundation, Medicare Advantage Plans, Medicare Part C, Medicare Part D plans, Medicare Supplemental Insurance, medicare supplements in 2015, medicare supplements in phoenix az
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In Arizona, medical beneficiaries who are in need of help for paying Medicare expenses must consider enrolling in a Medicare Supplement Plan known as Medigap Plan. It must be noted that Medigap plans are available through private insurance companies, not only in Arizona but in every state across U.S.
Medigap plans generally help with the expenses which are incurred under original Medicare plans which are Plan A and Plan B. Medigap plans are now almost same across all of the United States in terms of both policies and cost. For those of you who are not sure about the number of Medigap plans, just know that there are 10 standardized Medigap plans available in all of the states. The plans are labelled from A to N where Plan A and Plan B are the most basic plans which every state offers under the rule of federal administration.
If you are already enrolled original Medicare Plan A and B, then you are eligible to sign up for Medigap Plans. Not many people know but the best time to buy a Medicare Supplement plan is during the Medigap Open Enrollment Period. This period starts as soon as you reach the age of 65 and is also enrolled in Medicare Plan B. Individuals can sign up for any Medigap plans during this time according to the plans available in their state. The important thing to keep in mind is that there are no additional enrollment periods besides each of theirs Medigap Open Enrollment Period.
In Arizona and across all of the United States, Medigap plans doesn’t include prescription drug coverage, so you have to enroll in a Part D plan for prescription for separate Medicare to cover the cost of medicines or drugs. Prescription drug plans for Medicare Part D in Arizona are available through private insurance companies.
It has been observed through the survey that Arizona is the most famous destination to retire. Surprisingly, above a million residents of Arizona are dependent on the Medicare for their main source of health insurance.While no revolutionary changes in Medicare supplement insurance is scheduled for 2016, there are some things to keep in mind which may affect the safety and availability of certain plans.
Here is the possible increase in premiums and Part B deductible. For example, Plan C, Plan F, and high deductible Plan F covers Part B deductible, so if the increased rates for these popular supplements may also increase. In Arizona, all the Medicare Supplement Plans must conform to the standards set by the Medicare Organization. Supplement standards include names from A to N. Each supplement offers basic benefits like coinsurance and blood donations. The only thing to remember is that every supplement is identical from one or another insurance company. In order to determine rates, you must compare different insurers providing Medigap plans however there should not be a big difference because of the Arizona Medigap Policy. It is important that you familiarize yourself before with the Medigap plan as well as each and every plan before you make any purchase.
Supplement Plan F is the most comprehensive among the 10 other plans, covering almost 100 % of Medicare related costs. But even for Medicare Supplement Plan F recipients in Arizona can still incur some out – of -pocket expenses such as Medicare Part B premium.
As soon as you reach the age of 65, you need only a phone call to buy Medigap policy and get excellent coverage without question. And if you buy a policy in the first six months of enrolling in Medicare, you do not have to answer questions about your health. Do not worry if your doctors are not in the network, because you will be covered if you see any doctor who accepts Medicare.
Many people don’t realize the fact that how much they will be spending if they will be selecting the plan which covers the entire Medigap plans. There are total of 10 Medigap plans and each one has its own benefit. The four most comprehensive plans are C, D, F and G which account for more than 60% of all the Medigap sales according to Kaiser Family Foundation research. Plan F, the most expensive among all of them and covers every Medicare gap represents 40% of all policies sold. If your health is good than you must consider a plan which is not much comprehensive for e.g. Plan N and L are good choices because they will save you around $200 to $400 a year.
Medicare and Medigap benefits are identical in all 50 states, however policies and pricing rules may differ (Massachusetts, Minnesota and Wisconsin have their own standardized plans). If you know the rules in your state, this may save you money. You can choose when to upgrade an existing plan to switch to another insurer or drop your current Medicare plan during the annual open enrollment to change Medigap policies.
Most of the people become eligible for Medicare when they turn 65, although some beneficiaries can get Medicare even before if they have some kind of disability. You will automatically get Medicare as soon as you turn 65 if you are already receiving Social Security benefits. Otherwise, you will have to enroll in Medicare during the enrollment period.
There are also many private Medicare options available if you are a Medicare beneficiary in Arizona. Medicare coverage like drug prescription and supplemental coverage are only available through private insurance companies. Your private Medicare options will depend on where you live and the plans available in your area. We hope you found this article helpful as we shed light on Arizona’s Medigap policies. If you are an Arizona resident, feel free to contact www.azmedicare.info for further details.
- July 27, 2016
- Arizona Medicare Advantage plans, centers for medicare and medicaid services, MA PLANS, medicare, Medicare Advantage, Medicare Advantage Plans, medicare az, Medicare beneficiaries, medicare supplements in phoenix az, Medigap plans, Part D plans, prescription drug plans
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Health is a blessing and its importance is only known to those who lack it. Ill health is resulted due to numerous reasons. Aging is one of the top reasons. Yes, elderly people become prey to most of the diseases and their care and treatment is of utmost importance. Some of the diseases are related to seniors only. Being old and weak, you need the best care so that you can fight against all the diseases. In Arizona, senior health care insurance policies are offered to address these needs. Now you might be thinking that you are old, or what age should be considered as old age for you.
Well, no age can be declared as the old age. People stay fit and healthy even in their 90s. On the other hand, some people in their 40s surrender to the old age. It all depends on your lifestyle. A healthy and balanced life style leads to a better health throughout the life. In the US, a person above the age of 65 is considered to be a senior citizen. This age limit is set on the basis of average calculated from the data of the population. It is also found that some specific diseases are found in the people aging 65 or above. Some of the diseases are as follows:
Prostate: The prostate enlargement is the disease caused primarily due to the old age. In severe cases it may lead to the prostatic cancer. The treatment for prostatic cancer is expensive and the best way to afford its treatment is health insurance.
Dental: Tooth and gum decay is normal for the elderly people. They often see the dental surgeon for dental problems. It is also thought that your mouth is the wallet for a dentist. The expensive dental treatment can only be afforded if you have a balanced health insurance policy.
Vision: The vision starts fading away once you cross the 65 figure. Cataract is a gift of old age which needs to be operated within a certain time period. Nowadays, cataract is operated using laser technology and optical lenses. It is appreciable if you manage to bear the expenses through an insurance policy.
Blood transfusion: The problem of blood transfusion is much expensive. The patient needs at least 3-4 rounds of transfusion. In Arizona, the US state offers some health insurance plans which exclusively covers it.
The list of diseases will go on and on, but the point of attention is solution to all these problems. In Arizona, the US state health department has offered health insurances for both the elderly and disabled persons. The basic health insurance plan is called Medicare plan which is directly administered by the federal government. It is comprised on Part A and Part B. Its extension is called the Medicare Advantage plan which also contains Part C and Part D. The most advance form of health insurance plan in Arizona is Medigap health insurance plans.
Medicare health insurance plans:
As mentioned above, it is federal health insurance program for different categories of people including who are aged 65 or older, includes younger people with disabilities, and people having End-Stage Renal Diseases. Every country has its own Medicare policies while the unfortunate countries don’t even have the basic medical insurance plans. The different parts of Medicare help in Phoenix, Arizona cover specific services that are mentioned as follows:
Part A: it covers the expenses on the hospital insurance. This Medicare policy is capable of covering inpatient hospital care, care in a skilled nursing environment, hospice care, and some health care. The participants are entitled free Part A insurance if the participant is 65 years of age and participant or his/her spouse has paid Medicare taxes for last ten years. A participant is also eligible of free Part A insurance if he receives social security or Railroad benefits. Same is the relaxation for the participants who worked for the government agency that offered Medicare coverage as an employment benefit. The patients who are less than 65 years of age and have either a full social security or kidney disease, are entitled to Part A of Medicare original for free.
Part B: It covers specific doctor fees, diagnostic tests, durable medical equipment, ambulance service prosthetic device, medical supplies and preventive services. Every medicare plan has at least Part A and Part B. it is an optional insurance coverage that can help reduce the cost of medical care. Plan B reimburses the reasonable cost up to 80%. In some procedures 100% reasonable cost is reimbursed. The insured party is responsible for the costs that are not covered by the Part B medicare original plan. Unlike Part A, every eligible participant, regardless of age, employment benefits or disability status must pay Medicare Part B health care premiums, if non-hospital health care coverage through Medicare is desired. Medicare Part B premiums can be withdrawn from a participant’s monthly Social Security, Railroad Retirement or Civil Retirement check. If a participant receives none of these payments, Medicare will send a quarterly bill for Part B premium.
These rules are directly state administered and no private insurance company can mold these rules. However, Medicare Advantage and Medigap insurance plans gives some flexibility while choosing them.
Medigap health insurance plans:
The Medigap health insurance plans fill the gaps that remain after the Medicare insurance coverage. Sold by the private insurance companies, the Medigap policies cover some of the health care cost that Medicare doesn’t cover like copayments, coinsurance and deductibles. If you buy a Medigap policy with the original Medicare plan, Medicare pays its share while the Medigap pays its own share. Paying a premium amount for the Medigap plan will result in covering all the medical expenses from hospitalization to the blood transfusion. These plans are also known as Arizona Medicare Supplement Plans. Arizona Medigap policy offers twelve different Medigap plans labeled through A to L. All you need is to select the plan which suits the requirements best.
There is no doubt that everyone needs medical attention at some point in their life. The younger generation has the ability to stay strong and fight small medical issues. Older people don’t have the stamina and persistence and power to fight back. They need proper medical attention and if they don’t insure themselves, then, they may be spending plenty of money on medical bills.
Federal government has already introduced Medicare Plan A and Plan B long time ago, now for people older than 65 there are variety of supplement plans which add to traditional Medicare. Basically Medigap or Medicare supplement insurance plans covers the gap between the traditional Medicare and your medical costs. These Medicare supplement plans are sold by private companies separately. These plans are perfect for senior citizens who have expenses that will not be covered under traditional Medicare Plan A and Plan B. If the original Medicare does not cover your medical needs, you may want to look to supplement that coverage with a Medigap or Medicare Advantage plan. Both of these plans can be further supplemented with Part D drug coverage.
Different insurance companies are allowed to sell the same Medigap plan for different amounts. Therefore, you will have to look around a little to get the best offer. If you are looking for a Medigap than you must already have Medicare Plan A and Plan B. It should be kept in mind that drug coverage is not a part of Medigap insurance plan. You will have to get the Medicare Part D separate to cover you drug prescriptions. Regarding Medicare, you must know that only Medicare Part A (hospital insurance) and Medicare Part C (Medicare Advantage) count as minimum essential coverage. If you have the minimum essential coverage you will not owe a fee for not having health insurance. Medigap itself is nothing, but it provides a lot of benefits when combined with original Medicare Part A and Part B.
In Arizona, there is a wide range of senior health insurance plans readily available. There are many options available which include health insurance plans for people who have certain health conditions, health insurance plans for people who like to travel in the US and abroad, health insurance plans for those who want to seek the best treatment from doctors in the United States accepts Medicare and health insurance plans for people with low incomes.
Arizona is the only state where majority of the people like to retire and it has the best senior citizen health insurance, Medicare, life insurance and retirement planning options. Not many people know that if you are eligible for Social Security retirement benefits, you will be automatically eligible for Part A of the Medicare as soon as you turn 65 years of age. If you receive a pension of social security benefits, you are automatically enrolled in Medicare Part B at the time you became entitled to Medicare Part A. All the Medicare Advantage plans are approved by Medicare but they are all offered through private insurance companies within the state. Sometimes these plans can be more beneficial, but might cost you a little more than the original Medicare plan.
These plans vary widely in costs and benefits from state to state, so go through your options carefully before you plan to choose one.Benefits of Medicare Plan A include hospital stays, skilled nursing and home health care. Medicare advantage plans also cover all Medicare Part B benefits, including doctor visits, outpatient care and preventive services. Many of them are also benefits as a routine hearing and vision care, fitness program, wellness service or helpline.If you plan to enroll Medicare advantage prescription drug plan than you will also get Part A and Part B coverage along with this combine in one plan. This plan is a good choice for many of the prescribers. In order to get fully insured, you may want to supplement your Medicare coverage to Medicare supplemental insurance i.e. Medigap, which generally pays the deductibles and extra payments which are not covered by Medicare Part A or B.
Medicare allows a small network of doctors but Medigap provides access to a broader network of doctors. In short, Medicare is recommended for those on a tight budget and if your pocket allows you to go for Medigap.Medigap policies are sold by private insurance companies to fill gaps in original Medicare plan. Most states have already adopted legislation restricting the sale of Medigap insurance for no more than a standard policy. The main difference between Medicare advantage and Medigap is that Medigap is used to supplement the original Medicare. These advantage plans are used to get more Medicare benefits, while a Medigap policy is only used to supplement the cost of your original Medicare benefits. Choosing the right Medigap plan depends on your medical needs and costs. If the original Medicare does not cover the actual cost of medical expenses and you have plenty of options. In most countries these options indicated by the letters A through N.
Each standardized Medigap policy must offer the same basic benefits, regardless of the insurance company selling. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies. According to the latest research, Medigap plans are typically more expensive than Medicare Advantage plans. Medigap offers a number of additional coverage for Medicare while Medicare and Medicare Advantage are almost the same. Medicare allows a small network of doctors but Medigap provides access to a broader network of doctors. In short, Medicare is recommended for those on a tight budget and if your budget allows you to go for Medigap.
According to the latest statistics, a huge amount amount of retired people find Arizona the best place to live because of the warm climate and medical facilities. Millions of residents are depending upon the Medicare for health and life insurances. Since basic Medicare plan doesn’t cover everything, people may want Medigap or Medicare advantage plans.
Arizona is only state which has the most amount of Medicare recipients. Phoenix, Tucson and Mesa are the largest cities of Arizona and there are about 15% Arizonians who are 65 years and up receiving Medicare and about 14% Arizonians receiving Medicare. Almost all seniors are dependent on Medicare benefits for health insurance. Among all the senior citizens, approximately 30% will choose the Arizona Medicare Advantage plans. The other 25% will choose Medigap plan instead. The remainder may have a different public or private coverage, but most do not just rely on Part A and Part B Medicare, because they want to ensure that health care costs remain affordable.
Anyone choosing Medicare insurance or any other type of health insurance needs to strike a balance between premiums and benefits. Medicare Advantage plans for Arizona are attractive because many still have a very low or even $ 0 premium surcharge. Medicare Advantage plans also include Part D drug coverage at no additional cost.
On the other hand, these cheaper plans have many co-pays and deductibles. Also many recipients operate on a tight budget during retirement. Everyone has their own plans for retirement, for some people it makes more sense to pay a hefty amount for the Medigap insurances that covers all the health expenses that are not originally covered in Medicare.
Interestingly, Medicare supplement insurance plans C and F are usually the most expensive but they are also the most popular among the people who purchase supplements.
As a beneficiary, you are free to enroll in any Medicare Advantage plans you like. All the plans offer health benefits under Part A and Part B both. Many Medicare Advantage plans also cover prescription drug coverage (Part D). Additional benefits can also be utilized by paying an extra cost on your Medicare advantage plan. You may qualify for these plans if you are entitled to Medicare Part A and enrolled in Medicare Part B.
There are many private companies who offer Medigap plans for senior citizens. People can easily sign up for one of several Medicare advantage plans if they want to receive the most of their medical insurance coverage company. Keep in mind that if you are going for Medicare advantage plan, you must be enrolled in Medicare Part A and B.
Secondly, you must be living in the area where they have Medicare network providing advantage plans. Most Medicare Advantage plans have prescription drug coverage built into the plan. This is not always the case, because it may be what is called stand-alone Part D plan.
Many people join the Medicare advantage plan as soon they turn 65. This process is called open enrollment period when you have only six months to enroll in the plan. After registration, if you want to change your plan, you’ll have to wait until the annual election period, which occurs every year from October 15 to December 7th. During this time, you can switch plans or return to original Medicare options, for this year you will not be able to move out of your plan, or join a new Medicare Advantage plans for 2016 outside of that enrollment period.
Type of Medicare Advantage Plans:
Below listed are some of the main advantage plans available across the United States:
Health Maintenance Organization (HMO):
Health Maintenance Organization plan only allows you to select certain doctors and hospitals within the network. Unless it’s an emergency, only then can you go to those approved locations. If you plan to visit someone outside your network, it will not be covered under your plan and it will be charged separately.
Preferred Provider Organization (PPO):
Preferred Provider Organization plan allows you to save your money by selecting the specified doctor and healthcare provider or hospital. You will be required to pay a bit more if you wish to go to those that are not on the list of approved providers.
Private Fee for Service (PPFS):
Private Fee for Service a plan which does not require you to go to an approved list of providers. Instead, you will have the choice to select any provider you want. The only drawback is that there are very few people who accepts the PPFS plan.
Special Needs Plans (SNPs):
Special Needs Plans are basically designed for the people who have some specific and severe disabilities and diseases. The list of accepted providers is made on the needs of the subscriber and who will be able to fulfill their needs.
Every Medicare advantage plan is created to operate on a network. It means that all health care providers will be located within a specific area. You are required to live in the local area if you want to get covered by a certain plan. If you move to a new area, you may change your provider or insurance plan, depending on where you moved and what type of network is used.
- July 27, 2016
- AARP, health care, health insurance, Kaiser Family Foundation, Medicare Advantage Plans, Medicare Supplemental Insurance, medicare supplements in 2015, medicare supplements in phoenix az, Part D plans, PDP, prescription drug plans, prescription drugs
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Medicare is actually the federal health insurance program for different categories of people including who are aged 65 or older. It also includes younger people with disabilities, and people having End-Stage Renal Diseases. Every country has its own Medicare policies while the unfortunate countries don’t even have the basic medical insurance plans. The different parts of Medicare help in Phoenix, Arizona cover specific services, some of them are mentioned below:
Hospital Insurance (Plan A):
This Medicare policy covers inpatient hospital care, care in a skilled nursing environment, hospice care, and some health care.
Medical Insurance (Plan B):
This medical insurance covers some specific doctor’s services, outpatient care, medical supplies and preventive services.
Medicare Advantage Plans (Plan C):
This type of special plan is mostly offered by private companies that contracts with Medicare to provide you with all the hospital and medical insurance benefits. Moreover, Medicare Advantage plan includes health maintenance organizations, preferred health service provider organizations, private fee-for-service plans, special needs plans and Medicare medical savings account plans. If you are enrolled in under such program then they may also offer prescription drug coverage.
Prescription Drug Coverage (Plan D):
This plan adds the prescription drug coverage to the original Medicare Advantage plan. These plans are mostly offered by insurance companies and other private organizations approved by Medicare.
In United States, essentially every 65-year-old person enrolls in Medicare and most of them also receive additional coverage. One medical plan of additional coverage is through supplements to traditional Medicare which includes prescription drug plan to cover some or all of the payments.
Now the question which confuses most people is which Medicare is plan is right for me?
Not every plan is right for everyone. There are numerous Medicare supplement insurance plans which are also sometimes called Medigap plans. What we need to understand is which plan is the best for us. Some of the Medicare supplement plans in Phoenix, AZ are mentioned below:
Full Coverage Plans:
Full coverage plan is the most comprehensive plan. It has the ability to pay for all of your expenses that are already approved but not have been paid by Medicare. This plan includes all your deductibles, co-pays and co-insurances that originally Medicare is not supposed to cover. Full coverage plan is typically the most expensive of all the plans, and is well suited for those who think that they will have medical expenses and/or for those who want the peace of mind knowing that all approved expenses will be covered.
The high deductible Plan is similar to Full Coverage Plan, when you meet the deductible, you pay for all expenses that are approved but not paid by Medicare . In 2015, the deductible amount was $2180. This amount usually changes every year. This plan works probably best for those who are healthy and think that they will require less expenses or those who are willing to take some risk in exchange for a much lower cost rate.
An important point to keep in mind it is that the Original Medicare plan still pays the fair share of medical expenses – for example, Medicare generally pays 80% of your medical/sickness costs and are responsible for 20%. Only 20% of this applies to your deductibles. Think of the high deductible Plan as a plan where you pay the difference to minor expenses, but if you have large expenditures for health, your maximum amount for the year is $2,180, and then your Medicare Supplement high deductible plan picks up all other expenses approved but not paid by Medicare.
Mid Range Plans:
There is a wide variety between 9 full coverage and deductible plans – so if you are not familiar with one of these two options , you have much more to choose from.
Basically, Medigap plans are sold to provide additional coverage for already covered Medicare services. The aim of a good Medicare Supplemental Insurance plan is to reduce some costs for services that are partially covered by traditional Medicare plans.
Medicare insurance plans offer twelve standardized service plans so that consumers can easily compare policies and costs. Medigap plans are labeled A through L, and offer more comprehensive set of covered services. A Medigap policy A example is the most basic Medigap policy. Medigap Policy B will cover all policy Medigap and will offer some improved benefits, however it will not provide as many benefits as Medigap Plan C does. Medigap policy only covers one person at a time, whether a participant is eligible for coverage through her husband or wife. Each participant must have their own Medicare insurance. Just as Medigap insurance plan is optional, participants pay Medigap insurance in addition to Medicare Part B and Part D premiums optionally.
Features of a Medicare Supplement Plan:
- The doctor’s Choice – Individuals can choose their preferred doctors and hospitals (as long as the patients receive Medicare) .
- Access to specialists – Individuals can see specialists without a referral.
- Convenience – Virtually no claim forms to file.
- Freedom – coverage that travels with you anywhere in the US
- Guaranteed changes – Medicare supplement plans are automatically renewed as long as the individual continues to pay their premiums on time, without twisting one or more of the basic facts after the first application registration.
To get a Medicare Supplement plan, you must have Medicare Plan A and B. You must continue to pay the monthly premium of Part B in addition to your monthly Supplement plan premium. You can get this plan during your Medigap open enrollment period, which is a six-month period starting in the first month, you are 65 years or older. During this period, you cannot deny coverage because of past or present medical problems. For more information, visit www.azmedicare.info now!
The US government understands that elderly people face financial as well as medical issues, more than any other age group. Disabled people also face the same circumstances. Keeping in mind, the severity of these issues, US government health department provides many options to these audiences.
In Arizona, a Medicare insurance policy cannot fulfill all of your medical needs. You will need a supplemental Medicare health insurance for better medical coverage. The supplemental Medicare health insurance is offered by the private health insurance companies, authorized by the US government health department.
Why opt for Medicare Supplement Insurance?
Medicare supplement insurance is also termed as Medigap insurance policy because it fills the gaps that remain after the Medicare insurance coverage. Sold by the private insurance companies, Medigap policies cover some of the health care cost that Medicare doesn’t cover like co-payments, co-insurance and deductibles. If you buy a Medigap policy with the original Medicare plan, Medicare pays its share while the Medigap pays its own share. Paying a premium amount for a Medigap plan will result in covering all the medical expenses from hospitalization to a blood transfusion.
Things you need to know about Medigap policies:
It is mandatory that you purchase Medicare Part A and Part B if you are going for to buy a Medigap plan. If you have a Medicare Advantage Plan, you can apply for a Medigap policy however, make sure that you can leave the Medicare Advantage Plan before your Medigap policy begins. It is also noted that the policy covers single person at a time. If you and your spouse both need the policy, then you should buy the plans separately.
Medigap insurance policies in Arizona can only be bought through the licensed insurance company. It also goes in your favor that any standardized policy is guaranteed renewable even if you have health problems. This means the insurance company cannot cancel your policy as long as you pay the premium.
Some of the old Medigap policies cover prescription drugs but the prescription drug coverage is not allowed anymore. You can only have benefits after joining Medicare Prescription Drug Plan (Part D). You should also make sure that you do not have any Medicare medical savings Account plan because it is illegal in Arizona to keep Medicare savings account and Medigap policy at the same time.
Best time to buy Medigap:
The best time to buy a Medigap policy is during your 6-month Medigap open enrollment period. This is because you can buy any Medigap policy sold in Arizona, even if you have health problems. This period automatically starts the month you are 65 and enrolled in Medicare Part B (Medical Insurance). After this enrollment period, you may not be able to buy a Medigap policy. If you are able to buy one, it may cost more.
During the open enrollment period, you have the option to buy any Medigap policy that the company sells regardless of any health problems. Outside the open enrollment period, the companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge. AZMEDICARE facilitates its patients in both the situations.
Tips while buying your Medigap policy:
- Fill out the application carefully and completely including medical questions. The answers you give will determine your eligibility for open enrollment. This is also known as Medigap protection.
- If someone else is filling the application on your behalf, check to make sure it’s correct.
- Remember that the insurance company cannot ask you any questions about your family history or require you to take a genetic test.
- If you buy a Medigap policy during the open enrollment period, the insurance company can’t use any medical answers you give to deny you a policy or change the price.
- If you provide evidence that you are entitled to a guaranteed issue right, the insurance company cannot use any medical answers you give to deny you a policy or change the price.
- It is the best option to pay by check, money order or a bank draft so that it may serve as documentary transaction evidence. If you are buying from an agent, make it payable to the company not the agent. You should also ask for the receipt with the insurance company’s name and address. The receipt should also be electronic.
AZMEDICARE and Medigap plans:
AZMEDICARE provides all the Medicare supplemental plans in Phoenix, AZ. The company also offers Arizona Medicare Advantage plans. AZMEDICARE has one of the best reputations in private insurance companies, authorized to sell the Medigap plans.
The company offers 12 standardized services plans so that the customers may choose the most suitable according to them. Medigap plans are labeled A through L and offer an increasingly comprehensive set of covered services. For example, a Medigap A policy is the most basic policy. A Medigap B policy will cover everything the Medigap A policy does and will offer some extended benefits, but it will not offer as many benefits as a Medigap C plan does and this debates goes on.
The premium amount for the plans varies from company to company. AZMEDICARE offers the best Medigap plans at the best price. The company also deals its clients outside the open enrollment period. The US government has set a dozen standardized Medigap plans so there is no difference in the coverage however the difference lies in the premium cost which is very reasonable in case of AZMEDICARE. You can give a call or stop by to get information about the medicare supplemental plans in Phoenix, AZ.
Are you aware of the Medicare Supplemental insurance plans in Arizona? Well, everyone wishes for a healthy and active life however one should also planfor unexpected health issues which can turn up as we age.
There should also be a proper medical insurance coverage plan especially if you are living in Arizona. The people who need supplemental medical insurance mostly are our senior citizens or they are the ones having certain disabilities issues. Some seniors cannot fully support the medical expenses. The US government offers medical insurance to the elderly and disabled people who cannot afford the medical expenses. This insurance is known as Medicare. Also, state provided Medicare has certain age and disability criteria.
People over the age group of 65 can benefit from the services of Medicare. Medicare health insurance cannot cover the whole medical expenses, therefore there remains a need of Medicare Supplemental insurance in Arizona. As the name depicts, these insurance plans supplement the Medicare plans and called as Medicare supplemental insurance plans.
MediGap is among these supplemental insurance plans. The supplemental insurance plans are provided by the authorized private health insurance companies. The people who are already enrolled in the government’s Medicare health care insurancecan only avail the Medigap insurance
Difference between Medicare and Medigap Insurance policies:
As discussed above, a Medigap supplemental plans are the private health insurance policies just to supplement the original Medicare plans. Both Medicare original and Medigap plans pay their share and cover the medical costs individually. Medigap plans cover the costs that are left out by original Medicare. The cost which is not covered in the Medicare plan is known as the coverage gap and as the name depicts, Medigap fills this gap.
Similarly, Medicare does not cover the amount exceeding Medicare-Approved amount and the purchase cost for the Medigap policy. We believe it or not, the old age brings a lot of diseases. The medical expenses are so high that even MediCare plans cannot fully cover them. It is a wise decision to go for the supplementary Medicare plan such as Medigap. AZMEDICARE one of the top Medigap policy providers, makes Standardized Medigap policies available for the people of Phoenix. These standardized Medigap policies are designed with the approval of US health department.
These policies are labeled by letters A, B. C. D. F, G, K, L, M and N. These are called as standardized policies because all the services providers offer the same coverage plans that meet a certain set standard. It should also be noted that all these plans have same benefits but their cost varies from one company to another.
Selecting a Medigap plan should be entirely based on your needs. You can chose the plan which best suits your requirements. Policies are renewable and the insurance provider cannot cancel your policy unless you are not willing to pay the premium amount. In addition to Medicare, the patient has to pay premium amount for this policy.
In contrast to Medigap health insurance in Arizona, the Medicare coverage is not much comprehensive. It can only be availed in a couple of ways. The first one is original Medicare consisting of Part A
Part B or Part C. Part A is the hospital insurance while Part B is medical insurance. Part C is a standalone plan which is used as a substitute for original Medicare, Part C is also known as Medicare advantage. It is administered by Medicare-approved private insurance companies like AZMEDICARE that operates in Phoenix, Arizona. In some cases, the users of original Medicare and Medicare advantage can get prescription drug coverage after purchasing Part D. Besides buying part D, they can also go for the Medicare supplemental insurance or Medigap. The users have to choose among Part D and Medigap as these are mutually exclusive.
Medicare Supplement insurances by AZMEDICARE:
- Aetna Medicare Supplement insurance plan:
Aetna Medicare Supplement Plans are offered in addition to Medicare Part A and Part B to help eligible individuals pay for additional healthcare costs
, like deductibles and co-payments. This plan is available in fifteen states, and allows members to visit doctors and hospitals of your choosing. The plans offered are A, B, F, G and N and are designed to enhance Medicare coverage. The benefits of this plan includes 20% medicare approved expenses, hospitalization coverage for 365 days and , first three pints of blood per year and Part A coinsurance.
Blue Cross-Blue Shield Arizona also known as BSBSAZ offers a supplemental insurance plan which covers expenses not duly covered by Medicare and Medicare Advantage plans These plans are offered in addition to Medicare Part A and Medicare Part B. They do not work with Medicare Part C (Medicare Advantage plans) or other insurance plans you may have as part of your retirement benefits. AZMEDICARE also offers BCBSAZ senior security plans with four medical supplemental insurance options.
- BCBSAZ Senior Security Plan A
- BCBSAZ Senior Security Plan C
- BCBSAZ Senior Security Plan F
- BCBSAZ Senior Security Plan N
Every plan has its own benefits. It’s totally up to the patients that in which type of plan he/she is interested. Plan C and Plan N are mostly preferred by the patients between the ages 65-67.
- Mutual of Omaha Medicare Supplemental Insurance
Mutual of Omaha offers Medigap insurance plans that are designed to reduce co-pays, premiums and deductibles for services provided by Medicare Part A and Medicare Part B plans. Although different private insurance companies offer Medigap policies, all Medigap policies are standardized, so all Medigap Plan A policies offer the same coverage, regardless of which insurer provider. Mutual of Omaha offers five Medigap insurance plans i.e. Plan A, Plan F, Plan G, Plan M and Plan N. The difference in these plans lie in their cost and the coverage percentage. Depending on your case, you can select any one of these plans. These options provide you the opportunity to create the plan that’s just right for you. AZMEDICARE has always wanted to provide its clients the power to customize the insurance plans.