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Medicare Advantage

Shedding Light On Arizona’s Medigap Policies

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.
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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. 

Medicare, Medicare advantage and Medigap plans

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.medicare

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.

Senior Healthcare Insurance Plans in Arizona

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. old-660831__180

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.

Arizona Medicare Advantage Plans – What are They?

The US health insurance system offers a variety of coverage options, designed to give citizens a peace of mind and reassurance when it comes to their healthcare costs. Medicare is the national health insurance program for seniors, instituted in the mid 1960s. You can get your health coverage through Original Medicare. You can also consider the Arizona Medicare Advantage plans as your coverage choice.

How do Arizona Medicare Advantage Plans and Medicare work?

Medicare addresses the needs of senior citizens aged 65 and above who have worked and paid their social security benefits and taxes. It’s administered by the federal government through around 30 private insurance providers across the country.

Medicare also provides coverage for people under 65 with certain qualifying disabilities and people with permanent kidney failure and amyotrophic lateral sclerosis of any age.

Different parts of Medicare cover different healthcare aspects. Original Medicare has two parts – A and B.

Medicare Part A (hospital insurance) covers inpatient care in hospitals, skilled facilities, hospice and home healthcare.

Medicare Part B (medical insurance) covers the costs of doctor visits, outpatient care, durable medical equipment, certain preventive services and eligible home health services.

Medicare Part C (Medicare Advantage or MA) is designed as a substitute for Original Medicare. It includes all benefits and services covered by Parts A and B. Medicare Prescription Drug Coverage (Part D) is usually bundled into the plan. MA is run by private companies approved by Medicare.

Medicare Part D subsidizes the costs of prescription drugs and drug insurance premiums for Medicare beneficiaries. It’s administered through Medicare-approved private insurance companies.

You can get your Medicare coverage through Original Medicare or you can join a Medicare Advantage Plan.

Choose your arizona medicare advantage plans wisely

Types of Medicare Advantage Plans

Health Maintenance Organization (HMO) plans: Your choice in most HMOs is limited to doctors and hospitals within the plan’s network (except in case of emergency). You may need a referral for specialist visits.

Preferred Provider Organization (PPO) plans: Using doctors and hospitals within the plan’s network will cost you less. However, you do have the option to receive medical care outside the network at a higher cost.

Private Fee-for-Service (PFFS) plans: As a plan beneficiary, you can use the services of any healthcare provider or hospital willing to treat you, similar to Original Medicare. The plan sets the costs it will cover for doctor visits and treatments, as well as the amount you will pay for your care.

Special Needs (SNPs) plans: SNPs provide care solely to people with specific conditions and characteristics, so that their needs can be met in the best possible way. This includes people suffering from severe or disabling chronic conditions, nursing home residents, or people eligible for both Medicare and Medicaid.

HMO Point-of-Service (HMOPOS) plans: These plans offer certain services outside the network for a higher copayment or coinsurance.

Medical Savings Account (MSA) plans: These plans combine a high-deductible plan with a bank account. Medicare deposits money to the account and beneficiaries use this amount to pay for healthcare services. Medicare drug coverage is not provided under these plans.

Important facts about Medicare Advantage

If you choose to join a Medicare Advantage plan, you will still be in the Medicare program. The difference is that you’ll be getting your Medicare Part A and B coverage from the Medicare Advantage Plan instead of the Original Medicare.

Medicare Advantage Plans cover all services available under Original Medicare, with the exception of hospice care. For Medicare Advantage beneficiaries, this type of care is covered by Original Medicare.

All Medicare Advantage plans cover emergency care.

Medicare Enrollment Form

In addition to the Part B premium, Medicare Advantage beneficiaries usually pay a monthly premium. Each month, Medicare transfers a fixed amount for your coverage to the Medicare Advantage providers.

Keep in mind that each MA Plan can have different out‑of‑pocket costs and rules regarding its services. These rules can change every year.

Your provider is obligated to notify you of any changes prior to the start of the next enrollment year (Annual Notice of Change).

Providers can join or leave your plan’s network anytime during the year. Also, your plan can change the providers in the network. In such a case, you may need to choose a new provider.

Medicare Advantage Plans can’t charge more than Original Medicare for certain services. This includes chemotherapy, dialysis and skilled nursing facility care.

Once you reach the yearly limit on your out-of-pocket costs for medical services set by the plan, you won’t pay anything for services. This limit may differ between Medicare Advantage plans and may be subject to annual changes, so make sure you do your research on this issue.

You can join or leave a Medicare Advantage Plan at certain times during the year. There are specific windows and rules, for example when you first become eligible for Medicare or if you get Medicare due to a disability. Between October 15 – December 7, anyone with Medicare can join, switch or drop a Medicare Advantage Plan.

Each year, MA Plans can choose to leave Medicare or make changes to their costs and services. If your plan decides to withdraw from Medicare, you’ll have to join another MA Plan or return to Original Medicare.

Enrollment Medicare forms

What are the benefits of Medicare Advantage

  • Comprehensive coverage from a single source.
  • MA plans have the potential for lower premiums compared to the total sum you would pay for Part D and a Medigap plan combined.
  • Some Medicare Advantage plans include benefits not covered by Medicare, such as dental, eye care and wellness.

What are the drawbacks of Medicare Advantage

  • Your healthcare choices may be limited to the doctors and hospitals within the plan’s network.
  • If you choose to get medical care outside the network, you may be responsible for 100% of the costs.
  • There may be a copay required each time you get medical treatment.

When choosing healthcare coverage, check if your area of residence is covered by the MA plan you’re considering.

If you have doctors or specialists whose care you prefer, check to see if they’re in the network.

Also, make sure to consult independent sources, since many sites are sponsored and therefore not objective. It’s best to consult the Medicare websites or those of non-profit organizations supporting the interests of seniors.

Medicare’s Star Ratings May Change Medicare Advantage Plans

Under new federal regulations, Medicare Advantage (MA) providers that earn a 4- or 5-star ranking from the Centers For Medicare and Medicaid Services will receive cash bonuses from the federal government. Star ratings are based on 33 independent criteria for health care plans and an additional 19 criteria for prescription drug plans (PDP).

This approach is likely to have an impact on all MA plans. Currently, the government pays MA providers about $8,800 per beneficiary, about $1,150 more per person, than it spends on traditional Medicare coverage. Although they are not required to, MA providers often use the extra funds to offer additional covered services, reduce premiums, co-pays or deductibles. These extras tend to make the MA plans more attractive to some seniors.

Beginning in 2011, however, this payment disparity will be eliminated. Instead, the extra cash will be used to fund the cash bonuses for MA plan providers. This will likely translate into some significant changes in the services provided under MA plans, and may also increase beneficiaries’ out-of-pocket expenses. MA plan providers will likely have to raise monthly premiums, co-pays and deductibles, or eliminate services currently being provided.

Initially, the star rating was designed to help seniors find high-quality plans from among potentially dozens of MA plan choices. Studies conducted by the Kaiser Family Foundation, however, indicate that about three-fourths of seniors choose a MA plan that is rated at 3.5 stars or less; and that only about 15 percent of MA enrollees live in a service area where a plan awarded four or more stars is available. The Kaiser Family Foundation’s analysis showed that the cost of a Medicare Advantage plan is a beneficiary’s primary consideration rather than a plan’s overall service rating.

The new rules will grant MA plans that receive four or five stars a bonus of 1.5% on top of their regular Medicare payments, beginning in 2012. The bonus amount will rise to 5% by 2014. Bonuses tied to a provider’s star rating have raised a few questions, since many plans currently approved by Medicare, including new plans and small plans, have no star ratings.

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