Medicare Terms To Know
There’s nothing wrong with not knowing what certain words mean when you’re looking into healthcare. A lot of the terms and phrases are ones that you would never see anywhere else! Medicare and all its parts can be confusing, but that’s why we’re here. These are some of the Medicare terms that we want to help you understand.
Ancillary – A policy that is not Original Medicare or Medicare Advantage (Medicare Supplements, cancer policies, and dental policies are just some examples). You can usually enroll at any time
COBRA –An act that requires your employer to keep your healthcare coverage for a limited time after you are fired to help you avoid a lapse in coverage
Coinsurance – The healthcare costs that you are personally responsible for
Copayment – The amount you pay out of pocket when you visit your doctor or purchase a prescription
Deductible – The amount you have to spend before your coverage kicks in
Dependents – Family members who can benefit from your plan (does not apply to Medicare)
HMO (Health Maintenance Organization) Plan – You will need to select one primary physician to turn to for all of your healthcare needs and can only see another provider if you have an official referral
HSA (Health Savings Account) – A separate bank account set up by your insurer that allows you to set aside tax-free money to use for healthcare expenses
In-network – A provider that is in agreement that your plan will provide coverage for the services that you receive there
Medicare Advantage – A Medicare plan offered by private insurers (not government-owned) that includes all Medicare benefits PLUS additional benefits like prescription drugs, dental, vision, hearing, fitness, etc.
Medicare Supplements – If you have Original Medicare only, you can add a Medicare Supplement plan to help you pay for your premiums, deductibles, and copayments
Out-Of-Pocket Limit – The maximum dollar amount you will be responsible for paying for your healthcare
Policyholder – The person whose name is on the plan
POS (Point-Of-Service) Plan – You will have a small network of providers to choose from but will be able to see any of those providers instead of choosing just one
PPO (Preferred Provider Organization) Plan – You can see any doctor, but some will be significantly cheaper for you than others
Premium – The regular payment (usually monthly) you are responsible for to keep your coverage
Why You Need A Final Expense Policy
Did you know that final expense is completely separate from life insurance? That’s right – even if you already have life insurance, you may not be completely covered for costs you incur at the end of your life.
We know planning for the end of your life can be upsetting, so we want to make it easy for you. Final expense policies are sort of like a way to pay for your funeral in advance. You’ll pay a monthly premium, and then when you pass away your policy will pay for your burial expenses and other related bills.
Planning for Final Expense
There are two main questions you’ll need to answer before you purchase a final expense policy. You’ll need to know what type of funeral your family will hold for you, and who your beneficiary will be (the person who uses the policy after you pass away). If you only expect a small ceremony or cremation, you won’t need as much coverage as you would for a large memorial service.
Keep in mind that when you purchase final expense, you’re really helping your family. Your family members are the ones who will be paying for your funeral and final costs. Investing in a final expense policy will help them greatly.
Other Benefits
If you’re still not convinced that you need final expense, keep in mind that these types of policies, much like life insurance, build cash value. If you have a financial emergency before you pass away, you can take out the cash value of your final expense policy and use it to cover your expenses.
Additionally, you should know that when you pass away and your beneficiary uses your final expense policy, the payout is tax-free. It’s a good way to help your family at least save money on your final expenses if not cover them altogether.
Get Started with Final Expense
Ready to buy a final expense policy? Our agents are not limited to Medicare sales; they can also help you with final expense, life insurance, cancer insurance, heart attack coverage, and more.
Fill out this form to get in touch with us or give us a call at 844-431-1832.
Preparing To Pay For Senior Living
Planning is crucial to having a successful financial life. You should always strive to leave room in your budget for potential health concerns, your retirement lifestyle, and your senior living facility if you find yourself needing one. You may be perfectly healthy now, but we as humans have to face reality: we can’t live forever, and our bodies and minds will start to deteriorate.
For Veterans – Aid & Attendance
Any veteran who is eligible for a pension from the VA and who is either housebound or needs help at home may be eligible for payments. It acts as an increased monthly pension and can help pay for either home care costs or nursing home fees. You can apply by visiting your local veteran benefit office. You’ll need evidence of your need for nursing care (any evidence of your disease or injury).
Life Insurance
Some life insurance plans allow you to take money out (tax-free) while you’re still alive. That means that you can use your life insurance policy as sort of a savings account for your future long-term care.
The younger you are when you purchase life insurance, the lower your premiums can be. If you don’t already have life insurance, buy now. Even if you don’t use it for your long-term care costs, you can use it to make sure your family is not left with your debts when you pass away.
Long-Term Care
Medicare will cover certain services based on your needs. For extra coverage, you may want to consider a long-term care policy. Long-term care policies will give you a daily allotment of money to spend on anything from your skilled nursing facility to an at-home aid. The catch is that you have to purchase long-term care insurance before you actually need it. If you’ve already had cancer, a stroke, Alzheimer’s, or another serious ailment, you might be denied long-term care insurance. Pre-existing conditions can prevent you from getting a good policy. If you buy now, you’ll be covered for when you get older and really need the help.
Ready to make a purchase? We can send an agent to your home to help you sort through your options and solidify your financial future. To get started, give us a call at 844-431-1832.
What Are Your Chances Of Developing Cancer?
Did you know that your chances of developing cancer are largely due to your DNA?
Last month, CMS (the Centers for Medicare and Medicaid) announced that Medicare can now cover genetic testing for cancer (as long as tests are FDA-approved). If you are aware of your chances of developing cancer early on, you can watch for it and be better prepared. Plus, cancer is almost always easier to cure when caught early on.
Is Cancer Hereditary?
Not necessarily. Scientists believe that inherited DNA only gives you about a 5 to 10% chance of developing cancer. The rest of your chance of developing cancer usually comes from your environment. Genetic testing looks for mutations in your DNA that reflect a chance of developing cancer. DNA mutation does not mean that you will definitely develop cancer, but it means that there is a chance that you will.
Genetic Testing For Cancer
Genetic testing is non-invasive. Sometimes it involves a simple cheek swab, and sometimes (depending on the test), the tester may need to draw blood. You may be able to complete a genetic test at home, but speak to your doctor first.
If you have any family history of cancer, or if you have lived in an environment with harmful chemicals or heavy smoke, it may be a good idea to seek out genetic testing. Always speak with your doctor before making these types of decisions. A doctor who knows your medical history may tell you that it’s not necessary or may encourage testing.
Cancer Coverage
Original Medicare (Part A and Part B) will cover hospital costs and doctor visits, and Medicare Part D will cover prescription drugs. However, cancer treatments generally are not kind on your piggy bank. You can purchase a Medicare Advantage plan that combines Part A, Part B, and Part D all into one plan. Then, purchase an additional cancer policy to cover extra items like physical therapy, ambulance transportation, surgeries, and replacement of lost income.
Cancer policies are usually reimbursement policies. The carrier will send you a check upon your diagnosis. That means that you can use your coverage for anything. If your family history or genetic testing tells you that you are at a high risk of developing cancer, you may want to invest in a cancer policy now so that you can be more financially prepared.
Our agents can help you decide what policies are best for you. Set up a free appointment by calling us at 844-431-1832.
How Seniors Can Combat Addiction
Are you or a loved one suffering from addiction? It’s actually quite common for seniors to suffer from addiction to drugs or alcohol due to lack of mobility, isolation and loneliness, and depression. Plus, seniors are more likely to have prescriptions for addictive drugs and are more likely to receive prescriptions that they don’t really need and become overmedicated.
The Recovery Process
The recovery process for seniors to combat addiction is not much different than the process for younger adults. There are two steps to every addiction recovery process: physical and psychological. Affected seniors will have to train their bodies to not be dependent on alcohol, drugs, or whatever they’re addicted to, but that starts with psychologically training the mind to not want those items. Most affected individuals will go through a withdrawal period that can bring symptoms like nausea, shakiness, sweating, loss of appetite, and anxiety.
Treatment centers often coach not only the affected senior but also the person’s family members or friends. That way, people can learn how to take care of their loved ones. Group therapy options are also available.
Treatment Coverage
Mental health and addiction treatment is one of the ten required services under the Affordable Care Act. That means that Medicare marketplace plans are required to cover addiction treatment. As long as services come from a provider or facility who participates in Medicare and a doctor states that the services are medically necessary, addiction treatment must be covered.
The Breakdown
Medicare Part A will pay for any hospitalization related to substance abuse and addiction treatment, but out-of-pocket costs (according to your individual plan) will apply. That means that you have to pay any copays or deductibles that you are normally responsible for. However, there is a limit. Medicare will only cover up to 190 days spent in a psychiatric hospital for an entire lifetime.
Medicare Part B will pay for substance abuse and addiction treatment at a doctor’s office or if you are a hospital outpatient. As usual, Medicare will pay 80% and you will be responsible for the other 20%. This coverage includes things like therapy, hospital follow-up visits, and hospital drugs. For other drugs, you will need a Part D or Medicare Advantage plan.
Are you or your loved one covered?
If you or someone you know has a problem with substance abuse or addiction, we can help make sure they have the best coverage possible. Our agents are licensed to sell products from multiple carriers, so we can supply the unbiased care they deserve. Call to set up a no-cost appointment at 1-844-431-1832.
What Is The Scope Of Appointment Form?
What Is The Scope Of Appointment Form?
Health care is personal, financial, and crucial. It can be difficult to hand your information over to strangers so they can start charging you fees, so you’re probably cautious about signing forms and documents. However, the Scope of Appointment form, or SOA, is an important one for you to sign.
The Centers for Medicare and Medicaid Services, CMS, requires that Medicare and Medicaid sales agents fill out the SOA at or before every appointment. The form documents exactly what the parties plan on discussing. The information is confidential but required for the agent to proceed.
Why?
SOA forms are just one way that CMS tries to protect you, the consumer. It prevents agents from trying to sell you more than you need or start discussing products illegally. By law, Medicare and Medicaid sales agents are only allowed to discuss the information they agreed to on the SOA form. The form is not required for Original Medicare enrollment. However, it is required for Medicare Advantage, Medicare Supplement, Part D (Prescription Drug) plans, Hospital Indemnity, and Dental/Vision/Hearing plans.
Fraud, Waste, and Abuse
SOA forms are one of the countless rules that Medicare and Medicaid sales agents are required to follow. An agent who breaks a CMS rule is considered guilty of fraud, waste, or abuse.
If an agent attempts to sell you a product that you did not agree to discuss, you can file a fraud, waste, and abuse complaint with The Centers for Medicare and Medicaid Services.
At MedicarePlanFinder, we’ll set you up with a Medicare Health Benefits agent who knows to always file an SOA and stick to it when meeting with you. Do you have any questions at all about your Medicare plan? Are considering changing or adding a plan? Call us to set up a meeting with one of our licensed and experienced agents at no cost to you. Call us at 1-844-431-1832.
Closing Your Medicare Coverage Gaps
Did you recently purchase a new health care plan, or are you reevaluating your existing plan? You may have noticed by now that your Medicare plan does not cover all of your health care needs.
If you only have basic Medicare, your plan only covers hospital treatments and doctor visits. If you have Medicare Supplements, your plan covers hospital treatments, doctor visits, and copayments and deductibles. If you have Medicare Advantage, your plan probably includes additional items like prescription drug coverage, dental and vision benefits, and physical fitness incentives.
Your prescription drug coverage can also leave you in the Donut Hole!
Thankfully, we can help you close your coverage gaps. This is how:
Ancillary Products
Even if you have Medicare Advantage, your Medicare plan is missing items like final expense coverage, life insurance, and more! If you don’t have Medicare Advantage, your Medicare plan definitely does not have items like dental, vision, and hearing insurance. These are all items that you can buy separately to give yourself additional coverage!
Dental, vision, and hearing policies are a great place to start, but you’ll really want to consider your other health care needs. Are you at a high risk for a stroke or heart attack? Do you have a family history of cancer development? If so, you may want to consider adding on a cancer, heart attack, or stroke policy.
Individual hospital indemnity policies are a great way to protect yourself for the event that you need to spend a long period of time in the hospital, and final expense policies are a great way to ensure that your family does not have to shell out thousands of dollars to pay for your burial expenses and any outstanding bills at the time of your death.
Extra Help
Thousands of seniors who qualify for Extra Help don’t even know it! We want to help you figure out if you’re missing out on great Medicare savings. If you qualify for Extra Help, otherwise known as LIS (Low-Income Subsidies), you can get help paying for prescription drug premiums, deductibles, coinsurance, and copayments.
Additionally, you can have an SEP, or Special Enrollment Period. This means that you’ll be able to change or add a plan outside of the Annual Enrollment Period (once per quarter during the first three quarters of the year).
LIS can also help you pay for late enrollment fees and cover you when you fall into the Donut Hole (the gap we mentioned earlier). Any Medicare beneficiary who has LIS does not have to worry about the Donut Hole coverage gap!
Find more information on LIS here.
Meet An Agent
Thankfully, we can help you with all of this! Our Medicare Health Benefits agents can come directly to your home, so you don’t even have to go anywhere. We’ll send them your way so they can help you pick the best plan from the best carrier for your individual needs. Our agents can also help you apply for LIS!
To get started, set up an appointment by giving us a call at 1-844-431-1832.
How Medicare and Retiree Coverage Work Together
How Medicare and Retiree Coverage Work Together
Does your employer offer retiree health care coverage? Even if you have a retiree plan, you still need to enroll in Medicare. Medicare and retiree coverage are not the same thing.
Your Medicare coverage will always come first. Your retiree coverage will work as extra coverage to backup your Medicare plan – kind of like a Medicare Supplement plan. While retiree coverage is not a Medicare Supplement plan, it is very similar. It can cover things like copayments and deductibles, or even extra hospital stay days. All retiree plans are different, though, so look over your plan and call your agent to find out what it covers.
Do You Have Coverage?
Not every employer offers retiree coverage. Since it isn’t required, your employer (or former employer) can cancel or change your retiree plan at any time. It’s safest for you to have Medicare as well. Plus, if you don’t enroll in Medicare when you first become eligible, you will face a penalty fee. Some retiree plans automatically stop when you turn 65 and become eligible for Medicare.
If your employer does not offer retiree coverage, retiring or losing your job gives you a SEP. A Special Enrollment Period means that you don’t have to wait for AEP, the Annual Enrollment Period, to buy coverage. You will have 60 days from your last day of work to enroll in a marketplace health plan. After those 60 days are over, you’ll have to wait until AEP (October 15 – December 7) to buy a marketplace plan, at which point you will be charged a penalty fee for having a lapse in coverage.
How To Enroll In Medicare
To get started with Medicare, speak with an agent! One of our licensed and highly qualified agents can help you sort out your options and pick the best plan for your needs. Our agents offer bias-free assistance because they are licensed with multiple carriers. We truly want you to have health care and coverage that works for you.
To set up a free appointment, call 1-844-431-1832.
Sign Up For Paperless Medicare
Sign Up For Paperless Medicare
Paperless Medicare will help you save time, money, and paper – benefiting you and the environment you live in!
MyMedicare.Gov
Medicare hosts its own free and secure digital service for account management and information. It will allow you to access important data quickly, easily, and cheaply and avoid problems like lost or stolen mail. If you’re still not convinced to switch and start using this digital system, remember that it also benefits the environment. No more paper bills and notices!
The service is easy to use – clicking a big blue button will download your Medicare information. You can also access your eligibility for discounts and Extra Help as well as details about your current plan. There’s even a video to help beneficiaries like you through the process of registering and using the service.
eMSNs (Electronic Medicare Summary Notices)
The biggest draw to electronic MSNs is the shorter wait time. Normally, these notices take three months to arrive by mail, but eMSNs are always accessible online. It’s also a good way for you to keep track of older MSNs. You won’t have to search through years of paper documents or stand in line at the Social Security office to access them. Just sign up for eMSNs by logging into your My Medicare account, then click “Email and Correspondence Settings” under the “User Information” tab. Then, just opt in for electronic Medicare Summary Notices!
eHandbook and eBooks
Every fall, you should receive a physical “Medicare and You” handbook, but the information will only get more and more outdated until the following fall. With electronic handbooks, you can always check online for the most updated information. Now, you don’t have to receive the physical copy. This will save a lot of paper and government money. Just enter your information here.
Access other electronic Medicare publications here.
Still confused about paperless Medicare? Speak to an agent! Call us M-F, 9-5 at 1-844-431-1832.
Holistic and Natural Health Care with Medicare
Holistic and Natural Health Care with Medicare
Medicare provides coverage for services with doctors, pharmacies, and hospitals that have legally agreed to serve Medicare clients. Holistic and natural health care providers are usually not legally equipped to support Medicare. In 2017, if you’re over the age of 65 you have to purchase a Medicare plan. But what if you only use holistic and natural methods and don’t plan on actually using Medicare?
Medicare Is An Investment
If you have Original Medicare, your premiums can be less than $200 per month. That’s a better deal than paying a fee every time you visit a holistic doctor. More importantly, if you have to rush to an emergency room one day, you’ll have to pay the total cost of your visit and care. An emergency medical professional is not going to drive you to your holistic care facility. A Medicare plan will help you pay for any potential emergency.
If you don’t purchase a plan now, you’ll be charged a penalty fee later – so it’s financially smartest to buy a Medicare plan as soon as you turn 65.
What To Buy
If you truly believe that you won’t use your Medicare plan, you’re still better off purchasing a small plan than not having coverage at all. If you prefer, you can enroll in Medicare Part A alone. It will only cover hospital services (no prescription drugs, no doctor’s appointments, no long-term, dental, hearing, or vision care). Additionally, you can enroll in a Medicare Supplement plan, which will help you pay for your coinsurance, copayments, and deductibles.
We’ll take your holistic health care needs into consideration and help you find a plan that best fits YOUR needs. Call today at 1-844-431-1832.
