Category: Health Insurance

‘Mutual Perks’ Announced by Mutual of Omaha

‘Mutual Perks’ Announced by Mutual of Omaha

‘Mutual Perks’ Announced by Mutual of Omaha

mutual perks by mutual of omaha

What are ‘Mutual Perks'(SM) = Are they Discounts?

Yes, and we like discounts.

Moreover, anyone in retirement or on a “fixed income” certainly appreciates discounts. So when Mutual of Omaha announced an added discount benefit to their insurance customers, we were very interested.

What are Mutual Perks?

Mutual Perks are not directly a part of a Mutual of Omaha Policy; rather, they are additional discounts with third-party companies that are available to life insurance policy holders as well as select medical insurance policy holders.

What Kinds of Discounts are Offered?

As far as we can tell, the discounts focus on companies that can either keep you or your bank account healthy. Here is a list of the types of companies that will feature “Mutual Perks” discounts.

  • Eyeglasses
  • Hearing aids
  • Home mortgages. T
  • Massage,
  • Chiropractic
  • Acupuncture
  • Low-cost gym memberships (at over 10,000 locations)
  • Also, retail, travel and dining coupons

The official press release from Mutual of Omaha didn’t specify any particular companies, but we will update this post in the future if we hear any more details.

Why is Mutual of Omaha Offering These Discounts?

The insurance industry is an old, mostly stable industry, but it is still very competitive. It’s great to see insurance company’s still adding benefits to serve their members better. In addition, healthier members are also always better for any insurance company’s bottom line. In this case, Mutual Perks seems like a win-win.

Here is what the corporate office has to say:

“Our customers, and their financial well-being, are important to us,” said Jennifer Wulf, Mutual of Omaha’s vice president of customer insights. “That’s why we’re excited to offer these exclusive money-saving opportunities. It might be a little surprising that an insurance plan opens the doors to these offers, but we are always looking for ways to delight our customers while partnering with them in their financial security and healthy living goals.”

Mutual Press Release on Feb. 25, 2020

How Can I Get Mutual Perks?

If you want Mutual Perks, you will need to be a Mutual of Omaha policy holder. If you already are, the company will most likely be getting in touch with you to let you know if the benefits apply to you.

Otherwise, if you are considering purchasing a life insurance policy, Mutual of Omaha is probably hoping Mutual Perks might make you look again at their options. I must admit, I am interested in hearing more myself!

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Medicare and Medicaid Difference Guide

Medicare and Medicaid Difference Guide

Medicare and Medicaid Difference Guide

medicare and medicaid difference guide

The Medicare and Medicaid Difference Guide helps you understanding both services, so you can make the best decisions for yourself and your loved ones.

The United States has two separate national health care systems: Medicare and Medicaid. The government created the two programs for two different kinds of people. However, they often overlap. Let’s look at both programs, including their similarities and difference. We will also look at who needs or qualifies for each program.

Let’s Start with Medicare vs Medicaid.

What is Medicare?

Medicare is the U.S. national health care program that provides seniors age 65 and older, and some disabled people, with health insurance.

The U.S. government started the program in 1966. The Centers for Medicare and Medicaid Services runs these programs. Medicare also covers people with end stage renal disease and amyotrophic lateral sclerosis.

Medicare does not cover all of the costs associated with health care. As a result, people with Medicare will also use a Medicare Supplement Insurance Plan (Medigap Plan) or a Medicare Advantage Insurance Plan to round out their care coverage.

Please read our Ultimate Guide article on “What is Medicare.

https://medicarelifehealth.com/glossary/medicare

What is Medicaid?

Medicaid is the United States National Health Care System that provides health coverage to over 64.7 Million People.

The program was created for people with low-incomes that cannot afford, or do not have access to, private healthcare insurance.

https://medicarelifehealth.com/glossary/medicaid

How are the programs similar?

Medicare vs Medicaid Pin

The programs are both National Health Care Systems. In fact, they are the only two nationalized heath care systems the United States has. Many other countries around the world have much more extensive national coverage for their citizens. The U.S. has a limited program for specific age, income, and health groups, and the rest of the country relies on private health insurance.

In addition, both programs cover specific hospital services, doctor services, and other health care related services.

Medicare has four parts. First, Medicare Part A, also known as “Hospital Insurance,” helps with coverage regarding: inpatient care, home health care, nursing facilities, and hospice.

Second, there is Medicare Part B, also known as “Medical Insurance.” Part B helps with coverage related to doctor and other provider services, including: doctors visits, health care providers, outpatient, prevention services, and medical equipment. Medicare Beneficiaries pay for Part B.

Finally, Medicare has a Prescription Drug Program that is administered by private insurance carriers. Click here to lean more about What Medicare Covers and Medicare Parts A, B, C and D are.

How are the programs different?

One of the biggest differences between the two programs is who runs them. Medicare is run on a national level, by the Federal government. On the other hand, Medicaid is run by each state individually.

Of course, the biggest difference is the the different populations the programs serve:

  • Medicare – For Seniors over age 65, and some disabled people
  • Medicaid – For people with low income and few resources

Medicare and Medicaid Differences in Beneficiaries – Who Gets What Program?

The U.S. government created Medicare and Medicaid to take care of different “vulnerable” populations – the poor, the disabled, and the elderly. Let’s look at each program and population.

Who should get Medicare?

Anyone who is a citizen or qualified resident of the U.S. can enroll in Medicare when they turn 65 years old. There is a seven month window of time starting three months before turning 65, the month of your birthday, and then three months after your birthday month.

How do I Sign-up for Medicare?

First, you may be automatically signed-up if you are already receiving Social Security (SS) or Railroad Retirement (RRB).

Second, if you are not already receiving SS or RRB benefits, you must sign up for it when you turn 65 years old.

Conversely, if you are not ready for Medicare when you turn 65, you must notify the government that you want to delay your benefits. If you do delay, it must be because you have credible coverage in place. An example of this would be an employer plan.

Click here to read more about Medicare, including where to go to enroll.

From Our Article What is Medicare? A Guide to All Medicare Basics

Supplemental Medicare Insurance Options

Medicare picks up about 80% of the health care costs for its beneficiaries. For the other 20%, seniors turn to either Medicare Supplements (aka Medigap Plans) or Medicare Advantage Plans. Click here to read our article on Medicare Advantage vs. Medigap, or see the informational articles below.

What is Medicare Advantage?
What are Medicare Supplements_

Who should get Medicaid?

Medicaid is for people with limited income and resources. Medicaid is run on a state level, not on a federal level. As a result, in order to qualify for Medicaid, you will need to determine what your state defines as a qualifying income level.

How Do You Enroll in Medicaid?

Again, since Medicaid is run by State Governments, you will need to contact your state’s agency to start see if you qualify to enroll.

You can find a list of State Agencies here on the Medicaid.gov website.

Who Can Get Both Medicare and Medicaid?

People of any age who have certain qualified disabilities and people over 65, who are also below their states Medicaid income levels, can qualify for both Medicare and Medicaid.

For example, Henry is a 55 year-old disabled man who is also unemployed and living below the poverty level set by his state. Consequently, he would most likely qualify for both Medicaid (because of his income level) and Medicare (because of his qualified disability).

People that qualify for both programs are called “Dual Eligible.”

Who Can Help?

Navigating one (let alone both) of these systems can be confusing. But there is help available.

  • If you need help enrolling in Medicare, then you can contact CMS and Social Security in the following ways:
  • Finally, if you need help finding a Medicare Supplement or Medicare Insurance Plan, or if you are dual eligible for both Medicare and Medicaid, then please contact an Insurance Agent. An Independent Medicare Insurance Agent will help you explore your options, and help you make the right choice for your unique situation.

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What is Silver Sneakers?

What is Silver Sneakers?

What is Silver Sneakers?

what is Silver Sneakers Senior Fitness

Maybe you just overhead your neighbor talking about his free gym membership, or maybe your doctor asked you if you are a SilverSneakers user. You might then be wondering, just what it Silver Sneakers?

SilverSneakers(r) is a fitness and wellness program for seniors age 65 and up. It includes free gym memberships across the country, and it is included with many Medicare Advantage Plans.

NOTE: If you are a part of AARP’s Unitedhealthcare’s Medicare Advantage Plans, then you will be a part of Renew Active. This is a similar program, but has several differences you can read about here.

Renew Active vs Silver Sneakers

What is Included in a Silver Sneakers Membership?

  • LOCAL GYM MEMBERSHIPS: Silver Sneakers has an extensive list of gyms that participate in their program that offers free gym memberships to seniors. Their website boasts having more gym facilities than there are Starbucks locations in the U.S. (at over 16,000).
    • If you are a part of a Medicare Advantage (MA) program that uses Silver Sneakers, then you can access the gyms in their network at no cost. You can use as many of these facilities as you like while you are a part of your MA plan.
  • ONLINE FITNESS CLASSES: If you prefer to workout at home, or do not have a physical location close to you, SilverSneakers offers online fitness classes.
  • APP: They also have an app to help you track your fitness goals and schedule your fitness plans. The app can also help you locate participating locations.

What you Need to Know About Silver Sneakers

First, there are a few things you need to know to get started. Here is an overview and some frequently asked questions about the program.

How do I know if I am a member of SilverSneakers?

Well, if you are part of a Medicare Advantage Plan, then there is a very good chance you are already a part of the program.

To check on your eligibility, click here.

Where can I find participating gyms and wellness facilities?

As an overview, SilverSneakers tries to be in as many convenient fitness facilities as possible. Moreover, they are doing an excellent job of reaching this goal! Right now, they are in over 16,000 fitness facilities.

Here is the official link to search for a participating fitness facility near you.

What if there are no facilities close to me?

If you are in a smaller town or rural area, there might not be a class or gym close to you. However, even if there is not a Silver Sneakers contracted location close to you, you can still participate. The program features online classes and workout kits.

Do I have to take the Silver Sneakers Classes?

what is silver sneakers?

Often, people will ask me if they have to attend the SilverSneakers branded classes at the gym. The answer is no. The program gives you access to the whole facility. This includes Silver Sneakers classes, but also all the other classes at the gym. You can also just go walk on the treadmill or lift weights.

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What Medicare Part A Covers

What Medicare Part A Covers

What Medicare Part A Covers

What Does Medicare Part A Cover

Here is what Medicare Part A Hospital Insurance covers:

  • Inpatient Hospital Care
  • Skilled Nursing Care
  • Stays at Skilled Nursing Facilities (short-term)
  • Home Health Care
  • Hospice Care

In addition:

  • Part A also includes inpatient care in a religious non-medical health care institution.
  • Blood is also a Part A covered service. You will have to pay for the first three units of blood that you use. However, if the blood is donated free to the hospital or donated to you, then you do not have to pay for it.

What Medicare Part A Will Not Cover

Medicare Part A or Part B will not cover custodial, long-term care, nursing home or assisted living facilities. Click here to read more about ways to cover these costs.

Will Medicare Cover My Costs?

How Do I Know if I am Signed-up for Medicare Part A?

Part A and B are separate in Original Medicare, and you can be signed-up for one and not the other. First, to see if you are signed-up for Part A, you can check your Medicare Card. If you are signed-up, it will say “Hospital” and then have an effective date listed right on the card.

In addition, if you are a part of a Medicare Advantage Program, they you are also already signed-up for Part A. This is a prerequisite for join a Medicare Advantage (aka Part C) plan.

For More on What Medicare Part A Covers & the Other Parts of Medicare

Please Read:

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Qualities of a Good Insurance Agent

Qualities of a Good Insurance Agent

The Top 6 Qualities of a Good Insurance Agent

What are the qualities of a good insurance agent you should be looking for when you are searching for an agent? Your insurance agent helps you make important decisions to protect you and your family – let’s make sure you have a good one.

The Top 6 Qualities of a Good Insurance Agent

Here are the top six qualities of a good insurance agent:

qualities of a good insurance agent
  1. Educator Over a Seller.
  2. Learner.
  3. Good Listener.
  4. Problem Solver.
  5. Trustworthy.
  6. Authentic & Likable.

Let’s take a look at each one of these qualities and why they are important.

1. Educator Over a Seller

No one wants to be just sold to. You want to be helped, informed and guided. That is why it is so important to pick an insurance agent that is an educator rather than a seller.

One of the reasons I encourage everyone to find an independent insurance agent is that independent agents do not have to push just one insurance company. This goes for Medicare, life insurance, health and even home and auto.

As an example, for those of you that don’t know me, I am an independent agent that specializes in Medicare insurance. When I meet with clients, I spend time helping them understand the two basic ways to set-up their Medicare. Then, I let them make an informed decision that is best for their unique situation. As a licensed representative for many companies I can feel like an educator and not a “salesperson.” This is an important distinction.

2. Learner

The Insurance Industry is constantly changing. Insurance companies roll out new products regularly. In addition, companies create new ways to use these products to best protect yourself and your family. You need an agent that truly enjoys learning about these changes and products so they can keep your financial plan up-to-date.

LTC “Learner” Example

For example, in the Long Term Care (LTC) insurance world, it is good to have an agent that can help you be creative with how to fund long-term care expenses. As the LTC products have changed and premiums have priced people out of the market, you need an agent that likes to learn about using different types of products that can meet LTC needs (like IUL riders).

The more information and insurance education your agent has, the more they can effectively meet your needs.

Medicare “Learner” Example

Again, to use my situation as another example, I sell Medicare and the Medicare plan landscape becoming crowded with options. In this niche, education is more important than ever. However, less agents are dedicating themselves to certify with all the Medicare options.

Medicare Advantage sales takes a lot of education. I had to take roughly 17 different tests on various Medicare Advantage (MA) plans offered in my service area just for 2020. In addition, all Medicare agents that sell MA must retake these tests every year as they are necessary to understand plan changes.

This is a big reason why independent agents that are fully certified in both Medicare Advantage and Medigap are difficult to find, but necessary for making informed decisions. My advice is it is worth it to have an agent that understands both well.

3. Good Listener

Insurance solutions should meet your needs and not the needs of the insurance agent. That is why being a good listener is one of the qualities of a good insurance agent.

You need to feel like your insurance agent has fully understood you, your family and your financial situation. Make sure you have an agent that asks lots of good questions. Moreover, make sure your agent actually listens to your answers.

4. Problem Solver

Creating the best insurance solution for your needs requires active problem solving. No two situations are exactly alike. We have already established that you should have an agent that is up-to-date on the latest products and trends in insurance. Then, you need an agent that can synthesize this information into a solution that meets your unique needs.

You may not realize it, but creativity is a big part of being a good insurance agent. Insurance is certainly used for asset protection, but it can also be a creative tool for retirement funds and estate building.

5. Trustworthy

Honesty and integrity come as a package deal. Insurance agents should have both and demonstrate it actively to earn your trust. Enough said.

6. Authentic & Likable

You must like your insurance agent, and they must also like you back! Otherwise, you will dread working with them, and they will probably feel the same about you.

I know when I leave 95% of my clients, I feel energized and happy from our meeting. Consequently, I know they do too. I am always working to get this number to 100%. I purposefully search out clients I can be myself with. When I am my authentic self, I know I can do my best work for my clients.

Conclusions

In summary, there is a good agent out there for everyone. However, it might take a few attempts to find the one that is right for you. Just be on the look out for agents that are: educators, learners, listeners, and problem solvers. In addition, they should be trustworthy and authentic, but above all, you should like them!

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Medicare Open Enrollment 2019

Medicare Open Enrollment 2019

Medicare Open Enrollment 2019

medicare open enrollment 2019

Medicare Open Enrollment 2019 runs from October 15th to December 7th. These are the same dates every year. In 2020, Annual Open Enrollment will also be 10/15/2020 – 12/07/2020.

What is Medicare Open Enrollment?

Also called AEP – Annual Enrollment Period is the time of year Medicare Beneficiaries can make changes to their Medicare Advantage Plans and Prescription Drug Plans.

Information for new plans starts to become available each year on or around October 1st, but changes can not be made until AEP actually starts on October 15th.

What Changes Can you Make During the Annual Enrollment Period?

  • If you are in Original Medicare, you can join a Medicare Advantage Plan during this time.
  • You can also join or switch Part D Prescription Drug Plans.
  • In addition, if you have a Medicare Advantage Plan, you can switch to another plan.
  • Finally, you can drop a Medicare Advantage plan to return to Original Medicare during this time.

Are Medicare Supplements Affected by Medicare Open Enrollment?

This enrollment period does not apply to Medicare Supplements (Medigap) Plans. You are free to change these plans when you please. However, if you are outside of a Special Enrollment Period (SEP) then you will need to go through medical underwriting to get into a new Medigap Plan. Medical Underwriting usually entails answering basic health questions by phone or in person with an agent.

What is the January – March Open Enrollment Period?

Sometimes also called Open Enrollment, the government created a new time period that runs from January 1st to March 31st each year where you can make limited changes. According to the Medicare and You Book,

If you’re in a Medicare Advantage Plan, you can make a change to a different Medicare Advantage Plan or switch back to Original Medicare (and join a stand-alone Medicare Prescription Drug Plan) once during this time. Any changes you make will be effective the first of the month after the plan gets your request.

Medicare and You 2020

The important thing to note here, is that you can only make ONE change during this time. Lawmakers created this time period to give you the opportunity to fix any problems you may have found in your current plan or any new plan you may have adopted.

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Railroad Medicare

Railroad Medicare

Railroad Medicare – What You Need to Know

Here is what you need to know about Railroad Medicare Benefits to be successful in your retirement planning.

Introduction to Railroad Medicare

Railroad Medicare Benefits and Choices at MedicareLifeHealth.com

So, you are retiring from the Railroad? Congratulations! Mostly, your options for Medicare planning will be the same as everyone else’s. Our articles on Medicare Basics, Medicare Supplements and Medicare Advantage will all apply to you.

However, there are just a few differences between Social Security and the Railroad when it comes to Medicare. Let’s look at what these similarities and differences are.

What is the Same

Signing-up

  • Already Retired: Signing-up for Medicare is the same on SS or RRB. If you are already receiving benefits from Social Security or the Railroad you will be automatically enrolled in Medicare Part A and Part B. You can then decline Part B if you want to. (Read about declining Part B here.)
  • Not Yet Retired or Not Receiving Benefits: For those of you that are not already retired and/or not yet receiving benefits, you will need to notify the local Railroad Board (RRB) office before you turn 65 that you would like to sign-up for Medicare. You can sign-up up to 3 months before you turn 65, and even if you are not planning on retiring at 65.

Your Medicare Path Choices

Just like Social Security Medicare, you will have two options for setting up your Medicare:

  • Original Medicare: You have the option of choosing to keep Original Medicare and then enrolling in a stand-alone Part D Drug Plan. In addition, you can then add a Medicare Supplement (Medigap) plan to pick up the costs Original Medicare does not cover. You can read more about Original Medicare here.
  • Medicare Advantage: You also have the option of moving to a “bundled” Medicare Advantage plan. These plans are run by private insurance companies and bundle together Parts A, B & D all into one plan with one point of contact. They are also called Medicare Part C. You can read more about Medicare Advantage here.

You can read about the difference between Original Medicare and Medicare Advantage here.

What is Different

Part B Claims Processing

The major difference in Medicare for Railroad Board vs Social Security, is how the Part B claims are handled. Unless you are enrolled in a Medicare Advantage Plan (where the private insurance company you use handles all of your Medicare claims), you will deal with a different claims handling entity than those enrolled in SS Medicare.

The Railroad Medicare program uses an outside company for medical insurance claims that fall under Part B services. (Read more about the different parts of Medicare and what they cover here.) This company Palmetto GBA. They are a subsidiary of Blue Cross and Blue Shield. You will need to submit claims directly to them if you are under Original Medicare through the RRB.

How to Contact Palmetto GBA for RRB Original Medicare Beneficaries

If you need to submit a claim for a Part B service or ask a question, you can contact Palmetto GBA here:

Palmetto GBA
Railroad Medicare Part B Office
P.O. Box 10066
Augusta, GA 30999-0001

Toll Free: 1-800-833-4455
TTY/TDD: 1-877-566-3572
Website: www.palmettogba.com/medicare
According to the RRB website, you will click on “RRB Specialty MAC Beneficiaries” on the website above

More Information

For more information about Railroad Medicare Benefits, you can visit their website here.

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Does Medicare Cover Hearing Aids?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hearing Aids?

Does medicare cover hearing aids doctor examining patient

One questions we hear a lot at Medicare Life Health is “Does Medicare Cover Hearing Aids?

  • The simple answer is NO.
  • However, some Medicare Advantage Plans will. Let’s look at both.

Original Medicare Will Not Cover Hearing Aids.

Original Medicare – Parts A & B run and administered by the Federal Government – does not pay for hearing aids. In addition, it does not cover exams or fittings needed for hearing aids.

As an exception, Medicare will cover any hearing exams ordered by your doctor for medical treatment. Here is the direct quote from the Medicare and You Guidebook. (Please see our Medicare and You User Guide for more information.)

Hearing and balance exams – Medicare covers these exams if your doctor or other health care provider orders them to see if you need medical treatment. You pay 20% of the Medicare-approved amount, and the Part B deductible applies. In a hospital outpatient setting, you also pay the hospital a copayment.”

Medicare and You 2020 Guidebook

What about Medigap (Supplement) Plans?

No, Medicare Supplement Plans (also called Medigap) do not cover hearing exams or hearing aids. These supplements cover the costs of covered services that Medicare leaves for beneficiaries to pay. (For example, coinsurances, co-pays and deductibles.)

They are not structured to pay for extra services like hearing, dental, vision, wellness or long-term care.

Do Medicare Advantage Plans Cover Hearing Aids?

Does Medicare Cover Hearing Aids PIN

All Medicare Advantage Plans are designed differently, but most of them offer benefits for exams and hearing aids. Depending on the plan, you may find covered, or partially covered, hearing exams. In addition, many plans will have co-pays or coinsurance on hearing aids.

As an example, one MA plan might offer 0% co-pay on a hearing exam and a co-payment on a hearing aid. They might have two kinds of hearing aids with different amounts you pay as your portion for either a standard hearing aid or a more advanced one.

Also, some Medicare Advantage Plans will contract with specific hearing aid companies to offer discounted or even fully covered hearing aids if you use these providers.

Summary & Action Steps

In summary, if you are in need of hearing aids, Original Medicare and Medigap Plans will not cover them. However, a Medicare Advantage plan often will.

With hearing aids often costing thousands of dollars, it can make sense to consider a Medicare Advantage plan where you can get discounted hearing benefits and hearing aids.

How to Get Started

  • Interested? Talk to an agent to learn more about plans with hearing aid options.
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Medicare and You 2020

Medicare and You 2020

Medicare and You 2020 Guidebook – Read This First

Your Introduction to the Medicare and You 2020 Book, and where to get a copy.

The Medicare and You 2020 Guidebook details what you need to know about Medicare benefits for the current year. In it you will find the basics of Medicare, how to get it, and what changes the program is implementing in the calendar year.

However, it is 120 pages long and very detailed. It is also very dry and technical.

So, if you are trying to learn more about Medicare – without falling asleep in the process – we have on-topic website article suggestions for you here that follow the elements of the Medicare and You 2020 Guide.

Where to find the guide

What is included in the Medicare and You 2020 Guidebook?

Here we will outline the sections of the guidebook and give you relevant articles that discuss the various Medicare elements and benefits.

What are the Parts of Medicare?

Intro Section (page 5)

The Medicare and You book starts out with summarizing parts A, B, and D and what they include.

Medicare Part C is discussed in the next section.

Related Article: For an illustrated overview of the four parts of Medicare, visit our medicare parts infographic and article “Medicare Parts A B C D.”

What are my Medicare options?

Intro Section on Original vs Medicare Advantage (pages 6-8)

how to read Medicare and You 2020 guidebook

Many online comparisons are between Medicare Supplements and Medicare Advantage plans as those are the additions that are in your hands to choose.

However, all these comparisons are in their simplest form between having Original Medicare vs Medicare Advantage. This section does a side-by-side comparison of the two (with or without a supplement).

Related Article: For a more in-depth discussion to help you decide what Medicare options are right for you, please read the “Medicare Advantage vs Medicare Supplements” article here.

How do I get Medicare?

“Section 1: Signing up for Medicare” (pages 15-24)

People get Medicare in different ways. Some are signed-up for it automatically if you are already receiving Social Security or Railroad Retirement. Some people must sign up for it when they turn 65 (or delay it if they are not ready at 65).

This section gives you people to call (Social Security at 1-800-772-1213) and places to visit (online at ssa.gov/benefits/medicare) if you need to sign yourself up.

Other topics covered include, when to sign-up, what to sign-up for, and what does each part cost?

Related Articles:

Hey, Medicare and You 2020, Will Medicare Cover My…?

“Section 2: Find out if Medicare covers your test, service or item” (pages 25-50)

This section lists all Medicare Benefits you will receive if you are signed-up for both Medicare Parts A and B. These benefits are universal, meaning they are the standards of care you will receive whether you are receiving Medicare from the federal government or through a private carrier with a Medicare Advantage Plan.

If you are looking to see if a specific benefit is included in Medicare, this is the section to search for it.

This section also reminds you of what is not included in Medicare, such as Long-Term Care insurance. In addition, Original Medicare does NOT include many services that ARE covered by Medicare Advantage Plans. These include dental care, eye exams, hearing benefits, and fitness programs.

2020 New Offering Alert: One interesting change noted in the Medicare and You 2020 book is that many Medicare Advantage programs are now offering “telehealth” benefits where you can see a provider at home instead of at their facility. The guidebook notes that this is typically beyond what Original Medicare can offer.

Related Article: To see the basics of what Medicare Covers, please see our article “Medicare Parts A B C D.”

What exactly is Original Medicare?

“Section 3: Original Medicare” (pages 51-54)

The Original Medicare section explains how our Federal Health Insurance for Seniors works. If you have Original Medicare, with or without a supplement, you are a beneficiary of a nationalized health care system and the government is the primary payer of your health benefits.

Read this section to learn how that works and how to use your benefits once you are on Medicare.

Related Article: Read “What is Medicare?

What is Medicare Advantage?

“Section 4: Medicare Advantage Plans & other options”

The other option than being on Original Medicare is to be on a Medicare Advantage Plan. In this case, a private insurance company becomes your primary payer and main contact. Medicare Advantage (MA/MAPD) Plans are called “bundled plans” because they combine parts A, B and D to form one “Plan C.”

They often have reduced costs for premium payments, with some of them even offering “$0” monthly premiums. In addition, they often include extra benefits, not included by government Medicare, such as dental, hearing and eye care. “Silver Sneakers” and similar fitness/wellness programs are also often an included benefit.

Related Articles:

What is a Medicare Supplement / Medigap Plan?

“Section 5: Medicare Supplement Insurance (Medigap) policies” (pages 69-72)

Medigap Policy Chart
CLICK HERE to see more about the various Medigap plans and what they offer.

When you opt for keeping Original Medicare (instead of a Medicare Advantage Plan) you will most likely want to pair that with not just a stand-alone drug plan, but also with a Medigap Plan. These plans are also called Medicare Supplement Plans.

They are supplemental insurance plans that pick up paying where Original Medicare leaves off – such as with the 20% coinsurance, co-pays and deductibles.

The government sets the requirements for each supplement plan and then the private insurance companies decide what price they can offer for each plan in each market they are in. These plans are labeled with letters, and offer the exact same benefits no matter what private insurance company you choose.

Related Article: For more information, please read this article on Medicare Supplement Insurance.

What is Part D?

“Section 6: Medicare Prescription Drug Coverage (Part D)” (pages 73-82)

Read this section to learn how Medicare Drug Plans work, where to get one, and when you can get one / switch them.

Remember, that if you opt for a Medicare Advantage Plan, you will most likely have your drug plan included (which is called a MAPD plan).

Related Articles:

Can I get help paying for medical costs?

“Section 7: Get help paying your health & prescription drug costs” (pages 83-88)

The government has set up several ways for Medicare Beneficiaries to get help in paying for their health insurance. Read this section to see if you qualify for the various tiers of assistance.

How can I protect myself?

“Section 8: Know your rights & protect yourself from fraud” (pages 89-100)

The U.S. government understands that health insurance can be confusing, and there are people out there that will try to take advantage of this confusion. Read this section to know how to protect yourself from health care and insurance fraud.

In addition, Section 8 also explains your rights under Medicare and how to make an appeal if you decide your rights have been violated. The Medicare and You 2020 book defines an appeal as “…the action you can take if you disagree with a coverage or payment decision by Medicare or your Medicare plan.”

How do I get my questions answered?

“Section 9: Get more information” (pages 101-112)

Next, if you have questions related to Original Medicare, the handbook offers you the following numbers to call:

1-800-MEDICARE (1-800-633-4227)
TTY users call 1-877-486-2048
Get information 24 hours a day, including weekends

Medicare and You 2020

Additionally, for questions regarding insurance plans like Supplement (Medigap) or Medicare Advantage (MA/MAPD) then we suggested talking to a licensed insurance professional.

If you are lucky enough to live in our headquarters of Nebraska or our neighboring state of Iowa, you can give Carly a call/text or email.

Related Article: Please see our Frequently Asked Questions page, and if you have a question, please leave it in the comments section or email us. Thanks!

What does this word mean?

“Section 10: Definitions” (pages 113-116)

Do you just live to read a good glossary? Well, here you go. You will find here definitions to all the health care and insurance lingo you need to know to navigate your health care effectively.

Related Article: Feel free to look through all our Medicare Articles. They are all listed on this page.

Medicare and You 2020 Handbook Review

We hope our review of the 2020 Medicare and You Book has been helpful.

Our one hope for next year is that the book might be more helpful in pointing beneficiaries towards ways to find LICENSED independent insurance professionals that can help them in making decisions. These agents are the only ones required to stay licensed, tested and up to date on the plans that are out there. Moreover, this applies especially for the Medicare Advantage approved agents as they have to be re-tested every year on changes.

Finally, we are MedicareLifeHealth.com just don’t understand how people can be offering advice on plans – that change yearly – they have not be certified to explain.

Our advice? Find yourself a good agent, and make them work for you.

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Medicare Part A B C D

Medicare Part A B C D

Medicare Parts A B C D Explained

Medicare has four different parts: Medicare Part A B C D. Each of these parts serve a different function in our national health care system for seniors.

As an overview of Medicare:

Here is More Detail on in our Medicare Parts A B C & D Infographic

Medicare Parts A B C D Explained

Original Medicare Components

Parts A & B come together to form “Original Medicare.” We have a detailed article on Original Medicare for you to read here.

If you are interested in the costs associated with Original Medicare Parts A and B, please visit our article “How Much Does Medicare Cost?

Medicare Part A Hospital Insurance Covers

Part A is dedicated to Hospital Insurance and covers care for…

  • Inpatient Hospital
  • Skilled Nursing Facilities
  • Hospice
  • Home Health

When you visit the hospital, Medicare will help you pay for the above services. However, Original Medicare does not pay for all of it. There are copayments, coinsurance, or deductibles may apply to each service. This is why most Medicare Beneficiaries will supplement Original Medicare with either a Supplement (Medigap) plan or a Medicare Advantage Plan.

Remember, Medicare does not cover Long-Term Care costs such as Nursing Home or Assisted Living Expenses.

Medicare Part B Medical Insurance Covers

Part B consists of Medical Insurance and covers the care of…

  • Outpatient
  • Home Health
  • Doctors
  • Health Care Providers
  • Durable Medical Equipment
  • Prevention

Again, Medicare will only cover some of these costs. You will also have copayments /coinsurance / deductibles that accompany these services. We highly recommend finding a Med Sup or Med Advantage plan to help you pay for the extra costs.

Additional Components of Medicare

Now that you understand the components of Original Medicare (Parts A & B), let’s look at the two additional parts of Medicare – Parts D and C – Drug Coverage and Medicare Advantage.

Medicare Part D Prescription Drug Insurance Covers

Part D is regulated by the government but handled by private insurance companies. This part includes care for…

  • Prescription Drugs
  • Covered Vaccines

To learn more about Part D Prescription Drug Coverage, please read our article about it here.

Medicare Part C – Also Known as Medicare Advantage (MA/MAPD)

MA / MAPD Plans are becoming more popular and more accessible to Medicare Beneficiaries all over the United States. Moreover, as more and more people are joining them, they are becoming very affordable options.

These plans offer additional benefits and services to what Original Medicare can offer such as dental benefits, vision benefits and hearing benefits. They also often include wellness benefits such as free gym memberships.

Read this article to learn even more about Medicare Advantage.

Medicare Parts A B C D Further Reading

If you would like the Parts of Medicare explained in even more detail, we shall direct you to our review of Medicare and You 2020. This is a User’s Guide to the government’s Medicare and You 2020 Handbook which has the yearly updates for what is available in the current plan year. In this case, 2020, when our article was published.

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