Category: Medicare Supplements

What is Medicare Plan F?

What is Medicare Plan F?

What is Medicare Plan F?

What is Medicare Plan F - simple answers to medigap questions

You may have heard, but there have been changes with who can get what Medicare Supplement Plans (aka Medigap Plans) now. Plan F and Plan C are not available to people turning 65 on or after 2020. So, you might be wondering, what is Medicare Plan F?

In this quick article, let’s look at what are Medicare Supplements and then specifically, what is Medicare Supplement Plan F.

Medicare Supplement Plans Explained

What are Medicare Supplements_

Medicare Supplement plans are supplemental policies that people can purchase to cover the costs that Original Medicare does not pick up.

There are many different plans to choose from, and they are all labeled with a Plan Letter. In addition, there are many different insurance companies that offer these plans, but they all over the exact same services as what is listed in the letter plan benefits. The only difference from private insurance company to company is the price they can offer in each specific market (area of the country).

Here is a Chart of What Supplement Letter Covers What Services

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

Why People Like Supplements (Medigap)

what is medicare Plan F Pin medigap made easy

People like Medicare Supplement Plans because of their flexibility and their routine costs. First, these plans offer flexibility because they allow beneficiaries to see any providers that accept Medicare in the whole country. Second, Medigap Plans have the same premium charged each month, and plans like F, have no costs other than that for covered services. As a result, Medigap Plans are good for budgeting and knowing what your costs are going to be each month.

Remember, the other option for supplementing Original Medicare covered services is a Medicare Advantage Plan. That is a plan you have INSTEAD OF a supplement (Medigap) plan.

Who is Eligible for a Supplement?

Anyone with Medicare Benefits can apply for a supplement. When you first age into Medicare, you have a window of “Guaranteed Enrollment Eligibility” to get the supplement of your choosing. After that, you will either need a special enrollment option to get into another one, or go through medical underwriting to get a supplement.

You can read more about Medicare Supplements here.

Medicare Supplement Plan F Explained

Medigap Plan F (aka Medicare Supplement Plan F) covers the most amount of services out of all the supplemental plans. So, this means if you have Plan F, you pay your monthly plan premium for the supplement, and then you pay no other costs for Medicare covered services.

As a result, it has been one of the most popular plans. If you take a look at the Medigap Plan chart above, you will see that…

Plan F Covers:

  • Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used
  • Part B coinsurance or copayment
  • Blood (first 3 pints)
  • Part A hospice care coinsurance or copayment
  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible
  • Part B excess charges
  • Foreign travel exchange (up to plan limits – 80%)

People like Plan F for its full coverage and it’s travel coverage both in the states and internationally.

Who Can get Medicare Plan F and Who Cannot?

A while back., the U.S. government passed MACRA bill, or “The Medicare Access and CHIP Reauthorization Act of 2015”, that made changes to who could sign-up for Medicare Supplement Policies that covered the Medicare Part B Deductible. These plans are not “going away,” but not everyone can get them as of January 1, 2020.

Here is who CAN get Plan F still:

  • You CAN get Medicare Supplement Plan F (or keep Plan F) is you turn 65 before January 1, 2020. (Same applies to Plan C.)
  • In addition, you CAN get Medicare Plan F (or C) if you turn 65 on or after January 1 2020, BUT ALSO you have a Medicare Part A Effective Date that started before the year 2020. (One example of this might be someone who was on Medicare prior to turning 65 because of a disability.)
  • You can KEEP your Plan F if you are already on one. It is not going away. However, there might be reasons for you to switch to a Plan G, or another plan that does not have the Part B Deductible covered. The main reason people switch is because the plans that can accept younger people into their pool, often have lower cost increases over time. You can read more about switching to a Plan G here.

Who CANNOT Get Plan F Now:

  • If you turn 65 on or after January 1, 2020, you cannot get Medigap Plan F or C. (Unless you fall into the Medicare Part A Effective Date Category explained above.)

Now, if you are someone who turns 65 after the cut-off, don’t fear. Plan G is the same as Plan F with only one difference: Plan G does not cover the Medicare Part B deductible.

Conclusions

In summary, Medicare Plan F is a robust, comprehensive Medicare Supplement Plan (aka Medigap Plan) that picks up all of the extra costs that Original Medicare does not cover.

Plan F is only available to people who already turned 65 before January 1, 2020. However, this plan is not going away at this time. It is still a popular plan and will continue offer full coverage and service flexibility to its beneficiaries.

Further Reading

What is Medicare Plan F - simple answers to medigap questions

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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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Is Medicare Plan F Going Away?

Is Medicare Plan F Going Away?

Is Medicare Plan F Going Away?

Is Medicare Plan F Going Away?

As a Medicare Health Insurance Agent I hear this question over and over: “Is Medicare Plan F Going Away?” The simple answer is, no, Plan F is not going away. However, not everyone can sign-up for it as of January 2020.

Who Can Still Get a Medigap Plan F?

Medicare Beneficiaries who turned 65 prior to January 2020, are eligible to purchase a Plan F Medicare Supplement. They will either have to have a special enrollment period for guaranteed acceptance, or go through Medical Underwriting to get into a plan.

Who Cannot Get a Medigap Plan F?

Beneficiaries who turn 65 after January 2020, are not eligible to purchase a Plan F Medicare Supplement.

Why Can’t Some People Purchase a Plan F?

Well, the government set a new rule that says anyone that turns 65, on January 1, 2020, or after, cannot purchase any supplement policy that covers the Medicare Part B deductible. This includes Plan F and Plan C.

2020 Part B Deductible

In 2020, the Medicare Part B Deductible is $198.

Click here to read all the 2020 Changes and Updates to Medicare Part B.

Medicare Supplement (Medigap) Plan Chart

Wondering what the difference is in Plan G vs Plan F? Here is a Medicare Supplement (Medigap) Plan Chart to remind you of what letter Plan covers what.

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

Plan G is More Competitive

Is Medicare Plan F Going Away Pin

The good news is that Plan G Medigap Plans are typically much more competitively priced than Plan F’s. Moreover, the only difference between the two plans is Plan F covers the Medicare Part B deductible, while Plan G does not.

Additionally, the Medicare Plan G Supplements are usually still less expensive than Plan F’s even after adding back in the Part B deductible.

Even if you are 65 years old before January 1, 2020, it is a good idea to see if you could save money by switching to a Plan G if you now have a Plan F.

Just know, You will have to pass medical underwriting to switch plans. Plan F’s will not have the ability to add younger (potentially healthier) beneficiaries to their pool. As a result, these plan prices will most likely rise at a faster rate than plans that can add younger people.

Plan F vs Plan G – How do They Work Differently?

Again, the only difference between Medigap Plan F and Plan G, is that Plan F pays the Medicare Part B Deductible and Plan G does not.

Part B pays for Medical Insurance. This includes:

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

Each year, when you use these types of services, you will pay the Part B Deductible ($198 in 2020) first. Then, you will pay no other costs as everything else will be picked up by your supplement.

With Plan G Supplements sometimes being up to $900 a year cheaper, it makes a lot of sense to see if you are eligible to switch to one or start on one.

Medicare Parts A B C D Explained
Click here for our infographic on the 4 parts of Medicare.
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2020 Part B Deductible

2020 Part B Deductible

2020 Part B Deductible for Medicare

2020 Part B Deductible

The 2020 changes for Medicare were released this month. The 2020 Part B Deductible is just one of the increases you will see.

The Centers for Medicare & Medicaid Services (CMS) released their updates for the coming year in a press release – 2020 Medicare Parts A & B Premiums and Deductibles. Let’s look at what is changing.

Part B Deductible for 2020

  • In 2020, the Medicare Part B Deductible will be $198.
  • In contrast, the deductible was 185 for 2019.
  • This is an increase of $13.

Part B Premiums for 2020

  • In 2020, the Medicare Part B Monthly Premium will be $144.60.
  • In contrast, the premium was 135.50 for 2019.
  • Consequently, this is an increase of $9.10.

Why are the Part B Deductible and Premiums Increasing in 2020?

The CMS adjusts the deductibles yearly, in accordance to the Social Security Act. Moreover, the increase reflects national healthcare trends.

In addition, the CMS has stated that the rate hike is mostly due to the increased use and cost of physician- administered drugs. Part B covers Physician-administered drugs.

What Part B Covers

Medicare Parts A B C D Explained

As a reminder, Medicare Part B covers:

  • Physician and Provider Services
  • Outpatient Services
  • Home Health Services
  • Durable Medical Equipment
  • Other non-hospital health services

To learn even more about the parts of Medicare and what they cover, you can see our infographic and discussion here.

Who Pays the Part B Deductible?

  • If you have Original Medicare only, you will pay the Part B Deductible.
  • In addition, if you have a Medicare Supplement that does not cover the Part B Deductible, you will pay it.
  • Some Medicare Advantage Plans have you cover the Part B deductible. This will be stated in your Summary of Benefits. However, 2020 plans have already been released, so deductibles are already set for the new year and will not be affected by this increase.

As of 2020, new beneficiaries to Medicare will not be able to choose a Medicare Supplement Letter Plan that covers the Part B Deductible. For example, Plan F covers the deductible, so seniors new to Medicare in 2020 and beyond will not be able to pick Plan F. Seniors that are already on these letter plans can keep them. Read more about this topic here.

Will the Changes Affect Part C or Part D costs?

No, these deductible and premium increases will not affect Part D Drug Plans or Part C Medicare Advantage Plans. The premium costs and the deductibles have already been set for the coming year. As a result, they are not affected.

According to the CMS press release,

As previously announced, as a result of CMS actions to drive competition, on average for 2020, Medicare Advantage premiums are expected to decline by 23 percent from 2018, and will be the lowest in the last thirteen years while plan choices, benefits and enrollment continue to increase. Premiums and deductibles for Medicare Advantage and Medicare Part D Prescription Drug plans are already finalized and are unaffected by this announcement.

CMS Press Release, Nov 2019

That is extra good news for those on Medicare Advantage Plans that have their deductibles satisfied with their plan. Some Medicare Advantage plans have a zero dollar deductible for their whole plan. These plans bundle Parts A & B and have the option of including the Part B Original Medicare deductible or covering it themselves.

Income Adjustments to Part B Premiums

There are no income related adjustments to the Part B Medicare Deductible. However, there are income related adjustments to your Part B Premiums.

  • First, the standard 2020 Part B premium of $144.60 applies to those with income less than or equal to $87,000 a year ($174,000 joint income).
  • Second, if you claim income between $87,000 and $109,000 ($174k-$218k joint), you will pay $202.40 a month.
  • Third, if you claim income between $109,000 and $136,000 ($218k – $272k joint), you pay $289.20.
  • Fourth, if you claim income between $136,000 and $163,000 ($272k – $326k joint), you pay $376.00.
  • Fifth, if you claim income between $163,000 and $500,000 ($326k – $750k joint), you pay $462.70.
  • Finally, if you have income greather than or equal to $500,000 ($750k+ joint), then you pay 491.60.
  • Click here if you need to see a table for premiums for spouses that file separate returns.

Are there Changes to Part A?

Yes, there are also changes to Medicare Part A. If you have a Medicare Supplement Plan, depending on which Letter plan you have, your supplement will continue to pick up these costs.

If you have a Medicare Advantage Plan, your plans benefits will still apply to you instead of the Original Medicare benefit structure. 2020 plans have already been released, so you will not be affected by these changes.

However, if you have Original Medicare only, you will want to take a look at the Part A changes that affect you here.

Further Reading

If you would like to learn more about Medicare we Suggest the following articles:

This Tool Kit answers your questions regarding Medicare Information, Medicare Supplements, Medicare Advantage, and Prescription Drug Plans. Discover what products are right for you and how to sign-up for them. 

Medicare 101

Read about basic Medicare Information. What is Medicare Part A? Part B? Get answers to your basic Medicare questions.

Medicare Supplements

What is a Medicare Supplement and how do I choose the best one for me? 

Medicare Advantage

What is Medicare Advantage and when is it, and what plans are, best for my situation?

Prescription Drug Plans

When do I need a drug plan and what do I need to look for in a good plan?

Medicare Advantage vs Medicare Supplements

What plan type is best for my situation and what do I need to consider when choosing.

Most Asked Medicare ?s

Answers to your questions and answers to questions you should be asking.

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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?

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.)

does medicare cover hearing aids?

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?

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.

Finally, to learn more about Medicare Advantage Plans – how they work and what they cover – please click here.

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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.

Further Medicare and You 2020 Topic Relevant Reading

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Railroad Medicare Benefits and Choices at MedicareLifeHealth.com

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does medicare cover hearing aids?

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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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5 Biggest Medicare Mistakes

5 Biggest Medicare Mistakes

The 5 Biggest Medicare Mistakes and How to Avoid Them

5 Biggest Medicare Mistakes

No one wants to make a mistake that will cost them hundreds (or thousands) of dollars down the road if they can help it! However, Medicare can be very confusing, and even very knowledgeable people can miss things. Here are the five biggest Medicare mistakes people make, and how you can avoid them!

#1 in Our Biggest Medicare Mistakes: Missing Enrollment Deadlines

Although the government gives us all a little wiggle room around each Medicare Milestone we pass, there are certain deadlines you must mind to avoid late penalties and inconveniences.

Original Medicare Coverage Deadlines

The 5 Biggest Medicare Mistakes and How to Avoid Them Article Pin

You will need to sign-up for Medicare when you turn 65 if you are not already getting Social Security. You will be automatically signed-up for Medicare if you are getting Social Security. In addition, you will need to tell the government if you are delaying Medicare because of other credible coverage (such as an employers coverage).

You will have three months before your birthday to sign-up, the month of you birthday, and then three months after to sign-up. However, what some people do not understand, is that if you enroll after you turn 65, your coverage will not start until the first of the month after you enroll. This could lead to a gap in your health care coverage.

A NOTE ON CREDIBLE COVERAGE: Some people will delay Medicare coverage if they have a good health plan from their employer. This is usually okay, but there is an exception for small business employers to be aware of: If your employer has less than 20 employees, you will need to enroll in Medicare right away when you turn 65.

This is because when you work for a small business, their insurance will become secondary insurance and Medicare will be your primary payer. If this is the case, you will need to enroll right away in Medicare to avoid a penalty. (Also note that Cobra is not credible coverage.)

Medigap Guaranteed Enrollment Deadlines

The last Medicare Enrollment Mistake people make is missing their Guaranteed Enrollment period for a Medigap Plan. You will have six months, from the beginning of the month you first turn 65, to enroll in a Medigap plan with a guarantee to be issued a policy. If you apply after this window, you will have to go through medical underwriting. This means that companies have the right to deny issuing you a policy based on your medical history after your open enrollment is over.

It is important to remember that Medicare Advantage Plans have a different enrollment process than Medigap. The Medicare Advantage Annual Election Period is not for Medigap Plans. Which lead us right into Mistake #2…

Medicare Mistake #2: Not Understanding Medigap Plans vs. Medicare Advantage Plans

There are two main ways you can set up your Medicare Health Care Plan: Medicare Advantage (Part C) and Original Medicare with a Medigap Plan. You either have one or the other, not both. Both can be good ways to set up your health care, but not understanding how they work can lead to making on of our biggest Medicare mistakes.

We have a whole article on Medicare Advantage vs. Medigap Plans here. I suggest reading it if you are unfamiliar with the two plan types. Considerations with these plans include how you get your Prescription Drugs and how you want to budget your money. Cash flow can be different plan to plan with premium payments and out of pocket expenses to consider when making a decision. Your lifestyle needs and travel patterns also need to be considered when making a choice between MA and Medigap.

Mistake #3: Assuming Your Doctors and Drugs are Covered

We all know what assuming can lead to… mistakes! It is very important to make sure that your doctors are covered with the Medicare option you choose. The carrier will be able to help you confirm that you will be able to continue with your current doctor if you so desire. If you are working with an Insurance Agent, they will have the ability to do this for you as well.

Checking your drug options with a plan is also an important part of finding coverage. The government does make sure that at least two kinds of drugs are available per category of treatment. Moreover, carriers will have a process for you to make an exception for a drug not on its list (called a formulary). However, it makes for a smoother transition to check ahead of time to see what is covered for your specific needs.

Biggest Medicare Mistake #4: Assuming Medicare Covers Long-Term Care

What Is Long Term Care Insurance

It is a common mistake to assume that your Medicare coverage includes long term care – it does not. Skilled nursing facilities for recovery from a certain event are covered (and come with different co-insurances based on different plans). However, long term stays in assisted living and nursing homes are not covered. You will need to have a plan in place to cover these needs. Your planning may include:

Another option, for those that do not have a lot of resources saved up for retirement, is to “spend down” your assets to qualify for Medicaid to help you in paying for your care. However, I would not suggest this option for those that have the means to plan ahead for the level of care they desire or those that want to pass money on when they pass.

Biggest Medicare Mistake #5: Enrolling Directly with a Carrier

Ok, follow me on this one. When you first turn 65, you are bombarded with advertisements for different Medicare plans. Sometimes, it feels easiest to just pick up the nearest postcard and give that insurance company a call. Or maybe you have done your research on your own (which is just fine!) and decide to enroll directly with the carrier you want to go with. Here is where you should stop and consider this as a mistake.

Here is the problem: when you enroll with an insurance company for one of their plans directly, you have to deal with them alone. On the other hand, when you enroll with that same company through an independent insurance agent, you now have an advocate and support system to help you work with that carrier.

Here is how an independent agent helps:

  • First, if something goes wrong, you can call your agent for help! You are not on your own, and this is a big deal. As we all know, everyone can make mistakes – you, your doctor’s office, your insurance company. When these mistakes happen, you can call your agent for support and they can work with you and the insurance company to make sure you are taken care of.
  • Second, rates and plans change! A good independent agent will keep on top of industry changes and plan changes for you. They can stay on top of your premium rates and what might be new or changing in your area to make sure you always have the best coverage. You will not get this level of service when you work directly with a carrier.
  • Finally, you do not pay anything extra for working with an independent agent. They are still paid as an independent agent from Whichever company you are placed with at no charge to you.

Medicare Mistakes Summary

In addition to this article, another great resource is the Medicare and You book put out by the government. Since this is a large (120 page) document, we have created a Medicare and You User’s Guide for you to read and reference here.

In summary, you can avoid the biggest Medicare mistakes with a little research and a little help.

Reach out to a professional to answer any of your market specific questions and find out more about Medicare, Medicare Advantage, Medicare Supplements, and their differences here on MedicareLifeHealth.com.

Further Reading:

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