Does Medicare Cover Ambulance Services?

Yes, Medicare covers ambulance services in approved emergency situations. As with all Medicare covered costs, you will pay 20% of the cost of service, unless you have additional coverage.

Let’s break down in more detail – what is covered and how it gets paid for.

Does Medicare Pay for Ambulance Services?

Medicare Part B covers ambulance services. (Part B is medical insurance. To learn more about what Part A and Part B offers, visit this page.)

What does the government describe as covered ambulance services? Well, they include:

• Emergency ground transportation to a hospital (including critical access and skilled nursing facilities)
• Emergency air transportation (via helicopter or airplane) when ground transportation is not available or is not adequate

Does Medicare Cover Non-Emergency Transportation?

No, Medicare does not typically cover non-emergency transportation. For example, you will not be able to get an ambulance to a doctors appointment.

However, there are certain Medicare / Medicaid programs that do offer non-emergency transportation to people who need it. Also, according to CMS (Center for Medicare Services), there are a few instances where Medicare may provide non-emergency ambulance services:

“In some cases, Medicare may pay for limited, medically necessary, nonemergency ambulance transportation if you have a written order from your doctor stating that ambulance transportation is medically necessary. For example, you may need a medically necessary ambulance transport to a dialysis facility if you have End-Stage Renal Disease.”

https://www.medicare.gov/coverage/ambulance-services

What are My Costs with Medicare Ambulance Coverage?

First, it is good to remember that the reason for your ambulance ride must be considered a “Medicare approved” service. Otherwise, your ride might not be covered at all. Also, CMS states that the ambulance can only take you to the nearest medical facility considered appropriate for your needs. (You can read more about it here.)

Next, if you only have Original Medicare Part B, then you will pay the 20% of the ambulance bill that Medicare does not pay. (If you only have Medicare Part A, then ambulance services are not covered. You will need to enroll in Part B to have them covered.)

However, most people have a supplement or a Part C (Medicare Advantage) Plan in addition to Medicare Part A and Part B. Original Medicare works together with your private insurance options to pay for ambulance services. Let’s look at both options and how they cover ambulance rides.

Medigap Ambulance Coverage

Remember that with Original Medicare Part B, the government pays for 80% of the cost of a Medicare covered ambulance ride. You are responsible for the rest, unless you have a Medigap plan. Also known as Medicare Supplement plans, these plans help you pay for the co-insurances, deductibles, and co-pays that Original Medicare does not pay for.

Coverage By Specific Medicare Supplement Letter Plan

In exchange for a monthly premium, Medigap plans will help you pay for some or all of your personal costs of Medicare approved services. The Part B Co-insurances or co-payments are

• Paid in full by Medigap Plans A, B, C, D, F, G and M.
• Plan K pays for 50%;
• L pays for 75%,
• And N pays for all minus a co-pay.

You can read more about the supplement coverage chart in our article: What are Medicare Supplements here.

Medicare Advantage Ambulance Coverage

Medicare Advantage (Part C) plans are private insurance options that “replace” Original Medicare as your only Medicare coverage. They offer everything that Original Medicare offers, and also offer extra benefits are services on top of what is covered in Part A and Part B.

Medicare Advantage plans cover at least what Part B covers for ambulance rides. In addition, they also may cover the 20% that Part B doesn’t cover, but they way they do that is specific to each individual private insurance company.

For example, some Medicare Advantage plans will have a set co-pay for ambulance use, or they may have a percentage they cover. They may also distinguish between air and ground emergency transportation in how they cover costs.

It is important to know that every Medicare Advantage plan has a set max out-of-pocket cost that you can never go above each year. So, for example, if your MA plan had you pay 10% of the cost for air transportation, then you would be responsible for that cost only up to the max out-of-pocket limit set for your plan.

Remember, each Medicare Advantage plan is different, and if you are a MA plan beneficiary, you will need to look at your plan information or “Summary of Benefits” to see how your costs will be covered.

If you want to compare Medicare Advantage vs Medigap plans, you can read more here.

Other FAQ’s

Here are a few other frequently asked questions:

• Does Medicare cover air ambulances?
  Yes, as long as it is a “Medicare approved” service, then it is covered. If you need an emergency air transportation and it is considered a necessary, approved situation, then Medicare will pay for it. Remember, you will be responsible for a 20% co-insurance payment unless you have additional coverage (like with a Medigap or Medicare Advantage plan).
• Does Medicare cover life flight?
  Life Flight or LifeFlight is just a branded name of a company that provides emergency air transportation services. If you use their services for a Medicare approved expense, then it will be covered accordingly.

Conclusions

Yes, Medicare will cover ambulance service for approved and necessary emergency transportation needs. You will still have co-insurance unless you also have a Medicare Supplement Plan or a Medicare Advantage Plan. Do you need help finding coverage in addition to what you receive through Original Medicare (Part A and Part B)? Then please reach out to us.

• If you live in Nebraska, please contact us here.

• If you live anywhere else in the lovely United States of America
  • Read more about Medicare Plans here or
  • Find an agent here.

The post Does Medicare Cover Ambulance Services? appeared first on Medicare Life Health.

Original Medicare Rehabilitation

Rehab, or Inpatient Rehabilitation Care, is part of Medicare Part A or “Hospital Insurance.” To learn more about what Part A covers, click here.

Rehab administered in an outpatient setting or by doctors / medical providers can be covered by Part B when considered necessary by Medicare Standards. One example of a covered program is Cardiac Rehabilitation Programs.

“Medically Necessary”

Original Medicare will pay for part of your rehab in most cases if your care is considered “medically necessary” by CMS (Center for Medicare and Medicaid Services) standards.

According to CMS, medically necessary rehabilitation requires:

• certification by a doctor that you have a medical condition that requires rehab
• continued professional medical supervision
• coordinated care from doctors and therapists

How Many Days does Medicare Pay for Rehab?

If you only have Original Medicare, you will have costs associated with rehab for each benefit period.

• For the first sixty days, a deductible will apply (in 2020, $1,364).
• After that, a $341 coinsurance will apply to days 61-90, and $682 coinsurance from day 91 and beyond.
• Finally, if you are going beyond 91 days in rehab, you will only have 60 more “lifetime reserve days” for coverage. What this means is that Medicare will only cover 60 rehab days total in your lifetime after you hit the 90 benefit period limit. These lifetime days do not start over each year. As a result, if you run out of lifetime reserve days, you will be paying 100% of all costs for rehab when you run out.

For more information on inpatient rehab, please visit this medicare.gov page.

Medicare Supplements (Medigap)

Medicare Supplements are designed to pick up the costs that Original Medicare does not cover (such as deductibles, coinsurance and co-pays.)

Click here to read more about Medicare Supplements.

There are some Medicare Supplements that pick up just about all costs that Medicare does not pay. (As long as they are “covered services.”) You can consult this chart to see what plan pays what.

Medicare Plan F and Plan G offer the most extensive coverage and among the most popular plans.

• Click here to learn more about Medigap Plan F
• Click here to learn more about Medigap Plan G

Medicare Advantage Rehab Coverage

Private insurance companies run Medicare Advantage plans. They are designed to “replace” Original Medicare. They cover at least what Original Medicare covers plus they offer additional coverage and extra benefits and services to their beneficiaries.

• You can learn more about Medicare Advantage here.
• In addition, you can learn about the differences between Medicare Advantage and Medigap Plans here.

Each Medicare Advantage Plan will be different in regard to their Medicare rehab coverage. However, they most often offer additional coverage or a different structure as to how they cover rehab days – both inpatient and outpatient.

Additionally, all Medicare Advantage Plans (also called MA / MAPD plans) are required to have a “max-out-of-pocket” limit for each annual benefit period. This means that you will not pay more than that predetermined amount each year for your covered health services.

Now that we have looked at the various plans and how long they cover rehab, let’s look at a few specific examples that Medicare addresses.

Does Medicare Pay for Physical Therapy?

Sometimes, when people ask if Medicare pays for rehab, they are referring to outpatient physical therapy.

Medicare covers some costs for outpatient physical therapy when it is considered “medically necessary” as we defined earlier in this article.

Medicare Part B helps pay for physical therapy, and if you only have Original Medicare, you will pay 20% of your medical costs.

How Long Does Medicare Pay for Physical Therapy?

According to CMS, “Medicare law no longer limits how much it pays for your medically necessary outpatient therapy services in one calendar year.”

Finally, always remember to make sure that your physical therapy is considered both medically necessary and a Medicare covered service. If it is not, you may end up paying for all of it.

How Long Does Medicare Pay for Cardiac Rehab?

If you have recently had a heart attack or some other cardiac event (see here for more information on what “events“ CMS covers), Medicare will cover most costs for Cardiac rehabilitation programs. These programs usually are covered for as long as they are needed.

Medicare covered costs can include both regular cardiac rehab and “Intensive Cardiac Rehabilitation” Programs (ICR).

According to CMS, programs can address exercise, education and counseling in some form, and can either be held in an outpatient hospital setting or at a doctor’s office.

In regards to costs, just remember…

• Original Medicare will cover 80% of approved medical bill amounts under Part B. (Part B deductibles may apply).
• If you have a Medigap Plan (aka Medicare Supplement) then that plan will pick up additional costs according to your plan’s letter specifications. (See the Medigap chart above or visit our Medigap Page for more information.)
• Or, if you have a Medicare Advantage Plan, your plan will list out how it covers cardiac rehab costs and what your copayments will be, if any.

How Long Will Medicare Pay for Nursing Home Rehab?

If you need rehab that extends beyond a stay as an inpatient at a regular hospital, your doctors may transfer you to a “Long-Term Care Hospital” (LTCH). Long-Term Care Hospital stays are different than living in a Long-Term Care facility (also called a nursing home). They are still considered a hospital setting, so they are covered by Medicare Part A.

Under Original Medicare, your coverage lengths and payment amounts are the same as the inpatient rehab amounts we detailed out above in the section, “How Many Days does Medicare Pay for Rehab?.” Or, you can find them on the government website here.

However, your benefit period does not start over if you are transferred from one hospital to another (including a LTCH). So, you will not have to pay another deductible.

Conclusions

We understand that Medicare rules and costs are often confusing. This is especially true when you are confronted with rehab options. Your coverage lengths and costs will often be different depending on how you have your Medicare coverage set-up.

If you need more help in answering questions regarding your specific plan, you can reach out to your insurance agent or plan directly. If you are looking for an agent, you can contact us for help.

The post How Long Does Medicare Pay for Rehab? appeared first on Medicare Life Health.

Attained Age vs Issue Age

Medicare Supplement Insurance Companies all price their plans differently. One of the biggest differences between plan prices is whether or not an insurance company uses attained age vs issue age to price their Medigap plans.

Background Information: What is a Medicare Supplement?

Medicare Supplement plans, also called Medigap Plans since they cover the gaps in Original Medicare coverage, are issued by private insurance companies.

Click here to read a simple, but comprehensive introduction to Medicare Supplement (aka Medigap) Plans.

Standard Coverages from Each Medicare Supplement Plan

The government tells each company what should be included/covered in each Medigap Letter Plan. As a result, they are standard in coverage. However, the insurance companies can price each plan differently, and each company does so according to its needs in each market (part of the country) they sell in.

Medigap Costs & Pricing Considerations

The way each private insurance company prices its plans has an effect on what the plan will cost you now, and then again down the road as premiums are re-evaluated each year.

Medigap Plans do tend to increase in price each year (some more than others if new people cannot enroll in them, such as Plan F or C).

Shop Your Plan, While You are Healthy

As a result, it is a good idea to shop your Medigap Plan year to year if you are still healthy enough to get medically underwritten into a new plan. (What this means is, switching Medigap plans, when you are not guaranteed to be issued one, is dependent on you being healthy enough for an insurance company to accept you into the new plan.)

• Call an Independent Insurance Agent to see what options are available to you in your area. (Ask about Plan G.)
  
• Call Carly, your Medicare Author and Independent Agent if you life in Nebraska or Iowa. Or if you live elsewhere, find an agent here.

Attained Age vs Issue Age vs Community Rated Pricing

Remember, when you are comparing private insurance companies plans, pricing is the only difference between letter plans. The coverage is the same for each letter plan, and set by the government, so pricing is your biggest consideration.

Additionally, you need to consider HOW the plan is priced, not just WHAT each plan costs. The way each plan is priced will affect how the price changes year-to-year.

There are three ways that insurance companies can price their Medigap Plans: Attained Age, Issue Age, and Community Rated Pricing.

Attained Age Pricing of Medigap (Medicare Supplement) Insurance Plans

Attained Age Plans are priced (or rated) based on your current age.

Medigap plans that use this pricing are based on your attained age. Your plan price rises as you get older. Premiums might start lower for younger beneficiaries on these plans, but when they hit certain ages set by the plan, their premiums will increase.

Attained age plans can also go up because of other factors (such as inflation or company actuarial assessments.)

Issue Age Pricing of Medigap Plans

Issue Age Rated Policies (or “entry age-rated”) have premiums based on the age you are when you purchase your plan. Or, as CMS puts it, when you are “issued” the plan. For example, when buying a new plan, a 70-year-old beneficiary will pay more for the same plans as a 65-year-old beneficiary.

This means that the younger you are when you buy this kind of policy, the less you will pay for it. In addition, the policy will not go up in price as you age, because of your age. It may go up for other reasons, but not because of your age.

Community Rated Pricing of Medigap Plans

The CMS (Centers for Medicare and Medicaid Services) and private insurance companies sometimes call Community Rated Plans “no-age-rated” plans, as their pricing has nothing to do with the age of their beneficiaries.

The price of the plan is not dependent on your age. If the plan goes up, it is not because your age went up. The increase in price may have been dependent on other factors (such as inflation).

Other Pricing Considerations

Insurance companies have other ways to raise or lower their Medigap Plan prices. According to CMS, these include:

• Plan discounts like household discounts, smokers ratings, or payment processing discounts.

• Discounts for people that apply through medical underwriting versus being a guarenteed issue.

• Using “Medicare Select” network providers in certain types of plans.

• Choosing “high-deductible” versions of specific Medigap letter plans.

Conclusions and Actions

In conclusion, since each private insurance company can price their plans differently, it is important to ask how your current supplement is priced or supplements you are considering are priced.

The pricing structure affects not only what you are paying now for your Medigap plan, but what you will also be paying in future years.

Again, call Carly, your Medicare Author and Independent Insurance Agent if you life in Nebraska or Iowa. Or if you live elsewhere, find an agent here.

Further Reading

• Read this article, if you need guidance on deciding what Medicare Plan type is right for you.

• Start here, if you need to learn the basics of Medicare, who can get it, and what it covers.

• Need to know how to apply for Original Medicare? Read this.

• Need Part D Coverage Information? Read this article on Prescription Drugs Coverage.

• Finally, start with this article, if you want to read the differences between the two paths of Medicare: Medicare Advantage vs Medigap.

The post Attained Age vs Issue Age appeared first on Medicare Life Health.

When people talk about Medicare Plan G, they are referring to the Medicare Supplement Plan G. It can also be called a Medigap Plan G. Plan G is on its way to becoming the most popular Supplement Plan.

2020, is the first year that people newly aging into Medicare cannot choose a supplement that covers the Medicare Part B Deductible. This included Plans F and Plan C. However, people who have already turned 65 before January 1, 2020 can still choose a plan F or C at any point going forward. They are considered “grandfathered in.”

Although, people age 65 before January 1, 2020 can still choose a Plan F or Plan C, it doesn’t mean that they should. These plans may get more expensive at a faster rate since they cannot enroll younger beneficiaries into them going forward. It makes sense then for everyone to learn about Plan G and all the other plans that are still available to everyone in Medicare.

What Does Medicare Plan G Cover?

Medicare Plan G is a Medigap Plan. This means it picks up the charges and fees that original Medicare does not cover.

Here is a list of the charges and fees that Plan G 100% covers, where Original Medicare leaves off:

• Part A Coinsurance
• Medicare Part A Deductible
• All Part B Co-payments and Coinsurance
• Medicare Part B Excess Charges
• The First 3 Pints of Blood
• Foreign Travel Emergencies (up to plan limit)
• Hospice Care Coinsurance
• Skilled Nursing Facilities Coinsurance

What Does Medicare Plan G Not Cover?

• What Plan G does not cover is the Medicare Part B Deductible. As of 2020, no one aging into Medicare on or after January 1, 2020, can apply for a supplement that covers the Part B Deductible.

Why? Well, the U.S. Legistlature passed a bill called the MACRA bill, or “The Medicare Access and CHIP Reauthorization Act of 2015”, that said so. It is a small attempt to keep Medicare costs lower for tax payers and assure our system is sustainable for future generations. Will it be enough? Who knows, that is beyond this article.

Plan G vs Plan F

The only difference in coverage between Medigap Plan F vs Plan G is the Part B Deductible. (Click here to learn more about 2020 Fees and Changes to Medicare Part B.)

Plan F and Plan G both have the most extensive coverage out of all the Medigap Plans. They cover 100% of the costs that Medicare leaves behind (minus the Part B Deductible for Plan G).

Even though this is the only difference between these two plans, Plan G’s will often be much less expensive to buy than Plan F’s – even after you take the Part B Deductible into consideration.

Why? The reason for this is mostly due to the fact that Plan G’s can enroll newer, younger (and hopefully, healthier) Medicare Beneficiaries into their plans. In contrast, Plan F’s will now have a shrinking pool of people to choose from as people age.

Plan F’s are not going away, as many millions of Medicare Beneficiaries still have them, but they may have steeper price increases each year – relative to other plans.

Conclusions and Actions

In summary, Medicare Plan G is a good replacement for Plan F, and offers the most comprehensive Medicare coverage available to people just now aging into Medicare.

Remember, Plan F is only available to people who already turned 65 before January 1, 2020. However, people in Plan F might benefit from seeing if they can get Medically underwritten into a Plan G as its premiums might be cheaper. In addition, Plan G’s premiums will most likely raise at a slower pace than Plan F’s as G can enroll new people.

The post What is Medicare Plan G? appeared first on Medicare Life Health.

Medicare Part B Excess Charges are important to understand when you are deciding what Medigap Plan (Medicare Supplement) to get.

Every once-in-a-while, we hear from a client that is confused about a doctor’s bill. They are confused that there is a fee they need to pay that Medicare didn’t cover that they thought was covered by Medicare. Moreover, they have a supplement, that they believe should have also picked up the rest of the cost.

Often times, this fee turns out to be an “excess charge.” Let’s see what this means.

Excess Charges in Medicare Defined

Excess Charges are amounts of money charged by doctors or other healthcare providers above what Medicare has stated it will pay for a specific service. In other words, the amount of money charged above the Medicare approved amount is the excess charge.

Basically, your doctor or healthcare provider is more expensive for a particular service than the Medicare approved reimbursement. If this is the case, you either have to pay the excess fee out-of-pocket, or you might have the fee picked up by your Medigap (aka Supplement) plan.

Medicare Supplements and Excess Charges

Beneficiaries of the Medicare Healthcare System use Medicare Supplements to pick up the costs that Original Medicare does not pay. (Medicare picks up 80% and beneficiaries pick up 20%, unless they have a supplement or a Medicare Advantage Plan.) These costs include co-payments, co-insurance and deductibles. Medicare

Supplements pay some or all of these extra costs, depending on what plan you get.

What Medigap Plans Cover Excess Charges?

Plan F and Plan G Cover Excess Charges.

• If you have aged into Medicare before 2020, you can pick either Plan F or Plan G. The only difference between Plan F vs Plan G, is G does not cover the Medicare Part B Deductible.
• If you age into Medicare after 2020 (i.e. your 65th birthday is on or after January 1, 2020) then you cannot get Plan F. Plan G would then be your only option for a plan that covers Part B excess charges.
• To read more about why this birthday cut off exists, please read this article.

All other plans do not cover excess charges. If you have any of the other Medicare Supplement (Medigap) Plans, you will be responsible for paying excess charges.

Is My Service or Procedure Covered by Medicare?

If you are trying to figure out if your needed service or procedure is part of Medicare’s covered services, and/or how much is covered, then start with the Medicare.gov web-page here.

Medicare Advantage & Excess Charges

If you have a “Part C” Medicare Advantage (MA / MAPD) Plan, then excess charges do not apply to you. Medicare Advantage Plans basically replace Original Medicare and cover all of the services they are required to, plus many have additional coverage and benefits.

Your specific Medicare Advantage plan costs will be outlined by your private insurance company. So, you will know exactly what is covered and what costs you are responsible for according to your plan. In addition, your plan may have a network of doctors that have negotiated rates with your plan, so excess charges may not even be relevant to your MA set-up.

Further Reading:

• Medicare Supplements vs Medicare Advantage

• How to Choose a Medicare Plan

• How to Apply for Medicare

• What is Medicare Plan F?

• What Medicare Part B Covers & Costs

• 5 Biggest Medicare Mistakes

The post What are Part B Excess Charges? appeared first on Medicare Life Health.

Applying For Medicare Overview Infographic

Applying for Medicare – Parts A & B

Let’s get right to it! If you are ready to enroll in Medicare, there are three ways to do it: in person, online, or by phone. Alternatively, if you are already on Social Security before you turn 65, your enrollment will be automatic.

(Read our FAQ’s below if you still need to determine if you are ready to enroll, or to see if you enrollment is automatic.)

Medicare Enrollment Preparation

Before you head over to apply in person, online or by phone, you might want to gather the necessary documents needed to apply.

The SSA has created a helpful checklist of what you will need to apply for Medicare. You can find it here.

How to Apply for Medicare in Person

For those that are not automatically enrolled (still working or not taking social security yet on your 65th birthday) you will need to enroll yourself. Your first option is to do this in person.

While appointment wait times in the SSA lobby can make this a longer application process, it is often the fastest way to get your benefits started. For example, I will have clients that walk into the SSA office needing their Part B instated, and leave the office that same day with their benefits active. If you are in a time crunch (i.e. sudden retirement via layoff!) this is the fastest way to get your benefits in place.

In addition, if you run into any problems or concerns with your enrollment process, visiting Social Security in person might also be the fastest way to resolve any issues.

Click here to find a Social Security Office Near You
to Apply for Medicare in Person.

How to Apply for Medicare Online

The Social Security Administration (SSA) has partnered with CMS (The Centers for Medicare and Medicaid Services) to offer you an online enrollment option. It is a fast process (about ten minutes) and is safe and secure.

____________________

Click here to be directed to the Social Security Website for Online Medicare Enrollment.

If you are retiring and need both Social Security Benefits and Medicare, you can complete one application for both here.

____________________

According to the Social Security Administration, when you apply for benefits online, you will get a receipt. Moreover, you will have the ability to check the status of your application with the confirmation number on your receipt. This is a big benefit to applying online, but if you prefer, you have one more enrollment option: phone.

How to Apply for Medicare by Phone

Finally, you can apply for Medicare by phone. However, this is the slowest option, as you will likely have to use “snail mail,” the U.S. postal system that is, to receive and send paperwork.

If you decide to enroll by phone, just understand that it will take a while. Confirm with the SSA representative you are talking with that you will have enough time to complete enrollment this way. It is important to have your benefits in place in time for when you need them so you are not without coverage.

To apply for Medicare by phone, call
1-800-772-1213. (TTY 1-800-325-0778)
from 7 AM to 7 PM Monday through Friday.
(Source: SSA website.)

Enrollment in Medicare Part D

Next, you may be wondering, how do I enroll in Medicare Part D – Prescription Drug Coverage?

Part D is actually run by Private Insurance Companies, not the CMS (Center for Medicare and Medicaid Services). For this reason, you will need to enroll in a Prescription Drug Plan (Part D) separately from your enrollment in Original Medicare Parts A and/or B.

You can only enroll in a Part D plan if:
– You are in your Initial Enrollment Period (IEP)
– Have a Special Enrollment Period (SEP)
– Or are in the Annual Enrollment Period (AEP) – Oct. 15 – Dec 7

How to Apply for Medicare Part D

To enroll in a Part D, Drug Plan, we highly suggest working with an agency, either online, by phone or in person, instead of just doing this on your own.

The main reasons we suggest using an agent, is…

1. First, if you ever have a problem with your policy, you can call your agent for support and they can talk to the carriers with you and for you.
2. Second, the Part D drug plans change often, and your agent will have the ability to stay on top of changes and premium rates. They can make sure you always have the best coverage and costs for your unique situation.
3. Finally, like we saw in 2019, there are sometimes issues with policy comparison technologies. An independent agent can help you compare plan information correctly.

How to Apply for Medicare Advantage & Medigap Plans

After you enroll in Original Medicare, you will need to decide if you want:

• Original Medicare + A Supplement + Part D Drug Plan
• Or a Part C Medicare Advantage Plan (includes Parts A, B, & D)

There are benefits to going both routes, and you will need to decide which plan fits your needs the best. We do advise seeking the help of a licensed, independent insurance agent to help you in your decision making process. Moreover, your agent can then help you to enroll in your plan and be your support into the future.

In the meantime, here are some articles to help you decide which Medicare Plan is best for you:

How to Choose a Medicare Plan	What is Medicare Advantage	What are Medicare Supplements

Medicare Enrollment Frequently Asked Questions (FAQ’s)

When Can I Apply for Medicare?

The Initial Enrollment Period (IEP): You will have a seven month window to apply for Medicare if you are not already on Social Security or Railroad Retirement Benefits. (Remember, if you are on Social Security/Railroad Benefits, you will be automatically enrolled.)

Your Seven Month Enrollment Window:

• Starts 3 Months Before Your 65th Birthday Month
• Continues Through Your Birthday Month
• And Then Lasts Until 3 Months After Your Birthday Month

During this time, you will need to apply for Parts A & B from the SSA or RRB (Social Security Administration or Railroad Retirement Board) and then decide if you want a stand alone Part D with a Supplement, or a Medicare Advantage Plan.

How Do I Enroll in Medicare Easy Pay?

Medicare Part B does cost money. You will pay a monthly premium for your Part B benefits. To see how to set up automated payments with Medicare Easy Pay, please click here.

How to Apply for Medicare Without Claiming Social Security?

You have access to Medicare at age 65, whether or not you decide to claim your social security benefits. You can do this in person, by phone, or online here.

How to Avoid Late Penalties

To read extensively about Medicare Late Enrollment Penalties, please read this article. In summary,

Part A – If you have to pay for Part A, and you don’t sign-up for it when you are first eligible, there is a late enrollment penalty: Premium price increase of 10% for “twice the number of years you could have had Part A, but didn’t sign up.” 

Part B – If you do not sign-up for Part B when you are first eligible, there is an even steeper late enrollment penalty: Standard premium price increase of “10% for each full 12-month period that you could have had Part B, but didn’t sign up for it,” for as long as you have Part B.

From https://medicarelifehealth.com/medicare-penalties-for-late-enrollment

To avoid these penalties, make sure you apply for Medicare during your Initial Enrollment Period (IEP) if you are not automatically enrolled through SS or RRB benefits.

What if you have health care with your employer at 65?

Make sure your employer’s insurance is considered “credible coverage.” Then, if it is you will let the government know you will be delaying your use of Medicare Part B until that coverage ends. (Part A does not cost you anything in most cases, so starting Part A when you are eligible is always a good practice, even with employer coverage. In this case, you would not have a penalty when you eventually begin Part B.

Dual Eligible? How to Apply for Medicare & Medicaid

People who meed the low income levels set by CMS may be eligible for both Medicare and Medicaid. If you are eligible for both programs, you have special plans that help to coordinate your care and make things easier to manage. Please contact an independent insurance agent to see what plans are available to you in your area.

The post How to Apply for Medicare appeared first on Medicare Life Health.

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

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

Why People Like Supplements (Medigap)

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.

• To start, you can read more about Medicare Advantage Plans here.
• Then, you can read more about Medigap vs Medicare Advantage.
• Or, you can read how to choose the right plan for you, here.

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.

For example, Medicare Supplement Plan F is one of only two Medigap plans that covers Part B Excess Charges (read more about this here.)

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.

Since every private insurance company offers the same coverage for each letter plan, it is important to understand and compare pricing. To learn how insurance companies price plans, read this article.

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.

• You can read more about how this can save you money on premiums here.
• You can also read more about the 2020 changes to Medicare Part B’s Deductible here.

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.

• If you need help in choosing a Medicare Supplement, including Plan F vs. Plan G, please contact us here if you live in NE or IA.

• If you live in any other state, please click here to find an agent near you.

Further Reading

How to Dispose of Old Medications

How to Dispose of Old Medications Do you have a stash of old or expired medications? Are you concerned about ...

Read More

Does Medicare Pay for Dentures

Does Medicare Pay for Dentures? One frequently asked question we get is "Does Medicare pay for dentures?" The short answer ...

Read More

Is Acupuncture Covered by Medicare

Is Acupuncture Covered by Medicare Is acupuncture covered by Medicare? Only if you have chronic low back pain as defined ...

Read More

What Does Medicare Cover?

What Does Medicare Cover? The Most Frequently Asked Medicare Coverage Questions This is a quick directory answering what Medicare will ...

Read More

Does Medicare Cover Chiropractic Care?

Does Medicare Cover Chiropractic Care / Services? Yes, when deemed medically necessary, Medicare does cover chiropractic services. Original Medicare Part ...

Read More

Does Medicare Cover Cataract Surgery

Does Medicare Cover Cataract Surgery? Yes, Medicare covers cataract surgery. Medicare Part B covers the costs associated with cataract surgery ...

Read More

Medicare Part B Premium 2021 Changes

Medicare Part B Premium 2021 The Center for Medicare Services has announced the costs of Medicare Part B Premium 2021 ...

Read More

Does Medicare Cover Ambulance Services?

Does Medicare Cover Ambulance Services? Yes, Medicare covers ambulance services in approved emergency situations. As with all Medicare covered costs, ...

Read More

Best Hearing Aid Alternatives

Best Hearing Aid Alternatives Hearing aids are expensive. We are talking thousands of dollars, sometimes even with insurance. In addition, ...

Read More

HMO vs PPO Which is Better?

HMO vs PPO Which is Better? Insurance has changed a lot over the last 20 years, and there is no ...

Read More

How Long Does Medicare Pay for Rehab?

How Long Does Medicare Pay for Rehab? How Long Does Medicare Pay for Rehab? It depends on what Medicare Plan ...

Read More

Does Medicare Pay for Stem Cell Therapy?

Does Medicare Pay for Stem Cell Therapy? When does Medicare pay for stem cell therapy? The answer is: in a ...

Read More

What is MAPD?

What is MAPD? There are a lot of acronyms in Medicare, and even more in insurance. We know, it can ...

Read More

Attained Age vs Issue Age

Attained Age vs Issue Age Medicare Supplement Insurance Companies all price their plans differently. One of the biggest differences between ...

Read More

What is Medicare Plan G?

What is Medicare Plan G? When people talk about Medicare Plan G, they are referring to the Medicare Supplement Plan ...

Read More

What are Part B Excess Charges?

What are Part B Excess Charges? Medicare Part B Excess Charges are important to understand when you are deciding what ...

Read More

How to Apply for Medicare

How to Apply for Medicare (An Ultimate Guide) With so many rules, regulations, exceptions and unique situations, Medicare enrollment can ...

Read More

How Much Does an MRI Cost?

How Much Does an MRI Cost? There is nothing worse than getting a hospital bill with an unexpected number on ...

Read More

The post What is Medicare Plan F? appeared first on Medicare Life Health.

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.“

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.

How are the programs similar?

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.

Both Medicaid and Medicare Advantage Plans can be set up as managed care plans with networks of doctors and hospitals members have access to. If you would like to learn more about how these networks work, please read, HMO vs PPO – Which is Better?

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.

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 with Medicaid or need to enroll in Medicaid only, then contact your state agency directly.

• If you need help enrolling in Medicare, then you can contact CMS and Social Security in the following ways:
  • BY PHONE: If you need to sign-up for Medicare, you can call Social Security at 1-800-772-1213.
  • ONLINE: Additionally, you can also visit CMS online at ssa.gov/benefits/medicare if you need to sign yourself up.
  • RAILROAD: Finally, if you are on Railroad Retirement 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 3 months before you turn 65 even if you are not planning on retiring at 65. You can read more about Railroad requirements in our article here.

• 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.
  • You can contact your author Carly Cummings here, for assistance if you live in Nebraska or Iowa.
  • Or, if you live in all other 48 states, you can find an agent in your area here.

Further Helpful Reading

How to Dispose of Old Medications

How to Dispose of Old Medications Do you have a stash of old or expired medications? Are you concerned about how to dispose of old medications? There are a lot ...

Read More

Does Medicare Pay for Dentures

Does Medicare Pay for Dentures? One frequently asked question we get is "Does Medicare pay for dentures?" The short answer is NO. Teeth are important part of your health. However, ...

Read More

Is Acupuncture Covered by Medicare

Is Acupuncture Covered by Medicare Is acupuncture covered by Medicare? Only if you have chronic low back pain as defined by Medicare. Let's look at what that means and what ...

Read More

What Does Medicare Cover?

What Does Medicare Cover? The Most Frequently Asked Medicare Coverage Questions This is a quick directory answering what Medicare will and will not cover. We will list out frequently asked ...

Read More

Does Medicare Cover Chiropractic Care?

Does Medicare Cover Chiropractic Care / Services? Yes, when deemed medically necessary, Medicare does cover chiropractic services. Original Medicare Part B pays for 80% of the cost of chiropractic services ...

Read More

Does Medicare Cover Cataract Surgery

Does Medicare Cover Cataract Surgery? Yes, Medicare covers cataract surgery. Medicare Part B covers the costs associated with cataract surgery. This includes if you need corrective lenses as a result ...

Read More

Medicare Part B Premium 2021 Changes

Medicare Part B Premium 2021 The Center for Medicare Services has announced the costs of Medicare Part B Premium 2021. In addition, they have announced the changes to Part A ...

Read More

Does Medicare Cover Ambulance Services?

Does Medicare Cover Ambulance Services? Yes, Medicare covers ambulance services in approved emergency situations. As with all Medicare covered costs, you will pay 20% of the cost of service, unless ...

Read More

Best Hearing Aid Alternatives

Best Hearing Aid Alternatives Hearing aids are expensive. We are talking thousands of dollars, sometimes even with insurance. In addition, they may be overkill for the amount of hearing support ...

Read More

HMO vs PPO Which is Better?

HMO vs PPO Which is Better? Insurance has changed a lot over the last 20 years, and there is no better example than the way we define and use provider ...

Read More

How Long Does Medicare Pay for Rehab?

How Long Does Medicare Pay for Rehab? How Long Does Medicare Pay for Rehab? It depends on what Medicare Plan you have. Medicare often pays for at least part of ...

Read More

Does Medicare Pay for Stem Cell Therapy?

Does Medicare Pay for Stem Cell Therapy? When does Medicare pay for stem cell therapy? The answer is: in a limited amount of cases. Stem cell therapy is still controversial ...

Read More

What is MAPD?

What is MAPD? There are a lot of acronyms in Medicare, and even more in insurance. We know, it can get very confusing when you are not hip to the ...

Read More

Attained Age vs Issue Age

Attained Age vs Issue Age Medicare Supplement Insurance Companies all price their plans differently. One of the biggest differences between plan prices is whether or not an insurance company uses ...

Read More

What is Medicare Plan G?

What is Medicare Plan G? When people talk about Medicare Plan G, they are referring to the Medicare Supplement Plan G. It can also be called a Medigap Plan G ...

Read More

What are Part B Excess Charges?

What are Part B Excess Charges? Medicare Part B Excess Charges are important to understand when you are deciding what Medigap Plan (Medicare Supplement) to get. Every once-in-a-while, we hear ...

Read More

How to Apply for Medicare

How to Apply for Medicare (An Ultimate Guide) With so many rules, regulations, exceptions and unique situations, Medicare enrollment can get confusing. We are here to make it simple and ...

Read More

How Much Does an MRI Cost?

How Much Does an MRI Cost? There is nothing worse than getting a hospital bill with an unexpected number on it. So, if your doctor says you need an MRI, ...

Read More

What is Medicare Plan F?

What is Medicare Plan F? 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 ...

Read More

Medicare Easy Pay

Medicare Easy Pay - What is it & How do I get it? Medicare Easy Pay is the automatic payment system set up by CMS to pay your Medicare Premiums ...

Read More

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 ...

Read More

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, ...

Read More

Renew Active vs Silver Sneakers

Renew Active vs Silver Sneakers Does it sometimes seem like Medicare and Insurance companies are trying to make things as complicated as they possibly can? Just when you think you ...

Read More

What is Silver Sneakers?

What is Silver Sneakers? 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 ...

Read More

What Medicare Part A Covers

What Medicare Part A Covers Here is what Medicare Part A Hospital Insurance covers: Inpatient Hospital CareSkilled Nursing CareStays at Skilled Nursing Facilities (short-term)Home Health CareHospice Care In addition: Part ...

Read More

What is the Medicare Donut Hole?

What is the Medicare Donut Hole? The Medicare Donut Hole (or Doughnut Hole) is a coverage gap in the Part D Prescription Drug Plan where beneficiaries could pay more for ...

Read More

2020 Part B Deductible / 2021 Part B Deductible

2020 Part B Deductible / 2021 Part B Deductible for Medicare The 2021 changes for Medicare were released this month. The 2021 Part B Deductible is just one of the ...

Read More

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? ...

Read More

Medicare Open Enrollment

Medicare Open Enrollment Medicare Open Enrollment runs from October 15th to December 7th. These are the same dates every year. What is Medicare Open Enrollment? Also called AEP - Annual ...

Read More

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 ...

Read More

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 ...

Read More

Medicare and You 2020 & 2021

Medicare and You 2020 & 2021 Guidebook - Read This First Your Introduction to the Medicare and You 2020 & 2021 Book, and where to get a copy. The Medicare ...

Read More

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 ...

Read More

Medicare For All Explained

Medicare For All Explained The Presidential Debates have started, and once again, the rising costs of health care is a hot topic. You will hear people (like Bernie Sanders and ...

Read More

5 Biggest Medicare Mistakes

The 5 Biggest Medicare Mistakes and How to Avoid Them No one wants to make a mistake that will cost them hundreds (or thousands) of dollars down the road if ...

Read More

How Much Does Medicare Cost?

How Much Does Medicare Cost? Medicare costs can be different person to person, depending on which type of plan you choose. After you have a basic understanding of Medicare and ...

Read More

Using an Independent Medicare Insurance Agent

Should I Use an Independent Medicare Insurance Agent? When it comes to making decisions on and signing up for Medicare health care planning, you will have a few paths to ...

Read More

Medicare Penalties For Late Enrollment

What are the Medicare Penalties for Late Enrollment? There are two main Medicare penalties for late enrollment to be aware of when you are planning your health care in retirement ...

Read More

What is AEP? Medicare’s Annual Enrollment Period

What is AEP? Medicare's Annual Enrollment Period AEP stands for Annual Enrollment Period. It is the time of year when Medicare Beneficiaries can switch or enroll in Medicare Part D, ...

Read More

Medicare Questions “FAQ’s”

The Most Frequently Asked Medicare Questions (FAQ's) & Answers Once you are familiar with the basics of Medicare, these are the Medicare questions we hear the most often that you ...

Read More

Part D Prescription Drug Plans

Medicare Part D Prescription Drug Plan Information Part D of Medicare covers Prescription Drugs. There are different Part D Prescription Drug Plans available. When you choose a plan you will ...

Read More

Medicare Advantage vs Medicare Supplement

Medicare Advantage vs Medicare Supplement (Medigap): What Medicare Plan is Best for Me? I am a firm believer that there is a good Medicare health plan out there for everyone ...

Read More

What is Medicare Advantage

What is Medicare Advantage? In this article, we look at what is Medicare Advantage (aka Medicare Part C). As we discussed in our Medicare 101 Post, there are two different ...

Read More

What are Medicare Supplements?

What are Medicare Supplements? What are Medicare Supplements? First, Medicare Supplements have many names: Medigap Policies, Med Sup, Medicare Supplement Insurance. However, they all refer to the optional insurance coverage ...

Read More

What is Medicare?

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 ...

Read More

The post Medicare and Medicaid Difference Guide appeared first on Medicare Life Health.

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.

Need Some Background Information? Please Read:

• What are Medicare Supplement Plans?
• What is Medicare Plan F?
• Medicare Supplements, aka Medigap vs Medicare Advantage
• What do I get with Original Medicare?

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.

In 2021, the Medicare Part B Deductible is $203..

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.

Plan G is More Competitive

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 G and Plan F, 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.

The post Is Medicare Plan F Going Away? appeared first on Medicare Life Health.

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.

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?

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.

The post What is Silver Sneakers? appeared first on Medicare Life Health.