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.
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.
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.)
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.
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.
Traditionally, Medicare covers about 80% of Medicare approved services. As a result, Medicare Beneficiaries are either left to cover the other 20% by themselves, or to supplement their Medicare insurance with an additional plan.
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.
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.
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.
How to Choose Which Supplement and Which Insurance Company
Each private insurance company will offer the same coverage for each letter plan. However, each company will offer different prices for different markets. For this reason, we recommend you speak to an independent insurance agent to discover what is available to you in your area of the country.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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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.
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.
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.
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.
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.
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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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.
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.
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.
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.
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.
Click here for our infographic on the 4 parts of Medicare.
Welcome to the ultimate guide to caring for elderly parents and/or grandparents. Aging is a natural part of life, and everyone should have a care plan for themselves and their aging loved ones. This guide helps you make the tough decisions to keep your loved ones safe and happy.
I personally know what it is like to live with elderly loved ones and care for them. I lived with my grandparents right before their health declined enough to move them to assisted living. It was the hardest year of my life. However, it was also rewarding to care for them after all of the years they cared for me.
This guide leads you through the decisions you will need to consider to help your elderly parents.
We will cover:
Where can my aging parents/grandparents safely live?
What services and products can keep them safe and happy?
How can I help them with health care and insurance?
Who should be in charge of their finances?
Where can I go for support?
Where can my loved ones safely live?
Helping your elderly parents or grandparents decide where they should live can be very emotional. This is true for all the people involved. The options range from staying at home to full-time care, and everything in between.
Senior Living Options
Living at Home – Options exist for helping your seniors live at home as long as possible.
There are non-medical care-giving services such as Home Instead and Right at Home. They provide help around the house and companionship, but not medical care.
The medical alert devices listed in the services in the next section also help give seniors and you peace of mind in regards to their safety. These are good for the home environment, as well as running around town.
Retirement Community / Apartment or Condo – Often times seniors will want to move to a retirement community or 55+ apartment or condo building. Seniors like the social aspects of these communities. In addition, there are add conveniences and informal safety networks in place to give everyone peace of mind.
Assisted Living – For seniors that need a level of care below the nursing home, assisted living is a great option. However, these homes can be expensive. There are not always spots open for low income or Medicaid beneficiaries.
Memory Care Centers – Dementia and Alzheimer’s is a growing disease in America. As a result, we see more centers and homes dedicated to residents with memory issues.
Nursing Homes and Long-Term Care – The last stop on the list is the nursing home / long-term care facilities. There are both private and public options in most cities, but it takes a lot of research to make sure you are finding the best fit for your loved one.
What services / products can keep elderly loved ones safe and happy?
Especially if your loved ones are living at home, there are different products and services that can give everyone peace of mind. These include aides to help with daily activities, as well as alert / check-in services.
Products to Keep Your Loved Ones Safe & Happy
We love products that keep seniors happy, independent and safe. Happily, more creative and innovative options exist that ever to make life easier. We are constantly on the hunt for life-improving and safety-enhancing innovations.
For now, you can start by looking at our senior gift lists.
We love the idea of thoughtful and helpful house warming gifts for seniors that are making a move. Especially if this move was out of necessity. A little love and thought goes a long way with these big transitions.
We all worry about falls and accidents. The elderly often experience a decline in balance and strength with each passing year. There are a few options out there of companies that will monitor your loved ones and give them the help they need in case of a fall. When we look at companies to refer you to, we look for ones with good customer service, customization options and no long-term contracts.
Here are our Top Senior Monitoring Picks:
MobileHelp – Provides an alert system that works with a “Fall Button” that can automatically detect when a fall occurs. This company gets almost 5/5 stars in most consumer review panels. Learn more here.
LifeFone – Is our other top pick for Medical Alert Systems. It also is rated very highly and offers a free trial period. Spouses are also included in their standard pricing, which makes it a good choice for couples.
Iamfine – As a different kind of monitoring service, Iamfine is a daily call service that checks in with your loved ones by phone. If they fail to answer after a few attempts, Iamfine will alert your “care circle.” The service has a free 2 week trial period as well.
How can I help elderly parents with health care and insurance?
If your loved one is either older than 65 or disabled, they probably qualify for the Medicare program. In addition, if they are living on a very small income, they could also qualify for Medicaid.
From a high level view, your loved one will need to choose if they want their Medicare coverage to be bundled with a Medicare Advantage Plan or to be put together with Original Medicare, a Supplement and a Drug Plan. These are the two paths to choose from.
Let’s back up now, and break down the parts of Medicare. We want you, the caregiver, to feel as comfortable and knowledgeable as possible when helping your seniors make their decisions.
Helpful Medicare Articles for Caregivers
MedicareLifeHealth.com is a great resource for learning about Medicare. We have articles to show you how to set-up your loved one’s health care. We understand it is so important to make sure they get the coverage and care they need.
Who can I call or email for help with Medicare/Medicaid/Health Care Insurance?
MedicareLifeHealth is a national community, but health care questions and registrations are often different state to state. So, we have a couple different resources for you to work with.
If you live in Nebraska or Iowa: Your fearless leader of Medicare Life Health Co. (Carly Cummings – that’s me!) is a licensed life/health agent in NE and IA. I would be glad to help you with your questions and enrollment needs.
If you live in all other 48 States: We are building our directory of national insurance agents. Find one now:
Who should be in charge of caring for elderly parents’ finances?
There might come a time when you realize your seniors need help with their finances. As a result, you will discover two phases of caring for your elderly parents’ or grandparents’ finances:
Assisting with their decisions.
Taking over the decisions.
This same process translates to Medical decisions, so we will include information on both.
Durable Power of Attorney
When working with seniors to help them in making financial and medical decisions, you will want to set up “Durable” Power of Attorney (POA). This is a document that will give you (or someone else they trust) power to act in their place if they become mentally incapacitated.
The “Durable” part is important. Regular power of attorney documents end when a person becomes mentally incapacitated. Durable powers of attorney contracts do not. With this document, you will be able to help your elderly parent with important decisions when they cannot.
In addition, you will want to have two separate Durable Power of Attorney Documents:
One for Medical
And one for Financial.
Medical Power of Attorney (POA)
Commonly called the durable power of attorney for health care, this document names the person who will be making health care decisions for your elderly parent.
The named person will be able to enroll the elderly parent in medical plans, speak to doctors on their behalf, and represent their wishes in regards to medical care.
Your elderly family member will also need to name someone to carry out their financial wishes when they cannot. This is where a comprehensive durable financial power of attorney is important.
Note, this should be a separate document from the medical POA. The financial POA allows someone take over your elder’s retirement accounts, taxes, and bills. For this reason, it needs to be someone they trust, and should be done as soon as possible to make sure they are represented in the ways they wish.
Working Together
Finally, although these are two separate documents, you certainly can name the same person on both. In fact, having the same person do both will make life much easier and simpler. If you do have different people named on each document, you will want to ensure they communicate well and can work together effectively.
Where can I get support for caring for elderly parents?
I remember pulling over to the side of the road, one very stressful day, because I couldn’t see through my tears to drive. At the time, I was living with my grandparents and trying to care for them while their health continued to decline.
I was overwhelmed by the amount of work it took to keep them safe in their own home (even with the help of a home care company). Consequently, we were reaching the tipping point of needing to move them to assisted living. However, the thoughts about and process of this change were also just sad. It was a lot for me to handle.
The first step is to reach out to someone to talk to and confide in. Care-giving takes a lot out of you. As a result, you need someone to listen to you and give back to you. Whether this is a professional counselor, or just a friend, you need to make “talking it out” a priority. Better yet, make your conversations a habit or a standing date.
Seek Outside Help
The second step is to get outside help. If your parent is still at home, see what is in the budget for hiring a care service. Even if just for a few hours a week. These companies help with daily living activities for seniors wanting to still live by themselves. (This is non-medical help.)
Alternatively, you can see what social network your seniors are a part of that might want to help. My mom was excellent at getting visitors for her elderly parents from not only their friends, church member, etc. but also from her own social network. You would be amazed at how many people are willing to swing by a nursing home and say hello during the week. You just have to ask!
Set-up Self-Care
Care-giving makes you busy, tired and often plain run-down. The only way self-care happens is when you make it a priority. Moreover, you need to set it in your schedule as an important appointment.
First, create and stick to a weekly workout schedule. Then, create a routine for getting healthy meals onto your table. Finally, make sure you keep your hair appointments, massages or other healthy ways to relax and stay on top of your health.
I know it is all easier said than done, but you will be much more efficient and helpful if you are well rested and cared for first.
Action Steps for Caring for Elderly Parents
In summary, caring for elderly parents, grandparent and loved ones is a long, hard journey. However, you are not alone! In addition to all the helpful organizations, services and innovations out there, there are also real people that want to love and support you. You cannot, and should not, do this alone.
Here are a few good steps to get you started or move you forward with your loved one’s journey.
First, if you are considering housing options, reach out to a home care service. If a move is a necessity sooner or later, start by touring one assisted living center or nursing home.
Second, for seniors living at home or even in assisted living, look into a couple of medical alert systems. Falls are all too common, and you need to be prepared.
Third, in regards to health care, reach out to a professional to make sure your loved one has the best coverage in their area. Plans change all the time, so a review is always a good idea.
Fourth, legally, make sure you understand what your loved one needs and wants in regards to making financial decisions. Get together all the proper documents needed to secure current or future Power of Attorney options.
Finally, create a plan now for taking care of yourself and start implementing it right away. You deserve it. Thank you for taking care of your elderly parents and loved ones.
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 increases you will see.
The Centers for Medicare & Medicaid Services (CMS) released their updates for the coming year in a press release. Let’s look at what is changing.
Part B Deductible for 2020
In 2021, the Medicare Part B Deductible will be $203.
In contrast, the deductible was 198 for 2020.
This is an increase of $5.
Part B Premiums for 2021
In 2021, the Medicare Part B Monthly Premium will be $148.50
In 2020, the Medicare Part B Monthly Premium was $144.60.
The premium was 135.50 for 2019.
Why are the Part B Deductible and Premiums Increasing in 2021?
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.
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.
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.
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.
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.
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.
One questions we hear a lot at Medicare Life Health is “Does Medicare Cover Hearing Aids?
The simple answer is NO.
However, some Medicare Advantage Plans will. Let’s look at both.
Original Medicare Will Not Cover Hearing Aids.
Original Medicare – Parts A & B run and administered by the Federal Government – does not pay for hearing aids. In addition, it does not cover exams or fittings needed for hearing aids.
As an exception, Medicare will cover any hearing exams ordered by your doctor for medical treatment. Here is the direct quote from the Medicare and You Guidebook. (Please see our Medicare and You User Guide for more information.)
“Hearing and balance exams – Medicare covers these exams if your doctor or other health care provider orders them to see if you need medical treatment. You pay 20% of the Medicare-approved amount, and the Part B deductible applies. In a hospital outpatient setting, you also pay the hospital a copayment.”
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.
How to Get Started
Interested? Talk to an agent to learn more about plans with hearing aid options.
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 and You 2021 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
If you would like to follow along with the Guide itself, you can find it online here: Medicare & You Handbook 2021
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)
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?
Hey, Medicare and You 2021, 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.
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.
“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.
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.
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.
“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 2021
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 contact us here.
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.
We hope our review of the 2020 & 2021 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 2021 Topic Relevant Reading
Does Medicare Cover Chiropractic Care / Services? Yes, when deemed medically necessary, Medicare does cover chiropractic services. Original Medicare Part ... Read More
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Best Hearing Aid Alternatives Hearing aids are expensive. We are talking thousands of dollars, sometimes even with insurance. In addition, ... Read More
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