• Lifestyle

by arroyoj

February 29, 2020

What Is the Best Medicare Supplement Plan for You?

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How to Find the Best Medicare Supplement Insurance Plan

If you qualify for Medicare coverage, our review will highlight important rules and benefits of Medicare Supplement insurance plans to help you pick the right one for you.

Medicare Supplement Insurance Plan Basics

Medicare Supplement insurance plans are health insurance plans issued by private insurance companies. They work with, or supplement, Original Medicare by helping to cover out-of-pocket expenses. Unlike Medicare Advantage plans, they do not replace Original Medicare coverage.

Medicare Supplement plans fill in some of the cost coverage gaps in Original Medicare. Because of this, Medicare Supplement plans are often referred to as Medigap plans.

Eligibility

To be eligible for Medigap coverage, you must be enrolled in both Part A and B of Original Medicare. In many states, you must be age 65 or older even if you enter Medicare earlier due to health or disability.

Enrollment Windows

The best time to enroll in a Medicare Supplement insurance plan is when you first enroll in Part B. The six months after you enroll in Part B is called your Medigap Open Enrollment Period. During these six months, you cannot be declined for coverage or charged a higher rate due to health issues.

During your Open Enrollment Period, you have Guaranteed Issue rights. If you don’t enroll in a Medicare Supplement insurance plan during this time period you may have to go through underwriting if you want a Medigap plan later.

If you go through underwriting you will be asked health questions. Your coverage could be declined, or you could be charged a higher premium due to health conditions. It is far better to enroll during your Medigap Open Enrollment Period.

There are times when you may be able to have extra Guaranteed Issue rights to a Medigap plan. You may be able to get a Medigap plan with Guaranteed Issue rights in these cases:

• You enrolled in Medicare Advantage when you first got Part B, and you’ve been on it for less than 12 months (Trial Right).
• You enrolled in Medigap when you were first eligible but dropped your coverage for your first Medicare Advantage plan, and you’ve been on it for less than 12 months (Trial Right).
• Your Medicare Advantage plan loses or fails to renew its contract with the government.
• You permanently move out of your Medicare Advantage plan’s service area.

There can be other reasons you’d qualify for Guaranteed Issue rights. They can be technical, so it’s recommended that you speak with an independent professional if you think you may qualify.

Medicare Supplement Insurance Costs

Not sure how much Medicare costs in 2020? As mentioned earlier, Medicare Supplement insurance works with Original Medicare. You must be enrolled in both Part A and B in order to get Medigap coverage. You will also need to obtain prescription drug coverage from a standalone prescription drug plan since Medigap plans don’t cover drugs.

When you use Medigap in conjunction with Original Medicare and a standalone drug plan, you can expect to pay the following premiums:

• Part B premium
• Medicare Supplement plan premium
• Prescription drug plan premium

Specifics of Medicare Supplement Insurance Plans

Medicare Supplement insurance plans fill in some or all of the gaps in Original Medicare. These gaps can include:

• Part A deductible – $1,408 in 2020
• Part B deductible – $198 in 2020
• Part B coinsurance – 20% of the cost for each Part B procedure
• Emergency services while traveling internationally

Medicare Supplement insurance comes in 10 standardized “plans.” Each plan offers slightly different coverage. The premium for each plan is different, too, increasing with the comprehensiveness of coverage.

Plan A

Plan A provides basic coverage. It covers:

• Part A coinsurance charges.
• Part B coinsurance charges.
• First 3 pints of blood.
• Part A hospice care charges.

Plan A does not provide coverage for:

• Skilled nursing care coinsurance.
• Part A deductible.
• Part B deductible.
• Part B excess charges.
• Foreign travel emergency.

Plan B

Plan B provides slightly more comprehensive coverage. It covers:

• Part A deductible.
• Part A coinsurance charges.
• Part B coinsurance charges.
• First 3 pints of blood.
• Part A hospice care charges.

Plan B does not cover:

• Skilled nursing care coinsurance.
• Part B deductible.
• Part B excess charges.
• Foreign travel emergency.

Plan C

Plan C is a comprehensive plan. It covers:

• Part A deductible.
• Part A coinsurance charges.
• Part B deductible.
• Part B coinsurance charges.
• First 3 pints of blood.
• Part A hospice care charges.
• Skilled nursing care charges.
• Foreign travel emergency coverage.

Plan C does not cover Part B excess charges.

Plan D

Plan D is not quite as comprehensive as plan C. It covers:

• Part A deductible.
• Part A coinsurance charges.
• First 3 pints of blood.
• Part A hospice care charges.
• Skilled nursing care charges.
• Foreign travel emergency coverage.

Plan D does not cover:

• Part B deductible.
• Part B excess charges.

Plan F

Plan F is the most comprehensive plan available. It fills in every gap in Original Medicare. It covers:

• Part A deductible.
• Part A coinsurance charges.
• Part B deductible.
• Part B coinsurance charges.
• Part B excess charges.
• First 3 pints of blood.
• Part A hospice care charges.
• Skilled nursing care charges.
• Foreign travel emergency coverage.

Plan F is also available in a high deductible version. With High Deductible F, you pay the first $2,340 (for 2020) and then the plan pays the rest of your Medicare-approved expenses. In exchange for the deductible, premiums are much lower than for regular Plan F.

Plan F has been the most popular Medicare Supplement insurance plan over the years. People choose it because they like the ability of not making any out-of-pocket payments for health care services.

Plan G

Plan G is the next most comprehensive. It covers:

• Part A deductible.
• Part A coinsurance charges.
• Part B coinsurance charges.
• Part B excess charges.
• First 3 pints of blood.
• Part A hospice care charges.
• Skilled nursing care charges.
• Foreign travel emergency coverage.

Plan G does not cover the Part B deductible. You must pay the first $198 (for 2020) of Part B services. The plan will pay 100% of all other Medicare-approved expenses.

Plan G is available in a high deductible version. For 2020, the deductible is $2,340. After you’ve paid this amount the plan will begin paying benefits for Medicare-approved expenses.

Now that Plan F is no longer available for people new to Medicare (see more below), Plan G is the most popular Medigap plan. People choose Plan G because they know that the most they’ll spend on Medicare-approved expenses is $198 – the Part B deductible.

Plan K

Plan K is a hybrid plan that offers partial coverage with a hard out-of-pocket maximum amount. Plan K covers:

• Part A coinsurance charges.
• 50% of Part A deductible.
• 50% of Part B coinsurance charges.
• 50% of the cost of your first 3 pints of blood.
• 50% of Part A hospice care charges.
• 50% of skilled nursing care charges.
• Annual out-of-pocket maximum is $5,880.

Plan K doesn’t cover:

• Part B deductible.
• Part B coinsurance.
• Foreign travel emergency coverage.

Plan L

Plan L is another hybrid type with partial coverage for many services combined with a low out-of-pocket maximum. Plan L covers:

• Part A coinsurance charges.
• 75% of Part A deductible.
• 75% of Part B coinsurance charges.
• 75% of the cost of your first 3 pints of blood.
• 75% of Part A hospice care charges.
• 75% of skilled nursing care charges.
• Annual out-of-pocket maximum is $2,940.

Plan L does not provide any coverage for:

• Part B deductible.
• Part B excess charges.
• Foreign travel emergency coverage.

Plan M

Plan M is a fairly comprehensive plan with coverage for most of the gaps in Original Medicare. It covers:

• 50% of Part A deductible.
• Part A coinsurance charges.
• Part B coinsurance charges.
• Part B excess charges.
• First 3 pints of blood.
• Part A hospice care charges.
• Skilled nursing care charges.
• Foreign travel emergency coverage.

Plan M does not cover:

• Part B deductible.
• Part B excess charges.

Plan N

Plan N resembles traditional employer-provided health insurance. It covers:

• Part A deductible.
• Part A coinsurance charges.
• Part B coinsurance charges.
• Part B excess charges.
• First 3 pints of blood.
• Part A hospice care charges.
• Skilled nursing care charges.
• Foreign travel emergency coverage.

Plan N is unique in that you pay small copays for seeing a doctor or using emergency services. Your copay is no more than $20 to see a doctor and no more than $50 to be seen in the emergency room.

Plan N doesn’t cover:

• Part B deductible.
• Part B excess charges.

Changes to Medicare Supplement Insurance in 2020

Plans C, F, and High deductible F will not be available for people who enter Medicare on or after January 1, 2020. If your Medicare coverage began before January 1, 2020, you will always have the right to enroll in these three plans, assuming you qualify for Guaranteed Issue rights, or can be approved by underwriting.

Extra Benefits

The benefits listed above are all standardized; they must be provided by all Medigap plans in every state except Minnesota, Wisconsin, and Massachusetts. These three states have their own rules for Medicare Supplement insurance.

Many insurance companies offer extra benefits to their customers. These benefits can vary by state and are not guaranteed. Some of these extras include:

• Discounts on vision coverage.
• Discounts on hearing coverage.
• Discounts on prescription drugs.
• Discounts on dental coverage.
• Gym memberships or fitness programs.
• Access to 24-hour nurse help lines.

The Best Medicare Supplement Plans Reviews for You

Getting your Medigap coverage right is important for your health and financial future. To get the best Medigap plan reviews for you you’ll need to balance your monthly premium cost with your tolerance for out-of-pocket expenses.

You’ll want a plan that has the right blend of coverage, extra benefits, and price. Not all insurance companies offer plans in every state, so be sure to connect with a professional to get quotes to find the best Medicare Supplement insurance plans in your area.

• Lifestyle

by arroyoj

February 15, 2020

Does Medicare Cover Dental? Options for Coverage

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What Dental Services Does Medicare Cover?

Medicare was designed to be a health insurance program and originally didn’t provide any dental coverage at all. However, in 1980, changes were made that allowed for coverage of dental services in some limited circumstances.

The change provides for coverage of a few services if they are provided in a hospital setting. Original Medicare will cover dental services in these circumstances:

• Oral exams in the hospital before a kidney transplant
• Dental services related to certain treatments for oral cancer, such as radiation
• Reconstruction when an oral tumor is removed
• Surgery and recovery for broken jaws

Aside from these emergency-type services, Medicare won’t help with your dental needs. Medicare offers no help for preventative services or dental maintenance. To get help paying for these services, you’ll need to look to the private market.

Medicare Advantage Plans

If you want to find something like Medicare dental plans, you’ll have to look into Medicare Advantage. These plans, which are sometimes called Part C plans, often offer dental coverage.

Dental coverage can come in two different forms with Medicare Advantage plans:

• Included in the plan with no additional premium
• Available for an additional premium

As you might expect, coverage that’s available for no additional premium is fairly basic, providing mostly routine, preventative coverage such as cleanings and X-rays.

Medicare Advantage plans that offer dental services for an additional premium often have more comprehensive benefits. These plans sometimes come with the choice of two coverage levels: a standard or value dental plan, or a more comprehensive premium dental option.

These more comprehensive dental plans provide preventative coverage as well as more major restorative services, such as:

• Fillings
• Root canals
• Crowns
• And more

Dental coverage provided by Medicare Advantage plans may come in HMO or PPO plans.

In an HMO plan, you’ll need to use the plan’s network of providers; you’ll likely receive no coverage for dental work done by an out-of-network provider. With a PPO plan, you’ll pay lower prices if you use a network dentist, but the plan will still provide some coverage if you go out of network.

Private Dental Insurance

If you don’t want a Medicare Advantage plan, perhaps because you already have a Medicare Supplement insurance policy, another option for dental coverage is standalone dental insurance. You can purchase dental insurance from a private insurer.

Private dental insurance for individuals and families is available from a wide range of insurance companies. When shopping for dental insurance, you’ll want to consider:

• The monthly premium
• The deductible, if any
• The plan maximum coverage
• The network of dental providers
• The waiting period for major services, if any

The monthly premium is a fairly basic item that’s easy to grasp, but pay close attention to the maximum coverage amounts. Many dental insurance plans limit payments to between $1,000 and $2,000 per person, per year. It won’t take many procedures to reach this cap, after which you’ll pay the full cost.

Also check to see if a waiting period applies to any dental plan you’re considering. For major services like root canals, and crowns, you may have to pay premiums for six months or more before you’ll be covered. This can be an unpleasant surprise, so make a point to find out before you enroll.

When you go to a dentist, make sure they accept your plan. If your dental plan is HMO-based, you may not receive any coverage if you see an out-of-network dental professional.

Dental Discount Plans

As the cost of dental services has gone up and dental insurance plan maximums have stayed stagnant, dental discount plans have become more and more popular.

Dental discount plans are not insurance at all. You don’t pay a premium for them and they don’t provide coverage like insurance does. Instead, you pay a fee in return for access to discounted dental services and procedures.

Most dental discount plans have an annual fee and a monthly payment amount. They are less expensive than almost all other forms of non-Medicare Advantage dental insurance. There are no waiting periods, plan maximums, or deductibles.

For any type of service, from cleanings and X-rays to repairing major decay with root canals and crowns, you can save by using a discount card.

Providers of dental discount cards are often insurance companies. The discount cards work with a select group of providers. The dental providers agree to charge discount plan members less than their normal prices. Frequently advertised discount plans mention discounts of 10% to 30%. Just like with dental insurance, be sure to find a discount plan that your preferred dentist participates in.

Pay Cash for Dental Services

If you can’t afford the premiums for dental insurance, and you’re not interested in a dental discount plan, you’ll have to pay cash for dental services. 

Properly taking care of your teeth with frequent brushings and flossing can go a long way to preventing poor oral health. Call your dentist and ask how much a cleaning would cost if you paid cash. If it’s beyond your budget, you can always save for it over several months, if need be.

You can utilize the same strategy for repair work; ask how much you would pay if you paid cash. You may receive a discount for paying in cash, even without paying for a discount card.

If you’ve experienced severe dental pain before, you know it’s better to cut back on your budget for a few months than to ignore a tooth problem. Plus, if you ignore it long enough, the cost when you finally address your dental issues can be far worse than if you’d taken care of it earlier.

Choosing Your Medicare Dental Coverage

Many people are concerned about the lack of Medicare dental plans. With enough research and planning, you can get the right coverage. Get a Medicare Advantage quote if you’re interested in the dental insurance options provided by these plans.

Beyond Medicare Advantage, look for a combination of affordable premiums, and a plan that your dentist accepts. If your dentist accepts a dental discount plan and dental insurance, compare the discounted prices to the premium for the insurance to see which is best for you.

• Lifestyle

by arroyoj

February 14, 2020

Medigap vs. Medicare Advantage — Which Plan Is Right for You?

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Medigap vs. Medicare Advantage — What Are the Differences?

Medicare offers a variety of options and plans for you to choose from to best fit your healthcare needs.

Original Medicare covers services like hospital visits and outpatient needs, but it has certain limitations. If Original Medicare doesn’t cover everything you’re looking for, you can enroll in a Medicare Supplement (Medigap) or Medicare Part C (Medicare Advantage) plan.

• Medigap plans are best if you’re seeking plan flexibility and control while reducing out-of-pocket costs.
• Medicare Advantage plans may better suit you if you want an alternative to Original Medicare with additional benefits like prescription drug coverage.

In this article, we’ll go further in-depth on the differences between Medigap and Medicare Advantage to cover:

1. Original Medicare and the gaps in coverage
2. Medigap plan options and extra benefits
3. Medicare Advantage plan options and extra benefits
4. How to choose the right plan

Review of Original Medicare

Before we discuss Medigap vs. Medicare Advantage, let’s review Original Medicare and the gaps in coverage. Original Medicare consists of two parts — Part A and Part B.

Medicare Part A 

Part A covers inpatient services and procedures like hospital visits, skilled nursing needs, home health, and hospice care. You must pay the Part A deductible before your coverage begins. For 2020, the deductible for Medicare Part A s $1,408.

You pay the deductible for each “benefit period.” A new benefit period begins when 60 days have passed since you received Part A services. If you go to the hospital twice in one month, that’s only one benefit period. But, if your visits are separated by six months, that’s two benefit periods and two deductibles.

You could pay the Part A deductible several times during the course of one year.

Medicare Part B Coverage

Part B covers all your outpatient medical needs. Part B helps with:

• Doctor’s visits
• Therapy visits (physical, occupational, etc.).
• Durable medical equipment like CPAPs and oxygen
• Diagnostic tests like blood work, X-rays, MRIs
• Infusion-based cancer treatments like chemotherapy

Just like with Part A, you will have some out-of-pocket expenses for these services. Costs for Part B come in several forms:

• Part B deductible ($198 for 2020)
• Part B coinsurance (20% of the cost for every Part B service or procedure)
• Part B excess charges (amounts up to 15% of the Medicare-approved amount—this only applies if your doctor or facility doesn’t accept Medicare pricing)

Gaps in Original Medicare Coverage

Important points to always remember about Original Medicare:

• Prescription drugs are not covered by Original Medicare.
• There is no out-of-pocket maximum—your total potential costs are uncapped.
• Original Medicare does not provide emergency coverage outside the United States.

Medigap Insurance

Medigap plans are a great tool for limiting your out-of-pocket costs with Medicare. These insurance policies, which are issued by private insurance companies, work with Original Medicare.

Medigap plans fill in some or all of the gaps in Original Medicare, hence the name. You will pay an additional premium for Medigap coverage. This premium goes directly to the insurance company.

Medigap policies are issued in standardized “plans.” Every insurance company must offer the coverage specified by Medicare for each plan. There are 10 standardized plans: A, B, C, D, F, G, K, L, M, and N. Not all companies offer every plan in every state. 

* Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,340 in 2020 before your Medigap plan pays anything.

** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.

Each plan covers a different portion of the gaps in Original Medicare. An important benefit to all the standardized plans is that they allow you to see any doctor in the nation, as long as they take Medicare patients. Several of the standardized plans provide worldwide emergency coverage.

Medigap plans do not provide drug coverage, so you’ll need to enroll in a standalone prescription drug plan if you enroll in Medigap.

Medigap Extra Benefits

Many insurance companies choose to offer extra benefits with their Medigap plans. They are not required to do this and the extra benefits are not guaranteed. However, insurance companies tend to keep the extra benefits in place as a service to their customers.

Some of the extra benefits that companies offer include:

• Discounts on vision, dental, and hearing services.
• Healthy living packages including gym membership programs.
• Access to 24-hour nurse hotlines.

Medicare Advantage Plans

Medicare Advantage is also known as Part C of Medicare. Unlike Medigap plans, Medicare Advantage is a distinct alternative to Original Medicare. When you enroll in a Part C plan you are no longer in Original Medicare.

Medicare Advantage plans combine all of the coverage you receive under Original Medicare Part A and Part B.

In addition, most Medicare Advantage plans also include Part D prescription drug coverage along with extra benefits such as hearing, dental, and vision coverage. 

Medicare Advantage plans work like traditional private health insurance. You will generally pay a small copayment or coinsurance for every service or procedure you receive. The payments are usually less than you would pay under Part A or B. Costs you may encounter with a Medicare Advantage plan may include:

• Monthly premium (many have $0 premium).
• Annual deductible (many have no deductible).
• Copayments / coinsurance for services and procedures.

Medicare Advantage plans are usually network-based.

• Some are Health Maintenance Organizations (HMOs), which require you to use their network of doctors and facilities. A HMO plan provides medical coverage and health care from a specific set of doctors, specialists, and hospitals in a plan’s network. If the situation is an emergency, medical care is accessible regardless of the network.
• Other plans are Preferred Provider Organizations (PPOs). One of the major benefits of PPOs is that you can receive care without a referral from a primary care physician. PPOs have a network of preferred doctors and facilities. You will pay less if you stay in-network, but you can use out-of-network doctors if you’re willing to pay more.

Medicare Advantage plans must offer a hard yearly out-of-pocket maximum. You will know with certainty the most you can spend in a bad year, unlike with Original Medicare.

Extra Benefits of Medicare Advantage Plans

Just like Medigap plans, Medicare Advantage plans frequently come with extra benefits. These plans often provide:

• Vision coverage (for exams, lenses, and sometimes frames).
• Hearing coverage (for exams, and also discounted hearing aids).
• Dental coverage (sometimes included, sometimes for a low extra premium).
• Fitness or gym memberships.

Choosing a Medicare Plan

We’ve looked at options for Medicare coverage and compared Medigap vs. Medicare Advantage plans, but you may still want a few guidelines to help you choose. Here’s a quick way to apply what we’ve covered:

• Medigap plans likely have a higher monthly premium, but more complete coverage
• Medigap plans allow you to see any doctor who accepts Medicare patients nationwide
• Medicare Advantage plans often include prescription drug coverage
• Medicare Advantage plans are likely to offer more complete extra benefits in the form of vision and hearing coverage

The bottom line is that:

• If you’re most concerned about out-of-pocket costs, Medigap is probably your best bet.
• If you’re worried about paying too much each month, then a Medicare Advantage plan probably suits you.

Regardless of the decision you make, conducting your own research, recognizing what your needs are, and speaking with a licensed Medicare insurance agent before choosing a Medigap or Medicare Advantage plan will help empower you during the enrollment process.