Monday, January 31, 2011

Medicare Special Election Period Extended

Special Election Period Extended

Answer: The Centers for Medicare and Medicaid Services (CMS) has extended the Special Election Period (SEP) for those people who lost their MA (Medicare Advantage) or PDP (Prescription Drug Plan) plans due to plan non-renewal the end of 2010 and who did not enroll in a new plan by 12/31/2010.

The new SEP goes through February 28th, 2011.

If you have already enrolled in a PDP plan, this SEP does not apply to you and you may not change PDP plans at this time. If you do qualify for the SEP and fail to make a selection by February 28th, you will be on original Medicare.

CMS has begun mailing out notices to those people who qualify for the SEP. If this SEP applies to you, keep an eye out for your letter from CMS. It is likely you will need to provide a copy of the letter with your new plan application. If you do not receive a letter and believe you qualify for the SEP, contact Medicare at 1-800-633-4227.

Wednesday, January 26, 2011

Medicare and Other Health Insurance

Medicare and Other Health Insurance

Question:  I go on Medicare soon and I have signed up for Part B. I also have other insurance from a work related retirement. What else do I really need to stay solvent from medical debt?

Answer:  You may not need anything else but verify a few things to make sure.

First, is your other insurance primary or secondary to Medicare? The easiest way to find out is to call the customer service phone number on your insurance ID card and ask them.

If your other insurance is primary to Medicare, you are probably in good shape. Unfortunately most retirement plans are secondary. If you are one of the few who still have a good primary retirement plan from your employment-you are fortunate. If this is the case, very likely you do not need to enroll in Medicare Part B, it would be a wasted expense.

Second, if your other insurance is secondary, know the plan’s deductible, coinsurance and co pays. A secondary plan pays claims after Medicare pays and it pays according to their own stipulations. If you have a deductible, coinsurance and office visit co pays, those must be met before the plan picks up any cost unpaid by Medicare. In the end, you see very little assistance from a secondary insurance unless it is structured as a supplement to Medicare.

Outside of a good retirement health plan from your employer, Original Medicare paired with a Medicare Supplement or Medicare Advantage plan will offer you the best coverage.

SOURCE:, Publication 02179; Medicare and Other Health Benefits: Your Guide to Who Pays First

Thursday, January 20, 2011

$100 Wal-Mart Gift Card Drawing

Would you like a chance to win a $100 Wal-Mart Gift Card? I am trying to get as many people as I can to "LIKE" my Facebook page, Medicare Answers from Connie. This will make it possible to reach more people who have questions about Medicare and those who are looking for Medicare Supplements and Part D Drug Plans. Everyone who “LIKE”s my page by February 28th will be entered in a drawing to win the $100 gift card, no strings! Details are on the page. All you have to do is go to Facebook, search for the Medicare Answers from Connie page and next to the name is the "LIKE" button-click it! I would appreciate your suggesting it to your friends too. Be sure to tell them about the drawing! Right under the profile picture it says "Suggest to Friends". Just click and choose your friends that you want to suggest it to (hopefully all of them). Thank you so much for helping me with this. There are so many people with questions about Medicare who don’t know where to turn and I am really trying to build this part of my business. I really do appreciate your help. – Connie Ulmer

Monday, January 10, 2011

Medicare Part D

Changes to Medicare Part D Prescription Drug plans for 2011

Question: Are there changes in the 2011 Medicare Prescription Drug Plans?

Answer: These are the changes in the 2011 Medicare Prescription Drug Plans

 Initial coverage phase has been increased from $2830 to $2840.
The initial coverage phase is the first phase of Part D Prescription Drug plans. In this phase, you pay your deductible, if you have one, and then pay copays until your total drug costs reach $2840 for 2011. Your total drug costs are made up of your deductible, the copays you pay and the amount your insurance company pays toward your drug costs. You can estimate when you will exit the initial phase by knowing the total retail cost of the drugs you take. Once you exit the initial coverage phase, you enter the Coverage Gap or Donut Hole.

 Help in the Gap.
Healthcare reform gave help in the form of a $250 rebate for people who entered the coverage gap in 2010. For 2011, people who enter The Gap will receive up to 50% off the retail cost of their medications. If you entered The Gap in the last quarter of 2010, you should receive your $250 in the first quarter of 2011.

 No increase in threshold for Catastrophic Coverage Phase.
Once your total out of pocket expense for your drugs reaches $4550, you enter the Catastrophic Phase. This is the same threshold as 2010. In this phase you have significantly lowered copays, $2.50, $6.30 or 5% of the retail cost of the drug, depending on the medication classification. You remain in the Catastrophic Phase through the end of the plan year which starts over every January.

 Reduction in plans offered and companies offering plans.
In an effort to simplify Part D Prescription Drug plans, it was mandated that companies offering these plans could offer no more than 2 choices of plans. As a result, many plans were discontinued for 2011 and many people are getting used to a new plan. Most insurance companies added deductibles to at least one of their plans. I have seen some confusion at the pharmacy with the deductibles in my clients’ situations so be alert the first few times you fill your prescriptions to make sure you are not over paying.