Monday, May 30, 2011

Nursing Home Alternative

My mother sent me this and I felt obliged to share it with you ~ Hope you enjoy!


No nursing home for us. We'll be checking into a Holiday Inn!

With the average cost for a nursing home care costing $188.00 per day, there is a better way when we get old and too feeble.

I've already checked on reservations at the Holiday Inn.
 For a combined long term stay discount and senior discount, it's $59.23 per night.
 Breakfast is included, and some have happy hours in the afternoon.
That leaves $128.77 a day for lunch and dinner in any restaurant we want, or room service, laundry, gratuities and special TV movies.

Plus, they provide a spa, swimming pool, a workout room, a lounge and washer-dryer, etc.
Most have free toothpaste and razors, and all have free shampoo and soap.
$5 worth of tips a day you'll have the entire staff scrambling to help you.
They treat you like a customer, not a patient.
There's a city bus stop out front, and seniors ride free.
The handicap bus will also pick you up (if you fake a decent limp).

To meet other nice people, call a church bus on Sundays.

For a change of scenery, take the airport shuttle bus and eat at one of the nice restaurants there.
While you're at the airport, fly somewhere. Otherwise, the cash keeps building up.

It takes months to get into decent nursing homes. Holiday Inn will take your reservation today.

And you're not stuck in one place forever -- you can move from Inn to Inn, or even from city to city.

Want to see Hawaii? They have Holiday Inn there too.

TV broken? Light bulbs need changing? Need a mattress replaced? No problem.. They fix everything, and apologize for the inconvenience.

The Inn has a night security person and daily room service. The maid checks to see if you are ok. If not, they'll call an ambulance . . . or the undertaker.
If you fall and break a hip, Medicare will pay for the hip, and Holiday Inn will upgrade you to a suite for the rest of your life.

And no worries about visits from family. They will always be glad to find you, and probably check in for a few days mini-vacation.

The grandkids can use the pool.

What more could I ask for?

So, when I reach that golden age, I'll face it with a grin!I
If you would like the original e-mail with pictures, click "Ask a Question" and request "nursing home alternative e-mail" . I'll send it to you.

Sunday, May 29, 2011

Nursing Home Cost in Texas

On Facebook, Medicare Answers From Connie asked:  What do you think is the average yearly cost in Texas of a nursing home semi-private room?

$46,000/Year - 5 people chose this answer
$25,000/Year - 1 person chose this answer
An Arm and A Leg - 1 person chose this answer
Unreasonable (a write in!) - 3 people chose this answer
The average yearly cost in Texas of a nursing home semi-private room is $46,000 / Year. Thats for a shared room. A private room runs around $60,000/year. Thanks everyone who participated!

Friday, May 27, 2011

Medicare and Long Term Care

Medicare and Long Term Care

Question:  Does Medicare cover Nursing home expenses?

Answer: In some situations Medicare covers Skilled Nursing Facility Care but you must meet Medicare requirements and the length of coverage is limited.

Medicare will cover the first 20 days in a Medicare approved skilled nursing facility IF the admission comes within 30 days of having been in a hospital for at least 3 days and all other Medicare requirements are met. After the first 20 days, Medicare covers all but $141.50/day (for 2011) up through the 100th day. From day 101, you are responsible for all costs.

A Medicare Supplement can pay the costs not paid by Medicare for days 21 through 100.

I’ve never had a client say they were looking forward to going to the nursing home and it’s not something any of us like to think about. As one ages it becomes more probable to require attention and so often it’s people 65 plus who are talking to me about long term care coverage. It’s expensive at that point! I will be addressing this issue in my June ’11 newsletter. You can join the mailing list on the HOME page.
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Monday, May 23, 2011

Medicare, What to Do, When to Do It?

What to Do About Medicare and When to Do It!

Question:  I turn 65 soon. I have no idea what I’m supposed to do about Medicare or when I’m supposed to do it!

Answer: First, you automatically get Medicare Part A when you turn 65 so long as you or a spouse has earned enough work credits. Part A is the part of Medicare that pays for hospitalization. Next you have to decide if you need Medicare Part B. Medicare Part B pays for doctor visits and outpatient procedures. Basically it comes down to whether you have other qualifying insurance. For instance, if you have insurance from an employer you may not need Medicare Part B. In these situations you will not be penalized for failing to enroll in Medicare Part B when you reach age 65. Otherwise, you have 3 months before you turn 65 and 3 months after you turn 65 to enroll in Medicare Part B. You will receive a penalty for enrolling late once outside your initial enrollment. If you are receiving Social Security payments you will automatically be enrolled in Medicare Part B at age 65. If you have postponed receiving Social Security, you must contact the Social Security office (1-800-772-1213) to enroll in Medicare Part B or let them know you are delaying or declining enrollment.

Once you get Medicare Part A and B taken care of you have to decide how you will get your prescription coverage and if you need a supplement. You may have discovered that you get your prescription coverage through an employer group plan or through military service-related coverage. If not, you have the option of a stand-alone drug plan or some Medicare Advantage plans offer prescription coverage as part of their plan (you have the same 3 months before/3 months after your 65th birthday time frame to make this decision). Medicare and Medicare Advantage Plans do not cover 100% of all services. A Medicare Supplement picks up what original Medicare does not pay. You have several options when choosing prescription coverage and coverage for the GAPS left by Medicare A and B.

Here are two videos. One explains what Medicare is, the other explains details about Medicare Part D. Hope you find them helpful.

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Friday, May 20, 2011

How to Leave a Medicare Advantage Plan

When and How You May Leave a Medicare Advantage Plan

Question:  I didn’t realize my choice of hospitals and doctors would be so limited when I enrolled in my Medicare Advantage plan. I don’t like this plan. How do I change plans?

Answer: There is a special enrollment period for people who have enrolled in a Medicare Advantage plan for the first time after becoming eligible (age 65 for most people). It is known as the 12 month “free look” and during the first 12 months of having enrolled in your first Medicare Advantage plan you may leave the plan and return to original Medicare at any time during those first 12 months. Leaving the Medicare Advantage plan under these circumstances also puts you in a guarantee issue period for Medicare Supplements and a special enrollment for a Part D prescription plan.

In general you may only make changes in your Medicare Advantage Plan at certain designated times throughout the calendar year. October 15 to December 7 is the annual open enrollment period for 2011. You also have a chance to leave a Medicare Advantage Plan and return to original Medicare between January 1 and February 14 each year. There are other special enrollment periods for certain situations. All of this is handled through Medicare directly. Medicare has created a tip sheet for understanding Medicare enrollment periods. Click “Ask a Question” and request “Medicare enrollment periods”- I will e-mail you the tip sheet.

Thursday, May 19, 2011

Medicare with Private Health Insurance

Part D and Private Health Insurance

Question:  I will be 65 this fall. My husband is retired from a large company. What we have heard is if we get a Medicare Supplement policy they will cancel our insurance with them. As it is now my husband cannot even afford all of his medication. I am not real sure but this is what I have heard. Just this month I have had an eye scratch and have spent out of pocket 350.00. Do you know anything about this?

Answer: All retirement insurance is not the same. I can't give you an absolute yes or no about a supplement policy canceling your company sponsored insurance but it really would not make sense to get a supplement and also have the company insurance unless the company is paying 100% of your premium and even then it wouldn't really benefit you to have both. Getting a Part D prescription plan WILL cancel your company policy IF the company policy has prescription coverage.

Here is what I recommend: Evaluate what your insurance through your husband’s former employer costs and what it pays in benefits. Compare that to what Medicare and a supplement and drug plan will cost. If your combined income for 2010 was less than $170,000, then you are going to pay around $275-$300 /month (each, assuming you don't use tobacco) for your Part B premium, Supplement Plan F and Part D drug plan. That combination would pay 100% of your medical costs leaving you only the expense of copays for your drugs.
I realize it can be confusing. I help people in your situation all the time. Sometimes it makes better sense to keep the company provided retirement insurance, sometimes not. I can help you figure out what's best for your situation.

Wednesday, May 18, 2011

Medicare and Diabetes Supplies

Medicare Coverage for Diabetes Supplies

Question:  I have been on insulin pump for 4 years and will be on Medicare soon.  Does Medicare cover pump inserts and supplies including insulin?

Answer: Yes, Medicare covers the pump inserts and supplies as well as the insulin pump. This is covered under Medicare Part B, Durable Medical Equipment. You will be responsible for paying the Part B deductible which is $162 for 2011 then 20% of the cost of the supplies.  Medicare has a publication called "Medicare Coverage of Diabetes Supplies and Services". Click “Ask A Question” and request “Coverage of Diabetes Supplies” and I will e-mail you the publication. If you would like to have this in print, request that directly from Medicare-1-800-633-4227.

A Medicare Supplement Plan F would pay the $162 deductible and 20% not paid by Medicare if you choose to enroll in a Supplement Plan. You are guaranteed issue for up to 6 months after your 65th birthday. After that you may not be eligible due to your diabetes. Please let me know if you would like a quote.

Tuesday, May 17, 2011

Medicare Part D

Part D Coverage Evidence

Question:  How do I know if I have prescription coverage?

Answer:  I am assuming you do not have employer sponsored health insurance and are Medicare eligible. In most cases you must enroll in either a Stand Alone Prescription Drug Plan (also known as a PDP) or you may receive prescription coverage if you are enrolled in an Advantage Plan that includes prescription coverage. If you qualify for extra help and failed to enroll in a plan when you were first eligible, Medicare will enroll you in one of their choosing. At the very least you will have an ID card for your coverage, either the PDP or the Advantage plan. If you have not been issued an ID card, it's likely you don't have prescription coverage.

Monday, May 16, 2011

Medicare, Tricare and Private Health Insurance

Medicare, Tricare and Private Health Insurance – OH MY!
Question: I have Blue Cross Blue Shield and Tricare. I turn 65 this October. I then must apply for Medicare or a replacement and Tricare for life. But one of the requirements to get Tricare for life is I must have Medicare Part B. My Blue Cross Blue Shield will at 65 go to my secondary insurance and Tricare for life will be third. I have two questions. What is best for me, Medicare or a Medicare replacement? If I choose a replacement for Medicare, do I pay the company of the replacement or the government? Also one more question. Can I apply for Medicare then get Medicare Part B from a replacement company?

Answer:  First, you need to be enrolled in Medicare Parts A and B and the only way to do this is through the federal government. Unless you are receiving Social Security Benefits, you will need to call Social Security (1-800-772-1213) to enroll in Part B. You may do this 3 months prior to your 65th birthday and I encourage you to do it sooner rather than later! (July for you) You should automatically be enrolled in Part A at age 65, but Social Security can confirm that for you when you enroll in Part B. Then you have the option of using your original Medicare Parts A and B as primary insurance and TRICARE for Life as secondary insurance (like a Medicare Supplement). TRICARE for Life will also cover your prescription drugs. When you refer to a replacement I am guessing you are talking about a Medicare Advantage plan where you assign your Medicare Parts A and B to the Advantage plan to manage and use their network. Unless you just really don't like TRICARE, there is no reason for you to do this. Tricare for Life will cover the deductibles and copays of Medicare. Unless your Blue Cross coverage is through an Employer paid group plan that costs you nothing, you don't need that either. It would be an unnecessary, added expense.

Medicare and Other Health Benefits: Your Guide to Who Pays First, a booklet available from The Centers for Medicare & Medicaid Services, may clear up some of this for you. I will be happy to e-mail you a copy of the booklet. Click the “Ask A Question” button and request “Who Pays First” Booklet.

Wednesday, May 11, 2011

Best Medicare Supplement

What is the BEST Medicare Supplement?

Question:  What is the BEST Medicare Supplement to purchase through which insurance or carrier?

Answer: The Federal Government regulates Medicare Supplement benefits. No matter which plan, A through N, no matter which insurance company, that particular plan's benefits do not vary. Any plan with one company has the same benefits as that plan with another company. Insurance companies may set their premiums so that is where the only real difference comes in with plans. Premiums are set by state and region so someone in North Texas will not pay the exact premium as someone is South Texas. Some companies offer discounts to their policy holders for things like Silver Sneakers Fitness or Vision discounts, etc. but these are not very significant and should be considered a nice addition but not a "deal breaker". Price is the only real difference in Medicare Supplement Plans.

Medicare Supplement Plan F offers the richest benefits, it is also the most expensive, but when compared to what the average 64 year old is paying for health insurance pre-Medicare, it's practically free! You can get a Plan F in Texas for between $110/month to $150/month depending on where you live.

There is no "Best Company" supported by documented fact! I work with all the major health insurance companies. I have a favorite based on my experience with their customer service both to me and on behalf of my clients. This is based on how quickly they pay claims, issue refunds; resolve problems, all those things that are important after the sale. Mutual of Omaha has customer service down to a T, it’s the best I get anywhere and exceeds everyone else. This is not to say I am not sometimes annoyed with them (and I will venture to bet the feeling is mutual about me sometimes!) There are other companies who do a good job but we're talking "BEST".

I know it's confusing and you get a TON of material on plans as you near age 65. My advice is to find an agent you trust. (I , of course, think that should be me but recognize you need to arrive at this conclusion yourself!!) Your agent should help you find the plan that is best for YOU based on your situation. Really, while indisputably Plan F is the best plan, it may not be what is best for you. You may not even need a supplement. Find someone who isn't trying to "SELL" you something but who is advising you and who will continue to advise you down the road after you make a decision on what is best for you.

I wish it was as cut and dried as saying "It's this plan from this company" . Please continue to ask questions as you need, I'm happy to help and hope I'm clearing some of the confusion.

Monday, May 9, 2011

Medicare Part D Prescription Drug Plan

Medicare Part D

This video was created in 2011. Dollar amounts cited have changed for 2012. Changes are:
Initial coverage stage increased to $2930
Coverage Gap increased to $4700
Maximum deductible increased to $320

Monday, May 2, 2011

First Medicare Beneficiary

On Facebook, Medicare Answers From Connie asked:  Who was the first Medicare beneficiary?

Tony Pallcaorolla - 0 people picked this one
Former President Harry Truman - 1 person picked this one
Ida May Fuller - 2 people picked this one

Former President Harry Truman was officially the first Medicare beneficiary. President Lyndon Johnson enrolled President Truman and presented him with the first Medicare card. Truman's wife Bess was the second person to enroll. Thank you for participating!

Sunday, May 1, 2011

When did Medicare Start?

On Facebook, Medicare Answers From Connie asked:  When did Medicare Start?

July 1, 1966 - 7 people chose this one
April 30, 1942 - 2 people chose this one
In 1814, AFTER we took a little trip with Col. Jackson down the mighty Mississip - 0 people chose this one

July 1, 1966 is the correct answer! President Lyndon Johnson signed the Medicare Program in to law on July 30, 1965 and beneficiaries began receiving benefits the next year. Thank you for participating!