Medicare and Glucose Testing Supplies

Medicare and Glucose Testing Supplies


Question: How will Medicare pay for my glucose testing supplies?

Answer: Medicare Part B covers test monitors, test strips, lancet devices and lancets. Some blood sugar control solutions and therapeutic shoes, in some cases, are also covered. With original Medicare alone, you pay the deductible then coinsurance of 20% of the cost. Medicare Supplements or an Advantage plan will pay part or all of the deductible and coinsurance.

Medicare Coverage for Dental and Vision Care

Medicare Coverage for Dental and Vision Care

Question: Is there any way Medicare pays for dental work or eye exams?

Answer: Original Medicare does not cover routine dental or vision care. Some Medicare Advantage plans offer some coverage for vision and dental but make sure you know what is and IS NOT covered before enrolling. Read the fine print! Some Advantage plans only cover vision and dental as covered by original Medicare.

Medicare Part A will pay for certain dental services that you get when you are in the hospital. Medicare Part A can pay for hospital stays if you need to have emergency or complicated dental procedures, even when the dental care itself is not covered.

Medicare provides limited vision coverage in some cases such as after cataract surgery or for some cases of macular degeneration. If you are in a high risk category for glaucoma, Medicare will cover screenings every 12 months. It is a good idea to check with Medicare or your Advantage plan rather than assume a procedure is covered. For more information on Medicare coverage go to www.medicare.gov/coverage .

Medicare Supplement ~Medicare Advantage Plan, That is the Question

Medicare Supplement ~Medicare Advantage Plan, That is the Question

 

Question: What is the difference in a Medicare Supplement and a Medicare Advantage plan?

Answer: Day and Night! Control and choice are the biggest differences. You have more control and choices with a Medicare Supplement than you do with a Medicare Advantage plan.

A Medicare Supplement works with your Medicare A and B and pays the Medicare approved charges not picked up by Medicare. You may use any doctor or facility you choose. Plan F is the favorite plan and covers 100% of charges not picked up by Medicare. Medicare Supplements are regulated by the federal government and all plans must offer the same benefits (with a few exceptions in a couple states – not Texas). Insurance companies may charge whatever they choose for the different plans, so costs vary.

A Medicare Advantage plan takes the place of your Medicare A and B. When you enroll in a Medicare Advantage Policy, you assign your Medicare A and B to that plan. As long as you are enrolled in the plan, you do not have the option of using just your original Medicare. Some plans allow you to go out of network for a higher cost share but many plans pay nothing if you go outside the plan network. You are responsible for the total out of network bill except in emergency situations. You MUST use the doctors and facilities in an Advantage plan’s network to see the full benefit in cost savings. If you are considering a Medicare Advantage Plan, be sure your doctor and a convenient hospital are in the plan network. Some Advantage Plans include drug coverage and other benefits like vision, dental and hearing plans. The services of these additional benefits are limited.

Costs of both types of plans can vary. Some Advantage plans do not charge a premium to be enrolled in their plan. If you are old enough to be on Medicare, you probably know by now there is nothing completely free, especially in health care. In many instances a Medicare Supplement Plan N is competitive in premium with an Advantage plan.

I use the analogy of driving your own car – the Medicare supplement option, (you can go when and where you would like) versus taking public transportation – the Medicare Advantage option, (it can get you there often for less money but will be less convenient).

Both Medicare Supplements and Medicare Advantage plans have their place. It is important to do your homework and understand either type of plan before you enroll.

SOURCE:  www.Medicare.gov , Medicare and You, 2011 Handbook

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 28^th, 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.

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:  http://www.medicare.gov/, Publication 02179; Medicare and Other Health Benefits: Your Guide to Who Pays First

$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

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.