Friday, December 28, 2012

Medicare Advantage Disenrollment Period (MADP)

Medicare Advantage Disenrollment Period (MADP)

Medicare Advantage Disenrollment period Begins January 1st and runs until
February 14th and replaces the open enrollment period. This is an opportunity
for beneficiaries to disenroll from a Medicare Advantage plan and return to original
Medicare. It is not an opportunity for Medicare Advantage members to switch to
different MA plans and it is not an additional enrollment period.

The effective date of a disenrollment request made during the MADP will be the
first of the month following receipt of the disenrollment request. A request
made in January will be effective February 1, and a request made in February
will be effective March 1.

We specialize in Medicare Advantage plans and  Medicare Supplement plans so contact our
agency and an agent can assist you and make sure you fully understand your options and make
sure you get the best rates available. We cover Southern California,counties of Riverside,
San Bernardino and surrounding area's. We also cover Nevada and all of Utah.  Please visit
 us online at Medicareplansdirect.net or call 760-413-9749.

Sincerely,
Tom Caress
760-413-9749

Thursday, December 27, 2012

Medicare Changes for 2013



Standard premium for Medicare Part B: going up to $104.90 a month

Medicare Part A premium: Decreasing to $441.00 down from $451.00 in 2012.
                         ( Only about 1 percent of people with Medicare pay a premium
                          for Part A services)


Medicare Part A Deductible: Increase to $1184.00 up from $1156.00 in 2012
(an increase of 2.4%)

Medicare Part B Deductible: Increase to $147.00 up from $140.00 in 2012.

Income-related Adjustments: People with Medicare who report 2011 income about
$85,000 a year($170,000 filing jointly) are legally responsible to cover a larger portion
of the cost of their coverage. These premium adjustments range from $42.00 to $230.80
a month for Medicare Part B.

We specialize in Medicare Advantage plans and  Medicare Supplement plans so contact our
agency and an agent can assist you and make sure you fully understand your options and make
sure you get the best rates available. We cover Southern California,counties of Riverside,
San Bernardino and surrounding area's. We also cover Nevada and all of Utah.  Please visit
 us online at Medicareplansdirect.net or call 760-413-9749.

Sincerely,
Tom Caress
760-413-9749



            

Wednesday, December 26, 2012

Health Care Exchanges

The exchanges are online supermarkets where people can shop for private health insurance
and obtain federal subsidies to help with the cost. At lest  25 million people are estimated
to eventually receive coverage through the exchanges says the Congressional Budget Office.

In any state that is unable or unwilling to set up and run the exchange the Federal officials
and federal contractors will set up and run the exchange.

A federal health official said the administration has encouraged states to establish their own
exchange but regardless of who is in charge of the exchange consumers will have access to
affordable health insurance in all states.

On Oct. 1, 2013 consumers can begin to enroll in health plans, for coverage starting on
Jan. 1, 2014 when most Americans will be required to have insurance.

Federal officials believe the concept of an exchange is simple: Competition will drive
down prices.


Sincerely,
Tom Caress
760-413-9749
medicareplansdirect.net

Friday, December 21, 2012

When can I apply for Medicare?

Now lets say you are already getting Social Security retirement or disability benefits, you will be
contacted about a few months before you become eligible for Medicare. They will send you all
the information you need. If you live in one of the 50 states, you will be enrolled in Medicare
Parts Aand B automatically. However, you can turn this down if you want. Any Resident of
Puerto Rico or any foreign countries can not receive Part B automatically. They must elect this
benefit.

Once you are enrolled in Medicare, you will receive a red, white and blue Medicare card showing
whether you have Part A, Part B or both. Make sure to keep your card in a safe place so you will
have it when you need it. If you do lose your card or it is stolen, you can apply for a replacement
card at www.socialsecurity.gov/medicarecard or call Social Security’s toll-free number. You also
will receive a Medicare & You handbook that describes all of your Medicare benefits and plan
choices and special enrollment situations.

Sincerely,
Tom Caress
760-413-9749

Wednesday, December 19, 2012

Guaranteed Issue Plan

Seniors often wonder when they are guaranteed to be approved for enrollment in any
Medicare supplement plan of their choice without the threat of being denied for medical
reasons. That right is called "guaranteed issue"

Initially, you are entitled to guaranteed issue during your open enrollment for Medigap.
Your open enrollment for Medigap begins when you meet the dual requirement of reaching
age 65 and enrolling in Medicare Part B, and last for a period of six months from the first
day of the month in which you meet these requirements.

Trail rights

If you join a Medicare Advantage plan or a program of all-inclusive care for the elderly (Pace)
plan at age 65, you may switch to original Medicare within your first year. If you decide to switch
then you are entitled to enroll for a Medigap plan under guaranteed issue status.  This is called
"trail right" because it allows you to try these other programs without incurring any penalty toward
a Medigap policy.

If you purchase a Medigap plan, but then cancel the policy to get a Medicare Advantage or
Medicare Select plan for the first time, you can switch back to a Medigap plan within the first year.

With both these trial scenarios, the rules grant you eligibility for the guaranteed issue of a Medigap
plan if you apply up to 60 days before but no more that 63 days after your current coverage ends.

These are just a few of your guaranteed issue rights.



We specialize in Medicare Advantage plans and  Medicare Supplement plans so contact our
agency and an agent can assist you and make sure you fully understand your options and make
sure you get the best rates available. We cover Southern California,counties of Riverside,
San Bernardino and surrounding area's. We also cover Nevada and all of Utah.  Please visit
 us online at Medicareplansdirect.net or call 760-413-9749.

Sincerely,
Tom Caress
760-413-9749



Monday, December 17, 2012

Medicare Savings Programs

Medicare Savings Programs, or MSPs are Medicaid subsidies that help low-income seniors
pay forthings like co-payment, deductibles and premiums for Medicare parts A and B. The
program specifics vary by state, but generally there are three different subsidy levels.

You usually must be at the poverty level to qualify and receive the largest subsidy.

The second level is a specified low-income medicare beneficiaries and they receive a
moderate subsidy.

And the third level, qualified individuals, receive the smallest subsidy.

If you qualify for a Medicare Savings Program but expect your income levels to increase and
bump you out of the program, then you might want to carry supplemental insurance along with
your MSP benefits. The reason for this is because medicare supplement premiums will often
be more expensive the longer wait to purchase a plan and because you can be denied based on
a pre-existing condition if you do not purchase a Medigap plan during your open enrollment period.
If you purchase an inexpensive Medigap policy like Plan A, then that can keep you enrolled in
Medigap before you lose your MSP benefits.

Remember that each state carries a slightly different version of Medicare Saving Program with
different income requirements and benefits, so make sure you contact the office in your state
administers those programs.

Sincerely,
Tom Caress
760-413-9749
medicareplansdirect.net

Friday, December 14, 2012

Special enrollment period for employer group health plans

Special enrollment period for employer group health plan

If you are 65 or older and are covered under a group health plan, either from your own or your
spouse’s current employment, you will have a “special enrollment period” in which to sign up for
Medicare Part B. What that means is that you have the option of delaying enrollment in Medicare
Part B without having to wait for a general enrollment period and paying the 10 percent premium
surcharge for late enrollment. The rules will allow you to:

Enroll in Medicare Part B any time while you are covered under the group health plan based on
current employment; or

Enroll in Medicare Part B during the eight-month period that begins following the last month your
group health coverage ends, or following the month employment ends—whichever comes first.

Now the Special enrollment period rules do not apply if employment or employer-provided group
health plan coverage ends during your initial enrollment period. Lets say you decide to enroll in
Medicare Part B while you are still in the group health plan or during the first full month when you
are no longer in the plan, your coverage will begin either:

On the first day of the month you enroll; or at your option, on the first day of any of the following
three months.

Now if you enroll during any of the remaining seven months of the “special enrollment period,” your
Medicare Part B coverage begins on the first day of the following month. If you do not enroll by the
end of the eight-month period, you then will have to wait until the next general enrollment period,
which begins January 1 of the next year. You also may have to pay a higher premium.

Sincerely,
Tom Caress
760-413-9749
medicareplansdirect.net




Tuesday, December 11, 2012

Health Care Reform

(Bloomberg) -- Health insurers who want to sell plans in states that refuse to create new U.S
 health-care marketplaces will have to pay fees for the federal government to regulate them.

Insurers will pay a fee of 3.5 percent of their premiums to sell plans in a federally run health
exchange, the government said today in a regulatory filing. The exchanges are new market
places somewhat like online travel services where uninsured people will buy policies.

Each state must tell the federal government by Dec. 14 whether they will run an exchange.
So far, 17 have said they won’t build one, according to the nonprofit Kaiser Family Foundation
of Menlo Park, California. In another six, the government will build the exchange and run it in
partnership with the state. The total amount of the fee announced today won’t be known until
all states have made their decisions, the government said.

The proposed regulation also describes how the government will prevent insurers from
cherry-picking healthy customers in the exchanges. The rule “will help to ensure that every
American has access to high-quality, affordable health insurance,” the Department of Health
and Human Services said in the filing.

Sincerely,
Tom Caress
760-413-9749
medicareplansdirect.net

Monday, December 10, 2012

Medicare Part B

Medicare Part B covers outpatient and preventative services, including:

> Office visits to specialists

> Ambulance transportation

> Outpatient diagnostic test (such as blood tests and urinalyses)

> Various outpatient therapies your doctor may prescribe, such as Occupational Therapy

> Preventative services, such as diabetes services and the flu shot


If you are eligible for Medicare Part A, you are also automatically enrolled in Medicare
Part B but you can choose not to be.  When you enroll in Medicare Part B, you will pay
a monthly premium. You must enroll in Medicare Part B when you are eligible because
for every year that you wait to join, the monthly premium permanently increases by ten
percent. For example, if you wait five years after you become eligible to enroll your
monthly premium will have permanently increased by 50 percent. (This does not apply if
you are part of an employer group plan that is only available to current employees.)



 Sincerely,
Tom Caress
760-413-9749

Thursday, December 6, 2012

What is Medicare Part A

What is Medicare Part A?

Medicare Part A will cover hospital inpatient services. This includes stays in a hospital or nursing
facility.It also pays for some home care and hospice. Now Medicare Parts A and B are sometimes
called "Original Medicare." Original Medicare is different from private insurance plans like health maintenance organizations, or HMOs.  HMOs will restrict you to doctors or hospitals in their
network. Traditional Medicare allows you to go to any doctor or hospital that accepts Medicare.
Original Medicareis also called a "fee-for service," which has to do with how the doctor or
hospital gets paid. This is what this plan covers in detail:

Nursing Home or Skilled Nursing Facility

The coverage is limited to a maximum of 100 days in a period. The first 20 days are paid in full,
and the remaining 80 days will require a co-payment. Medicare Part A will not cover long-term
care, non-skilled care, daily living, or custodial activities.

Hospice Care

This is for the terminally ill who have six months or less to live. This Coverage will include pain
relief and symptom control drugs, medical and support services, grief counseling, and other services.

Home Health Services

Home health services include limited reasonable and only medically necessary part-time care and
services such as skilled nursing care, physical or occupational therapy, home health aide service,
speech language pathology, medical services.

We specialize in Medicare Advantage plans and  Medicare Supplement plans so contact our
agency and an agent can assist you and make sure you fully understand your options and make
sure you get the best rates available. We cover Southern California,counties of Riverside,
San Bernardino and surrounding area's. We also cover Nevada and all of Utah.  Please visit
 us online at Medicareplansdirect.net or call 760-413-9749.

Sincerely,
Tom Caress
760-413-9749




Wednesday, December 5, 2012

Medicare Part D

Medicare Part D offers prescription drug coverage within a regular Part D prescription
drug plan or through some Medicare Advantage plans. If you are already receiving
coverage from Medicare parts A and B, you must sill actively enroll in Part D and
be sure to choose a plan that covers the prescriptions you need. You can no long
purchase Medigap plan that includes prescriptions drug coverage.

When choosing a Part D prescription drug plan keep these few things in mind:

Know what drug your Part D program covers.  You must know whether the plan covers
the medication you are using or could use in the near future. Also, find out whether
that particular plan covers generic as well as branded versions of the drugs. 

What pharmacies do you buy or will buy your prescriptions from? Medicare prescription
drug plans limit drug purchases to an exclusive network of pharmacies. If you purchase
medication from a pharmacy that does not belong to your prescription plan network you
could end up paying a higher co-payment. Make sure you understand the network you
belong to.

Will you need "donut hole" coverage?  While recent legislation has brought some relief
to the amount you could spend if you reach this gap in coverage, you could still end up
spending thousands out of pocket. If you expect you might have expensive medications
or a high number of prescriptions in the future you might want to consider getting Part D
plan with donut hole coverage.

Individual Part D plan options vary from state to state and offer various levels of coverage
for different drugs. Make sure you compare premiums and co-payments from different
companies.

We specialize in Medicare Advantage plans and  Medicare Supplement plans so contact our
agency and an agent can assist you and make sure you fully understand your options and make
sure you get the best rates available. We cover Southern California,counties of Riverside,
San Bernardino and surrounding area's. We also cover Nevada and all of Utah.  Please visit
 us online at Medicareplansdirect.net or call 760-413-9749.

Sincerely,
Tom Caress
760-413-9749

Tuesday, December 4, 2012

Medicare Part C

Medicare Advantage, also known as Medicare Part C, is an option when you need more
coverage than your traditional Medicare plan. With the Medicare Advantage plan it allows
 you to substitute your basic plan with a private plan that is approved and subsidized by
Medicare. These plans help with hospital cost, doctor visits and other medical services that
you get with Original Medicare. Usually these plans offer coverage that improves on original
Medicare. For instance they can include prescription drug coverage, as well as coverage for
vision, hearing and even a health club membership.

Medicare advantage plans are run by private insurance companies and the levels of these
Medicare Advantage plans will  be different from insurance carrier to insurance carrier and
plan to plan. So make sure you shop around.

To apply for a Medicare Advantage plan you have to be eligible for Medicare and paying
your monthly Part B premium.  For most, you can enroll in a Medicare Advantage plans when
you hit 65 or once a year during the annual enrollment period. A lot of Medicare Advantage
plans come with an annual deductible to help keep your monthly premium down. You pay a
co-pay, or co-insurance, for only the services you use and not for those you don't use.

We specialize in Medicare Advantage plans and  Medicare Supplement plans so contact our
agency and an agent can assist you and make sure you fully understand your options and make
sure you get the best rates available. We cover Southern California,counties of Riverside,
San Bernardino and surrounding area's. We also cover Nevada and all of Utah.  Please visit
 us online at Medicareplansdirect.net or call 760-413-9749.

Sincerely,
Tom Caress
760-413-9749


Monday, December 3, 2012

Medicare Advantage Star Ratings

Medicare Advantage Star Ratings

In 2010 Medicare introduced a new Medicare Advantage rating system that
highlights plans with services that are better that average. The Medicare
Advantage plan is rated based on how the plans measures up to guidelines
set by CMS. The plans can receive a star between one and five. Five being
the best. The system allow consumers to identify the best Medicare Advantage
plans while rewarding insurance companies by providing incentive to improve
their health care services.

Each Medicare Advantage plan is rated by Medicare on 36 performance factors grouped
in five different categories:

* management of chronic health conditions

* keeping plan members healthy

* appeals and complaints by beneficiaries

* care and responsiveness of the plan

* customer service provided on the telephone


Medicare Advantage plans will be awarded additional payments in 2012 based on their ratings.
CMS has proposed using these rating to fund plans based on quality factors through 2014.

We specialize in Medicare Advantage plans and  Medicare Supplement plans so contact our
agency and an agent can assist you and make sure you fully understand your options and make
sure you get the best rates available. We cover Southern California,counties of Riverside,
San Bernardino and surrounding area's. We also cover Nevada and all of Utah.  Please visit
 us online at Medicareplansdirect.net or call 760-413-9749.

Sincerely,
Tom Caress
760-413-9749