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When You’re Not Feeling Well Do You go to the ER, Urgent Care or a Retail Minute Clinic?

You wake up with a horrible headache, fever and dizzy. You feel sick all over.  You think you should see a doctor or a nurse but it’s Sunday and your primary physician doesn’t have office hours today. Who do you call for to get treatment? Do you call 911 for an ambulance to take you […]

Medigap Enrollment and Medicare Supplement Update

Key Findings

  • The share of beneficiaries with Medigap varies widely by state—from 3 percent in Hawaii to 51 percent in Kansas.
  • Federal law provides limited consumer protections for adults ages 65 and older who want to purchase a supplemental Medigap policy—including, a one-time, 6-month open enrollment period that begins when they first enroll in Medicare Part B.
  • States have the flexibility to institute consumer protections for Medigap that go beyond the minimum federal standards. For example, 28 states require Medigap insurers to issue policies to eligible Medicare beneficiaries whose employer has changed their retiree health coverage benefits.
  • Only four states (CT, MA, ME, NY) require either continuous or annual guaranteed issue protections for Medigap for all beneficiaries in traditional Medicare ages 65 and older, regardless of medical history (Figure 1). Guaranteed issue protections prohibit insurers from denying a Medigap policy to eligible applicants, including people with pre-existing conditions, such as diabetes and heart disease.
  • In all other states and D.C., people who switch from a Medicare Advantage plan to traditional Medicare may be denied a Medigap policy due to a pre-existing condition, with few exceptions, such as if they move to a new area or are in a Medicare Advantage trial period.

Life Insurance Facts to Consider

Many of us take life insurance for granted. If your employer offers it to you, it’s probably something that you never stopped to review. If you don’t have it as an employee benefit when was the last time you reviewed your coverage. Consider if these statements apply to you You have life insurance and the […]

It’s Summertime – Make Sure Your Staying Cool!

The weather is finally warming up.  You’ve taken off all of your layers, hats, scarves and gloves.  Now, you and your family are ready to enjoy the warm sun. But, have you thought about what it takes to stay safe from the hot sun during the summer months. Did you know that in 244 people died […]

Deducting Medicare costs on your taxes

Medicare premiums for Part B and Part D are indeed tax-deductible, as are supplement premiums for added insurance.

You can also deduct your out-of-pocket costs under Medicare, such as copayments, prescription expenses, and the like.

There's just one catch: You can only deduct expenses that exceed a certain portion of your income, so if you earn too much or don't spend enough, you're out of luck.

Medicare Advantage

Medicare Advantage Plan Types

Medicare contracts with insurers to offer the following types of health plans:

HMOs and Local PPOs contract with provider networks to deliver Medicare benefits. HMOs account for the majority (63%) of total Medicare Advantage enrollment in 2017; local PPOs, account for 26% of all Medicare Advantage enrollees (Figure 3).

Medicare Advantage: How Robust Are Plans’ Physician Networks?

This report is the first known study to examine the size and composition of Medicare Advantage plans’ physician networks. This analysis draws upon data from 391 plans, offered by 55 insurers in 20 counties, and accounted for 14% of all Medicare Advantage enrollees nationwide in 2015. Key findings include:

19 million people on Medicare are in a #MedicareAdvantage plan, yet little is known about their provider networks.

Feds: Skimping can’t save seniors from rising med cost

— Drugmakers raised prices more rapidly for the most commonly used brand-name medications, with the highest demand among Medicare patients. Average costs for the 200 drugs with the most prescriptions in 2015 rose at nearly double the rate of increase for branded drugs as a whole.

—The share of Medicare enrollees spending $2,000 a year or more of their own money for brand-name drugs nearly doubled over the five years studied, reaching 7.3 percent in 2015.

—Total program spending for brand-name drugs increased by 77 percent from 2011 to 2015, from $58 billion to $102 billion. That statistic is a measure of taxpayers’ growing exposure.

A Look Into the Medicare Prescription Part D Drug Plan

As the new millennium arrived, so too did the introduction of the Medicare Part D by President Clinton. Also known as the Medicare Prescription Drug Benefit Program, the program provides prescription drug coverage to eligible participants. Up until the implementation of Medicare Part D in 2006, Medicare did not cover the cost of self-administered prescription […]

For years, confusion has surrounded the conditions under which older adults can receive physical, occupational and speech therapy covered by Medicare.

For years, confusion has surrounded the conditions under which older adults can receive physical, occupational and speech therapy covered by Medicare.

Medicare Beneficiaries Feel The Pinch When They Can’t Use Drug Coupons

Medicare Part D Rules, under the federal anti-kickback law, it’s illegal for drug manufacturers to offer people any type of payment that might persuade them to purchase something that federal health care programs like Medicare and Medicaid might pay for. The coupons can lead to unnecessary Medicare spending by inducing beneficiaries to choose drugs that are expensive.

Drugmakers Blamed For Blocking Generics Have Jacked Up Prices And Cost U.S. Billions

Drugmakers Blamed For Blocking Generics Have Jacked Up Prices And Cost U.S. Billions

Advocacy groups blast CMS for incorrectly promoting MA plans, misleading beneficiaries

Three Medicare beneficiary groups say the Centers for Medicare & Medicaid Services (CMS) is improperly propping up Medicare Advantage plans by misinforming beneficiaries through official educational documents. 

It’s Disability Awareness Month – Make Sure It’s Part of Your Plan for Facing the Unexpected

May is disability awareness month, a reminder that it’s important to evaluate if disability insurance is part of your income protection plan. Disability insurance provides financial protection at stressful time and is very different from other insurance products. An illness or injury can happen to anyone. Disability insurance pays you a portion of your salary […]

Help Your Doctor Help You

When your doctor asks you how you’re doing, he or she is not just being polite. Your doctor wants to know what’s going on in your life. Going to the doctor isn’t fun, but not communicating with him or her can be a critical mistake.  That’s why it’s important to share what’s going on in […]