Medicare Part D Coverage Gap – Page 5 – Total Benefit Solutions Inc

Medicare & Coronavirus

July 27, 2022July 14, 2022Ed MacConnell

Medicare covers the COVID-19 vaccine at no cost to you. Medicare covers the vaccine for anyone who has Medicare due to their age, a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). Be sure to bring your Medicare card. To learn more about Medicare and the COVID-19 vaccine and boosters, click here. If you have Medicare and have a disability or face other challenges in getting to a location away from home for a vaccination, Medicare will pay a doctor or other care provider to give you the COVID-19 vaccine in your home. You may need to give them your Medicare Number for billing, but there’s… Read More

What’s Not Covered by Part A & Part B?

July 25, 2022July 14, 2022Ed MacConnell

Medicare doesn’t cover everything. Some of the items and services Medicare doesn’t cover include: Long-Term Care (also called custodial care ) Most dental care Eye exams related to prescribing glasses Dentures Cosmetic surgery Acupuncture Hearing aids and exams for fitting them Routine foot care To find out if Medicare covers a test, item, or service you need, click here. The professionals at Total Benefit Solutions, Inc are here to help you understand your Medicare Health Insurance choices. Call us today at (215)355-2121.

Did you know? Aetna Medicare Supplement Members can pay their premiums now at CVS stores?

July 23, 2022July 19, 2022Ed MacConnell

Members with Aetna Medicare Supplement policies can now pay their monthly premiums at their local CVS store. Their billing statements (for premiums less than $999) will have a unique barcode, which they can take to their local CVS store. The cashier will scan it just like they do any other CVS merchandise. Members can then pay their premiums by cash, debit card, or credit card. NOTE: The pay in store option is not available at CVS in Target stores at this time. If you have any questions, please contact your Total Benefit Solutions, Inc Medicare supplement specialists at (215)355-2121

Case Study Library

July 22, 2022July 22, 2022Ed MacConnell

We present a few case studies to illustrate how we have helped our clients solve their complicated employee benefit challenges. Click here to learn more!

Time to Prepare for Medicare Part D Notice Requirements

July 20, 2022July 6, 2022Ed MacConnell

An important deadline is approaching quickly – October 15 for the Medicare Part D notice requirement. The creditable-coverage notice must be given to all Part D-eligible individuals who are covered under, or apply for, an employer’s prescription drug benefits plan. This requirement applies to Medicare beneficiaries who are active employees and those who are retired, as well as Medicare beneficiaries who are covered as spouses under active or retiree coverage. Click here for a video explaining Medicare Part D notices. Please contact your Total Benefit Solutions Inc Medicare health insurance specialists at (215)355-2121 if you have any questions or concerns.

Clarification of the Special Enrollment Period (SEP) for Government Entity-Declared Disaster or Other Emergency

July 8, 2022June 29, 2022Ed MacConnell

The memo clarified that the COVID-19 pandemic does not currently qualify for the SEP for Government Entity-Declared Disaster or Other Emergency (disaster SEP); however, it does qualify for the Exceptional Circumstances SEP. What you need to know: As a result of this guidance, do not submit enrollments for clients impacted by COVID-19 using the disaster SEP. Going forward, any new enrollments submitted for this reason will be declined.

What are Medicare Supplements? Medicare Basics The Series

June 30, 2022June 18, 2022Ed MacConnell

The professionals at Total Benefit Solutions, Inc are here to help you understand your Medicare Health Insurance choices. (215)355-2121

What is the IRMAA Surcharge?

June 23, 2022July 7, 2022Ed MacConnell

What is the IRMAA Surcharge? The income-related monthly adjustment amount (IRMAA) sliding scale is a set of statutory percentage-based tables used to adjust Medicare Part B and Part D prescription drug coverage premiums. The higher the beneficiary’s range of modified adjusted gross income (MAGI), the higher the IRMAA. Want to apply for relief from the IRMAA charges? The form required is posted below, just download and complete the form!

Lower 2023 Medicare Part B Premium Could Be on the Way

June 16, 2022June 16, 2022Ed MacConnell

Some changes in the health care industry resulted in expected cost savings for the Medicare program for 2022. CMS’ recent announcement states they plan on passing these savings to consumers via their 2023 Part B premium. Click here to read the details on the lower Part B Premium Please contact your Total Benefit Solutions Inc Medicare health insurance specialists at (215)355-2121 if you have any further questions or concerns.

How Medicare Works Part A

May 24, 2022May 24, 2022Ed MacConnell

How Medicare Works Medicare is a federal insurance program that provides health insurance for people 65 and older and individuals younger than 65 who may qualify due to certain disabilities. There are four different parts to Medicare — Part A, B, C, and D. Click the icons below to learn more about each part! Medicare Part A Medicare Part A can be thought of as your hospital insurance. It helps to pay for your stay at a health care facility, whether that be a hospital, skilled nursing facility, or nursing home, among others. If you’re admitted as an inpatient, Medicare Part A covers many services like meals, a semi-private room,… Read More

What is a 5-Star Medicare Plan?

May 5, 2022May 5, 2022Ed MacConnell

Did you know that Medicare plans come with a handy rating system and that the highest-rated of these plans have a Special Enrollment Period associated with them? Get ready to learn all about 5-star Medicare plans and what makes them special! Click here for more information! As always contact your Total Benefit Solutions Medicare health insurance specialists at (215)355-2121 with any additional questions or concerns!

What is Medicare’s Secondary Payer Program?

April 28, 2022April 28, 2022Ed MacConnell

Depending on your circumstances, you may be able to have Medicare and an additional type of health coverage to help you pay for health care costs. Medicare’s Secondary Payer Program lays out how they work together. It’s not uncommon to have an insurance plan for everything, just in case. You can have a Medicare plan, a drug plan, and a dental, vision, and hearing plan. You also may have life insurance, long-term care, and more. It’s possible to have one that plan encompasses mutliple types of coverage, like a Medicare Advantage plan that covers prescription drugs, and dental, vision, and hearing services. Sometimes, it’s possible to have multiple policies for a single… Read More

When Can You Enroll on a Medicare Advantage or Drug Card?

February 6, 2022February 6, 2022Ed MacConnell

What Are Medicare Guaranteed Issue Rights?

August 24, 2021August 23, 2021Ed MacConnell

2021 Second Quarter Compliance Bulletins Compilation

July 7, 2021July 7, 2021Ed MacConnell

This document is a valuable resource, putting all of the latest health care reform news and updates in one location!

CMS Announces Medicare Plan Finder Improvements

June 8, 2021April 23, 2024Ed MacConnell

What Is Medicare Supplement Insurance?

May 12, 2021May 14, 2021Ed MacConnell

Medicare coverage can be complex. Some of the rules of Medicare coverage can change without the beneficiary even knowing. Who even knows when their employer crosses an enrollment threshold? Best advice is to always speak to a health insurance specialist who is certified and experienced in the many facets of health insurance including the intersections between Medicare and Employer coverage. Contacting Total Benefit Solutions, Inc is the first step!

5 reasons you may want to switch Medigap policies

May 7, 2021May 7, 2021Ed MacConnell

Indy Medicare Part D Health Plan Terminated

April 14, 2021April 23, 2021Ed MacConnell

Indy Health Insurance Company, a stand-alone Part D plan in Arkansas, Pennsylvania, West Virginia, Illinois, and Georgia has been terminated.

Does Medicare Cover Oral Surgery?

April 5, 2021April 2, 2021Ed MacConnell

Can Employers Pay Medicare Premiums for Active Employees?

April 17, 2019April 17, 2019Ed MacConnell

Companies with fewer than 20 employees that offer group health coverage that pays secondary to Medicare (those not subject to the MSP rules) may be able to pay for the Medicare Part B, Part D, and Medicare Supplement Insurance premiums for their active employees. This is known as a Medicare Premium Reimbursement Arrangement. However, this is not an option for companies with 20 or more workers that are subject to the Medicare Secondary Payer provisions. All companies, regardless of size, can pay the health insurance or Medicare premiums for their retired employees, but no company can payfor individual health insurance coverage for their active employees . Our best practice: A… Read More

What is Medicare?

November 7, 2018June 12, 2023Ed MacConnell

It’s important to know your benefits and how they work together. Here is an easy to understand article so you fully understand Medicare’s Parts in order to customize coverage that works for you! Here at Total Benefit Solutions, Inc we have highly trained and certified Medicare Enrollment Specialists to help you each step along the way. If your Medicare options confuse you, or you just want the piece of mind of having an impartial review your needs prior to selecting a plan, feel free to reach out to us at 215-355-2121! Medicare Part A helps cover hospital costs. This part is free for most and is provided by the federal… Read More

Common Questions: Rules For Your HSA After Becoming Medicare Eligible

October 16, 2018October 16, 2018Ed MacConnell

Medicare and Your HSA In 2017, over 22 million Americans have a Health Savings Account. Each year that number goes higher and higher as High Deductible Plans become more popular with Individuals and Employers. Once you turn 65 and enroll in Medicare, you can no longer open an HSA or deposit money into it, but what if you already had one with a balance? You don’t have to worry about a “Use It Or Lose It” clause. That money can still be used towards out-of-pocket costs! Here are some very common questions about how you can continue to benefit from your HSA and why keeping funds in it for your… Read More

President Trump Signs Prescription Drug Gag Clause Legislation

October 16, 2018Ed MacConnell

President Trump Signs Prescription Drug Gag Clause Legislation On Wednesday, President Trump signed into law S. 2553, the Know the Lowest Price Act, and S. 2554, the Patient Right to Know Drug Price Act. The legislation was passed by the House and Senate last month with bipartisan support and will ban “gag clauses” that prevent pharmacists from telling customers when they can save money on their prescriptions by paying out of pocket for the retail price of the drug, rather than using their insurance and making the co-payment. These bills comprise portions of President Trump’s “America First” prescription drug initiative that were released as part of a blueprint to lower drug prices in May.… Read More

Medicare Part D Notification Requirements

September 20, 2018Ed MacConnell

Employers sponsoring a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as to whether the drug coverage provided under the plan is “creditable” or “non-creditable” prior to October 15th, 2018. Please follow this link for more information: Medicare Part D Notification Requirements As always, if you have any questions or concerns about this notification or your specific policy, please contact us at 215-355-2121

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this: