How can I get help with my Medicare Part A and Part B premiums?

(En español) States must help pay some of the Medicare costs for beneficiaries who have limited income and resources. Under these programs, states help pay for Medicare Part A and Part B premiums, deductibles and copayments. Some of these programs also pay additional Medicare expenses for elderly and disabled people. To find out if you are eligible for state help, contact your local medical assistance office. A representative can tell you the specific requirements and help you apply. If you have any questions or concerns please contact your Total Benefit Solutions, Inc Medicare health insurance specialist at (215)355-2121.

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Navigating the 2024 CMS Final Rule: What You Need to Know

The Centers for Medicare and Medicaid Services (CMS) have set the stage for significant changes with their Final Rule provisions for 2024, slated to take effect on September 30, 2023. These updates will play a pivotal role as we gear up for the 2024 Annual Enrollment Period (AEP). The main points of the new rules Stay Informed: For more insights on these changes and additional updates, please visit the full 2024 CMS Final Rule here. As always if you have any questions or concerns about this bulleting please contact your Medicare health insurance experts at Total Benefit Solutions, Inc (215)-355-2121

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Medicare Diabetes Prevention Program: PDF Download

Medicare covers a health behavior change program to help you prevent or delay type 2 diabetes. The program includes 22 group sessions with a behavior coach who works with you to make lasting diet and exercise changes. You’ll also get support to keep you motivated. For a comprehensive understanding of Medicare prevention programs, download this informative PDF today! As always if you have any questions or concerns about this bulleting please contact your Medicare health insurance experts at Total Benefit Solutions, Inc (215)-355-2121

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Annual Enrollment Period: Your Path to Tailored Medicare Coverage

Are you ready to take charge of your healthcare journey? The Annual Enrollment Period (AEP) is swiftly approaching, and it’s your golden opportunity to customize your Medicare coverage to align perfectly with your evolving health needs. At Total Benefits, we’re here to guide you through this crucial period, ensuring that your Medicare plan reflects your unique requirements and aspirations for a healthy future. AEP: Your Key to Tailored Coverage: Circle the dates on your calendar: AEP commences on October 15 and concludes on December 7. These six weeks are a window of empowerment, during which you hold the reins to make changes that suit you best. Whether you’re seeking enhanced… Read More

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Mark Your Calendars for These Crucial Medicare Dates!

We’ve got some important dates coming up that you’ll want to circle on your calendars. Your Medicare choices are about to take center stage, and we’re here to help you navigate them like a pro! Pre-Annual Election Period (Pre-AEP) – Starting 10/1 Get ready to dive into the world of Medicare choices! The Pre-AEP is your head start, your chance to gather information and get prepared for what’s ahead. It’s like laying the groundwork for a solid plan that suits your needs. Medicare Annual Election Period (AEP) – Starting 10/15 This is the moment you’ve been waiting for! The AEP kicks off on October 15, and it’s your golden opportunity… Read More

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Understanding When Your Medicare Coverage Starts

Approaching 65 or exploring Medicare? Knowing when your coverage begins is vital for your protection and preparation. Enrollment timing is key for activating your benefits. Let’s simplify the essentials of when your Medicare coverage starts. Initial Enrollment Opportunity Medicare coverage launch centers around your Initial Enrollment Period, typically when you turn 65. This 7-month period spans 3 months before and after your 65th birthday. Coverage Commencement Date Your coverage initiation hinges on your sign-up month during the Initial Enrollment Period. Note that coverage always begins on the first day of the month. Late Part A Enrollment Opting for Part A after 65? Coverage begins six months back from your sign-up… Read More

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Medicare Covers Diabetes Supplies & Services for Your Health

Discover the power of Medicare, a federal health insurance program in the US designed for individuals aged 65 and older, as well as certain younger people with disabilities, providing access to essential medical services and supplies. Don’t miss the invaluable “Medicare Coverage of Diabetes Supplies, Services, & Prevention Programs” booklet available on Medicare.gov/publications. This comprehensive guide highlights coverage options for individuals with diabetes, including supplies and services, preventive programs, and access methods. Plus, it features a must-have checklist for your next doctor’s visit, empowering you to ask the right questions about treatments, preventive services, covered supplies, and lifestyle recommendations. Take control of your diabetes management and overall well-being with this… Read More

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Medicare Diabetes Prevention Program

If you have been diagnosed with prediabetes, it’s essential to take proactive steps to manage your condition and reduce the risk of developing type 2 diabetes. The good news is that there are programs available designed specifically to assist individuals like you in preventing or delaying the onset of type 2 diabetes. These programs often encompass a comprehensive approach that includes education, lifestyle modifications, and support systems tailored to your specific needs. Let us help, don’t miss this opportunity to take control of your health and potentially prevent the development of type 2 diabetes. Download this PDF for more information! As always if you have any questions or concerns about… Read More

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Medicare Coverage of Diabetes Supplies, Services, & Prevention Programs: Booklet

This booklet explains Medicare coverage of diabetes supplies and services in Original Medicare and with Medicare drug coverage (Part D). Original Medicare is fee-for-service coverage. The government usually pays your health care providers directly for your Medicare Part A (Hospital Insurance) and/or Part B (Medical Insurance) benefits. If you have other insurance that supplements Original Medicare, like a Medicare Supplement Insurance (Medigap) policy, it may pay some of the costs for some.services described in this booklet. For a comprehensive understanding of Medicare coverage for diabetes supplies and services, download this informative booklet today! As always if you have any questions or concerns about this bulleting please contact your Medicare health… Read More

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Understanding the Plan Annual Notice of Change (ANOC) in Medicare

Staying informed about your healthcare coverage is vital, especially when it comes to Medicare plans. One key document that plays a significant role in this process is the “Plan Annual Notice of Change” or ANOC. What is the ANOC? If you’re enrolled in a Medicare plan, the ANOC is your compass for upcoming changes. Every fall, your plan sends you this crucial document, detailing any adjustments that will take effect in January. These changes encompass a range of aspects, from coverage modifications to shifts in costs and more. When Can You Expect It? Mark your calendars for September. This is the month when the ANOC usually arrives, providing you with… Read More

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Medicare Coverage of Home Health Care: Booklet

This booklet describes the home health care services that Medicare covers, and how to get those benefits through Medicare. If you get your Medicare benefits through a Medicare health plan (not Original Medicare) check your plan’s membership materials and contact the plan for details about your Medicare-covered home health benefits. Download the Medicare Coverage of Home Health Care: Booklet to help you understand the home health services that Medicare covers and much more. As always if you have any questions or concerns about this bulleting please contact your Medicare health insurance experts at Total Benefit Solutions, Inc (215)-355-2121

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Are You Up To Date on Your Preventive Services?

Medicare covers a full range of preventive services to help keep you healthy and find problems early when treatment works best. Ask your doctor what services are right for you and use the document below to track appointment dates, times, and other important information. Download our Medicare check list sheet below to help you keep track of your Preventive Services! If you have any questions or concerns, please contact your Total Benefit Solutions, Inc Medicare health insurance specialist at (215)-355-2121.

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4R’s for Fighting Medicare Fraud

This comprehensive and insightful factsheet is specifically designed to equip individuals who are enrolled in Medicare with invaluable knowledge and effective measures to actively combat Medicare fraud. With a focus on promoting awareness and prevention, this factsheet not only educates beneficiaries about the various types of Medicare fraud but also offers practical advice and actionable steps to detect, report, and prevent fraudulent activities. By implementing the recommended measures outlined in this factsheet, individuals can actively participate in safeguarding the integrity of the Medicare program, ensuring that their healthcare benefits are utilized for their intended purpose while mitigating the risk of falling victim to fraudulent schemes. This factsheet provides a person… Read More

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Exploring the Traits of Medicare MSA Plans

As the healthcare landscape continues to evolve, so do the options available for Medicare beneficiaries. One such option gaining traction is the Medicare Medical Savings Account (MSA) plan. Designed to provide a unique blend of control, flexibility, and financial freedom, the MSA plan is worth considering for those seeking a personalized approach to their healthcare needs. 1. High Deductible Health Plan (HDHP): Balancing Costs and Coverage At the core of the Medicare MSA plan is the High Deductible Health Plan (HDHP). This plan structure offers beneficiaries a way to balance out-of-pocket expenses with coverage. The idea behind the HDHP is that you’ll have a higher deductible to meet before your… Read More

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Decoding Medicare Supplement Charts

So, you’re on the quest to unravel the complexities of Medicare supplement plans, and in your journey, you’ve stumbled upon the elusive “Medicare Supplement Comparison Chart.” It’s like a mosaic of options, donning a variety of colors and fonts, yet each one is strangely reminiscent of the other. But what exactly are these charts? What secrets do they hold? Well, that’s what we’re here to uncover today. Cracking Open the Chart Imagine this: you’re face-to-face with a Medicare Supplement Comparison Chart. But what’s beneath the surface? Every column you see represents one of the ten available Medigap plans up for grabs – think Plans A, B, C, D, F, G,… Read More

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CMS announces lower Medicare Part D premium for 2024 

According to an official statement by the Centers for Medicare and Medicaid Services (CMS) on Monday, the projected average total premium for Part D beneficiaries is anticipated to decrease by 1.8% in 2024. This reduction would bring the average monthly premium down to $55.50 from the 2023 figure of $56.49. The computed average monthly premium for Medicare Part D coverage in 2024, at $55.50, encompasses the combined average basic premium and the supplementary premium for plans featuring enhanced coverage. CMS emphasizes that this projection offers the most precise estimate of individuals’ 2024 Part D premium expenses. In addition to this update, CMS has disclosed several other important figures for the… Read More

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CMS Issues Final Rule, Making changes to MA and Part D

In April, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule regarding the Medicare Advantage (MA) and Part D programs. The Final Rule includes changes related to various aspects of those programs, including utilization management (UM) programs, Star Ratings, marketing and communications, health equity, provider directories, and network adequacy. Click here to read the bulletin

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Making HSAs Work Smarter

In the dynamic world of employee benefits, leaders have come to grasp the immense potential benefits hold in achieving their key goals. One approach that has gained significant traction is the combination of High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs), a powerful duo that not only reduces benefits costs but also empowers employees with greater control over their healthcare expenses. However, despite the evident advantages, the journey to unlocking the full potential of HDHPs + HSAs is far from over. There lies an untapped opportunity to optimize plan design and elevate employee education, enabling companies to enhance their workforce’s well-being while achieving cost-effectiveness. If you are eager… Read More

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What is a Medicare MSA?

Medicare MSA (Medical Savings Account) is a specific type of Medicare Advantage plan available in the United States. However, please note that policies and plan names may change over time, so it’s important to consult official sources for the most up-to-date information. A Medicare MSA is a high-deductible health plan (HDHP) that works in conjunction with a medical savings account. It combines a high-deductible insurance policy with a savings account where funds are deposited and can be used to pay for eligible medical expenses. Here are some key features of a Medicare MSA: High-Deductible Health Plan: Medicare MSA plans have a higher deductible than traditional Medicare plans. This means you’ll… Read More

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Request to lower an Income-Related Monthly Adjustment Amount (IRMAA)

If you’ve had a life-changing event that reduced your household income, you can ask to lower the additional amount you’ll pay for Medicare Part B and Part D. Life-changing events include marriage, divorce, the death of a spouse, loss of income, and an employer settlement payment. Amended income tax returns Call +1 800-772-1213 and tell the representative you want to lower your Medicare Income-Related Monthly Adjustment Amount (IRMAA) if you had an amended income tax return. Fax or mail your request Fill out the Medicare Income-Related Monthly Adjustment Amount-Life-changing Event (SSA-44) (PDF) form. Fax or mail your completed form and evidence to a Social Security office. For support completing this task call +1 800-772-1213… Read More

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What Additional Changes Are Being Made to Part D?

As of 2023, the out-of-pocket cost of insulin products is limited to no more than $35 per month in all Part D plans. In addition, adult vaccines covered under Part D, such as the shingles vaccine, are covered with no cost sharing. Starting in 2024, people with Medicare who have incomes up to 150% of poverty and resources at or below the limits for partial low-income subsidy benefits will be eligible for full benefits under the Part D Low-Income Subsidy (LIS) Program. The law eliminates the partial LIS benefit currently in place for individuals with incomes between 135% and 150% of poverty. Also starting in 2024, the calculation of the… Read More

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How Is the Medicare Part D Benefit Changing in 2025?

Changes in 2025 include a new $2,000 out-of-pocket spending cap, elimination of the coverage gap phase, a higher share of drug costs paid by Part D plans in the catastrophic phase, along with a new manufacturer price discount and reduced liability for Medicare in this phase, and changes to plan costs and the manufacturer price discount in the initial coverage phase. Out-of-pocket drug spending will be capped at $2,000 Beginning in 2025, Part D enrollees’ out-of-pocket drug costs will be capped at $2,000. This amount will be indexed to rise each year after 2025 at the rate of growth in per capita Part D costs. (This cap does not apply… Read More

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How Is the Medicare Part D Benefit Changing in 2024?

In 2024, costs in the catastrophic phase will change: the 5% coinsurance requirement for Part D enrollees will be eliminated and Part D plans will pay 20% of total drug costs in this phase instead of 15%. The 5% coinsurance requirement for Part D enrollees in the catastrophic phase will be eliminated In 2024, once Part D enrollees without low-income subsidies (LIS) have drug spending high enough to qualify for catastrophic coverage, they will no longer be required to pay 5% of their drug costs, which in effect means that out-of-pocket spending for Part D enrollees will be capped. In 2024, the catastrophic threshold will be set at $8,000. This… Read More

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Medicare Cheat Sheet: Download Today

Medicare insurance can seem complex on your own. We’re here to help! Medicareful is our easy-to-use Medicare plan finder that compares some of the available plans in your area and connects you with a Total Benefit Solutions, Inc. licensed sales agent who will guide you through enrollment. Whether it’s a Medicare Supplement, Medicare Advantage Part C Plan, or a Medicare Part D drug plan, we’ve got you covered. https://medicareful.com/totalbenefitsolutions Download our Medicare cheat sheet below to help you keep track of your most important points while shopping for a Medicare supplement! Contact Total Benefit Solutions, Inc today at 215-355-2121 or www.totalbenefits.net to get started. 

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Video: Medicare Supplements vs. Medicare Advantage Plans. What’s the difference?

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