Who Needs Extra Protection During Flu Season?

The flu season is upon us once again, and it’s time to make sure you and your loved ones are protected. The flu is more than just a pesky inconvenience; it can be a serious illness that leads to hospital visits and even death. By getting vaccinated, not only are you protecting yourself from getting sick, but you’re also playing a significant role in preventing the flu from spreading to others. Where to Get Your Flu Shot Getting a flu shot is convenient and accessible. You can receive one at your doctor’s office, your local pharmacy, or various clinics in your area. Plus, if you’re covered by Medicare, you’re in… Read More

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How income affects your Medicare drug coverage premiums

You could pay a higher monthly premium for Medicare drug coverage (Part D) depending on your income. This includes Part D coverage you get from a Medicare drug plan, a Medicare Advantage Plan with drug coverage, or a Medicare Cost Plan that includes drug coverage. This is true even if your drug coverage is through your employer. Download this bulletin to learn more about extra Medicare drug coverage premiums 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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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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Medicare Freezes Late Enrollment Penalties for Qualifying Enrollees

Many people enroll in Medicare as soon as they can, unless they have creditable coverage from an employer or other source. Why? Often, it’s because they’re looking to avoid Medicare late enrollment penalties. This year, due to ongoing issues at the Social Security Administration, Medicare has decided to extend a grace period for anyone who isn’t enrolled in Parts A and B but is eligible to do so. This will assist a number of people who would have otherwise been hit with a late enrollment penalty.Click Here For more info on this Article! Or call into Total Benefits Solutions at (215) 355-2121

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Medicare Supplement Plan F or G?

  Many of our clients ask what is the “best” Medicare supplement that they can buy. While there is no overall “best”, the Medicare Supplement Plan F is generally considered the most comprehensive coverage among Medicare supplements due to the fact that most services are covered without any member co-pay or cost sharing at all. Keep in mind that Medicare supplements, like Plan F do not cover prescriptions and that a beneficiary with Medicare supplement will need to have other coverage for prescription drug coverage.  A little known fact about Medicare supplements is that they do not have an annual “open enrollment” period so a beneficiary with a supplement can… Read More

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“I’m paying for Health Insurance I don’t even use!”

You hear it all the time: “I’m paying for Health Insurance I don’t even use!” But, Health insurance isn’t only for when you’re sick!  You can use it to maintain your healthy status, you can use it for Preventative Care and you can also use this time to learn how your coverage works before you get sick. Also, many Health Insurance Plans offer things such as discounted gym memberships and rewards for healthy lifestyle choices (such as quitting smoking). Some plans even offer vision or dental benefits, so you can take advantage of an eye screening or 6 month dental check-up. Take advantage of free insurance benefits anytime Get preventive services,… Read More

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Your New Medicare Card is on the way! Watch out for scams!

Watch out for scams Your new Medicare card is on the way, so if someone calls and says you need to give them your personal information or money to get the new card, hang up! It’s a scam. Medicare will never call uninvited and ask for personal information or money for you to get your new Medicare Number and card. Learn what to do if you get a suspicious call like this. If you haven’t gotten your new Medicare card yet, don’t worry. Mailing cards to each group of states takes at least a month, so you might get your card at a different time than friends or neighbors in your area.… Read More

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Can I Work and Have Medicare?

Some individuals, maybe even you, will still be actively employed upon becoming eligible for Medicare. Can you enroll in Medicare while you’re still in the work force, and if not, will you get a penalty? If the employer has fewer than 20 employees, you’ll probably want to enroll in Parts A, B, and D upon becoming eligible for them. In this situation, Medicare usually becomes your primary coverage. If the employer has 20 employees or more, you may want to delay Parts A, B, and/or D if you have sufficient group coverage and know you won’t incur late enrollment penalties. Medicare usually pays second to group coverage from larger employers.… Read More

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Independence speaks out on PA Premium Tax, Treat No Transport, and recently introduced bills

Independence speaks out on PA Premium Tax, Treat No Transport, and recently introduced bills Updates from IBX Government Affairs including the proposed PA premium tax changes, Treat No Transport reimbursement, scope of practice for nurse practitioners, and proposed bills on drug transparency and prior authorization… Download the Bulletin See IBC’s breakdown of the proposed budget impact here. As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any questions or concerns.

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Did You Know About Medicare’s Preventative Services?

Medicare pays for many preventive services to keep you healthy. Preventive services can find health problems early, when treatment works best, and can keep you from getting certain diseases. Preventive services include exams, shots, lab tests, and screenings. They also include programs for health monitoring, and counseling and education to help you take care of your own health. The Affordable Care Act makes many improvements to Medicare. If you have Original Medicare, you can get a yearly “Wellness” visit and many other covered preventive services! Click here to download Medicare’s Preventative Services Guide Click below to watch a video from Medicare about the preventative services benefits.

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Medicare and Employer Coverage

From the Medicare Rights Center download this excellent Q&A about Medicare Coverage, the guidelines and how it may or may not integrate with employer coverage. Part-2-QA-Current-Employer-Insurance Have more questions about Medicare and your employer coverage? Call your Total Benefit Solutions, Inc account manager today at (215)355-2121.           Learn more on Medicare Interactive.

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8 things to know about Medigap policies

Medicare Supplements or Medigap Plans A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy… Read More

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IBC: What is Medicare Video

A Simple video from Independence Blue Cross explaining Medicare. As always please contact Total Benefit Solutions, Inc if you have any questions or concerns about Medicare health insurance or supplements at (215)355-2121.

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Download: Medicare Made Clear

Download Medicare Made Clear: From our partners at United Healthcare and Medicare Made Clear, download the 2016 version of the Show Me Guide for an impartial overview of Medicare plans as well as eligibility, glossary, frequently asked questions and more. A virtual Medicare training in one handy workbook! Download Show Me Guide 2016 As always, if you have any questions about Medicare health plans, eligibility and more, contact you Total Benefit Solutions account manager at (215)355-2121.      

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Medicare Exclusions-Who Pays First?

Medicare primary payer rules are complicated. Especially when it comes to different employer sizes and special circumstances like End Stage Renal Disease and disabilities.  Coverage issues can be significantly complex when mixing Medicare and employer coverage, or individual coverage for those who are early Medicare enrollees. Chances are, if you are already enrolled on Medicare, AND you are getting bills from providers, you are already experiencing these problems, or you are encountering a coordination of benefits issue. It’s always best to speak to a professional when encountering these problems, most especially a health insurance professional. If at all possible, before getting enrolled on Medicare. The documents below may help provide… Read More

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Fraud, Waste & Abuse-Did You Know?

Fraud, Waste & Abuse: did you know? As a nation, we spend over $2.7 trillion on healthcare every year, and it is estimated that tens of billions are lost each year to FWA.  One recent study estimated that fraud and abuse added as much as $98 billion to annual spending on Medicare and Medicaid. It affects not only the cost but quality of care received. Combating healthcare fraud in Medicare and Medicaid is an important priority for the Federal Government. The Centers for Medicare & Medicaid Services (CMS), the Federal agency responsible for administering these programs, takes its role in leading anti-fraud efforts very seriously and has issued strict requirements… Read More

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What about Medicare Supplements or Medigap Policies?

Medicare Supplements or Medigap Plans A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy… Read More

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CMS has uploaded a new video Medicare & You: Cervical cancer

Get information about how Medicare can help you detect cervical and vaginal cancer.  

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If an employee turns age 65 this month and enrolls in Medicare Part A, can he still receive/contribute funds into an HSA?

Question: If an employee turns age 65 this month and enrolls in Medicare Part A, can he still receive/contribute funds into an HSA until the end of the year or must he enroll in a different plan now? Answer: If an employee is enrolled in Medicare, then beginning with the first month the employee is enrolled in Medicare, he can no longer contribute to the health savings account (HSA). However, the money that is already there is still his. Note that whether or not the employee is eligible to make new HSA contributions, existing HSA account funds are not affected. Even if the employee is no longer HSA-eligible, he or… Read More

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2015 Medicare Part B premiums and deductibles to remain the same as last two years

Premiums, copays and deductibles for other Medicare programs for 2015 also announced  Secretary of Health and Human Services Sylvia Burwell announced today that next year’s standard Medicare Part B monthly premium and deductible will remain the same as the last two years. Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items.  For the approximately 49 million Americans enrolled in Medicare Part B, premiums and deductibles will remain unchanged in 2015 at $104.90 and $147, respectively. This leaves more of seniors’ cost of living adjustment from Social Security in their pockets.

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Medicare: Medicare & You Online

Did you know? You can go paperless and get your Medicare and You Handbook Online!   As always, if you have any questions about Medicare health plans, please contact your Total Benefit Solutions account manager at (800)924-6718 or (215)355-2121.  

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Aetna: Small Group Medicare Plans Being Discontinued

Aetna Small Group Medicare Plans will be Discontinued January 1, 2015 Total Benefit Solutions Inc received the following notification from Aetna that they will be not be renewing Small Group Medicare plans effective January 1, 2015. We have included a link to the original notification as well as a brief summary below. Please click on the link for the complete announcement and disclaimers from Aetna. Click here to read the rest of the release    

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Amerihealth: Medicare PDP RX Plans Going Away

AmeriHealth® Medicare Rx PDP Non-Renewal  This week, AmeriHealth Medicare Rx PDP members will receive a non-renewal notice in the mail. Coverage will end for these members on December 31, 2014. This non-renewal applies only to AmeriHealth Option I and II stand-alone prescription drug plans. Members will need to enroll in another Medicare drug plan in order to get prescription drug coverage for 2015. AmeriHealth Rx PDP members will be given a Special Enrollment Period (SEP) to enroll in a new prescription drug plan. Members can enroll in a new plan anytime from October 15, 2014 through February 28, 2015. If members do not choose a new plan during this time, they… Read More

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Medicare: Video-Parts of Medicare

  CMSHHSgov has uploaded Medicare & You: Different Parts Of Medicare :     As always, if you have any questions about Medicare health plans, please contact your Total Benefit Solutions account manager at (800)924-6718 or (215)355-2121.  

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Medicare: What are the STAR ratings?

Many of our clients ask us what the STAR ratings for each health plan really mean. Medicare.gov gives us the answer as: The Overall Star Rating combines scores for the types of services each plan offers: What is being measured? For plans covering health services, the overall score for quality of those services covers 36 different topics in 5 categories: Staying healthy: screenings, tests, and vaccines: Includes whether members got various screening tests, a yearly flu shot, and other check-ups that help them stay healthy. Managing chronic (long-term) conditions: Includes how often members with different conditions got certain tests and treatments that help them manage their condition. Member experience with the health plan: Includes… Read More

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