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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Reminder to Notify CMS

  Employers sponsoring a group health plan are required to report information on the creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). Download the bulletin below for details and specific links for employer reporting Download Medicare Part D – Reminder

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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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Total Benefit Solutions Joins Medicareful

How do I know which Medicare plans are right for me? Medicare Supplement, Medicare Advantage, Part D drug coverage — the options seem endless! Don’t worry, Medicareful is here to help. By entering your zip code, you’ll unlock all of the Medicare plans available in your area. You can navigate them on your own or leave it to our professionals who can guide you to a plan based on your needs.  From experience, we know how complex Medicare is and that people who work with trusted independent licensed sales agents are far more confident in their choices. It’s our job to help you find your plan, and we’re happy to do… Read More

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Medicare Premiums and Deductibles Updated for 2016!

As the Social Security Administration previously announced, there will no Social Security cost of living increase for 2016. As a result, by law, most people with Medicare Part B will be “held harmless” from any increase in premiums in 2016 and will pay the same monthly premium as last year, which is $104.90.   Beneficiaries not subject to the “hold harmless” provision will pay $121.80, as calculated reflecting the provisions of the Bipartisan Budget Act signed into law by President Obama last week. Medicare Part B beneficiaries not subject to the “hold-harmless” provision are those not collecting Social Security benefits, those who will enroll in Part B for the first… Read More

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Medicare Part D Creditable Coverage Notice Due Soon

Medicare Part D Creditable Coverage Notice The Medicare Modernization Act (MMA) requires employers whose policies include prescription drug coverage to provide a written disclosure notice to all Medicare eligible policyholders of whether such coverage is creditable. Creditable coverage means that the coverage is expected to pay, on average, as much as the standard Medicare prescription drug coverage.  This disclosure must be provided prior to October 15th, 2015 (and at various times as stated in the regulations) to: Medicare eligible active working individuals and their dependents (including a Medicare eligible individual when he or she joins the plan); Medicare eligible COBRA individuals and their dependents; Medicare eligible disabled individuals covered under… Read More

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Total Benefit Solutions Joins Geriatric Advisory Council

  Total Benefit Solutions is proud to announce that we have become a founding member of the Greater Philadelphia chapter of the Geriatric Advisory Council to better serve the needs of our senior clients.  The Geriatric Advisory Council is a professional organization comprised of local businesses and non-profit organizations who are focused on eldercare and senior related issues.The council was formed with the mission of assisting seniors and their caregivers by providing FREE educational resources along with targeted referrals to help caregivers provide the quality of life care that their loved ones need and deserve. Click here to learn more about the GAC and the professional resources available.

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Video: Independence Blue Cross Medicare Plans

  Enjoy the latest TV Commercial from Independence Blue Cross about their Medicare supplement plans. Remember, Independence Blue Cross is just one of the many insurers that  Total Benefit Solutions works with, on the healthcare.gov marketplace, on the private market, in the senior market and also small groups. Call us at (215)355-2121 to see if IBC has a plan that’s a good fit for you.

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Take Advantage of Medicare’s Free Preventive Services

  Many seniors are unaware that preventive tests, screenings and counseling sessions are now available for free, with no copays or deductibles, thanks to the Affordable Care Act. More than 60 million people took advantage of these services, at no cost to themselves, during the first three years after the services became free in 2011, according to government reports. Click the link below to download a list from Medicare for Dummies of Medicare preventative services. Medicares-preventive-services-chart13   Questions about Medicare eligibility, open enrollment, supplements, health plans or PDP drug cards? Total Benefit Solutions, Inc.  has a dedicated team of Medicare health plan professionals who are trained, annually re-certified, licensed and… 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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Total Benefit Solutions New Individual Dental & Vision Choices

As always at Total Benefit Solutions Inc, we are looking for ways to help our clients get the coverages they need. With our new dental and vision enrollment portal we can now offer individual dental and vision plans from top notch insurers like Delta Dental and Davis Vision. Easy to quote and easy to enroll! Try it today  and see for yourself by clicking here  

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Medicare Supplements: Did You Know?

Medicare Supplements: Did You Know? Medicare supplements do not have an annual open enrollment! Medicare beneficiaries on supplement plans can do comparative shopping and change plans (if qualified)at anytime during the year! If you have not checked your rates in two years or more, chances are there is a better rate available now. Medicare supplements are often called Medigap plans. Medicare supplements are not the same as Medicare Advantage plans. Medicare Part A and B do offer relatively good coverage, however they do not pay for all the expenses you will incur as a patient. Most Medicare supplements do not cover prescription drugs, dental, eyeglass or gym memberships. Standard Medigap plans are… Read More

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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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Group Health Plan Notices 2015 CALENDAR

Group Health Plan Notices 2015 CALENDAR From our partners at HR360: This calendar/checklist is designed to help companies review the key reporting and notice requirements that may apply to their employer-sponsored group health plans under ERISA , the Affordable cxare Act, Medicare and more. Please note that this list is for general reference purposes only and is not all-inclusive. Note: ERISA and benefit requirements are complex, and your plan’s responsibilities may vary depending on the individual circumstances surrounding your company’s plan. Employers who have questions are encouraged to consult with their plan administrators, the U.S. Department of Labor’s Employee Benefits Security Administration, the Internal Revenue Service, or a knowledgeable employment law attorney… Read More

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Total Benefit Solutions is your Marketplace Navigator

What do you get with Total Benefit Solutions as your Marketplace Navigator? A broker who is Unbiased and objective  Trained Local Certified Licensed Insured Up to date Representing you Part of a team of dedicated professionals Click here for more information and to see our “Marketplace Navigator” brochure: Individual Enrollment Navigator Brochure  

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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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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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United Healthcare: National Medicare Education Week

Do you find Medicare confusing? If so, you’re not alone. We recently conducted a survey1 that found that nearly 60 percent of Medicare beneficiaries described their understanding of Medicare as either “excellent” or “good,” but most were not able to correctly identify the health care expenses that each “part” of Medicare covers. And many said they found certain aspects of Medicare confusing. But, there’s some good news: Anyone can master Medicare with some help and education. That’s exactly why UnitedHealthcare created National Medicare Education Week (Sept. 15 – 21), an official week dedicated to Medicare education. National Medicare Education Week is meant to encourage people to spend time learning about… Read More

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UnitedHealthcare is introducing a new wellness initiative

UnitedHealthcare is introducing a new wellness initiative called ‘At Your Best’ as a pilot program to New Jersey consumers who are enrolled in an AARP® Medicare Supplement Insurance Plan, insured by UnitedHealthcare Insurance Company. This new pilot program, which was introduced in mid-June, is a personalized health and wellness solution designed to help AARP Medicare Supplement insured members improve their overall health and wellness. Please note: All ‘At Your Best’ program communications will take place after the member is enrolled. About the ‘At Your Best’ program The ‘At Your Best’ program is for insured members of an AARP Medicare Supplement Insurance Plan. The program offers support through online health resources,… Read More

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Medicare Supplement Plan F

  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.   Click the link below to get a brief overview of the Medicare Supplement Plan F and a concise comparison chart: Medicare Supplement Plan F… Read More

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