CMS publishes updated 2018 Medicare cost-sharing amounts

The Centers for Medicare & Medicaid Services (CMS) recently published updated cost-sharing amounts for 2018 which are outlined below. 2018 Medicare Costs at a Glance Standard Part B Premium Most people pay $134 each month Medicare Part B deductible (Medical deductible) $183 per year Medicare Part A deductible (Hospital deductible) $1,340 for each benefit period Beneficiaries will pay $134 (or higher depending on income) if they: • Enroll in Part B for the first time in 2018, or • Are directly billed for their Part B premium, or • Are dually eligible for Medicaid and have their premium paid by state Medicaid agencies pay an income-related premium Some beneficiaries who were held… Read More

Continue Reading

Total Benefit Solutions Partners with Clover Health

New to Bucks County this year, Total Benefit Solutions is proud to announce that we have added Clover Healthg to our list of outstanding Medicare partners. Ask us during your briefing if Clover Health is a good fit for you!

Continue Reading

Compare Medicare Plans in Your Area in real time!

  With Medicareful you can search and compare Medicare health plans at your own convenience, but with an expert nearby at Total Benefit Solutions Inc to help guide you along the way. Log in today and see for yourself! http://www.medicareful.com/totalbenefitsolutions

Continue Reading

Humana and Tenet have reached a new network agreement

Humana and Tenet have reached a new network agreement Humana is pleased to announce we have signed a new agreement, effective June 1, 2017, that allows Humana commercial, Medicare Advantage, Medicaid, and individual exchange health plan members to receive in-network care at Tenet hospitals, hospital-affiliated outpatient centers, and with Tenet physicians. We are currently in the process of loading Tenet providers to all applicable systems. There may be a delay in providers appearing in Physician Finder even though they are participating. For the best possible member experience, as always, we advise the member to check Physician Finder before seeking non-emergent care from a provider in order to help avoid any… Read More

Continue Reading

Compliance Bulletin & Reform Center

Health Care Compliance and Reform Education Center A fundamental change in the way the United States handles health care has arrived. Benefit rules and coverage change faster today than they used to in ten years! Our Compliance and Health Reform Education Center is where we will keep a copy of our health care reform bulletins throughout the year, in an easy  to view format where you can download a brief summary or watch a short informative video. Click here to visit totalbenefitscomply.com Please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any further questions.  

Continue Reading

MEDICARE PART D: CMS NOTIFICATION REMINDER

Employers sponsoring a group health plan need to report information on the creditable status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS). Watch a video overview   Download a bulletin

Continue Reading

2016 Compliance Year In Review Digest

2016 Compliance Year In Review Digest A complete digest of all our compliance bulletins for the entire year of 2016 from our business partners at Emerson Reid. A handy guide to all of the year’s updates and changes all in one place. Download your copy now and keep it for future reference.   Click to Download Compliance Digest 2016 Year in Review     As always please contact your Total Benefit Solutions Account Manager at (215)355-2121 if you have any questions or concerns.

Continue Reading

Total Benefit Solutions participating in CVS Retail Locations During Medicare Open Enrollment

Total Benefit Solutions is pleased to announce that we are participating in the Independence Blue Cross Medicare/ CVS Pharmacy retail program for the upcoming open enrollment period. What this means to our clients is that we will be on site at our local CVS Pharmacy during the AEP. Starting on Saturday October 15th and continuing through open enrollment we will be on site nearly each  Monday, Wednesday and Friday at the CVS Pharmacy in Feasterville from Noon to 2 PM each day. Please feel free to stop in without an appointment to get your questions answered and pick up your 2017 plan information from Independence Blue Cross.   We will… Read More

Continue Reading

Reminder to Distribute Creditable Coverage Notice

  Employers who sponsor 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.” This notification must be provided prior to October 15th each year. Download medicare-part-d-reminder-to-distribute-creditable-coverage-notice-

Continue Reading

Original Medicare: Did You Know?

Many Medicare beneficiaries are unaware that original Medicare coverage has significant deductibles and co-pays. Part A helps cover medically necessary inpatient care in hospitals. In 2016, for each benefit period (typically 60 days as defined by Medicare) in a year, beneficiaries pay: $1,288 deductible and no coinsurance for a stay of up to 60 days $322 coinsurance per day for days 61-90 of a hospital stay $644 coinsurance per “lifetime reserve day” after day 90 each benefit period (up to 60 days over your lifetime) All costs for each inpatient day beyond 150 days   At Total Benefit Solutions, Inc we specialize in Medigap programs that are affordable and cover most or… Read More

Continue Reading

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.

Continue Reading

Now Available: Health Advocate Member Advocacy

Total Benefit Solutions clients can now take advantage of enrolling on Health Advocate as a group or as an individual/ family! It’s part of our Benefit Aid packages and it’s so easy you can enroll today by clicking here or ask your Total Benefit Solutions account manager at (215)355-2121 for more information. This video will tell you all about the benefits of Health Advocate!  

Continue Reading

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.

Continue Reading

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

Continue Reading

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

Continue Reading

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.

Continue Reading

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.      

Continue Reading

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

Continue Reading

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

Continue Reading

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

Continue Reading

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

Continue Reading

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.

Continue Reading

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.

Continue Reading

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

Continue Reading

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

Continue Reading