Medicare – Page 2 – Total Benefit Solutions Inc

Financial Support Soars for Mental Health Integration

October 19, 2023October 19, 2023Wendy Lopez

Mental health is an essential component of overall well-being, and every American deserves access to quality mental health and substance use disorder treatment. Access to mental health care can be a transformative step in managing and coping with mental health concerns, allowing individuals to lead more fulfilling lives. This article explores the importance of integrating mental health services into other care settings and highlights the Collaborative Care Model (CoCM) as a promising approach to enhance access to mental health care. Expanding Access Through Integration Integrating mental health into broader healthcare settings is a pivotal strategy to increase accessibility and support for patients. The Collaborative Care Model, often abbreviated as CoCM,… Read More

2023 Rule Alert: How Will It Affect Fixed Indemnity Plans?

October 13, 2023October 13, 2023Wendy Lopez

In today’s world, the rising costs of healthcare have left many Americans grappling with the financial burden of medical expenses. While comprehensive health insurance is essential, fixed indemnity health insurance has emerged as a valuable supplemental resource, offering financial protection to individuals when they need it the most. This blog explores the concept of fixed indemnity health insurance and its importance in providing financial peace of mind to Americans. Fixed Indemnity Insurance: This supplemental insurance differs from major medical plans. It pays a fixed sum directly to you when specific medical events, like doctor visits or hospital stays, occur. While it doesn’t cover all the essential health benefits mandated by… Read More

The Value of Employee Health Benefits

October 12, 2023October 12, 2023Wendy Lopez

In today’s world, where healthcare costs can be a significant burden on individuals and families, employer-provided health coverage stands out as a vital resource. More than half of all Americans – over 180 million hardworking individuals and their families – rely on their jobs to secure access to healthcare. In this blog, we’ll explore the invaluable benefits of employer-provided coverage and how it offers affordable access to care, improved health, and peace of mind. Affordable Access to Care Healthcare expenses can quickly add up, and without insurance, it can be a daunting task to manage them. However, for millions of Americans, the path to affordable healthcare begins with their employers.… Read More

Medicare Supplement Insights: Protecting Your Wallet

October 9, 2023October 9, 2023Wendy Lopez

In a world where healthcare costs are a growing concern for many, Medicare Supplement coverage has emerged as a reliable solution to bridge the gaps in original Medicare. As we delve into the latest data from 2021, including insights from the National Association of Insurance Commissioners (NAIC), the California Department of Managed Health Care, and the Medicare Current Beneficiary Survey (MCBS) from 2020, a compelling narrative about the significance of Medicare Supplement plans unfolds. Key Takeaways: 1. A Majority Embrace Medicare Supplement: In 2020, a staggering 54% of original Medicare enrollees without additional insurance coverage, such as Medicaid or employer-provided insurance, turned to Medicare Supplement policies for added peace of… Read More

2024 Healthcare Premiums Revealed: The Impact Factors

October 4, 2023October 4, 2023Wendy Lopez

The American Health Insurance Providers (AHIP) Association is committed to ensuring that every American has access to affordable and comprehensive health coverage. With nearly 21 million Americans enrolled in the individual market for the 2023 plan year, it’s crucial to understand the factors that will influence individual market premiums in 2024 and beyond. In this blog post, we’ll delve into some of the key drivers shaping the future of individual market premiums. Factors Driving Premium Changes in 2024 As we look ahead to 2024, several key factors will influence individual market premiums: Increasing Provider Costs: The rising cost of medical services provided by doctors and hospitals contributes significantly to premium… Read More

Medicaid & CHIP Enrollment Extension!

October 3, 2023October 3, 2023Wendy Lopez

In a recent development, the Centers for Medicare & Medicaid Services (CMS) and the Departments of Labor (DOL) and the Treasury have issued a letter urging employers, plan sponsors, and carriers to consider extending the enrollment period for employer-sponsored health plans. This extension is aimed at helping individuals who have lost their Medicaid and Children’s Health Insurance Program (CHIP) coverage due to the resumption of normal eligibility and enrollment procedures. Traditionally, Medicaid coverage requires annual renewal of eligibility. However, during the COVID-19 Public Health Emergency, these renewal requirements were temporarily halted to prevent members from losing their coverage. Unfortunately, this pause in eligibility rules came to an end on March… Read More

What is your Medicare Part D ANOC?

September 30, 2023September 30, 2023Ed MacConnell

The Annual Notice of Change (ANOC) is a document that Medicare Advantage and Medicare Part D prescription drug plans are required to send to their members every year. The ANOC outlines any changes in coverage, costs, and more that will be effective in January 1. If you’re enrolled in a Medicare plan, your plan will send you an ANOC each fall. The ANOC includes information about any changes to your plan’s coverage, costs, and service area that will be effective in January 1. It’s important to review the ANOC carefully to understand how your plan’s coverage and costs may change in the upcoming year. If you have any questions or concerns about the changes, you can contact… Read More

Benefits Notices: What Employers Need to Know

September 27, 2023September 27, 2023Wendy Lopez

As an employer, it is important to be aware of the various benefits notices that you are required to provide to your employees. These notices are designed to inform employees of their rights and benefits under various laws and regulations. Failure to provide these notices can result in penalties and legal action. One of the notices that employers with 1-19 employees are required to provide is the Part D Creditable Coverage Disclosure Notice or Non-Creditable Coverage Disclosure Notice. This notice is provided to Medicare-eligible individuals who are offered prescription drug coverage under the employer’s group health plan. It must be provided annually prior to October 15th, upon request, and at… Read More

Employer’s Guide to Medicare Compliance

September 25, 2023September 26, 2023Wendy Lopez

Medicare is a critical healthcare program in the US, covering seniors and certain disabled individuals. Employers offering group health insurance to Medicare-eligible individuals must meet specific requirements. In this blog, we’ll discuss three key Medicare requirements for employers: Employers must ensure compliance with these Medicare regulations to provide necessary healthcare information and process claims correctly. This ensures employees receive the coverage they’re entitled to. For comprehensive information and resources, refer to our PDF document below. Meeting these obligations supports employee well-being and eases healthcare coverage complexities. As always, if you have any questions or concerns about this bulletin, please contact your Medicare health insurance experts at Total Benefit Solutions, Inc.… Read More

COBRA and Medicare: Complementary Health Insurance Explained

September 21, 2023September 21, 2023Wendy Lopez

In today’s rapidly changing job landscape, it’s not uncommon for individuals to find themselves eligible for both Medicare and COBRA simultaneously. This dual eligibility can be a bit bewildering, but understanding how these two crucial insurance options interact is vital to making informed decisions that could impact your finances and peace of mind. Let’s delve into the intricacies of how COBRA works with Medicare and explore the options available to you. COBRA Unveiled First, let’s demystify COBRA. The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal program designed to provide a safety net for workers and their families. It allows you to maintain the health coverage provided by your… Read More

Choosing the Right Health Insurance: HMO vs. PPO

September 15, 2023September 15, 2023Wendy Lopez

When it comes to health insurance, understanding the differences between various plans is crucial for making an informed decision. Two common types of health insurance plans are Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs). While both offer coverage for medical expenses, they have distinct features that can significantly impact your healthcare experience and costs. In this blog, we’ll explore three key differences between PPOs and HMOs to help you decide which one aligns better with your needs. 1. Network Flexibility: PPO: Preferred Provider Organizations are known for their expansive networks of healthcare providers. This includes a wide array of specialists and the option to seek care from out-of-network… Read More

Unlocking Medicare’s Potential: Top 3 Broker Benefits

September 13, 2023September 13, 2023Wendy Lopez

It’s that time of year again – the Annual Open Enrollment period for Medicare is almost here, and it’s a crucial opportunity you won’t want to miss. If you’re eligible for Medicare, this is your chance to make important decisions about your healthcare coverage. Here are some compelling reasons why you should take advantage of this opportunity: Expert Guidance: Navigating the world of Medicare can be a complex and overwhelming task. Fortunately, during the Annual Open Enrollment period, you can access personalized advice and guidance from experienced brokers who understand the ins and outs of Medicare. These professionals can help you make informed decisions tailored to your unique healthcare needs.… Read More

Who Needs Extra Protection During Flu Season?

September 11, 2023September 11, 2023Wendy Lopez

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

How income affects your Medicare drug coverage premiums

September 8, 2023September 8, 2023Ed MacConnell

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

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

September 7, 2023June 27, 2023Ed MacConnell

(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.

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

September 6, 2023September 6, 2023Wendy Lopez

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

Medicare Diabetes Prevention Program: PDF Download

August 31, 2023July 12, 2023Wendy Lopez

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

Annual Enrollment Period: Your Path to Tailored Medicare Coverage

August 29, 2023August 28, 2023Wendy Lopez

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

Mark Your Calendars for These Crucial Medicare Dates!

August 28, 2023August 28, 2023Wendy Lopez

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

Understanding When Your Medicare Coverage Starts

August 27, 2023August 25, 2023Wendy Lopez

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

Medicare Covers Diabetes Supplies & Services for Your Health

August 26, 2023July 24, 2023Wendy Lopez

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

Medicare Diabetes Prevention Program

August 25, 2023August 25, 2023Wendy Lopez

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

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

August 24, 2023July 12, 2023Wendy Lopez

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

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

August 23, 2023August 23, 2023Wendy Lopez

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

Medicare Coverage of Home Health Care: Booklet

August 23, 2023July 12, 2023Wendy Lopez

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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