“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

Continue Reading

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

Continue Reading

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

Continue Reading

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.

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

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

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

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

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

Continue Reading

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

Continue Reading

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.

Continue Reading

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.  

Continue Reading

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    

Continue Reading

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

Continue Reading

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.  

Continue Reading

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

Continue Reading

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

Continue Reading

Third Annual National Medicare Education Week Offers Help Before Open Enrollment Period

Educational events and online resources to help baby boomers, Medicare beneficiaries and caregivers learn more about Medicare MINNETONKA, Minn. (Sep. 08, 2014) —  The third annual National Medicare Education Week begins Monday, Sept. 15, exactly one month before the start of Medicare’s annual Open Enrollment Period (Oct. 15-Dec. 7). The observance was created to help people learn more about Medicare. Since National Medicare Education Week began in 2012, thousands of people have participated in educational events during the week in more than 60 cities across the country. This year, National Medicare Education Week events will be held for the first time in Boston, Salt Lake City and Richmond, Virginia; a… Read More

Continue Reading

Medicare Update: Medicare is no longer prevented from recognizing same-sex marriages

Medicare is no longer prevented from recognizing same-sex marriages Special Update: As a result of the June 2013 U.S. Supreme Court ruling invalidating part of the Defense of Marriage Act (DOMA), which denied federal benefits to legally married same-sex couples,Medicare is no longer prevented from recognizing same-sex marriages for determining entitlement to, or eligibility for, Medicare. The Social Security Administration is now processing requests for Medicare Part A and Part B Special Enrollment Periods, as well as reductions in late enrollment penalties, for certain eligible individuals in same-sex marriages.  Click here for more information.

Continue Reading

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

Continue Reading

Health Reform: Law Repeals Deductible Limits for Small Group Plans

The Protecting Access to Medicare Act of 2014, legislation extending the “doc fix” for Medicare payments, also includes a provision that repeals the maximum deductible limits applicable to many small group health plans. As you recall, deductible limits for non-grandfathered small group plans are capped under the ACA at $2,000 for single coverage and $4,000 for family coverage effective for the first plan year on or after January 1, 2014. This legislation repeals the deductible limits as of the date health care reform was enacted (March 23, 2010). Click here to download the bulletin

Continue Reading