Ways to Save Money on Your Prescription Drugs

Prescriptions costs are skyrocketing. We all know that. But did you know that there are several ways for people to save money on their monthly medications? As health insurance plans are becoming more catastrophic in nature, that means that people will need to become better health care consumers. Sometimes that means using the tools that the insurance company offers at no charge. Sometimes it means using discounts and other resources that are available outside the health plan. Here are a few ways, some already widely known and others not so much, to help drop down your costs at the Pharmacy. While this is not a comprehensive list of money-saving ideas, it is… Read More

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End of Summer Social Media Drive 2018

Please help us get the word out on social media in August & September You Could Win a $25-$100 Amazon Gift Card!!! While everyone is getting ready for the End of Season BBQs, gearing up for Back-to-School, and trying to fit in as much adventure as possible the next few weeks, we here at Total Benefit Solutions are getting ready for our busiest time of year: Open Enrollments! Your friends and family members may not be concerned with the open enrollment period.. YET, but it is quickly approaching and we’d like to help them! As always, We appreciate all the referrals and recommendations that we get online from everyone, but we… 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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Your Medicare Card Is Changing!

  The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires that Social Security Number-based Health Insurance Claim Numbers (HICN) be removed from Medicare cards by April 2019; this is in an effort to lessen the current risk of beneficiary medical identity theft. A unique Medicare number, called the Medicare Beneficiary Identifier or MBI, will replace the current HICN. Beginning in April 2018, the Centers for Medicare and Medicaid Services (CMS) will begin the process of mailing new Medicare cards and will meet the statutory deadline for replacing all cards by April 2019. Educational Resources:  CMS Transition to New Medicare Numbers and Cards – Fact Sheet CMS Website –… Read More

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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

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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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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

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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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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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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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2014 Compliance Bulletin Compilation

Download our 2014 Compliance Bulletin Compilation, featuring all of our released compliance bulletins for the entire year!  Topics include, Health Savings Accounts, The Individual Mandate, Employer “pay or play” mandate, exemptions, FSA carryovers and much, much more. All of the bulletins are in an easy to search format for your convenience. 2014 Compliance Compilation – Download As always please contact your Total Benefit Solutions account manager at (215)355-02121 if you have any further questions or concerns.

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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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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 Part D: Reminder to Distribute Creditable Coverage Notice

 Medicare Part D: 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. Please click the link below to read the detailed bulletin. Medicare Part D Reminder-091914R    

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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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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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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.

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Total Benefit Solutions to partner with ThinkHR

        In another effort to enhance our client experience and bring value to our small business clients, Total Benefit Solutions is proud to announce that we have entered into an agreement to provide Think       HR. Soon our clients will get an introductory e-mail with instructions on how to access their complimentary ThinkHR account. We expect to have this resource available to our clients in September 2014, just in time for this year’s open enrollment period!   Think HR will help our clients: Stay up to date with the latest news and resources Remain compliant with best practices from HR professionals Build tools like job… 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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2014 Updated Medicare Deductibles & Official Medigap Handbook

  Click the link below to download an updated sheet with the Medicare deductibles for 2014. Download also includes the official CMS Handbook Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. Click this link to download: BA9917ST (04-13)_lo res

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