#medicaresupplements – Page 3 – Total Benefit Solutions Inc

Medicare Advantage (MA) Quick Facts

August 30, 2022August 3, 2022Ed MacConnell

What is it? A Medicare Advantage Plan is a type of Medicare health plan offered by a private company, such as Independence Blue Cross, that contracts with Medicare to provide all Part A and Part B benefits. If enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Plan types offered: Medicare Advantage Plans include Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO), for example. Independence offers Keystone 65 HMO as well as Personal Choice 65 PPO. Medical Coverage: If enrolled in a HMO, members must choose a PCP (which also will coordinate referrals) and must stay In-Network. PPO… Read More

What kind of plans can participate in the Part D Senior Savings Model?

August 26, 2022August 26, 2022Ed MacConnell

Most Medicare Part D plans that people choose from during Open Enrollment can participate in the Model. This includes stand-alone Medicare Part D Prescription Drug Plans (PDPs) as well as Medicare Advantage Prescription Drug plans (MA-PDs) that offer enhanced alternative Part D coverage. Private fee-for-service plans (PFFS plans), employer/union only direct contact plans (local coordinated care plans, prescription drug plans, PFFS plans), section 1876 cost contract plans, dual-eligible special needs plans (D-SNPs), section 1833 health care prepayment plans, Program of All-Inclusive Care for the Elderly (PACE) organizations, Medicare-Medicaid plans, and religious fraternal benefit plans (local coordinated care plans and PFFS plans) aren’t eligible to participate in the Model. Please contact… Read More

Medigap Quick Facts

August 23, 2022August 3, 2022Ed MacConnell

What is it? A Medigap policy (also called “Medicare Supplement Insurance”) is private health insurance that’s designed to supplement Original Medicare. This means it helps pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Play types offered: Insurance companies can sell only a “standardized” policy identified in most states by letters. Independence Blue Cross offers Plans A, B, F, F-HD, G, G-HD, and N. Medical Coverage: No selection of a PCP is required; members are able to choose any doctor or hospital as long as they accept Original Medicare. This also allows for no referrals and no network. Prescription Drug Coverage:… Read More

What is the Part D Senior Savings Model?

August 19, 2022August 19, 2022Ed MacConnell

The Part D Senior Savings Model allows participating Part D prescription drug plans to offer a broad set of formulary insulins at a maximum $35.00 copayment per month’s supply, throughout the deductible, initial coverage, and coverage gap phases of their Part D drug coverage. This means that participating Part D plans offer enrollees predictable, stable copayments for insulin to help enrollees save money on their drug costs. If you have any questions, please contact your Total Benefit Solutions Inc Medicare specialists at (215)355-2121.

MACRA: Medicare Access and CHIP Reauthorization Act of 2015

August 16, 2022July 29, 2022Ed MacConnell

Since January 1, 2020, Medigap plans sold to people new to Medicare aren’t allowed to cover the Part B deductible. Because of this, Plans C and F are no longer available to people who were “new to Medicare” on or after January 1, 2020. For this situation, people “new to Medicare” are people who turned 65 on or after January 1, 2020, and people who got Medicare Part A (Hospital Insurance) on or after January 1, 2020. If you already have either of these 2 plans (or the high deductible version of Plan F) or you were covered by one of these plans before January 1, 2020, you will be… Read More

Medigap Guaranteed issue rights

August 12, 2022July 28, 2022Ed MacConnell

Guaranteed Issue Rights (Also Called “Medigap Protections”) are rights you have in certain situations when insurance companies must offer you certain Medigap policies. In these situations, an insurance company: Must sell you a Medigap policy Must cover all your pre-existing health conditions Can’t charge you more for a Medigap policy because of past or present health problems In most cases, you have a guaranteed issue right when you have other health coverage that changes in some way, like when you lose the other health coverage. In other cases, you have a “trial right” to try a Medicare Advantage Plan (Part C) and still buy a Medigap policy if you change your mind.… Read More

Medicare & Coronavirus

July 27, 2022July 14, 2022Ed MacConnell

Medicare covers the COVID-19 vaccine at no cost to you. Medicare covers the vaccine for anyone who has Medicare due to their age, a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). Be sure to bring your Medicare card. To learn more about Medicare and the COVID-19 vaccine and boosters, click here. If you have Medicare and have a disability or face other challenges in getting to a location away from home for a vaccination, Medicare will pay a doctor or other care provider to give you the COVID-19 vaccine in your home. You may need to give them your Medicare Number for billing, but there’s… Read More

What’s Not Covered by Part A & Part B?

July 25, 2022July 14, 2022Ed MacConnell

Medicare doesn’t cover everything. Some of the items and services Medicare doesn’t cover include: Long-Term Care (also called custodial care ) Most dental care Eye exams related to prescribing glasses Dentures Cosmetic surgery Acupuncture Hearing aids and exams for fitting them Routine foot care To find out if Medicare covers a test, item, or service you need, click here. The professionals at Total Benefit Solutions, Inc are here to help you understand your Medicare Health Insurance choices. Call us today at (215)355-2121.

Did you know? Aetna Medicare Supplement Members can pay their premiums now at CVS stores?

July 23, 2022July 19, 2022Ed MacConnell

Members with Aetna Medicare Supplement policies can now pay their monthly premiums at their local CVS store. Their billing statements (for premiums less than $999) will have a unique barcode, which they can take to their local CVS store. The cashier will scan it just like they do any other CVS merchandise. Members can then pay their premiums by cash, debit card, or credit card. NOTE: The pay in store option is not available at CVS in Target stores at this time. If you have any questions, please contact your Total Benefit Solutions, Inc Medicare supplement specialists at (215)355-2121

What is the IRMAA Surcharge?

June 23, 2022July 7, 2022Ed MacConnell

What is the IRMAA Surcharge? The income-related monthly adjustment amount (IRMAA) sliding scale is a set of statutory percentage-based tables used to adjust Medicare Part B and Part D prescription drug coverage premiums. The higher the beneficiary’s range of modified adjusted gross income (MAGI), the higher the IRMAA. Want to apply for relief from the IRMAA charges? The form required is posted below, just download and complete the form!

Lower 2023 Medicare Part B Premium Could Be on the Way

June 16, 2022June 16, 2022Ed MacConnell

Some changes in the health care industry resulted in expected cost savings for the Medicare program for 2022. CMS’ recent announcement states they plan on passing these savings to consumers via their 2023 Part B premium. Click here to read the details on the lower Part B Premium Please contact your Total Benefit Solutions Inc Medicare health insurance specialists at (215)355-2121 if you have any further questions or concerns.

What is the Medicare Part B Premium Give Back?

May 29, 2022May 27, 2022Ed MacConnell

The Part B give back benefit helps those on Medicare lower their monthly health care spending by reducing the amount of their Medicare Part B premium. When you enroll in a Medicare Advantage Plan that offers this benefit, the carrier pays either a part of or the entire premium for your outpatient coverage each month

How Medicare Works Part A

May 24, 2022May 24, 2022Ed MacConnell

How Medicare Works Medicare is a federal insurance program that provides health insurance for people 65 and older and individuals younger than 65 who may qualify due to certain disabilities. There are four different parts to Medicare — Part A, B, C, and D. Click the icons below to learn more about each part! Medicare Part A Medicare Part A can be thought of as your hospital insurance. It helps to pay for your stay at a health care facility, whether that be a hospital, skilled nursing facility, or nursing home, among others. If you’re admitted as an inpatient, Medicare Part A covers many services like meals, a semi-private room,… Read More

Understanding Medicare Part B Exemption Secondary Payer Rules

May 9, 2022May 9, 2022Ed MacConnell

What is Medicare’s Secondary Payer Program?

April 28, 2022April 28, 2022Ed MacConnell

Depending on your circumstances, you may be able to have Medicare and an additional type of health coverage to help you pay for health care costs. Medicare’s Secondary Payer Program lays out how they work together. It’s not uncommon to have an insurance plan for everything, just in case. You can have a Medicare plan, a drug plan, and a dental, vision, and hearing plan. You also may have life insurance, long-term care, and more. It’s possible to have one that plan encompasses mutliple types of coverage, like a Medicare Advantage plan that covers prescription drugs, and dental, vision, and hearing services. Sometimes, it’s possible to have multiple policies for a single… Read More

WHAT IS MEDICARE PART B?

February 6, 2022Ed MacConnell

Medicare can seem complex on your own. We’re here to help! Medicareful is an easy-to-use Medicare plan finder that compares some of the available plans in your area and connects you with a licensed sales agent who will guide you through enrollment. Whether it’s a Medicare Supplement, Medicare Advantage Part C Plan, or a Medicare Part D drug plan, we’ve got you covered. https://medicareful.com/totalbenefitsolutions

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