What You Need to Know About Medicare Supplement Policies (Medigaps)

Apr 21

Medicare supplement policies are meant to “supplement” original Medicare Part A and B policies, to include any missing services or supplies. At Brindle Insurance Group, we specialize in Utah Medicare supplement plans. Medicare supplement policies are sold by approved, private insurance companies that can also cover the costs that original Medicare does not, such as copayments, coinsurance, and deductibles.   In most U.S. states, including Utah, insurance companies are only allowed to sell “standardized” policies, identified by letters ‘A’ through ‘N’. All policies offer the same basic benefits, but include various additional benefits.   It is important to remember that you must have original Medicare Parts A and B in order to purchase a supplemental policy. You will pay separate monthly premiums—one to the private insurance company for your supplement and one to the federal government for your original Medicare policy. Also, a supplemental policy only covers one individual, so spouses will need to purchase individual policies.   If you are in a Medicare Advantage Plan (Medicare Part C) then you may want to drop any Medigap policies you have. By law, the two policies cannot be used in conjunction, so you would be wasting your money on a supplemental policy. You can switch back to original Medicare and a Medigap policy if you do not like the Medicare Advantage Plan and choose to cancel it.   For more information about Medicare supplement policies or Utah Medicare Advantage plans, click here or call Brindle Insurance Group at (800) 603-5099 to speak to a knowledgeable representative.

Help Prevent Medicare Fraud

Mar 31

Medicare fraud affects everyone by raising costs, lowering coverage, and making it more difficult to qualify. At Brindle Insurance Group our dedicated and helpful agents and Utah Medicare Advantage experts are teaching our customers and readers how to identify, report, and stop fraud and identity theft.   Here are some things you can do:

  • Protect your Medicare and Social Security Numbers like you would your credit cards.
  • If someone calls and asks for your Medicare number, Social Security Number, bank or credit card information, HANG UP THE PHONE! Medicare agents will NEVER call or come to your home uninvited to sell Medicare products or ask for this information.
  • Be suspicious of anyone offering free medical equipment or services and then requests your Medicare number. It is illegal, and it is not worth it!
  • Do not lend your Medicare ID card or your identity.
  • Check your Medicare claims for errors. Look at your summary notices and statements as soon as your claims have been processed. You can also check MyMedicare.gov or call (800)-MEDICARE (800-633-4227) for these. The sooner you see and report errors, the sooner we can stop fraud.
  • Call 800-MEDICARE to report any suspected fraud.

Learn more about the signs and get tips on reporting and protecting yourself from Medicare fraud and identity theft. Click here or call our specialized Utah Medicare insurance agents today at (800) 603-5099.

What is the “Donut Hole?”

Feb 19

If you aren’t familiar with the Medicare Part D “donut hole” then this post is for you. Medicare Part D, a Medicare advantage plan, provides prescription drug coverage for beneficiaries of Medicare. Basic Medicare Part D cover works like this:

  • You pay out-of-pocket monthly Part D premiums all year.
  • You pay 100% of your drug costs until you reach the $310 deductible.
  • After you reach the deductible, you pay 25% of your drug costs, and Part D pays the rest, until the total (your out-of-pocket expenses and Part D combined) reaches $2,800.
  • When the total reaches this limit you have a coverage gap called the “donut hole,” and thereafter you are responsible for the full cost of your prescriptions until the total you have paid out-of-pocket reaches the yearly limit of $4,550.
  • After this yearly spending limit is reached, you are only responsible for about 5% of the cost of your prescriptions for the year.

 

Needless to say, this poses a problem for many Medicare Part D beneficiaries. But at Brindle Insurance Group we can help. We provide Medicare Supplement insurance in Utah. We can help you find Medicare products to provide for all of your healthcare needs, sometimes at no cost to you. For instance, there is a program called Medicare Extra Help that helps pay your premiums and reduce the cost for your prescription drugs. This and other amendments to the Affordable Care Act help relieve the financial burden posed by Medicare gaps.

 

If you would like more information about Medicare Supplements or other services, please click here or call Brindle Insurance Group today at (800) 603-5099.

Medicare Advantage vs. Medicare Supplement–Is one better than the other?

Sep 13

In order to make an informed decision about Medicare Advantage versus Medicare Supplement plans consumers should first understand both options individually. When considering if one is better than the other, it depends on your needs.

 

Medicare Advantage (MA)

Medicare Advantage plans, or MAs, are offered by private insurance companies, rather than the government. In addition to offering a health plan with hospitalization and medical coverage similar to Medicare Part A and Part B, MA plans may include additional benefits, such as prescription drug coverage, that are not covered by Medicare. Similarly, MA plans utilize HMO (Health Maintenance Organization) networks as well as PPO (Preferred Provider Organization) networks. With HMO, consumers choose from a coordinated list of primary care physicians and must attend that physician whenever necessary and possible. With PPO, consumers do not have to choose a primary care physician and allow for more flexible options.

 

Medicare Supplement Insurance (Medigap)

Medicap plans are designed to cover the expenses not paid by Medicare Part A and Part B. There are supplemental plans A through N in all states except Massachusetts, Minnesota, and Wisconsin. Each of the plans covers a different combination of benefits and deductibles.

 

So What’s the Difference Between the Two?

Medicare Advantage plans are required to carry the minimum coverage of Medicare Part A and Part B, more benefits are optional. But there is typically only one policy to keep track of. With Medigap, consumers will receive more coverage than standard Medicare Part A and Part B, with all plans being the same in all states (with the exception of the three previously mentioned), but it does require a juggling of multiple policies and sometimes more cost.

 

At Brindle Insurance Group we can help you choose the best fit for you and your budget. When choosing a plan that best suits your needs it is important to keep in mind:

  • Monthly premium
  • Deductibles
  • Doctor and healthcare facility restrictions
  • Benefits
  • Anticipated plan costs given your typical use of healthcare and hospitalization services
  • Prescription drug coverage cost sharing as it relates to your medication usage

Nearly 3.5 Million people saved more than $706 on prescriptions in 2012

Jun 12

When you need to buy prescription drugs, it is important for you to understand the full extent of your medicare coverage. With the medicare advantage, you may never have to pay for prescription drugs again. The total cost of your prescription drugs may be paid for under the medicare advantage.

 

You can save hundreds of dollars when you use your medicare benefits to pay for prescription drugs. You will need to meet with a doctor to see whether certain prescriptions fall under your medicare coverage. Your appointments at a doctor’s office may also be covered under medicare benefits.

 

Medicare benefits are typically available for individuals who are older than 65 years old. If you want to learn about whether you qualify for Medicare benefits, then you can schedule an appointment to meet with a Medicare specialist. He or she will know whether you are able to qualify for these benefits. It is also possible for individuals with rare illnesses to qualify for Medicare benefits if they are having difficulties in meeting their medical expenses. There are also exceptions that are made for young people who wish to obtain Medicare benefits.

 

The major reason people want to learn about the extent of their Medicare coverage is for the drug benefits. Drug benefits can cover a wide range of illnesses and disorders. You may be surprised to learn about the different types of medications that you can receive to pay for your illnesses. There are also different types of medical equipment that you can purchase with Medicare coverage.

 

If you have to pay the full price for a prescription drug, then you may be surprised to see how much you owe. The full price of a prescription drug can be hundreds of dollars. No one should have to pay this high fee for a prescription drug that can be purchased at a much lower rate with Medicare benefits. There are plenty of different standardized plans available under Medicare that offer individuals different payment options for prescription drugs. Senior citizens may wish to meet with an insurance specialist who can help them understand the benefits of all of these programs.

 

Medicare coverage also covers medical benefits that are far greater in scope than just prescription drugs. People can also save hundreds of dollars on visits to the emergency room or other hospital services. A person may also qualify for benefits that cover the cost of certain surgeries.

 

Protect your bones—Medicare can help

Jun 05

Brindle Insurance Group can help clients who face medical issues in their lives. If you want to receive an annual check-up, then you can take advantage of the services offered by Brindle Insurance Group. It is a smart idea to check in with a medical professional from Brindle Insurance Group to make sure that all of your bones are healthy and strong.

 

Every year, thousands of women suffer from osteoporosis. This severe illness can cause a person’s bones to feel weak. A person can feel pulled down by the weight of the world when he or she has osteoporosis. If you want to avoid ever having this illness in your life, then you should schedule a check-up at a doctor’s office. You can speak with a doctor and figure out whether you need to be consuming more calcium on a daily basis.

 

You may need to consume more calcium to help your bones grow stronger. If so, then a doctor may prescribe a supplement pill for you to take. You will need to consume the pill once or twice a day. A doctor may also make a list of the foods that you should consume. There are certain foods that contain high amounts of calcium and can be helpful for those individuals who need to build strength in their bodies.

 

You should check to see whether your appointments can be covered under medicare. It may be possible for all of your medical treatments to be fully covered under your medicare benefits. It is to your advantage to research all of the offerings that are available to you by getting in touch with Brindle Insurance Group. It is vital for you to learn all about the medicare advantage so that you will be able to make the most of your benefits.

 

Your medicare coverage may also cover all of the prescription drugs that you receive from a doctor. This can help you to save thousands of dollars in the fees that you are required to pay for prescription drugs every year. Take the time to fully understand the benefits available to you under your medicare coverage.

 

Enjoying a Medicare Advantage Plan that Works for You

May 08

Medicare is a medical health benefit available to those who are 65 years of age, disabled, or those that have end stage renal disease. Those that are 65 years of age typically are retired and collecting social security benefits. These are benefits that they have paid for during their working career. Those that are disabled due to some chronic disease or illness that keeps them from working are also qualified for Medicare; however, the disabled must wait 24 months before they are eligible for Medicare benefits.

Those that are eligible for Medicare will receive a benefit card that is red, white, and blue. This card shows that they have part A and part B coverage. Part D coverage is the drug benefit and Medicare enables beneficiaries to choose their own drug carrier.

There are many private plans that are available to provide this drug coverage. Medicare also allows beneficiaries to choose a Medicare advantage plan. This plan is through a private medical insurance company, and this plan typically covers the 20% that Medicare will not pay. Medicare coverage covers 80% of most medical costs, so there is a coverage gap of about 20%. Beneficiaries must either pay this 20% or find some type of supplemental plan that will pay the difference.

The Medicare advantage plan covers the 20% and provides prescription drug coverage. Those that choose this plan will still be responsible for their Medicare Part B premium, and they will also be responsible for the monthly premium for Z-Medicare Advantage. Although there is a cost involved in getting this coverage, this coverage is much less expensive than having to pay the 20% out of pocket costs and the costs of prescriptions. This advantage plan offers several benefits for the members.
If you are interested in this coverage, you can call or go online to sign up for the coverage.

This Medicare advantage plan will directly contact Medicare to set up everything. You don’t have to worry about doing this. There are certain yearly deductibles and co-payments that are due, but again, these costs are much less expensive than not having some type of advantage plan or a supplemental plan. You have enough to worry about. There is no need to stress over your coverage with Medicare. You have earned your Medicare benefit by paying into it during your working career. Call or go online and sign up today.

What is the difference between Medicare and Medicaid?

May 01

Medicaid differs from Medicare in that it is an assistance program funded by federal, state and local tax funds. The state administers the program and the federal government dictates program guidelines. The program targets low-income individuals of every age. Patients generally have no out-of-pocket costs. However, in some cases, patients may have a small co-pay. Unlike Medicare, Medicaid requirements vary from state to state.

Medicare is a federal program operated by the Centers for Medicare & Medicaid Services. It functions like an insurance program. Individuals pay into the program, and those funds cover the insured’s medical bills. Generally, people over 65 years of age qualify for coverage, regardless of their income. Disabled individuals and those receiving dialysis services also qualify. Out-of-pocket costs include a monthly premium for non-hospital coverage, hospital deductibles, prescriptions and other costs not covered by Medicare.

Medicare Advantage Plans offer an alternative to standard Medicare. The program is a Medicare-approved health plan offered through private insurance companies. Approved insurance companies contract with Medicare to provide all Part A (hospitalization) and Part B (medically necessary and preventative services) benefits. Many Medicare advantage plans also offer Medicare Part D (prescription) benefits. Patients can choose from a variety of plans types including

Health Maintenance Organizations Plans (HMO) have in-network doctors, hospitals and specialized providers that patients must use. Generally, a referral from a primary care physician is needed to use an out-of-network healthcare professional.
Preferred Provider Organization Plans (PPO) have in-network doctors, hospitals and specialized providers, but patients can choose an out-of-network health professional at a higher cost.
Private Fee-for-Service Plan (PFFS) have predetermined fees for doctors, hospitals, providers and patient co-pays. Patients can choose any Medicare-approved health professional or facility that participates in the PFFS program.
Special Needs Plans (SNPs) are limited to patients with specific diseases or symptoms. All SNPs provide prescription drug coverage.
HMO Point of Service Plans (HMOPOS) is an HMO plan that allows the patient to use an out-of-network hospital, doctor or other healthcare provider at a higher cost.
Medical Savings Account (MSA) plans links health plans with high deductibles with a checking or savings account. Medicare puts money into the patient’s account, and the money is used to pay for medical services throughout the year.

Contact Brindle Insurance Group  for help in choosing a plan that fits your healthcare needs.

Got questions about Medicare? Call Brindle Insurance Group at (800) 603-5099 to speak with one of our Licensed Sales Agents.