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In most states, private insurance companies don't have to offer all 10 Medigap plan types offered by Medicare Supplement...
02/06/2025

In most states, private insurance companies don't have to offer all 10 Medigap plan types offered by Medicare Supplement insurance companies. The insurer must offer at least Plan A if they offer any Medigap plans, as well as Plan C or Plan F if they offer any Medigap plans other than Plan A. Due to its popularity, many insurance companies offer Plan F. You should always research and compare plan options for your local area.

Below is a list of costs and benefits covered by Medicare Supplement Insurance Plan F:
- Part A hospital and coinsurance costs up to an additional 356 days after Medicare benefits are exhausted
- Medicare Part A hospice care copayment or coinsurance
- Medicare Part B coinsurance or copayment
- Medicare Part B excess charges
- Medicare Part A deductible
- Medicare Part B deductible
- First three pints of blood used in an approved medical procedure (annually)
- Skilled nursing facility coinsurance
- Foreign travel emergency coverage (80%, up to plan limits)

Warning: Medicare Part D Drug Plans May Not Cover ChemotherapyMedicare Part D provides prescription drug coverage. Part ...
02/03/2025

Warning: Medicare Part D Drug Plans May Not Cover Chemotherapy

Medicare Part D provides prescription drug coverage. Part D covers most prescription medications, including chemotherapy drugs.

It is important to note that not all chemotherapy drugs are covered by Medicare Part D. Each Medicare Part D plan has its own list of covered drugs, called a formulary. You can check your plan's formulary to see if your chemotherapy drug is covered.

If your chemotherapy drug is not covered by Medicare Part D, you may be able to get financial assistance from other programs. For example, the Patient Assistance Program (PAP) Foundation can help people with cancer get access to free or low-cost prescription medications.

Here are some tips for finding a Medicare Part D plan that covers chemotherapy:

- Compare different plans to find one that covers your chemotherapy drug and has low out-of-pocket costs.
- Ask your doctor or pharmacist for recommendations.
- Use the Medicare Plan Finder tool to compare plans and find one that is right for you.

You can also contact Medicare directly for more information about chemotherapy coverage.

1 - Compounded treatmentsMedicare supplements cover most broad categories of medication-the key is to find one that work...
02/02/2025

1 - Compounded treatments
Medicare supplements cover most broad categories of medication-the key is to find one that works for you.
The reason for this is that compounded medications are not usually approved by the FDA and therefore are not covered by Medicare Part D.

2 - Sexual dysfunction medications
Medications for erectile dysfunction and sexual dysfunction are also not covered by Medicare, since they are not considered medically necessary.

3 Cosmetic drugs
By Priority Health, cosmetic drugs will also never be covered by Medicare. Nonetheless, some drugs used to treat skin conditions may also have cosmetic benefits, so it's worth asking.

4 Fertility medication
In spite of the fact that Medicare is primarily intended for retirees, some individuals on disability may be eligible for Medicare benefits before they reach retirement age. Unless a doctor deems it medically necessary, these people are unlikely to be eligible for fertility assistance, according to a Kaiser Family Foundation (KFF) report.

If you have a body mass index (BMI) of 30 or more, Medicare Part B (Medical Insurance)covers obesity screenings and beha...
01/30/2025

If you have a body mass index (BMI) of 30 or more, Medicare Part B (Medical Insurance)covers obesity screenings and behavioral counseling to help you lose weight by focusing on diet and exercise. Medicare covers this counseling if your primary care doctor or other qualified practitioner gives the counseling in a primary care setting (like a doctor's office), where they can coordinate your personalized prevention plan with your other care.

As an example, if weight loss is necessary for treating diseases like diabetes, hypothyroidism, and cardiovascular disease (among others), Medicare will cover the costs.

In order to reduce complications, Medicare also pays if your doctor advises you to lose weight before surgery.

The type of services and programs that Medicare helps pay for are:
- Initial assessment of your eating and activity habits.
- Health counseling.
- Dieting and exercise education.
- Follow-up visits to monitor your diet and weight loss progress.
- Up to three hours of individual counseling services the first year, and two hours each year after that.

As a general rule, Medicare does not cover long-term care facilities. As a result, Medicare does not pose a challenge to...
01/28/2025

As a general rule, Medicare does not cover long-term care facilities. As a result, Medicare does not pose a challenge to your clear title to your home. It is common for people in care settings to pay for their care. Some deplete their liquid assets over time and qualify for Medicaid assistance.

For more information on Medicaid eligibility, check your state's website.

Medicaid liens on homes have become common since the federal Omnibus Budget Reconciliation Act (OBRA) of 1993, which forces estate recovery if the homeowner:

- Relied on Medicaid at age 55+.
- Left the home, at any age, for a permanent care setting.
- Has no dependents with valid claims to the house.

For states to receive federal Medicaid funds, they must recuperate for nursing, hospital, and drug services.

Prohibition on Superlatives in Marketing: Agents and brokers are still prohibited from using superlatives like “best,” “...
01/26/2025

Prohibition on Superlatives in Marketing:
Agents and brokers are still prohibited from using superlatives like “best,” “largest,” or “most affordable” in marketing Medicare Advantage (MA) or Part D plans unless they can provide factual, up-to-date data to support those claims.

Recording of Marketing, Sales, and Enrollment Calls:
As of October 1, 2025, agents are required to record all marketing, sales, and enrollment calls between themselves and beneficiaries. This applies to third-party marketing organizations (TPMOs) as well. These recordings must be stored for at least 10 years for compliance purposes.

48-Hour Window Between Scope of Appointment (SOA) and Appointment:
Agents must continue to wait a minimum of 48 hours after a beneficiary signs a Scope of Appointment (SOA) form before they can discuss specific Medicare plans.

Training and Testing Requirements:
Agents and brokers will still need to complete mandatory training and testing every two years. This includes in-depth knowledge of Medicare plan benefits, compliance with sales and marketing guidelines, and updates on recent changes in regulations.

This list is a summary and not meant to be inclusive of all new CMS guidelines.

Every year, they are after the same kind of data: Medicare numbers and bank account information. However, fraudsters' ta...
01/22/2025

Every year, they are after the same kind of data: Medicare numbers and bank account information. However, fraudsters' tactics can change from year to year. The scammers thrive on anything that might confuse the Medicare population and target that.

As open enrollment begins, beneficiaries will receive text messages and emails requesting their personal information.

Medicare beneficiaries can be led down a terrible path by legal activities. There are a lot of TV and radio commercials for lead agencies that want viewers to call them first and then pass their information on to agents and brokers in other states.

Keep your 11-digit Medicare number, as well as your Social Security and credit card numbers, private.

Do you have any doubts about the legitimacy of an agent?

Call 1-800-MEDICARE.

When your income is higher than the IRS-defined limit, you cannot avoid the additional IRMAA (income-related monthly adj...
01/20/2025

When your income is higher than the IRS-defined limit, you cannot avoid the additional IRMAA (income-related monthly adjusted amount) premiums, whether you are enrolled in Original Medicare and a Medicare Supplement or a Medicare Advantage plan.

When your income exceeds the limit and your Medicare prescription drug plan is either Medicare Advantage with Prescription Drug Plans (Part C) or Medicare Prescription Drug Plans (Part D), you will be required to pay an additional IRMAA premium, regardless of whether you deduct your premiums from your Social Security check or pay them directly to Social Security (since you have not yet begun receiving your Social Security check).

Also, if you fail to enroll in a Medicare Part D prescription drug plan on time, you will not only be without prescription drug coverage, but you will be penalized for late enrollment in Part D.

High Required Minimum Distributions (RMDs) are likely to trigger Medicare means testing surcharges (avoidable taxes by a...
01/20/2025

High Required Minimum Distributions (RMDs) are likely to trigger Medicare means testing surcharges (avoidable taxes by a different name) during retirement in the form of higher premiums on Medicare Part B (doctor visits) and Part D (prescription drugs).

Income from your assets whether through IRA withdrawals or by dividends, interest and capital gains from non-IRA assets can make your social security taxable or increase your Medicare premiums.

When you apply for Medicare coverage for 2024, the IRS will provide Medicare with your income from your 2023 tax return. You may pay more depending on your income. In 2024, higher premium amounts start when individuals make more than $103,000 per year, and it goes up from there.

The 2019 SECURE Act eliminated the stretch IRA, which allowed heirs to stretch out RMDs from inherited IRAs over their projected life expectancy. Under the new law, RMDs for inherited IRAs no longer exist, but the entire account must be depleted within 10 years, and every withdrawal is taxed as ordinary income at the heirs' marginal tax rate.

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