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11/05/2021

https://news.yahoo.com/steve-israel-wary-celebrity-pitchmen-163653146.html

Be wary of celebrity pitchmen for Medicare plans.

09/28/2020

Dear Marci,

I have had Original Medicare for a few years. I’m considering enrolling in a Medicare Advantage Plan during Fall Open Enrollment this year. What should I consider when I’m looking at Medicare Advantage Plans?
-Reva (Detroit, MI)

Dear Reva,

Fall Open Enrollment runs from October 15 through December 7 each year. During this time, you can make changes to your health insurance coverage, including adding, dropping, or changing your Medicare coverage. Even if you are happy with your current health and drug coverage, Fall Open Enrollment is the time to review what you have, compare it with other options, and make sure that your current coverage still meets your needs for the coming year.
Ask yourself the following questions before choosing a Medicare Advantage Plan:
• How much are the premium, deductible, and coinsurance/copay amounts?
• What is the annual maximum out-of-pocket cost for the plan? This amount may be high, but can help protect you if you have expensive health care costs.
• What service area does the plan cover?
• Are my doctors and hospitals in the plan’s network?
• What are the rules I have to follow to access health care services and my drugs?
• Does the plan cover additional health care benefits that are not covered by Original Medicare?
• How will this plan affect any additional coverage I may have?
• What is the plan’s star rating?
Medicare Advantage Plans usually include prescription drug coverage. You should also consider these questions when choosing a Medicare Advantage Plan to make sure that the prescription drug coverage that the plan offers meets your needs:
• Does the plan cover all the medications I take?
• Does the plan have restrictions on my drugs (i.e. prior authorization, step therapy, or quantity limits?)
• Prior authorization means that you must get approval from your Part D plan before the plan will pay for the drug.
• Step therapy means that your plan requires you to try a cheaper version of your drug before it will cover the more expensive one.
• Quantity limits restrict the quantity of a drug you can get per prescription fill, such as 30 pills of Drug X per month.
• How much will I pay for monthly premiums and the annual deductible?
• How much will I pay at the pharmacy (copay/coinsurance) for each drug I take?
• Is my pharmacy in the plan’s preferred network? You pay the least if you used preferred network pharmacies.
• Can I fill my prescriptions by mail order?
• If I have retiree coverage, will the Medicare drug plan work with this coverage?
• What is the plan’s star rating?
You may find it helpful to use Medicare’s Plan Finder tool, which gives you a list of Medicare Advantage and Part D plans, the drugs they cover, and their estimated costs for the year. You can access Plan Finder by going online at www.medicare.gov or calling 1-800-MEDICARE.

-Marci

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08/04/2020

Dear Marci,

I’m 68 years old, I have Medicare, and I’m very healthy. My daughter recently suggested that I should consider putting together an advance directive and some other documents about my health care preferences in the future. What is this, and why would I need one if I’m healthy and able to communicate about my preferences?
-Marisol (Tampa, FL)

Dear Marisol,
Advance directives and living wills are legal documents that give instructions to your family members, health care providers, and others about the kind of care you would want to receive if you can no longer communicate your wishes because you are incapacitated by a temporary or permanent injury or illness. Other kinds of documents, like health care proxies and powers of attorney, appoint a trusted individual to make certain kinds of decisions on your behalf in certain situations.

Many people assume that their family members would automatically be able to make decisions about medical treatments if they were to become incapacitated. Each state has different rules regarding who becomes the default decision-maker if you do not have a health care proxy or some other means of expressing your treatment wishes. If you become unable to make medical decisions because you are incapacitated by a temporary or permanent injury or illness, anyone from your next of kin to hospital administrators could be making treatment decisions on your behalf.
If you are able, it is important you put your health care wishes in writing. If you do not:
• Your family may have to go through a costly and time-consuming court process to get the legal right to make medical decisions for you (called guardianship or conservatorship).
• Your family members may disagree on who should make medical decisions on your behalf, which could lead to legal disputes.
• Someone unfamiliar with your preferences may be placed in charge of your treatment decisions.
It is therefore important to have a plan ahead of time to avoid disagreements around treatment issues if you are incapacitated. Advance directives, living wills, health care proxies, and powers of attorney can help ensure that decisions made on your behalf meet your needs and preferences:

1. Health care proxy: A document that names someone you trust as your proxy, or agent, to express your wishes and make health care decisions for you if you are unable to speak for yourself.
2. Living will: A written record of the type of medical care you would want in specific circumstances.
3. Advance directive: Often refers to a combination of the living will and health care proxy documents.
4. Power of attorney: A document—typically prepared by a lawyer—that names someone you trust as your agent to make property, financial, and other legal decisions on your behalf.
You may choose to appoint the same person to be in charge of your medical and financial decisions by naming them your health care proxy and granting them power of attorney. However, doing so usually requires two separate documents.
If you have an advance directive, your doctors should make note of it in your medical record. Be sure to give these documents to the hospital each time you are admitted.

03/31/2020

Dear Marci,

I will be leaving my job soon and my employer has informed me about my right to COBRA coverage. I’ll also be eligible for Medicare soon. How do Medicare and COBRA work together? I want to make sure I make the right enrollment decisions.
-Clayton (Twin Falls, ID)

Dear Clayton,
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that lets certain employees, their spouses, and their dependents keep group health plan (GHP) coverage for 18 to 36 months after they leave their job or lose coverage for certain other reasons, as long as they pay the full cost of the premium.
Under COBRA, a GHP is defined as a job-based insurance plan that provides medical benefits to employees, their spouses, and/or their dependents.
As you make COBRA-related decisions, keep in mind that health coverage under COBRA is typically expensive because it tends to be comprehensive, and you may pay the full cost of the premium yourself (employers often pay part of the premium for current employees). However, COBRA coverage may be less expensive than similar individual health coverage.
The way that COBRA and Medicare coordinate depends, in part, on which form of insurance you have first. While it is possible to get COBRA if you already have Medicare, it is not usually possible to keep COBRA if you have it before you become Medicare-eligible. Specifically, whether you can have both COBRA and Medicare depends on which form of insurance you have first. If you have both forms of coverage, COBRA pays secondary to Medicare.
• If you have COBRA when you become Medicare-eligible, your COBRA coverage usually ends on the date you get Medicare. You should enroll in Part B immediately because you are not entitled to a Special Enrollment Period (SEP) when COBRA ends. Your spouse and dependents may keep COBRA for up to 36 months, regardless of whether you enroll in Medicare during that time.
• You may be able to keep COBRA coverage for services that Medicare does not cover. For example, if you have COBRA dental insurance, the insurance company that provides your COBRA coverage may allow you to drop your medical coverage but keep paying a premium for the dental coverage for as long as you are entitled to COBRA. Contact your plan for more information.
• If you have Medicare Part A or Part B when you become eligible for COBRA, you must be allowed to enroll in COBRA. Medicare is your primary insurance, and COBRA is secondary. You should keep Medicare because it is responsible for paying the majority of your health care costs. COBRA is typically expensive, but it may be helpful if you have high medical expenses and your plan covers your Medicare cost-sharing or offers other needed benefits, or if the COBRA policy also covers other family members who are not Medicare eligible.
Note: If you are eligible for Medicare due to End-Stage Renal Disease (ESRD), your COBRA coverage is primary during the 30-month coordination period.

-Marci

03/02/2020

While most of the proposals involving Medicare are largely aimed at behind-the-scenes shifts, the budget also would make it easier for older Americans to opt out of Medicare and would allow recipients to put money in tax-advantaged accounts earmarked for health-care costs.

12/05/2019

If you are being told that you must change your Medicare Supplement Plan F for January 1, you have been misinformed. If you like it - you can keep it. For more information, please visit www.MedicareChanges.com or call us at 1-800-247-9889.