Showing posts with label Medicare Advantage Plans. Show all posts
Showing posts with label Medicare Advantage Plans. Show all posts

Tuesday, October 18, 2022

Get the 2023 Medicare Benefits You are Entitled to


Aging into Medicare opens you to a wide variety of great benefits and money savings. 

If you are receiving Social Security, you are automatically enrolled in Medicare Part A if you have earned 40 credits through payroll taxes while working. If not, go to the Medicare web site or visit your local Social Security office either three months before your birthday month, on your birthday month, or no later than three months after your birthday month. This is your eligibility window.

Medicare Part A covers hospitalizations, blood transfusions during hospitalization, home health care, hospice care, and stays in skilled nursing facilities.

With regards to Medicare Part B, you do not need any work credits to qualify for Part B. However, if you don't sign up during your eligibility window, but then decide to enroll later, your premium goes up 10% for each 12 month period.   As an example, if you wait five years to sign up, your premium would then be 50% higher than someone who signed up on time.

If you have health insurance through your work or your spouse's work, you can delay enrolling in Part B. But if your employer has fewer than 20 workers or if you are on a company retirement plan, you must enroll in Part B as soon as you turn 65. Your workplace or retiree plan will become your secondary plan.

Remember that Part B Medicare which pays 80% of doctors, supplies, outpatient services, physical or speech therapy does not have a cap after the 80% is paid by Medicare.

However, you can choose Medicare Part C, which is Medicare Advantage and self enroll  These are managed care type plans which covers all your benefits under Part A and Part B, and often will cover your Part D Prescription benefit and may include dental, vision, physical fitness and transportation.  These plans usually have zero or minimum monthly premium and have a cap on how much you will pay out of pocket annually. They are comprehensive plans and I highly recommend that you choose one. 

You will need to check your prescription benefits every year because the list of covered drugs can change. Make a list of the medications you are taking, and check to see if they are covered under the plan you are considering.  

Leave your questions or comments below. Or, email me at bwillbar@gmail.com

Will Barnes, Medicare Consultant


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Thursday, October 21, 2021

Here's What You Need to Know About Medicare 2022


Know Your Medicare 2022 Benefits

Knowing about  your Medicare 2022 benefits is deeply important. You paid into it during your work life and you deserve all the benefits you have coming. You have come to the right place for all the information you need. 

Medicare has Four Parts
Part A is inpatient hospital insurance. It also covers skilled nursing facility stays, home health care, and hospice care.

Part B is medical insurance, covering doctors' services, diagnostic tests, durable medical equipment, and outpatient hospital services. 

Part C covers Medicare Advantage Plans, and Part D covers prescription drug plans. 

Part A, which is free for most Americans, and Part B, which charges a monthly premium of $158.50 for most people, provides the foundation of health insurance for Americans 65 and over.

But here's more. Medicare Part A has large deductibles (for example, $1,556 for a hospital stay of 60 days or less). Medicare Part B has no cap on out-of-pocket costs after Medicare pays 80 percent of approved expenses. 

Once the annual amount of $217 Part B deductible is met, as an example, Medicare will pay 80 percent of  your bill and you will have to pay 20% of whatever amount remains with no limits. The $217 is the 2022 deductible up from 2021. All deductibles, premium, and co-insurance amounts above are for Part A and Part B effective January 1, 2022. 

Medicare Additional Coverage
The limitations of Parts A and B prompts an estimated 39 percent of people on Medicare to enroll in a Medicare Advantage Plan. Medicare Advantage plans, Part C, are offered by private companies approved by Medicare, Besides services included in Medicare Parts A and B, they usually offer additional coverage, including vision and dental, health club membership, and both prescription drugs and transportation. 

Go to Medicare Advantage Plans And see what plans are available to you and take advantage of the benefits you have coming.

If you have additional questions call (773) 614-3201 or email me at bwillbar@gmail.com

Friday, December 21, 2018

Easy Way to Get Extra Help with Your Prescription Costs


Even though the AEP (Anuual Enrollment Period) is over, you can still get help with your prescription costs.  

In times like these, every dollar counts. Some people qualify for big savings on their Medicare prescription drug costs and don't even realize it. 


In fact, if you receive Medicare, you may be eligible for the Extra Help, which could save you about $4,000 per year on your monthly premiums, annual deductibles, and prescription co-payments.

Many People Quality and Don’t Know-It
To qualify for Extra Help, you must be receiving Medicare, have limited resources and income, and reside in one of the 50 states or the District of Columbia. 

To find out if you qualify, Social Security will need to know the value of your savings, investments, real estate (other than your home), and your income. We will also need information about you and your spouse, if you are married and living together.

Even if you were previously turned down for Extra Help due to income or resource levels, you should reapply. If you qualify, you'll get help paying for Medicare prescription drug coverage premiums, co-payments, and deductibles. To qualify, you must make less than $17,655 a year (or $23,895 for married couples). 

Even if your annual income is higher, you may still qualify for partial extra help. Your resources must also be limited to $13,640 (or $27,250 for married couples). Resources include bank accounts, stocks, and bonds, but not your house or car.

How to Apply for Extra Help
To get through the Extra Help process, call me at (773) 614-3201 and I'll help you with the process. It will take only a few minutes. 

Once you are determined to be qualified, you can choose either a Medicare prescription drug plan or a Medicare Advantage Plan for your savings.

Make sure you aren't missing out on these easy savings. The sooner you call, the sooner your savings begin.

Any comments? Leave them below.


Friday, November 24, 2017

Medicare Enrollment Periods You Must Know About

The issue of the Enrollment Periods needs to be expanded upon. Remember, the Center for Medicare and Medicare Services (CMS) has established four basic enrollment periods in which Medicare recipients with both Part A and Part B can enroll in a Medicare Advantage Plan (MAP), Part C or a stant alone Prescription Drug Plan (PDP).

Enrolling in Medicare Advantage Plans
Enrolling in Medicare Part C or Medicare Advantage Plan (MAP) is optional. If you want to enroll in a MAP, you must be entitled to both Part A and Part B.

Your Enrollment Periods

  • Initial Enrollment Period (IEP) allows you to join a MAP three months before your birthday month, your birthday month, and three months after. 
  • the Annual Enrollment Period (AEP) from October 15th to December 7th, 
  • the General Enrollment Period (GEP) from January 1st to March 31st 
  • and, the Special Election Period (SEP)

During the AEP beneficiaries may change their PDP, change their MAP, return to Original Medicare, or enroll in a MAP for the first time.

Re-enrollment and Dual Eligibility
During the GEP, if you didn't enroll in Part A or B during the IEP, or terminated your Part A or Part B benefits and want to re-enroll in either or both Parts, you may do so during this period. If you enroll during the GEP, your benefits will begin the following July 1st.

Finally, during the SEP if you  have special needs, specifically diabetes or have Dual Eligibility (qualify for both Medicare and Medicaid) ,you can change your plan anytime during the year with no limit to the number of changes. This includes your prescription drug plan. This choice under the SEP is also available to those who move into, reside in, or move out of a nursing home.


If you have any questions regarding what plan would be best for you, call (773) 614-3201.

Any comments? Leave them below.

Monday, October 16, 2017

Medicare Annual Enrollment Started October 15

The Annual Election Period (AEP) for Medicare recipients is upon us again.

From October 15th to December 7th covered individuals can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.

During the AEP, you can: 

  • change from Original Medicare to a Medicare Advantage Plan; 
  • change from Medicare Advantage Plan back to Original Medicare; 
  • switch from one Medicare Advantage Plan to another Medicare Advantage Plan; 
  • switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn't offer drug coverage; 
  • join a Medicare Prescription Drug Plan; switch from one Medicare drug plan to another Medicare drug plan; 
  • or drop your Medicare drug coverage completely.

If you don't take advantage of this Special Election Period (SEP), then you are "locked in" until the next AEP unless you qualify for a SEP which allows you to change plans between the AEP.

Among the circumstances that may qualify you for a SEP are: you move to a new location; you're eligible for Medicaid; you qualify for Extra Help with Medicare prescription costs; you're getting care in an institution (like a skilled nursing facility or long term care hospital); or, you want to switch to a plan with a 5-star overall quality rating.

If you are satisfied with your, Plan you don't have to do anything. You'll simply remain in your existing plan. If you want to change, you'll need to contact the representative for that plan and complete the necessary application forms for enrollment.

If you decide to change, you'll need to: make sure that your primary doctor and your specialists are in the plan and whether they taking new patients who have this plan; know what you will have to pay if you see a doctor outside of the network; look at the limits on your out-of-pocket expenses; and, make sure that your plan includes preventative medicine, such as wellness visits as well as services such as vision, dental, hearing, prescriptions, and transportation. 

For more information, Chicago and Cook County residents, call (773) 614-3201.

Thursday, February 9, 2017

Medicare Annual Election Period is Over, But not for Everybody

Image result for MEDICARE IMAGES
If you meet certain requirements you can still 
make some changes in your healthcare coverage 
even after the Annual Enrollment Period (AEP) 
ended December 7th.

Here are 6 requirements for your eligibility:
1.     If you are duo eligible, that is, if you are eligible for both Medicare and Medicaid, you can make changes in your healthcare plan throughout the year.
2.     If you have a special need, specifically diabetes, you can also make changes throughout the year. 
3.     If you just you just turned 65 and became eligible for Medicare, you have a seven month (three months before your birthday, your birthday month, and three months after the birthday month) window to enroll in whatever Medicare Advantage plan or Part D Prescription plan you choose. 
4.     If you become eligible due to a disability.     
5.     If you move, you may change to a different plan than was offered in an area where you formerly lived.      
6.     And, if your coverage through your employer or union group health plan ends, you have a Special Election Period (SEP) to enroll in a Medicare Advantage Plan or a Part D Prescription plan. The SEP ends two months after your coverage through the group plan ends.



Still have questions about your health care plan? Still thinking about changing, call me at (773) 614-3201.

Sunday, November 6, 2016

Medicare Most Frequently Asked Questions - Part 1

Centers for Medicare and Medicaid Services (Me...

Understanding the Medicare system can be confusing. Here are answers to Frequently Asked Questions on Medicare


1. What is Medicare?
Medicare is the Federal health insurance program established in 1965 which is administered by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health Services. Medicare is health insurance for the following people:
  • Age 65 or older;
  • Under age 65 with certain disabilities who qualify for disability benefits from Social      Security or Railroad Retirement Board (RRB);
  • Any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant);
  • Diagnosed with ALS (Amyotrophic Lateral Sclerosis), also called Lou Gehrig's disease) the month your disability benefits begin.

2. How do I enroll in Medicare Part A (Hospital) and Part B (Medical)?
  • If you aren't getting Social Security or Railroad Retirement (RRB) benefits, you will need to sign up in one of three ways: 1) online at www.socialsecurity.gov; 2) call Social Security at 1-800-772-1213, or; 3) visit your local Social Security office.
  • In most cases, if you're already getting benefits from Social Security or the Railroad Retirement Board (RRB), you will automatically get Part A and Part B starting the first day of the month you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.
  • If you're under 65 and disabled, you automatically get Part A and Part B after you get Social Security disability benefits (SSDI) or certain disability benefits from the RRB for 24 months.
  
3. What does Medicare Part A (hospital) cover?
  • Inpatient care in hospitals;
  • Inpatient care in a skilled nursing facility (not custodial or long-term care);
  • Home health care services;
  • Hospice care services;
  • Blood.

4. What does Medicare Part B (medical) cover?
  • Doctor's services and tests
  • Outpatient care
  • Home health care services
  • Durable medical equipment and other medical services  
  • Ambulance services
  • Chiropractic services
  • Diabetes supplies
  • Preventive services

5. What is NOT covered by Medicare Part A and Part B?
Medicare doesn't cover everything. If you need certain services that Medicare doesn't cover, you will have to pay for them yourself unless you have other insurance to cover the costs. Even if Medicare covers a service or item, you generally have to pay deductibles, coinsurance, and copayments. Some of the items and services that Medicare does not cover include the following:
  • Long-term care;
  • Routine dental care;
  • Dentures;
  • Cosmetic surgery;
  • Acupuncture;
  • Hearing aids;
  • Exams for fitting hearing aids.

6. What are Medicare Advantage (MA) plans (Part C plans)?
Medicare Advantage plans are offered by private insurance companies that contract with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan.  

7. What is Medicare Part D (Prescription Drug Plan)?
Medicare offers prescription drug coverage to everyone with Medicare. Even if you don't take a lot of prescriptions now, you should still consider joining a Medicare Prescription Drug Plan (PDP). To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. Take time and read the Formulary for each company.. If you decide not to join a Medicare drug plan when you're first eligible, and you don't have other creditable prescription drug coverage, you will likely pay a late enrollment penalty.

8. How can I get help paying for my prescription drugs?
Frequently Asked Questions by Medicare Beneficiaries I Senior Advocacy Services
You may qualify for "Extra Help", also called the low-income subsidy (LIS), from Medicare to help pay prescription drug costs if your yearly income and resources are below the following limits: Single Person: Monthly income less than $1,471 and resources less than $13,640; Married Person Living with a Spouse and no other Dependents: Monthly income less than $1,991 and resources below $27,250.

9. What other Low-Income programs are available?
You may qualify for the Medicaid program or any of the Medicare Savings Programs (MSP) if you meet certain monthly income and asset levels. 

10. What are Medicare Supplement plans (Medigap plans)?
A Medigap policy, sold by private insurance companies, can help pay some of the health care costs ("gaps") 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 Medicare Parts A and B 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. Medicare doesn't pay any of the premiums for a Medigap policy. 

11. What if I am still covered by my Employer Group Health Plan when I become eligible for Medicare (either while I am still working or now that I have retired)?

Do you have, or are you eligible for other types of health insurance or prescription drug coverage (like from a former or current employer or union)? If so, read the materials from your insurer or plan, or call them to find out how the coverage works with Medicare. If you have coverage through a former or current employer or union or other source, talk to your benefits administrator, insurer, or plan before making any changes to your coverage. If you drop your coverage, you may not be able to get it back.

In Part 2, I will answer additional questions. So be sure to send yours if you have particular ones. Be sure to watch for my next blog on how to qualify for Medicare Advantage Plans all year around.  Call (773) 614-3201 or e-mail me at bwillbar@gmail.com with your urgent questions.

Friday, September 2, 2016

What's the Medicare Part D Late Enrollment Penalty?


The Medicare Enrollment Period Period will be here in less than ninety days. Take a moment now to consider the impact of the late enrollment period and specifically the penalty on your prescription drugs. 

The late enrollment penalty is an amount added to your Medicare Part D premium. 

You may owe a late enrollment penalty if, at any time after your initial enrollment period is over, there's a period of 63 or more days in a row when you don't have Part D or other creditable prescription drug coverage. 

You must learn how to avoid the late enrollment penalty. Please note, if you get Extra Help, you don't pay the late enrollment penalty.

How much is the Part D penalty?
The cost of the late enrollment penalty depends on how long you went without creditable prescription drug coverage. The late enrollment penalty is calculated by multiplying 1% of the "national base beneficiary premium" times the number of full, uncovered months you were eligible but didn't join a Medicare Prescription Drug Plan and went without other creditable prescription drug coverage. 

The final amount is rounded to the nearest $.10 and added to your monthly premium. The national base beneficiary premium may increase each year, so the penalty amount may also increase each year.

How will you know if you owe a penalty?
Your plan will tell you if you owe a penalty. After you join a Medicare drug plan, the plan will tell you if you owe a penalty, and what your premium will be. You may have to pay this penalty for as long as you have a Medicare drug plan. If you had to pay a Part D late enrollment penalty before you turned 65, the penalty will be waived once you reach 65.


Do you have any Medicare questions or comments, leave them below.












Saturday, July 23, 2016

Medicare Most Frequently Asked Questions - Part 2

Medicare in Australia's brand.

When Can I Sign Up for Medicare?
You can sign up for Medicare as soon as you become eligible, regardless of what month it is. But each year, you have the option of making changes to your Medicare Advantage and prescription drug plan (or Medicare Part D) during open enrollment. Open enrollment ran from October 15 to December 7 and has been so for several years. 

During that period, you could have switched from original Medicare to a Medicare Advantage Plan, or vice versa. You could have also switched from one Medicare Advantage plan to another, or from one Medicare part D prescription drug plan to another, or dropped your Medicare Part D coverage altogether.

There is also the Medicare Advantage disenrollment period in which you are currently in. This period runs from January 1 to February 14 each year. During this time, Medicare Advantage enrollees can switch back to Original Medicare and then sign up for Medicare part D as well. Again, if you are newly eligible for Medicare, you can enroll the year around.

Are There  Other Times I Enroll in Medicare?

There are also special circumstances where Special Enrollment Periods are available. According to Medicare.gov, if you are covered under a group health plan from a current employment, you can sign up for Part A and/or B during the Special Enrollment Period as long as you or your spouse are working and are covered by a group health plan through your employer.  Additionally, there is an eight month period where you can sign up for Part A and/or B the month after employment ends or group health plan insurance ends

If you have any additional Medicare questions or comments, leave them below.

Saturday, January 16, 2016

Medicare Open Enrollment is Over, but not Obamacare, yet

Barack Obama signing the Patient Protection an...

While the Open Enrollment Period (OEP)was over for most senior citizens on December 7, those who are duo eligible (have both Medicare and Medicaid), or have a chronic illness such as diabetes can change or replace Original Medicare, Medicare Advantage or a Prescription drug plan anytime throughout the year. Also, specific situations, such as moving into a new area of realizing an eligibility change can allow you a Special Enrollment Period (SEP).

However, if you are not yet eligible for Medicare, you are vulnerable to Obamacare, and all of its problems. If you have been able to enroll on healthcare.gov, you are “lucky”. And, if you did enroll you probably discovered that you had an increase in premiums along with a higher deductible and co-payments. Keep in mind that although you have enrolled, you do not have insurance until you have paid the first premium.

Here’s why your premiums have gone up: Obamacare has the requirement that insurance policies has to cover “ten essential health benefits”. Obamacare requires you to pay for these benefits whether or not you want them or need them. For example, a childless person must pay for a plan that includes pediatric services.

Now, here are these ten essential health benefits:
1. Ambulatory patient services
2. Hospitalization
3. Prescription drugs
4. Prevention and wellness care.
5. Emergency services
6. Maternity and newborn care.
7. Rehabilitation services
8. Laboratory services
9. Mental health services
10. Pediatric services

If you voted for Obama, you got what you voted for. Always remember, elections have consequences. Another election is coming up in November 2016. Research the candidate’s position on the issues that matters to you. Keep in mind that a vote for Hillary Clinton is a vote for a 4 year extension of Obama's policies, including Obamacare.

Consider if the candidates positions become law, how would it impact you, your, family and your bank account.  Know their past voting records, and then decide who would be the best candidate for your vote. Don’t vote on superficial qualities and then have buyer’s remorse.


What are your thoughts? Leave your comments below.














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Tuesday, September 15, 2015

Are You Ready for the 2016 Medicare Enrollment Period?


Again this year the Annual Enrollment Period (AEP) period for Medicare recipients with Part A and Part B runs from October 15th to December 7th.

Beyond this (AEP) there is a Special Election Period (SEP) for those receiving the Medicare Low Income Subsidy and for those with Special Needs or a chronic illness, usually diabetes. 

The Special Election Period
This SEP specifically refers to the population which includes: the dual eligible, those with chronic illness, and those who are institutionalized. The dual eligible are those who qualify for both Medicare Part A and B and Medicaid. Those who have a chronic illness are those who a physician has certified as being treated for a qualified medical condition that is specifically designated in the plan. And those  institutionalized refers to those who are confined to a long-term care facility.

The Medicare Supplement Plan Enrollment
Finally, if you're interested in a Medicare Supplement Plan  you can enroll in it year around if you have Original Medicare A and B. If they accept Medicare, a Medicare Supplement Plan allows you to go to any doctor or hospital of your choosing . Also, you can change your Medicare Supplement Plan any time. 

It certainly may be a good idea to have a qualified agent to evaluate your coverage to see if you can save some money on your policy.

Call (773) 614-3201 for help in choosing the best Plan for yourself. 


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Sunday, August 23, 2015

How to Avoid the Medicare Part B Penalty

Medicare Part B is optional and covers outpatient expenses such as lab tests, outpatient surgeries, doctor visits and limited outpatient prescription drugs (typically not drugs you would administer yourself). 

Coverage begins after you meet an annual deductible of $147 (2015) as well as paying a monthly premium of $104.90. After meeting the deductible, you must also pay a coinsurance of 20 percent of the Medicare-approved charges for most doctor services.

You may be wondering whether you should sign up for Part B at the same time as Part A. Naturally, you are concerned about paying premiums for Part B if you don't need the coverage. But the timing for enrolling in Part B is a bit trickier and the stakes much higher, since late enrollment can cause you a permanent premium increase.

One thing you should consider: If you don't have employer group coverage, then this is a no-brainer. You should apply during their seven-month initial enrollment period.

If you are covered under a group health plan based on your current employment -- whether it's your employer or your spouse's -- you may qualify for a Special Enrollment Period, often abbreviated as SEP. If so, you may delay enrolling in Part B until your group health coverage is terminated, and avoid the late enrollment penalty.

The eight-month special period starts the month after the end of either your employment or the group health insurance coverage based on that employment -- whichever happens first. I'll remind you periodically regarding your Part B coverage.

Keep in mind that COBRA coverage does not qualify as employer coverage, and so it won't allow you to escape the penalty for delayed enrollment. Be sure to educate yourself so you don't make this common mistake.

There are other considerations as well. Some smaller employers require Part B coverage to be integrated with their existing insurance plans, for instance, while larger employers may not. Talk to your human resources department to find out whether Part B coverage is necessary for yourself.


Contact me if you have any questions, (773) 614-3201 or leave them below. Comments are welcome.



Tuesday, August 18, 2015

What You Need to Know About Medicare Now and into 2016

One of the most important decisions seniors will make is choosing the right Medicare coverage when they become eligible for the federal health insurance program.

Your first year of Medicare eligibility is one of the most critical times because of the variety of choices you have to make and the potential for costly mistakes that may last your lifetime. That’s because there are recurring penalties you will have to pay if you don't sign up for certain types of Medicare coverage when you first become eligible.

If you do not have creditable coverage that is as good or better than Medicare, there are penalties that you will have to pay once you finally do enroll and will have to continue to pay for as long as you have Medicare. There also are "some complex choices" that can impact your entire family. For example, if your employer's insurance plan provides coverage for your spouse and dependents and you leave the plan to enroll in Medicare, your family could be left without coverage. So it's important to choose Medicare plans that match your health needs and financial resources. It's all driven by cost and how the benefits are going to work.

The second thing is, can I still see my current doctor? What about my medications? Are they covered and how are they going to be covered?"

Generally, if Medicare beneficiaries want to change their coverage, they must wait until the next Open Enrollment Period (OEP), which runs from October 7th through December 15th
Here's what you need to know.
THE BASICS
Medicare has four parts:
  • Part A is hospital insurance. It covers inpatient care at hospitals, care at skilled nursing facilities, hospice care and home health care.
  • Part B is medical insurance. It covers services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services.Together, Part A and Part B make up Traditional or Original Medicare.
  • Part C referred to as Medicare Advantage Plans are Medicare approved private health insurance plans for individuals enrolled in Original Medicare, Part A and Part B. When you join a Medicare Advantage Plan, you are still in the Medicare plan and must continue paying your Part B premium
  • Part D is prescription drug coverage. It is offered through private Medicare-approved insurance companies. The monthly premium for this coverage depends upon the extent of the coverage and can vary between companies.
Medicare Advantage is significant because it provides all of your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. They generally offer additional benefits, such as vision, dental, and hearing, and may include prescription drug coverage. Call (773) 614-3201 if you are interested in a Medicare Advantage Plan.

If you have any Medicare questions or comments, leave them below. 



Wednesday, February 27, 2013

How ObamaCare is Destroying Medicare Advantage Plans

While the  Obama administration is trying to scare people about the automatic spending cuts that are scheduled to hit this Friday, they don't want to talk about its own devastating cuts in Medicare. On Friday, February 15, the Centers for Medicare and Medicaid Services (CMS) announced $716 billion in cuts over the next ten years. Instead of being put this money towards the debt, most of the money will go toward a new entitlement -- ObamaCare's vast expansion of coverage for the uninsured. 

Savings to Come Out of Medicare Advantage Plans
At least half of the savings will come out of Medicare Advantage, under which a full 28 percent of seniors buy privately managed health insurance that often includes added benefits such as vision and dental care or chronic-illness management. In exchange, patients agree to stay within a medical network, which helps insurance companies manage their costs. The program is most popular with Hispanics and African-Americans.  

A study by CMS found that 38 percent of Hispanics and 31 percent of African Americans on Medicare were enrolled in Medicare Advantage, compared with 27 percent of whites. Despite the fact that the program reports high levels of consumer satisfaction,the Obama administration is determined to cut it, even if it means driving millions of seniors back into traditional, one-size-fits-all Medicare. 

  
Restriction of Senior's Choices
They want to restrict seniors' choices by curtailing private plans competing in Medicare. To add cynicism to injury, the Obama administration postponed the Medicare Advantage cuts until after the 2012 election, using a slush fund to tide the program over and conceal the true costs of Obamacare to seniors. The cuts are so much larger than expected that health care stocks tanked across the board after they were announced. The Congressional Budget Office projects that the payment cuts will result in an enrollment drop of 3 million for Medicare Advantage which would turn almost every plan in the industry unprofitable. 


Seniors must pressure their Representatives and Senators to revise or reverse the cuts before they are made final in April. Some adjustments are possible, but the law will continue to mandate a squeeze on Medicare Advantage. President Obama promised Americans in 2009 that "if you like your health-care plan, you can keep your health-care plan." The reality is that not only are millions of Americans likely to lose health-care coverage from their employers, but millions more will lose the Medicare Advantage plans they've grown used to.  

Seniors Will be Forced Back Into Traditional Medicare
Unless it is changed, ObamaCare will relentlessly restrict the choices seniors have by forcing them into traditional Medicare with all of its attendant contradictions, restrictions, and waste. Medicare Advantage has its problems, but they could be surgically addressed. Instead, the bureaucrats running ObamaCare are set on slowly starving the program. By focusing solely on the politics of the sequester, the media are ignoring the Obama administration's bigger, more brazen threat to vulnerable American seniors.


Email your Medicare questions to me at Ask Will , wwillbar@gmail.com.

Leave your comments below.