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.

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What You Need to Know About Your 2019 Medicare Benefits

AEP is here. Know your 2019 Medicare benefits.

AEP stands for Annual Enrollment Period. It is the one time of the year you're allowed to make changes to your Medicare coverage, including your Prescription Drug Plan (Part D).

You will also learn about any changes to Medicare as well as changes to your Medicare Advantage Plan (Part C).

AEP is from October 15th to December 7, 2018. This is the Medicare's Open Enrollment for 2019 begins and ends. It is your once a year opportunity for you to switch from a traditional Medicare plan to a private Medicare Advantage Prescription Drug plan (MA/MAPD) or vice versa and to disenroll from the MA/MAPD) and enroll in a Private Prescription Drug (PDP) plan.

Before the start of AEP, if you have a MA/MAPD you will be receiving two important documents the:

1. Annual Notice of Change (ANOC), which lets you know of any changes to your current health plan for the upcoming year

2. Evidence of Coverage (EOC), which provides details about your health plan, including what it covers and how much you will pay for health care for the coming year.

They should have been in your mailbox by September 30th.

If you are pleased with your Medicare Advantage coverage, you don't need to do anything. Your coverage will automatically renew for another year.

If you have any questions about AEP and need a free consultation simply call (773) 614-3201 or e-mail me at bwillbar@gmail.com. I'm ready to help you.

The Annual Enrollment Period has come to an end. However, there is an Open Enrollment Period coming up on January 1, 2019 where you can change to another Medicare Advantage Plan or to return to traditional Medicare, and choose both a Prescription Drug Plan, and a Medicare Supplement Plan. Detail on this in my next blog. Look for it. 

Medicare Most Frequently Asked Questions - Part 1

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.

Medicare ABCs You Need to Know

With the huge clutter of information available on the internet and otherwise about Medicare, it can be both confusing and overwhelming to you. 

Here I want to cut through the maze and to help you make the best decision when to comes to your health care. Remember, if you are age 65 and on Medicare is your concern is not Obamacare. Always feel free to call or e-mail me if you have any questions.

Part A Medicare
Part A usually costs nothing as people have already paid for it through payroll deductions.  It covers hospitalizations, inpatient services in a skilled nursing facility, home health care services, hospice services, and blood.  For beneficiaries who did not pay for Part A in payroll deductions, the payment is about $426 a month.

Part B Medicare
Part B usually cost about $104.90 per month. If you are a higher earner, you have to pay a higher monthly premium. And, if you are just signing up for Part B for the first time, your premium will be $159.30 per month. Part B covers other medical services, such as doctor visits, outpatient care, home health care services, durable medical equipment, ambulance services, chiropractic services, diabetes supplies, and preventive services. 

Many people buy Medicare Supplemental Insurance, commonly referred to as Med Supp or Medigap, to cover the services original Medicare does not cover.

Part C Medicare
Medicare Advantage Programs (Part C) are Medicare products that are offered by Medicare through private health insurance companies.  They are Medicare regulated, approved, and monitored, and usually offer more benefits at a lower cost.  For instance, unlike original Medicare, MA plans have yearly maximum out-of-pocket cost protection and may cover vision, hearing, and preventive dental coverage.  Medicare advantage plans are available with or without integrated part D prescription drug coverage, which may include zero co-payments for certain generic medications.

Part D Medicare
Medicare part D covers prescription drugs. 

Medicare beneficiary with original Medicare Part A and Part B, a Med Supp policy, and a stand alone Part D may pay about $250 or more each month in premiums.

Additionally, private health insurance may have long-standing relationship with Medicare to process claims under the original Medicare program.


Have a question regarding your Medicare benefits. Just call I'm ready to help.