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New Humana Medicare Plans 2016

New Humana Medicare Plans 2016 –  There are some new Humana Medicare plans that clients can purchase in 2016. The new plans have many great options for members to choose from.  Humana offers Medicare Advantage plans both with and without drug plans in multiple states.  Please note that in some states such as NY, they only offer a stand alone PDP plan while in others they offer both the PDP and Medicare Advantage plans.  They have multiple MAPD plan types with HMO and PPO plans in various states.  Click the link below to review Humana Medicare plans 2016 in all states. The link will also provide PDP Rx summaries.  Please call our office with any additional questions about plan designs, or benefits.

Click for Humana benefit summaries for all states 2016

Humana Medicare is also looking to fill a market void in the Long Island NY region.

This new HMO plan offers to it’s members:

• $37 monthly premium.
• $5 PCP co-pays.
• $30 specialist co-pays.
• $6,7000 Maximum out of pocket (MOOP) cost.
• This plan also includes a Silver Sneakers membership.
• It also provides preventive dental coverage.
• There is also a vision allowance of $200 toward the purchase of new glasses.
• They provide members hearing aid coverage.
• In addition this plan offers optional supplemental benefits (OSB), if you so choose.
• Travel options are built in to allow for in-network benefits in select Florida counties.

The network has been expanded to include the following:

• North Shore Lone Island Jewish Hospitals as in-network participants.
• Both Pro-Health providers as well as surgical centers are in-network participants.
• In addition, the network includes Advanced Urology.

Medicare Supplemental Plan Rates

There are many various options when you decide to purchase a Medicare supplement plan. Medicare Supplemental Plan Rates are listed below. Coverage for Original Medicare, Part A and Part B, include monthly premiums, deductibles as well as co-insurances. There is no limit for out-of-pocket spending.  Long term care, dental and vision are not covered.  To stabilize and or limit some of the cost, many choose a Medicare Supplemental or Medigap Plan.  As you have most likely heard, Medicare enrollment can be complicated.  For your own piece of mind, we recommend speaking with an experienced, licensed health insurance agent.  A knowledgeable agent can help you  to choose the best option for YOU.

There are actually 10 Medicare Supplement Plan options available to you. Each plan has different, yet standardized, benefits and coverage. This means that no matter which insurer you buy from, the benefits of each plan will be the same.

However, while the plans are standardized across insurance companies, the Medigap costs can be vastly different. So even though you will ultimately be getting the same benefits, it pays to shop around to get the best rate.

Click for rates in CT

Click for rates in NY

Do you have questions or concerns regarding your current Medicare plan? If you would like to learn more about future Medicare Advantage, Supplemental as well as Prescription Drug Plan options?   Please contact us either at 203-796-5403 or at admin@croweandassociates.com to discuss your Medicare options in detail.

What is the Medicare Part D Penalty

If you have gone without Part D or other credible drug coverage for a period of 63 days or more after your initial enrollment period. You may owe a Medicare Part D Penalty.  What is the Medicare Part D Penalty –

With Medicare as with all insurance plans it is wise to know all the ins and outs before you start.  If you find a knowledgeable insurance agent to help you sort things out, you will be ahead of the game.  Here at Crowe and Associates our job is to help clients understand insurance.  We want you to feel confident that you have chosen the right policy for both your health needs and your budget.  That is why it is important that you are aware of any possible penalties that can cost you money.

The dollar amount of the penalty

Medicare will officially calculate your penalty based on the number of full months you went without coverage.   The penalty is 1% of the national base beneficiary premium multiplied by the number of uncovered months and then rounded to the nearest $0.10.  That amount will be added to your monthly part D premium.  (Note: Since the national benchmark premium may increase each year, the penalty amount will also change accordingly.

Click Here for a Part D Late Enrollent Penalty Reconsideration Request Form

You should mail both completed forms as well as supporting documentation to the address below:

MAXIMUS Federal Services
3750 Monroe Avenue, Suite 704
Pittsford, NY 14534-1302

Or faxed to:
Fax number: (585) 869-3320 or  toll free fax number: (866) 589-5241

Do you have questions or need assistance navigating the Part D late enrollment penalty reconsideration process?  Please contact the office at either 203-796-5403 or at admin@CroweAndAssociates.com if you have questions or require additional information about insurance.

Medicare Supplement High Deductible Plan F

Medicare Supplement High Deductible Plan F includes cost-sharing features.  These features allow you to save on premiums while still receiving dependable coverage.

In fact, The high deductible Medicare Supplement insurance plan pays the same benefits as Plan F.   AFTER you have paid the annual deductible of $2,180.  Benefits  from the High Deductible Plan F will not begin until out-of-pocket expenses are $2,180.

What’s does Medicare include in a Medicare Supplement High Deductible Plan F?

• Your $1,260 Part A deductible and coinsurance
• The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
• $147 Part B Medicare deductible
• Your Part B coinsurance and the cost of the first three pints of blood
• 100 percent of Part B physician charges that are in excess of the Medicare-approved amount (by law no physician may charge more than 115 percent of Medicare-approved amounts).
• Skilled nursing facility copayment
• Hospice care
• Foreign travel emergency care

Medicare Part A Coverage:

Medicare Part B:

CT Medicare Advantage and Supplements

There are many choices when it comes to CT Medicare Advantage and Supplements.  These choices can confuse anyone. We can help you feel comfortable not only with your choice of health care plans but the cost as well.  Crowe and Associates is one of the region’s leading Medicare brokerages.  Are you looking for CT Medicare Advantage and Supplement information in Connecticut?  We can help. Crowe and Associates is an independent brokerage agency that works with all major Medicare Advantage and supplement plans.  We work with clients everyday to help them understand the difference between Advantage plans and supplements. We use that knowledge to choose the best plan and company for them.  The insurance companies pay us so you will never receive any type of bill or fee for our services.

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How Are Hospital Observation Services Covered?

How Are Hospital Observation Services Covered? For those covered under Original Medicare or a Managed Medicare plan there can be a big difference in out of pocket costs for a hospital stay.  The amount of coverage you receive depends on how your carrier classifies the services.  Your insurance carrier may consider a hospital either inpatient or outpatient even if someone stays overnight.

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Teladoc Doctor and RX by Phone

Teladoc Doctor and RX by Phone.  This Teladoc service is such a great help for today’s active on the move individuals and families. This is a national network of U.S. board-certified and state-licensed physicians.  The physicians use electronic health records, telephone consultations and online video consultations to diagnose, recommend treatment as well as write short term, non-DEA controlled prescriptions.  This is all done without a face to face meeting.  Physicians are available 24 hours a day for 365 days a year.  This allows it’s members of any age to conveniently access quality care either from their home, work or on-the-go.  In fact, Teladoc coverage includes both a dental as well as a vision discount plan.  LASIK vision correction and a prescription saver program are also included in this plan.  All programs are included in the pricing below.  In fact, this service is approved in all 50 states.

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True Freedom Home Care Service Plans

True Freedom home care service plans are designed for consumers who are not currently in need of care but could be classified as in “declining health” which would prevent them from being able to secure a traditional plan.

While loved ones will have the best intentions to be there for a family member who needs assistance, many are not prepared and quickly become overwhelmed by the amount of work involved in giving care.  Traditional home health care insurance is an option for such services.  However, it is limited to only the extremely healthy, creating challenges for many that do not qualify.  True Freedom plans are a viable alternative to traditional home health care insurance.  These plans support seniors with their regular activities while providing independence and privacy with at home care

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Medicare Excess Charges Connecticut

Medicare Excess Charges Connecticut:    Medicare excess charges or sometimes called excess billing is applied by doctors that do not accept Medicare assignment.  A doctor who chooses not to accept assignment is able to bill a patient 15% over the allowable Medicare charges.  However, Those providers are not able to bill over Medicare allowable limit on all charges.  Some items that providers cannot use the excess charge on include Durable Medical Equipment. This is true even if they are not accepting assignment.   Non par is another way of saying that the doctor does not have to accept the Medicare contracted price for services.   You should not confuse Non par with a Medicare opt out.  An opt out is when a doctor does not participate with Medicare.   Medicare will not provide any coverage for services rendered by an opted out physician or facility.

Be very careful when you ask a provider if they “take” your insurance!

You might think, if the provider says that they “take”  your insurance they participate with your insurance carrier.  This is not always the case. This only confirms that they will accept payment from your insurance company and they may submit your claim for you.  It does always not mean that they  have a contract with your carrier.

If you want to be sure, you should always ask healthcare providers if they are contracted as a participating provider with your insurance carrier.  Unfortunately, there are some providers out there who will mislead you with their wording in order to get your business.  This is more common than you would think. For this reason you must ask the right questions to avoid costly situations.  Your carrier cannot protect you from any carrier they do not have a contract with.

Fortunately, Connecticut does not allow excess charges or billing from doctors that are non par.  Some Medicare supplement plans cover excess charges.    That benefit is not necessary in CT and should not factor into deciding which plan you should choose.

Click here to access the government site on Medicare.

If you have questions or need additional information regarding your current or future Medicare needs, call the office at 203-796-5403 or email us at admin@croweandassociates.com.  Allow us to use or many years of experience and in-depth knowledge of all Connecticut Medicare plans and providers to help you navigate the Medicare process.

Medicare Assignment

Medicare Assignment:  Doctors who don’t accept assignment may charge you more than the Medicare approved amount.  Although, they can not bill more than 15% over the Medicare approved amount.  This is called the “limiting charge.”  The limiting charge applies only to certain services. It  does not apply to some supplies and durable medical equipment (DME).  When you purchase certain supplies and DME, Medicare will only pay for them if the suppliers are enrolled in Medicare.  It does not matter who submits the claim  either you or your supplier.  Some states do not allow excess billing even if a doctor is not accepting assignment.  (Connecticut is a good example)

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