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Home 2015 July
What is the Medicare Part D Penalty

What is the Medicare Part D Penalty

By Ed Crowe | Medicare, Medicare Drug Coverage | 0 comment | 29 July, 2015 | 0

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.

 Individuals who would like to challenge the penalty may do so by completing and returning the Penalty Reconsideration form.

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

By Ed Crowe | Medicare | 0 comment | 29 July, 2015 | 0

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:

Services Medicare Pays After You Pay
$2,180 Deductible**,
Plan Pays
After You Pay
$2,180 Deductible**,
You Pay
HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies
First 60 days All but $1,260 $1,260
(Part A Deductible)
$0
61st through 90th day All but $315 a day $315 a day $0
91st day and after:
— While using 60 Lifetime Reserve days
— Once Lifetime Reserve days are used:
Additional 365 days
All but $630 a day$0 $630 a day100% ofMedicare-eligibleexpenses $0$0***
Beyond the additional 365 days $0 $0 All costs
SKILLED NURSING FACILITY CARE*: You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital
First 20 days All approved amounts $0 $0
21st through 100th day All but $157.50 a day Up to $157.50 a day $0
101st day and after $0 $0 All costs
BLOOD
First three pints $0 Three pints $0
Additional amounts 100% $0 $0
HOSPICE CARE: You must meet Medicare’s requirements, including a doctor’s certification of terminal illness
All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care Medicare copayment/coinsurance $0

Medicare Part B:

Services Medicare Pays After You Pay
$2,180 Deductible**,
Plan Pays
After You Pay
$2,180 Deductible**,
You Pay
MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians’ services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment
First $147 of Medicare-approved amounts* $0 $147
(Part B deductible)
$0
Remainder of Medicare-approved amounts Generally 80% Generally 20% $0
PART B EXCESS CHARGES (above Medicare-approved amounts)
$0 100% $0
BLOOD
First three pints $0 All costs $0
Next $147 of Medicare-approved amounts* $0 $147
(Part B deductible)
$0
Remainder of Medicare-approved amounts 80% 20% $0
CLINICAL LABORATORY SERVICES—TESTS FOR DIAGONOSTIC SERVICES
100% $0 $0

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