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Anthem MediBlue Select HMO

Anthem MediBlue Select HMO is a Medicare Advantage plan with prescription drug coverage (MAPD).   In fact, Anthem Blue Cross Blue Shield offers this plan only in Hartford county in the state of Connecticut.   This, like all HMO plans, require that participants use in network providers.  If you choose to use out of network providers, this plan will not cover your expenses.  An exception to this would be urgent or emergency care which allows of of network services.

The plan has a monthly premium of $26. This would be in addition to the part B premium of $121.80.  There are no referrals required for this plan. Co-pays for a primary doctor are $15 and $40 for a specialist.  The plan has an annual out of pocket max of $6,100 per year.  Annual maximum indicates the most the insured would need to pay in medical claims for  the year.  You can not apply either Monthly premiums or cost-sharing for part D prescription drugs to the maximum out of pocket amount.

You can add dental services to the plan for an additional premium.  In Addition, Silver Sneakers is included in the $26 monthly premium and pays a local gym membership monthly fee.   If you use approved diabetic supply vendors your diabetic supplies are covered at 100%.

This plan offers prescription drug coverage with $220 annual deductible.  This deductible applies only to tiers 2-5.  The plan excludes both Tiers 1 and 6 from this deductible.  There is no limit to how much the plan will pay.

A Medicare Advantage plan should not be confused with a Medicare Supplement plan (also called Medigap).

MAPD plans offer both medical and drug benefits combined with the insurance company as the primary insurance.  With a Medicare Supplement, original Medicare is primary.  The insurance company would be the secondary insurance.  As a result, a Medicare Supplement plan does not have a network.  Because members may see any provider that participates with Original Medicare, it is different from an Advantage plan.

 HMO summary of benefits Anthem MediBlue Select

Anthem MediBlue Selelct HMO application

Click here to request a personal Medicare review.

Aetna Medicare Plan HMO Connecticut

Aetna Medicare Plan HMO Connecticut is a Medicare Advantage Plan (MAPD).  This plan is  offered in Fairfield, New Haven, and New London counties.  Aetna refers to this plan as the Shoreline plan. They also offer a similar version of it called “inland”.  The inland plan includes Hartford, Litchfield and Tolland counties. The Aetna Medicare Plan HMO Connecticut is an HMO plan. Members must use in network providers (except for emergency and urgent care).  If  you choose to use an out of network provider in an non emergency or urgent care situation, there will be no coverage at all.  Medicare A and B will not provide the standard 80% part B coverage when going out of network on a Medicare Advantage plan.

In addition to a $6,700 maximum out-of-pocket contribution (for medical expenses only), this Aetna plan is a $0 premium offering and requires referrals to see specialists.  You only need to obtain a referral once per specialist each calendar year.  The plan features very low co-pays for a $0 premium plan. With a $10 primary doctors copay and a $40 specialist copay. Most other co-pays are also low compared to other plans offered in the same market such as a $600 inpatient hospital co-pay and a $150 major radiology copay (basically means MRI’s, CAT and PET scans).

The prescription drug plan (included with benefits of plan)

is one of the few that does not have a deductible on tier 3, 4 and 5 drugs.   Overall, this is a solid plan with a large national network of providers that can be accessed anywhere in the country.  The one benefit that should be noted with this plan is the fact that it does have an annual deductible of $1,000 for some services such as Inpatient hospital, major radiology, Outpatient surgery, ambulance and some other services. A plan summary has been provided below for review.

CLICK HERE FOR AETNA MEDICARE PLAN HMO CONNECTICUT PLAN SUMMARY

Click here for a free Medicare review and quote.

Anthem MediBlue Plus HMO

Anthem MediBlue Plus HMO is a Medicare Advantage plan with prescription drug coverage (MAPD). This plan is offered by Anthem Blue Cross Blue Shield in 4 counties in the state of Connecticut.  Clients can purchase in either Fairfield, Litchfield, New Haven as well as Windham counties.  Given the plan is an HMO plan, participants must use in network providers.  In fact, if you use out of network providers  anthem will not cover your claims. An exception to this would be when getting urgent or emergency care which allows of of network services.

The plan has a monthly premium of $37 a month. This would be in addition to the part B premium of $121.80.  This plan does not require a referral. Copays for a primary doctor are $15 and $40 for a specialist.  The plan has an annual out of pocket max of $6,700 per year. Annual max indicates the most the insured would need to pay in medical claims for  the year. It does not include prescription drug out of pocket costs. You can add dental coverage to this plan for an additional premium. They include Silver Sneakers  in the $37 monthly premium and they pay a local gym membership monthly fee for members. Diabetic supplies are covered at 100% when using approved diabetic supply vendors.

A Medicare Advantage plan should not be confused with a Medicare Supplement plan (also called Medigap).  MAPD plans offered medical and drug benefits combined with the insurance company as the primary insurance. With a Medicare Supplement, Original Medicare is primary.  The insurance company would be the secondary insurance. As a result, a Medicare Supplement plan does not have a network.  In fact, members may see any provider that participates with Original Medicare.  This is not the case with an Advantage plan.

 MediBlue Plus HMO Anthem summary of benefits

Anthem Mediblue Plus HMO application

Click here to request a personal Medicare review.

United Healthcare Medicare Complete Plan 1 Connecticut

United Healthcare Medicare Complete Plan 1 Connecticut is a Medicare Advantage plan with Prescription Drugs (MAPD).  Medicare Complete Plan 1 is an HMO plan.  This plan is available in all eight Connecticut counties.   The plan has a $99 monthly premium.  The annual out of pocket limit for medical expenses is $4,850.  Primary doctor visit co-pays are $10.   The specialist visit co-pay is $30.   In fact, this plan does not require PCP referrals for specialist visits.    Additional benefits are provided for podiatry care, hearing aids, SilverSneakers fitness program and also the NurseLine.  This plan features contributions for vision exams.  These plans include preventative dental coverage.

The drug plan has a  co-pay plan with 5 tiers as well as a $130 deductible that applies to tiers 3,4 and 5 only.  Like all other part D and MAPD drug plans in CT,  a Coverage Gap (formerly called donut-hole) applies to this RX benefit.  Although it is an HMO plan, the Medicare Complete Plan 1 does have the 2016 UHC Passport Program which provides access to doctors in other states on an in-network basis.  Passport is not available in all states, but they do include it in the Connecticut plan.   A dental benefit is also offered for an additional premium.

Please note:

A Medicare Advantage Plan with Prescription Drugs (MAPD) is NOT a Medicare Supplement plan (Medigap). With an MAPD plan, Medicare is not the primary or secondary insurance.  The company offering the MAPD is your primary insurance and services must be obtained through participating providers in most cases.   A Medicare Supplement plan is secondary to Original Medicare and does not include Part D prescription drug coverage.   With a Medicare Supplement, there is not a network but instead, the insured would go to any provider that accepts or participates with Original Medicare.

A 2016 Summary of benefits as well as a 2016 application are available in the links below.   You can send applications back to us either by email at Admin@croweandassociates.com or by fax at 203-567-6235.

Click here to download the UHC Complet Plan 1 Summary of Benefits – Connecticut

Click here to download the UHC Complete Plan 1 Application – Connecticut

Looking for a lower monthly premium?  Click here to learn more about the United Healthcare Complete Plan 2.

Click here for a no-obligation Medicare quote.

United Healthcare Medicare Complete Plan 2 Connecticut

United Healthcare Medicare Complete Plan 2 Connecticut is a Medicare Advantage plan with Prescription Drugs (MAPD) offered by United Healthcare Medicare.  Medicare offers the Complete Plan 2  in Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland as well as Windham counties. This plan is a HMO and has both a $29 monthly premium and an annual out of pocket max of $6,000 (Medical only). It features co-pays of $15 for primary doctor visits as well as $40 for specialist visits.  Subscribers do not need specialist referrals.

United Healthcare pays %100 of preventative care as part of this plan. This includes;  annual physicals, mammogram, cardiovascular screenings as well as certain vaccines.   Plan 2 includes; home health care, podiatry services, hearing services, vision services and also basic dental services.  The drug plan has a 5 tier copay plan with a $200 deductible for Tiers 3,4 and 5 only.

Like all other part D and MAPD drug plans in CT, there is a Coverage Gap ( donut-hole) that applies to this RX benefit.  Although it is an HMO plan, the Medicare Complete Plan 2 does offer the 2016 UHC Passport Program at no additional cost.  The Passport program provides access to doctors in other states on an in-network basis.   Although the CT plan includes Passport,  every state does not offer the Passport progam.  For an additional premium,  your coverage can include a dental benefit rider.

Please note:

A Medicare Advantage Plan with Prescription Drugs (MAPD) is NOT a Medicare Supplement plan (Also called Medigap). With an MAPD plan, Medicare is not the primary or secondary insurance.  The company offering the MAPD is your primary insurance and services must be obtained through participating providers in most cases.   A Medicare Supplement plan is secondary to Original Medicare and does not include Part D prescription drug coverage.   With a Medicare Supplement there is not a network, instead, the insured would go to any provider that accepts or participates with Original Medicare.

A 2016 Summary of benefits and 2016 application are available in the links below.   You can send applications back to us  either by email at Admin@croweandassociates.com or by fax at 203-567-6235.

Click here for a UHC Plan 2 Summary of Benefits – Connecticut

To download a UHC Plan 2 application – Connecticut Click here

Click here for a no-obligation Medicare quote.

 United Healthcare Medicare Complete Plan 3 Connecticut

United Healthcare Medicare Complete Plan 3 Connecticut is a Medicare Advantage plan with Prescription Drugs (MAPD) offered by United Healthcare Medicare. The Medicare Complete Plan 3 is an HMO plan.  UHC offers Medicare Complete Plan 3  in Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland  as well as Windham counties.  The plan has both a $0 monthly premium and an annual out of pocket max of $6,700 (Medical only). It features co-pays of $20 for primary doc visits as well as $50 for specialist visits.  If you would like coverage for a specialist visit, you will need a referral from you PCP.  Referrals are valid for the full year.  This plan provides additional benefits for vision, foot-care, hearing aids, SilverSneakers fitness program as well as NurseLine.  This plan includes basic preventative dental services.

This Plan includes Preventative care at no cost.

In additional expenses the plan covers are,  annual wellness visits, mammograms, colonoscopy and also annual gynecological exams.  Plan members pay nothing for hospice care from a Medicare-certified hospice.

The drug plan has a 5 tier copay plan with a $140 deductible for Tiers 3,4 and 5 only.  Like all other part D and MAPD drug plans in CT, there is a Coverage Gap ( donut-hole) applicable to this Rx benefit.  Although it is an HMO plan, the Medicare Complete 3 does have the 2016 UHC Passport Program which provides access to doctors in other states on an in-network basis.  Passport is not available in all states.   A dental benefit is available with this program but there is a premium for adding it.

Please note:

A Medicare Advantage Plan with Prescription Drugs (MAPD) is NOT a Medicare Supplement plan (Also called Medigap). With an MAPD plan, Medicare is not the primary or secondary insurance.  The company offering the MAPD is your primary insurance and services must be obtained through participating providers in most cases.   A Medicare Supplement plan is secondary to Original Medicare and does not include Part D prescription drug coverage.   With a Medicare Supplement, there is not a network but instead, the insured would go to any provider that accepts or participates with Original Medicare.

Both a 2016 Summary of benefits and 2016 application are available in the links below.   You can send your application back to us either by email at Admin@croweandassociates.com or by fax at 203-567-6235

Click here for a UHC Plan 3 Application – Connecticut

Click here for a UHC Plan 3 Summary of Benefits – Connecticut

Interested in a lower maximum out of pocket plan?  Click here to learn more about the United Healthcare Complete Plan 1.

Click here for a free personalized Medicare quote.

SilverScript Medicare Prescription RX Plans

Meidcare now offers clients new options for SilverScript  Medicare Prescription RX plans in 2016.

SilverScript will provide two prescription plan options in 2016: SilverScript Choice as well as SilverScript Plus.  The SilverScript Choice offers comprehensive coverage with low premiums and co-pays.  SilverScript Plus provides additional coverage in the coverage gap (commonly referred to as the donut hole). The Plus plan is designed for people who need to take several medications on a regular basis.  Because these people are more likely to reach the donut hole during the 2016 plan year.

Both SilverScript prescription medication plans offered in 2016 will feature a $0-deductible, low co-pays for many drugs and competitive premiums. In fact, SilverScript premiums in 30 states are lower than they were in 2015.  In fact, premiums in eight of those states is below $20.  Also,  SilverScript Choice plans have the lowest prescription drug plan premium in four states.  Members can access a convenient nationwide network consisting of a wide selection of pharmacies across the country. These include many large national and regional chains, many independent, community-based pharmacies, and the CVS/Caremark mail service pharmacy.  Additionally, in 2016, SilverScript is introducing a new list of covered medications.  This will help to keep co-pays low for some frequently prescribed drugs.

SilverScript recently received a 4-star performance rating from CMS for delivering value, clinical outcomes and customer service.

CLICK HERE TO REQUEST MEDICARE QUOTE INFORMATION.

Most Medicare Prescription Drug Plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs.

   Click here to learn more about the Medicare donut hole.

Please contact us if you would like to learning more about the SilverScript or any other Medicare RX plan. You can either call the office at 203-796-5403 or email us at admin@croweandassociates.com for an appointment.

Original Medicare Enrollment

Original Medicare Enrollment in parts A and B is automatic for those drawing Social Security.   Those people who are not that are not will need to enroll.

If you’re already collecting Railroad Retirement Board or Social Security retirement benefits when you turn 65, you will automatically be enrolled Medicare Part A .  If you are under 65 and you receive Social Security or Railroad Retirement Board disability benefits, you will automatically be enrolled in Medicare Part A and Part B after 24 months of disability benefits.

You will need to sign up for Medicare part B, if  you are not receiving retirement benefits before age 65 or  if you qualify for Medicare through disability. Please note, you can sign up during your Initial Enrollment Period (IEP). This is the seven-month enrollment period that begins three months before you turn 65.  This enrollment period includes the month you turn 65, and ends three months later.

Click here to visit the Medicare.gov site to learn details.

CLICK HERE TO REQUEST MEDICARE QUOTE INFORMATION.

Still have questions?  We are Medicare specialists.  Please call if you have questions or need help navigating the Medicare enrollment process.  You can either call the office at 203-796-5403 or email us at admin@croweandassociates.com.

We are a full-service brokerage and offer clients not only guidance with Medicare, but all health plan needs.  We offer dental insurance, both long and short term care policies.  Crowe and Asscoiates can help with estate planning by offering several types of life insurance as well as investment opportunities.

Medicare Part D Premiums

Medicare Part D premiums range from between $10 and $100 per month.  The amount depends on what plans  are available in your area as well as  the particular plan you choose. The maximum deductible in 2016 is $360. This is the amount you must pay out-of-pocket before Medicare will contribute to your prescription costs.