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What is a High Deductible F Plan

If you are ready to take your Medicare benefit, you might want to know; What is a High Deductible F Plan.

Although the High Deductible Plan F 2020 will not be available for new beneficiaries, there is a similar plan called Plan G.  Plan G has most of the same coverage benefits as Plan F, with the exception of the plan B deductible payment.

Humana over the counter catalog

If you are a member of Humana, you will want to know how to get your Humana over the counter catalog.  Please remember, only some of the Humana plans have an OTC benefit.

For an OTC order form, Click here.

If you have questions about how to use your OTC benefit, you can call Humana Pharmacy at 1-855-211-8370.  There are Customer Care representatives available from Monday to Friday, 8 a.m. to 11 p.m.  They are also available on Saturdays from 8 a.m.  until 6:30 p.m., Eastern time. 

There are a few ways to order your OTC items:

You can order by Mail.  Just Fill out the Health and Wellness Products Order Form (download a copy here) send the order form to:
Humana Pharmacy
PO Box 1197
Cincinnati, OH 45201-1197

You can Fax your order into Humana. Once you download and fill out the order form, fax the pages to 1-800-379-7617.

How much is the OTC benefit allowance?

Compare Medicare Advantage plans

If you are new to Medicare, you should Compare Medicare Advantage plans to find the one that fits you best.  Some people refer to Medicare Advantage plans as either Part C or MA Plans.  These plans are used as an alternative to original Medicare.  If you choose to participate with a Medicare Advantage plan, you do not lose your Medicare benefit.  These plans include your Medicare Part A and Part B and in most cases a prescription drug plan or Part D.

How does a Medicare Advantage Plan work with Medicare:

Private insurance companies must have their plan approved by Medicare before they can offer them to clients.  Medicare has very strict guidelines that insurance companies must follow.  Once Medicare approves the plan, Medicare will pay a certain amount to these insurance companies every month for your care.

Every plan has different charges, costs and rules for services you receive.  Some plans require you to get a referral before seeing a specialist and weather or not you have to go to certain approved providers for your medical care for non emergency care.  Insurance companies change there policies every year.  That means you should check your policy each year during open enrollment to be sure it is still the best option for you.

Compare Medicare Advantage plans to be sure what services are covered:

Although Medicare Advantage Plans cover all the services that original Medicare approves, some Medicare Advantage plans offer additional extra coverage.  The options can include things like; vision, hearing and dental coverage.  The cost for each plan also varies depending on the company you choose as well as your location and a few other things.  Click here for more cost information.

Click here to compare Medicare Advantage plans in your area.

Medicare Advantage plan prescription drug coverage:

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What is Medicare Part D

If you are thinking about signing up for Medicare, you will need to ask the question; What is Medicare Part D.  Medicare Part D is prescription drug insurance.  This insurance will cover your medication needs. If you choose a Medicare Part D plan, you will pay a monthly premium to an insurance carrier for your coverage. The insurance carrier will send you an ID card to use at your  insurance provider’s network of pharmacies to fill your prescriptions. In most cases you will not pay full retail price for your medication, you will pay a copay (a percentage of the drug’s price).  The insurance carrier pays the remaining balance.

The federal government controls the Medicare Part D program:

Medicare Part D is administered through private insurance companies. These companies provide beneficiaries prescription drug coverage. This program began in 2006 and offers Medicare recipients a valuable benefit that saves them thousands of dollars on medication each year.  Beneficiaries can choose 2 ways to receive this benefit.

1.  They can enroll in a standalone prescription drug plan along with a Medigap/Medicare Supplement plan.
2.  They can choose a Medicare Advantage(Part C) plan that includes prescription drug coverage.

All Medicare Part D plans must follow guidelines set by the federal government.  This means, every insurance carrier who participates must submit it’s plan to the CMS/Centers for Medicare and Medicaid Services.  The carriers have to do this every year to have their plans approved before they can offer them to clients.

Each year the drug plan providers make changes to benefits; this includes the formulary, in network pharmacies, providers as well as costs.  The changes go into effect on January 1st.  Be sure to check your coverage during open enrollment every year.  This is important if you need to change your insurance provider.  If you do not check, it could end up costing you a lot.

Find the best prescription drug plan for you, click here

If you need help finding the right plan for you, please contact us either by phone at (203)796-5403 or by email at teal@croweandassocites.com.

Click here to sign up for Medicare A & B

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Anthem OTC catalog

This post will give you the information you need to access the Anthem OTC catalog. That way you can use your OTC benefit. Beneficiaries can use the benefit to purchase certain non-prescription, over-the-counter items such as; vitamins, pain relievers, first aid supplies, and orthopedic support braces, as well as other items to help with minor health concerns.  You can use the benefit one time each quarter.  Any benefit that you do not use during the quarter, will not rollover to the next quarter.  If you do not use the entire OTC benefit amount for the year it will not roll over to the next calendar year.

If you are a member of  a participating Anthem Medicare Advantage plan:

You will receive an OTC card.  This card is called Healthy Benefits Plus.  This card is used for select over-the-counter item purchases. Beginning in January 2019, beneficiaries can use this benefit to purchase OTC supplies in Walmart stores and in a few states, such as California, New York and new Jersey you can shop in CVS stores.

To get a copy of the OTC catalog, just call the customer service number on your member ID card

There are a few ways to order over the counter items.

1.  In-Store – to use your OTC card in store, simply purchase eligible items and use the card as your form of payment 2.  Order items online either at Walmart.com or in the App.  You must first download the app to use it. If you want to place an order online at Walmart.com, once you create an account you can sign in and place items in you cart and then check out using your OTC card number as a gift card for payment. 3.  You can call 866-413-2582 to place an order by phone.

When can you collect Medicare

There is one important question many people need the answer to; When can you collect Medicare.

When can you collect Medicare:

If you are going to turn 65, you should plan to sign up for Medicare.  You are eligible to receive Medicare at the age of 65.  In fact, if you delay your enrollment you will be charged a penalty that will last the entire time you receive Medicare benefits.  If you are disabled you can sign up for Medicare any time otherwise, you must be 65 years old to receive Medicare benefits. Unfortunately, many people think you can get Medicare when you are eligible for Social Security benefits. Unfortunately, if you retire early at age 62 you still have to wait until 65 to claim Medicare benefits.

You can sign up for Medicare three months before you turn 65 and for the 3 months after. If you already receive Social Security benefits, you will automatically be enrolled in both Medicare Part A & B the beginning of the month you turn 65.

There are many choices to make when you sign up for Medicare:

Medicare has four main parts:  The first part is Medicare Part A, Part A  covers hospital stays.  Second is Medicare Part B , Part B covers doctors fees and medical expenses.  The third part is Part C also know as; Medicare Advantage. If you choose to use a  Medicare Advantage plan, it will take the place of both your Medicare Part A as well as Part B. This means it will cover hospital care and doctor visits. The last part is Part D. Part D covers prescription medications. There are also plans called Medigap or supplements that you can purchase to help pay the 20% of Medical costs that Medicare A & B do not cover.  So you can cut down or eliminate your out-of -pocket expenses.

If you are still working and receive health insurance from an employer:

You may not need to sign up for Medicare Part B immediately. It is important to meet with your employer to find out whether the employer’s plan is the primary insurer. If you will have Medicare, for your primary insurer, then you need to sign up for Part B. Either way, you still need to sign up for Part A.  This can help with some of the costs your group health plan does not cover.

If you don’t have employer health insurance, or when your employer coverage is secondary to Medicare, you must enroll in Medicare Part B during your initial enrollment period.

Important;  Medicare does not consider Cobra, retiree coverage or VA benefits as a health insurance plan.  In order for a plan to be considered health coverage by Medicare, you must be actively working for an employer with 20 or more employees.  You must either have an approved health plan or you must sign up for Medicare Part B in order to avoid penalties.

If you delay signing up for Part B:

You will be subject to a penalty of 10%  for every year you were eligible and did not sign up for Part B benefits. In addition, you will have to wait for the general enrollment period to enroll. The general enrollment period starts  January 1 and goes to  March 31 each year. If you enroll during this period, your coverage will begin on July 1.

When can you collect Medicare, Medicare Part C, also called Medicare Advantage:

Before you enroll in Part C /Medicare Advantage plan, you must be enroll in Medicare Parts A and B. Medicare Advantage Plans provide all of your Part A and Part B coverage.  Some of these plans offer options, such as vision, hearing, dental, and wellness programs such as discount gym memberships. Many of these plans include Part D/prescription drug coverage.

After you consider deductibles, copays and exclusions, There are a good portion of medical expenses that Medicare does not cover. Medigap or Medicare supplement plans can help you pay the health care costs left over after Medicare pays their portion. If you would like more information on these plans, please contact us either by phone (203)796-5403 or email at teal@croweandassociates.com.

When can you collect Medicare, Medicare Part D:

Medicare part D is prescription drug coverage. If choose not to sign up for a Medicare Advantage plan with prescription drug coverage, you should enroll in a prescription drug plan.  You should enroll in Part D coverage when you sign up for Part A & B. If you do not sign up for some type of Part D coverage, you will receive a 1% penalty for every month you wait to sign up after your initial enrollment period.  You will not receive a penalty if you have drug coverage from a private insurer (retirement plan).  This is referred to as credible coverage. Check with your insurer to verify that your coverage is credible.

CLICK HERE TO QUOTE AND COMPARE MEDICARE ADVANTAGE, SUPPLEMENT AND PART D PLANS

This is a lot of information and it can be confusing, please feel free to contact us with any questions. Click here to learn more about Crowe and Associates

How do I apply for Medicare

If you are like most people who are almost 65, you might be wondering How do I apply for Medicare.  A common misconception is that you can get Medicare as soon as you claim Social Security benefits, which can be as early as age 62. Unfortunately, if you retire early and claim your Social Security benefit, you’ll have to wait until 65 before you’ll be eligible for Medicare benefits.

In cases where you already receive Social Security retirement benefits, you will automatically be enrolled in both Medicare part A & B when you turn 65.  You will receive your Medicare card a little before you turn 65.

If you are not receiving Social Security retirement benefits when you turn 65, you will need to apply for Medicare.  This is easy to do on line at www.SocialSecurity.gov. It can also be done by phone 1-800-325-0778 Monday-Friday, 7 am to 7 pm, or in-person at your local Social Security office. Your initial enrollment period starts three months prior to your 65th birthday and ends three months after the month you turn 65.

Enrolling in Medicare can be confusing, because of all the plan options available.  Finding an experienced Medicare agent can make it easier to find a plan that both suits your needs and budget.

First:

As we stated above, the initial enrollment period for Medicare starts 3 months before the month you turn 65 and ends 3 months after the month you turn 65. That gives you seven months to complete your enrollment. In other words, it is best to get yourself enrolled as soon as possible to get your benefits in place so you avoid any coverage gap that might occur when you lose your current health coverage.

Click here to enroll in Medicare A & B on-line

Third:

If you choose a Medicare Supplement/Medigap plan, you need to find a drug plan or Part D coverage.  If you take any medication now or may need to in the future, this is an important thing to consider.  There are many companies that offer Par D coverage.  Because of this,  you will need to check each company’s formulary to find the best coverage for your needs. This is something your insurance agent can do for you.

What is Medicare Plan F

If you are ready to enroll in a Medicare supplement, you might ask; what is Medicare Plan F?  Medicare supplement/Medigap Plan F is the most comprehensive Medicare supplement you can buy. Plan F covers both Medicare deductibles and copays as well as coinsurance.  That means you will have no out-of-pocket expenses.

What is Medicare Plan F:

Plan F has been the top selling Medicare supplement plan for quite some time. More than half of all Supplement/Medigap policies in effect are Plan F.

Medicare Supplement/Medigap plans, pay the amount left on your medical bill after Medicare pays.  This will cover your deductibles, copays, and coinsurance. These plans do not replace either Medicare Part A or Part B. You must enroll in both Part A and Part B to be eligible to enroll in any Medicare supplement Plan.  Once you add a Plan F to your Part A & B coverage you will have complete Medical coverage.  That translates to zero out-of-pocket medical expenses.

Benefits of a Medicare Supplement Plan F:

• Plan F covers your Part A hospital deductible as well as your Part B outpatient deductible.
• Medigap plan F covers the 20% of medical expenses that Medicare Part B does not pay.
• This plan also covers Part B excess charges.  This means you will not have to pay the standard 15% excess charge that doctors who accept Medicare are allowed to charge for Part B services.
• You do not need a referral to use Medicare Supplement plans. You can use any doctor who participates with Medicare.  This gives you a wide variety of health care providers to choose from.
• Your coverage can never be canceled because of medical issues; these plans are guaranteed to renew as long as you make your payments.
• All Medicare supplement Plan F coverage is exactly the same.  It does not matter which carrier you choose to purchase it from.  The only thing that differs by carrier is the price of the plan.

What is Medicare Plan F: Benefits; what does the plan cover/not cover:

All Supplement/Medigap plans cover medications that you receive while you are in a hospital or clinic.  Although, Supplement/Medigap plans DO NOT COVER prescription drugs.  You need to enroll in Part D in order to receive prescription coverage.

Supplement plans DO cover chiropractic services that Medicare approves, such as adjustments.  Medicare does not cover x-rays done in conjunction with a chiropractor.

Supplement/Medigap plans don’t cover dental, hearing or vision exams or services.  If you need coverage for any of these services, you must purchase a stand alone plan.

How much does a Plan F cost:

The costs for Medicare Plan F depends on a few different factors.  The first thing that determines the cost of your Plan F is the carrier you choose to use.  Other things that decide the cost include the area you live in(this had the greatest effect on the cost), your gender, and whether or not you use tobacco.   Some carriers charge a higher price for a male as opposed to a female of the same age.  Certain carriers offer a  household discount when both spouses use the same company for their coverage. If you would like a quote for plan in your area, please contact us either by phone at (203)796-5403 or email at edward@croweandassociates.com.

NEED TO QUOTE MEDICARE SUPPLEMENT PLANS? -CLICK HERE

Is the Plan F being discontinued:

The answer to that is yes.  In the year 2020, plan F no longer be available to new enrollees.  If you are already enrolled in the plan, you will be able to stay in it.  In 2020, new Medicare beneficiaries will no longer be able to have Medicare supplements cover their Part B deductible.

If you have questions about this or any other aspects of Medicare, please contact us either by phone (203)796-5403 or email edward@croweandassociates.com.  For more information, click here