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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 [email protected]

Click here to sign up for Medicare A & B

Looking for a Medicare Quote?   Click here to Quote, Compare and Apply!

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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 [email protected]

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 [email protected]

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 [email protected]  For more information, click here 

IRMAA Part D

Most people do not pay IRMAA part D and only pay their Part D premium.  Be aware if you do not sign up for Medicare part D when first eligible, you may have to pay a Part D late enrollment penalty.

If your modified adjusted gross income (MAGI) is above a certain amount of income for you and/or your spouse, you may have a Part D income-related monthly adjustment (Part D-IRMAA). Medicare will use the MAGI  on your IRS tax return from 2 years prior to the current year. If the income is over the stated 2019 guidelines you will may pay the Part D-IRMAA amount in addition to your monthly part D plan premium, This extra amount of monthly premium is paid directly to Medicare but is billed through your plan. The chart below shows the additional amounts and income for 2019 but is based on 2017 earnings.

IRMAA Part D

Social Security will send a notice stating the Part D-IRMAA, based on your income. The amount you pay is adjusted each year based off the prior two years earnings. If you do not agree with the IRMAA amount or make a lot less than you did two years ago you can appeal, use this form to contact Social Security [PDF, 125 KB].  If you have questions about your Medicare prescription drug coverage, contact our office.  Crowe and Associates phone number is 203-796-5403

The chart below shows your estimated prescription drug plan monthly premium based on your income as reported on your IRS tax return. If your income is above a certain limit, you’ll pay an income-related monthly adjustment amount in addition to your plan premium. 

Do you want to learn more about Medicare Part B IRMAA?   Click to learn more

IRMAA Part B

Most people with Medicare part B will pay the standard premium amount of $135.50 a month. If your modified adjusted gross income goes above certain  income thresholds, you may pay an Income Related Monthly Adjustment Amount (IRMAA Part B). Medicare uses the MAGI reported on your IRS tax return from 2 years prior to determine the amount you will pay. They do this in order to have access to a filed tax return in order to determine income.

Part B deductible & coinsurance

Get more information about your Part B premium from Social Security [PDF, 341 KB].

Looking for the IRMAA amounts for Part D of Medicare?   CLICK TO LEARN MORE

Medicare savings program CT 2019

There have been some updates to the income limits for the Medicare savings program CT 2019.

The first question you might ask is; who is eligible for the Medicare savings programs CT 2019?  Anyone that qualifies for Medicare part A who has income below a certain level may be eligible for the program.  In most cases, you qualify for Medicare Part A when you turn 65.  Although, certain people who have a permanent disability for 2 years or more can also qualify.

Below is a chart that shows the current income limits for the Medicare savings program Ct 2019:

If you have Medicare Part B:

You may receive help paying your monthly premium.  The premium for Part B normally comes out of your Social Security check.  When you qualify for any of the Medicare savings programs (either QMB, SLMB or ALMB) the state will pay your Part B premium.

If you do not qualify for Part A or Part B benefits,  the state of CT will help you get them.  If you qualify for QMB, the state will pay your Part A premium for you.  You can “conditionally” apply for Medicare Part A through your local Social Security Administration office or by phone at 1-800-772-1213.

When you qualify for any level of MSP, you are able to apply for benefits outside the normal enrollment period.  This enrollment is called a “buy-in”.  The QMB program will also help with co-insurance payments as well as deductibles.  The SLMB and ALMB programs do not pay either co-insurance or deductibles for you.

Click here to download the MSP Brochure in English.

Click here for MSP Brochure 2019 in Spanish.

These programs take time to go into effect.  It can be 90 days before there is a difference in your Social Security check.  If this happens, Social Security will reimburse you for the premiums that you paid during that time.  Keep in mind, there is no asset limit for any of the programs.  The only thing that matters is your income.  The amount of help you get will depend on your income.

What is considered income?

Things such as; wages, alimony, rental income, interest or dividends as well as Social Security, pensions and disability payments area all considered income.  You will not have to supply proof of your income when you first submit your application for benefits.  Social Security can easily check the information you provided them.  They will notify you if they need more information to process your request.

MSP 2019 Quick guide 2019 – click here

How to apply for benefits:

MSP application CT – click here

Either you can send your application to:
DSS ConneCT Scanning Center
P.O. Box 1320
Manchester, CT 06045-1320
Or, speak to a representative at 2-1-1.  The representatives are available 24 hours a day every day.  You can also call a Choices health insurance counselor at 1-800-994-9422.

To learn more about the services we offer at Crowe and Associates, click this link.

You can also contact us either by phone at (203)-796-5403 or by email at [email protected]

How to find and compare hospitals

If you are aware either that you will need medical care in the future or if you are moving to a new area you will want to know How to find and compare hospitals.  You can compare hospitals easily by clicking on the link to use the new Hospital Compare tool.   This tool can be found at Medicare.gov.  When you get to the page, all you need to do to start the search is to enter the zip code of the area you want to look in.  It is that easy.  Of course, it is always best to speak to you health care provider before making any medical decision.

This tool will also let you view both Department of Defense and Veterans Health Administration hospital performance data.  You can also find information about things like; how to file a compliant, Medicare coverage and healthcare providers.

Hospital Compare gives you information about over 4,000 Medicare-certified hospitals.

This includes more than 130 Veterans Administration (VA) medical centers.

How to find and compare hospitals helps you decide where to get health care services.  By providing patients both options and information, this tool also helps give hospitals an incentive to improve on care.

• Important:  In an emergency, always go to the nearest hospital.

Hospital Compare was made with help from the Centers for Medicare & Medicaid Services (CMS), in collaboration with organizations that represent consumers such as; hospitals, doctors, employers, accrediting organizations, as well as other federal agencies.

Please contact us either at (203)796-5403 or by email at [email protected], if you would like help with your Medicare coverage options.

If you would like to see what we can offer you; go to the Crowe and Associates home page – click here .

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Medicare Part D plan finder 2019

What is Medicare Part D?  Medicare Part D provides you with prescription drug coverage.  The Medicare Part D plan finder 2019 will help you choose the drug plan that will best suit your prescription needs as well as your budget.  This can be very important coverage to have and can save you thousands of dollars each year on the cost of prescription drugs.  Before you go to the website to check on the best plans for you, you will need a list of medications that you currently take along with the doses. Once you have that information in front of you, you are ready to get started.

Recorded Webinar on how to use the Medicare.gov drug plan finder tool

Click here to go to the Medicare plan finder 2019

When you get to the website you will enter your zip code and click on find plans.

1. On this screen you will see 3 questions:

   1. How do you get your Medicare coverage? There are 4 options to choose from.  If you are unsure, just pick the one that says I don’t know.
   2. Do you get help from Medicare or your state to pay Prescription drug costs? There are 6 choices for this question. Again, if you are unsure, choose I don’t know.
   3. Would you like to add drugs? There are 3 options for this question. If you have a list of medications, choose yes then click on the continue to plan results tab.

     2.  The next screen will ask you for the name of the medication.

A.  Type in the name of the medication, click on find my drug.

B.  When you see the correct drug, click on add drug.

C.  The following screen will prompt you to choose a dosage and quantity as well as the frequency and pharmacy type. Answer each question accordingly and continue to the next drug until you have entered all your medications.

D.  Once you have a complete list of your medications, click on my drug list is complete.

     3.  When you get to the Next screen,  you will choose which pharmacies you like to use. You can choose only 1 or 2, no more.  Then you click on the continue to plan            results tab.

     4.  The next screen you will ask you what type of plan you are looking for.

A.  Prescription drug plans (with original Medicare).

B.  Medicare Health Plans with drug coverage.

C. Medicare health plans without drug coverage.

   5. After you click on the appropriate choice, click continue to plan results.

On the next screen, you will see which plans are available and the costs associated with those plans.   You are able to choose up to 3 plans to compare.  Once you have selected the plans you want to compare, you will click on compare plans.   The next screen will show the plans side by side so you can compare them by cost and coverage to find the one that best suits your needs.

Once you use the Medicare Part D plan finder 2019, you will see what a great tool this really is.

If you need help choosing a plan or signing up for Medicare, please contact us.  You can reach us either by phone at (203)796-5403 or by email at [email protected]

For more information about the products that we can offer you, go to our website – click here.

Medicare what’s covered app

This post will explain to consumers the new Medicare what’s covered app.

If you have questions about your medical coverage, find a quick answer by using the Medicare what’s covered app.  If you want to avoid surprise medical expenses, this is a great tool for you.  The “What’s covered” app gives you accurate cost and coverage information on your mobile device.  You can easily check coverage from your doctor’s office, hospital or any place you can use your mobile device.

You can get the app for free from either Google Play or the Apple App Store.

Simply search for either What’s Covered or Medicare to easily locate and download the app to your smart phone. The app is available in Google Play at:  click here for google play app, and is available in the Apple App Store at: click here for itunes app.  This way you will have reliable Medicare information as quickly as you need it.

CMS had the app made to give people a better way to answer the many questions Medicare beneficiaries have. The Medicare population will almost double in size in the next decade. This can add up to about 80 million people. Many Medicare beneficiaries use the internet on a daily basis. There are almost 15 million views by beneficiaries on medicare.gov every year. If you add this to the over 3 million phone calls a year that 1-800-MEDICARE gets, that is a lot of coverage questions.

The new Medicare app gives you general cost as well as coverage details for both Medicare A &B approved supplies and services. 

You can use this tool to look up what Medicare does and does not cover. There is also important information about how and when to use Medicare approved benefits.  You can also access basic cost information for medical supplies and services.  Additionally, you will have access to a list of preventative services that Medicare covers.

Access to reliable Medicare coverage information is just one part of the eMedicare initiative. 

If you want to stay current on the many improvements that the administration is making to Medicare, you can sign up to receive email notifications from the centers for Medicare and Medicaid services, just click here.  You can also find valuable information on the Facebook page for Medicare by using the ink below:

just click here.

If you either need help with or have questions about Medicare coverage options, please contact us.  You can reach us either by phone at (203)796-5403 or by email at [email protected]  We are always happy to help people navigate the Medicare system. Contact Crowe and Associates and make sure you get the Medicare coverage you deserve.

To find out more about what Crowe and Associates offers; click here

United Health Care OTC Catalog

This post will give members of the United Health Care HMO MAPD  plans 1,2 and 3 access to the 2019 United Health Care OTC Catalog.

If you are a member of either a United Health Care Medicare HMO Plan 1, 2, or 3, you have an over the counter benefit as part of your health plan.  Although each plan has different quarterly benefit amounts, you can use the same form to look up products and find out what is available to you. Please refer to your specific plan benefits to find out exactly what your OTC benefit amount is.  You need to be aware that the quarterly over the counter benefit not transferable and cannot be used once a given quarter has ended.  This means if you do not use your benefit for each quarter you simply lose it.

In fact, when you chose to use your over the counter (OTC) benefit you must do so in one single order.  This means you should plan what you will need by looking through the United Health Care OTC catalog before the end of each quarter and order everything you think you will need at once.  United Health Care will only allow you to place 1 order per quarter.

If you would like to view a copy of the United Health Care OTC Catalog, CLICK HERE FOR THE 2019 OTC for HMO MEDICARE ADVANTAGE PLANS 1 2 & 3.

If you are a member of a DSNP plan, click here for 2019 DSNP member OTC Catalog.

You may order only items listed in the catalog for your OTC benefit.

The name of the company that handles the OTC orders is Firstline Medical.  There are 2 ways to order.  Either you can order by mail or you can order online.  If you would like to order by mail you need to contact FirstLine Medical at 1-877-795-4521. You can call them from 7a.m. until 7 p.m. Monday -Friday and 7 a.m. until 4 p.m. Saturday (Central time). You will need to have your UHC card available before you call.

If you would like to place an order on line you can go to www.OTC-Essentials.com.

1. Click on REGISTER to create your account (you only need to register one time).
2. Login to check your balance, view product images and descriptions. Place your order.
3. Track your order status or manage your account information.

Please use these helpful tips to register on the website:
1.  Have your health plan member ID card available.
2.  When you enter your member ID, only enter the numbers that are before the dash.
3.  Your Username is from 6 to 25 characters long.
4.  Your Password is from  8  to 25 characters long and will need to have at least one number, one capital letter and one lower case letter.  The password is case sensitive.

Additionally, if you need help finding the right Medicare plan or have questions on your current health care plan.  Please contact us at 203-796-5403. Our agents will be happy to make sure you have the coverage you need at the best price for your budget.

Are you looking to quote or compare Medicare plans?  CLICK HERE