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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.

Access Health Special Enrollment Period – April 1 – 30, 2015

Access Health CT has announced a special enrollment period from April 1 through April 30, 2015.  This special enrollment period is intended to allow both individuals and families the opportunity to enroll in coverage in 2015.   This is a chance for people who did not have health coverage in 2104 and are now subject to a federal tax penalty to get the coverage they need.

Although, individuals who do not qualify for an exemption from Access Health and went without health care coverage in 2014 will have to pay a penalty.  The penalty is $95 per adult or 1 percent of their income, whichever is greater.  This amount is added in when they file their taxes this year. Additinally, the tax penalty will increase to $325 per adult or 2% of income for the 2015 calendar year.

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Medicare Savings Program Connecticut

Medicare Savings Program Connecticut (MSP) is a drug help program available to Connecticut residents on Medicare.   The program provides help for drug copays, deductibles and premium to those who qualify based on income.

MSP is available to individuals and couples making under stated income guidelines which have been provided here:

• QMB – $2,088.90 for a single person and $2,816.85 for a couple
• SLMB – $2,286.90 for a single person and $3,083.85 for a couple
• ALMB – $2,435.40  for a single person and $3,284.10 for a couple

MSP applications and brochures

Do you have questions or need more help?  Are you looking for more information? If you are, we can help with whatever you may need with MSP, Medicare plan choices or any other questions.  Call us at 203-796-5403 or email Edward@croweandassociates.com

United HealthCare Medicare Complete Plan 2 Connecticut 2014

The United HealthCare Medicare Complete Plan 2 Connecticut 2014 is a Medicare Advantage plan available in all Connecticut counties.  The base of the plan is an HMO .  It is currently available for a $0 month premium. (You will still pay your Part B premium to Medicare)  HMO means that participants must use in network providers in order to receive coverage.  The exception to this rule is in the case of either an emergency or urgent care situation.  In an emergent situation you may visit any provider who is necessary at that time.

Like all Medicare Advantage plans,  the Medicare Complete plan 2 is a Managed Medicare plan.  This means it will become the primary insurance provider in place of Original Medicare.  Benefits are based on co-pays as well as cost shares for the services the client receives. The plan also includes Part D prescription drug coverage.  Members have access to in network providers in other states (Including Florida) utilizing a program called Passport.  The program is very useful for snowbirds and anyone planning an extended stay in a different state.

Benefits on Medicare Advantage plans are subject to change every January 1st and Medicare Complete plan 2 has had many changes over the past few years.  Links to benefit summaries and applications have been provided below.

2017 HMO MAPD PLAN 2 APPLICATION

2017 UHC Plan 1 and 2 directory

Please contact us in the event that you have  any other questions.  You can reach us either by phone at 203-796-5403 or by emailing us at Edward@croweandassociates.com.  We are here to help you grow your client base and be a successful agent.  In fact, we offer all our agents full support with training and a 50% lead services reimbursement program.

Want to know the difference between a Medicare Advantage Plan and a Medicare Supplement (Medigap) plan?  CLICK HERE

Annuity For Retirement

Baby Boomer as set to retire and annuity business is up to 200 billion dollars a year.  Does it make sense to buy an annuity for retirement?  Here is an introduction into annuities to give you a better understanding of how they may help you. Read more

Medicare Advantage Plans Connecticut 2014

Below we have provided some information about Medicare Advantage Plans Connecticut 2014.

Medicare Advantage plans have become the go to option for seniors.  Advantage plan enrollment has increase from a little over 5 million in 2004 to over 13 million in 2013.  While the number of people enrolling has increased, the value of the benefits inherent in Advantage plans has been steadily declining year over year.

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A Medicare supplement plan (Also called Medigap) is an insurance policy that is designed to cover the benefits that Medicare A and B do not cover.  If you are not familiar with Medicare A and B benefits CLICK HERE  Doctors, hospitals and all other Medical providers, bill Medicare A and B (Original Medicare Card). Medicare covers their portion and the balance is sent to the Supplement plan to cover the amount specified by the plan you buy.  So is it worth it to buy a supplement?

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Health Reform (Affordable Care Act) uses state and federal exchanges to organize health care offerings.   Each state had to choose to offer their own exchange or instead, utilize the federal governments exchange.  Connecticut decided to create their own as did about 50% of the states.

Start Date:  The Connecticut based exchange will be up and running on January 1, 2014.   The enrollment period will start on October 1, 2013 for a coverage start date of January 1, 2014.

Who Can Get A Plan?: Just about any Connecticut resident under the age of 65 can get a plan starting in January.  There are no exclusions for health conditions and pre existing conditions and not be taken into consideration.

What are the Benefits?: There will be 4 plan types offered in the exchange called Bronze, Silver, Gold and Platinum.   The Bronze has the lowest benefits and they increase by plan with the Platinum having the best benefits.  Basic benefits levels are 60% coverage Bronze, 70% Silver, 80% Gold and 90% Platinum.

Kaiser summarized the benefits in this manner:

• Households between 100 percent and 150 percent of the federal poverty level can get a plan that covers 94 percent of costs (more than a platinum-level plan would) with an out-of-pocket spending cap that’s one-third of the standard HSA level.
• Households between 150 percent and 200 percent of the federal poverty level can get a plan that covers 87 percent of costs (more than gold, less than platinum) with an out-of-pocket spending cap that’s one-third of the standard HSA level.
• Households between 200 percent and 250 percent of the federal poverty level can get a plan that covers 73 percent of costs (just above the silver level) with an out-of-pocket spending cap that’s one-half of the standard HSA level.
• Households between 250 percent and 300 percent of the federal poverty level can get a silver plan with an out-of-pocket spending cap that’s one-half of the standard HSA level.
• Households between 300 percent and 400 percent of the federal poverty level can get a silver plan with an out-of-pocket spending cap that’s two-thirds of the standard HSA level.

How Much Does It Cost?: The amount of premium that an individual or family pays is based off the federal poverty level.  The poverty level for an individual in 2012 was $11,170 and increases with each additional family member. The plan rates are reduced for those within 400% of the poverty level.  Those earning over 400% will not be eligible for a subsidy and will pay the full premium.  The subsidy is based on a percentage of income that can be paid.  NOTE:  There are examples at the bottom of this post giving examples of the actual monthly cost.

AARP Plan N Supplement has a preferred price point in Maryland and is a good option for Medicare recipients as a result.   Other companies offer the Plan N but AARP currently prices it at the best rate which ranges from $85.00 a month to $105.oo a month depending on county.

For those not familiar with it, plan N covers all medical expenses with 3 exceptions. 1- It does not pay the Medicare Part B deductible of $144.00, 2- You can be billed a maximum of $20.00 for physician services and tests, 3- you pay $50 for ER visits.  Everything else (including inpatient hospital) is covered in full.

Plan N is a good option for those that want to keep Medicare primary in order to have access to more providers.  Plan N also eliminates the risk of any large copays for major services.   Plan N would be a good consideration for those with a Plan F supplement or those whom have a Medicare Advantage plan and would like to consider a Medicare supplement instead.

Feel free to call our office or email Ed Crowe if you have any additional questions or would like to apply for Plan N.

Ed’s cell 860-992-4494

Email: Edward@Croweandassociates.com