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Home Archive by category "Medicare" (Page 3)
When is The Medicare Advantage Dis-enrollment Period (MADP)

When is The Medicare Advantage Dis-enrollment Period (MADP)

By Ed Crowe | Medicare | 0 comment | 14 January, 2016 | 0

When is The Medicare Advantage Dis-enrollment Period (MADP)

Here is the answer to a question that you might like to ask. When is The Medicare Advantage Dis-enrollment Period (MADP) – It runs from January 1 to February 14 every year in accordance with the guidelines of the Centers for Medicare & Medicaid Services (CMS). The purpose of the MADP is to give Medicare Advantage (MA) members an opportunity to dis-enroll from any MA plan.  After they dis-enroll they can return to Original Medicare. Enrolling back in original Medicare allows members to then purchase a Medicare supplement plan and/or part D drug plan if they wish.

Important:

the MADP is not an additional enrollment period, nor is it an opportunity to switch to a different MA plan. The effective date of a dis-enrollment request made during the MADP will be the first day of the month following receipt of the dis-enrollment request.  For example, a dis-enrollment request made in January will be effective February 1.   Medicare considers this election period a special election plan change.

Important Warning!

  Members of MA-PD plans who enroll in a stand-alone PDP plan will  automatically be dis-enrolled from their MA-PD plan.  Those members will return to Original Medicare.  They will NOT have the option to enroll in another MA(Medicare Advantage) plan.

You can call the office if you have questions regarding your current Medicare Advantage plan at 203-796-5403.  If you would like to discuss all the Medicare options that are available to you, don’t hesitate to ask us.

New Humana Medicare Plans 2016

New Humana Medicare Plans 2016

By Ed Crowe | General Articles, Medicare | 0 comment | 8 September, 2015 | 0

New Humana Medicare Plans 2016

New Humana Medicare Plans 2016 –  There are some new Humana Medicare plans that clients can purchase in 2016. The new plans have many great options for members to choose from.  Humana offers Medicare Advantage plans both with and without drug plans in multiple states.  Please note that in some states such as NY, they only offer a stand alone PDP plan while in others they offer both the PDP and Medicare Advantage plans.  They have multiple MAPD plan types with HMO and PPO plans in various states.  Click the link below to review Humana Medicare plans 2016 in all states. The link will also provide PDP Rx summaries.  Please call our office with any additional questions about plan designs, or benefits.

Click for Humana benefit summaries for all states 2016

Humana Medicare is also looking to fill a market void in the Long Island NY region.

This new HMO plan offers to it’s members:

  • $37 monthly premium.
  • $5 PCP co-pays.
  • $30 specialist co-pays.
  • $6,7000 Maximum out of pocket (MOOP) cost.
  • This plan also includes a Silver Sneakers membership.
  • It also provides preventive dental coverage.
  • There is also a vision allowance of $200 toward the purchase of new glasses.
  • They provide members hearing aid coverage.
  • In addition this plan offers optional supplemental benefits (OSB), if you so choose.
  • Travel options are built in to allow for in-network benefits in select Florida counties.

The network has been expanded to include the following:

  • North Shore Lone Island Jewish Hospitals as in-network participants.
  • Both Pro-Health providers as well as surgical centers are in-network participants.
  • In addition, the network includes Advanced Urology.
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

Crowe and Associates

By Ed Crowe | Medicare | 0 comment | 8 August, 2013 | 0

Crowe and Associates (Edward K. Crowe -Owner) is a brokerage agency located at 304 Federal Road, Suite 107, Brookfield CT.  The agency is A rated with the BBB and is independent offering all major insurance companies.  The company website is croweandassociates.com

Read more

Wellcare Medicare Enrollment Connecticut

By Ed Crowe | Brokers, Medicare | 0 comment | 16 July, 2013 | 0

Through this site you may research all Wellcare Medicare plans and/or enroll in a plan online.   There is also a plan comparison function that may be used to find the right plan.  A general overview is included below.  If you would like to speak with someone about Wellcare, call our office at 203-796-5403 or email Edward Crowe at Edward@Croweandassociates.com

CLICK HERE FOR WELLCARE PLAN INFORMATION AND ENROLLMENT LINK

Wellcare offers three plans in 4 Connecticut counties (Fairfield, Hartford, New Haven, Tolland) which are the Choice (HMO-POS), Access (HMO -SNP) and Value (HMO) plans.

VALUE PLAN-  The Value plan has very strong benefits compared to the other HMO Medicare Advantage plans in Connecticut.  The Major Radiology benefit at a $100 copay and the Outpatient surgery benefit at $200 copay is the lowest respective copays available.   CLICK HERE TO ENROLL IN VALUE PLAN

ACCESS PLAN-  The Wellcare Access plan provides a good value to dual eligible customers.  (QMB or higher state level of help to join)  This plan features a $30 a month over the counter benefit, vision, dental, hearing benefits and transportation. This plan is open to enrollment year round for anyone on Medicaid/Medicare & QMB’s.  It fully coordinates with Medicaid to provide for no out of pocket costs for Medicare covered services and benefits.  CLICK HERE TO ENROLL IN ACCESS PLAN

You may call (203-796-5403) our office or email Edward Crowe (Edward@Croweandassociates.com) with any additional questions or concerns.

Medicare Advantage Plan Enrollment Periods

By Ed Crowe | Medicare | 0 comment | 3 April, 2013 | 0

There are only certain times when you can enroll/dis enroll or change a Medicare Advantage plan. Note that Medicare Advantage plans are sometimes called Medicare Part C or an MAPD plan.   There is a general period when someone turns 65 in which they can enroll.  This time frame is 3 months before the month they turn 65, the month they turn 65 and three months after they turn 65.  There is also the AEP period during which current members can make any type of plan change. This period runs from October 15th to December 7th every year. During this time, an application can be put in to make a change for a January 1 effective date.   The last type of period is the SEP period (Special Election Period) in which a change can be made at any time during the year.  Click on the link below for access to a grid showing all elections.

Medicare election period cheat sheet

Medicare Advantage Plans Connecticut

By Ed Crowe | Medicare | 0 comment | 18 March, 2013 | 0

There are 5 companies offering Medicare Advantage Plans (MA or MAPD) in the state of Connecticut. The 5 companies are Anthem BCBS, Aetna, United HealthCare, Connecticare and Wellcare. They do not all offer their plans in all counties of Connecticut however. This post provides an overview of what is available. Please call or email us for a benefit summary on any of the plans listed below.

WellCare- Offers plans in Fairfield, Hartford and New Haven Counties. Wellcare has a $0 premium plan that boasts the lowest copays of any $0 premium MAPD in Connecticut. They also have the only Dual Eligible offering in the state. Both plans are very strong from a copay and additional benefit standpoint. Wellcare does have network limitation that need to be considered. Networks tend to be best in and around cities. They do not have network in northern Fairfield county.

Anthem BCBS- Anthem offers plans in all counties of Connecticut. They have an HMO offering for $28 per month. They also have a PPO (available in limited counties only) for $18.00 that boasts very strong benefits compared to all other PPO plans in Connecticut. Anthem has a very large network but is missing some major Physician IPA groups in CT.

United HealthCare- United offers plans in all counties of Connecticut. They have 2 HMO plans ($99 a month plan and $0 a month plan) along with an AARP branded PPO plan for $24.00 a month. United has an extensive provider network through Connecticut. The UHC plans do not participate with Quest Labs which should be taken into consideration. All other major labs do participate however.

Aetna- Currently offer plans in Fairfield, Hartford, Litchfield and New Haven county. They have a $0 premium plan HMO, $94.00 HMO and a $90 PPO plan. The $0 premium plan has benefits second only to Wellcare when compared to the other $0 premium plans in the state. They also have a substantial network to go with the plan and allow for access to any Aetna Medicare HMO provider nation wide. The Aetna PPO is not competitive at this point due to a $1,000 out of network deductible.

Connecticare- We have a contract with Connecticare but they will not allow to post any comments about their plan. Call the office if you want information on this company 203-796-5403 or email Edward@Croweandassociates.com

HOW CROWE & ASSOCIATES CAN HELP YOU:

Crowe & Associates is an independent based in Brookfield CT. We are A rated with the BBB and are contracted to sell every Medicare Advantage plan in Connecticut. We are paid commission from the companies and do not charge clients a fee for our services as a result. We work with seniors in Connecticut every day to help them find the right Medicare plan to meet their needs. Feel Free to call our office at 203-796-5403 or email me at Edward@Croweandassociates.com

Would you like to learn More? Register for our “How to choose a Medicare plan” Webinar by clicking this link

Medigap Insurance Connecticut

By Ed Crowe | Medicare | 0 comment | 18 March, 2013 | 0

Medigap Insurance plans in Connecticut (Also called Medicare Supplement) confuse many people but it is actually very simple to understand once you understand the key points. This post is intended to provide a general overview of “Medigap” to help consumers make an educated decision when choosing one. We will start with the basics of the things you need to know about Medigap plans and then touch on the basics.

HOW A MEDIGAP INSURANCE PLAN WORKS:

The first thing to understand is how a Medigap plan works. A medigap plan works as a secondary coverage to Medicare A and B (also called original Medicare). Original Medicare parts A and B provide coverage for Medical Services. In general, original Medicare coverage 80% of medical costs. The Medicare supplement plan covers what original Medicare does not. As a result, medical providers will bill orginal Medicare and the cost share (patient responsibility) is then sent over to the Medigap company.

WHAT MEDIGAP INSURANCE COVERS:

Medigap plans will only provide coverage on benefits that original Medicare covers to some extent. If Medicare does not provide any coverage for a procedure, the Medigap plan also will not provide coverage (There are some exceptions to this). There are a number of different plan in CT with plans A – M offered. Each lettered plan covers a different percentage of the costs that original Medicare does not cover. Some plans cover everything that Medicare doesn’t such as Plan F. Others only cover 75% such as plan L.

Supplements in the state of Connecticut are standardized which makes life much easier when choosing a plan. This means that they plans can not vary in the benefits they provide. For example, if you purchase a Plan F supplement, the coverage will be the same regardless of the company you choose. The only difference will be in the monthly cost of the plan. Some companies will add additional, value added benefits such as Silver Sneakers or other programs but the mandatory coverage must be the same for every plan.

Medicare Supplements do not cover drugs. If you want drug coverage, you must purchase it separately. (Called a Medicare Part D plan or “PDP plan)

WHO CAN BUY A MEDIGAP INSURANCE PLAN:

Medigap plans are guaranteed issue in CT. This means that you can enroll in any available plan regardless of your health or age. The only requirement is that you are on Medicare A and B. If you are willing to pay the monthly premium, you can have a plan. For people age 65 and older, the price is the same for everyone regardless of how old you are. (Example: If the AARP plan N costs $152.00 a month for a 65 year old, it costs the same for an 85 year old) People on Medicare under the age of 65 are also eligible for a supplement but they can have fewer choices if they are under the age of 50.

POPULAR PLANS AND COMPANIES:

Medigap comes down to plan type and price. If one company offers a plan L Medigap for less than the other companies, you should go with the one offering it for the least. Benefits are standardized so they can not be cutting out any benefits. They just have the best price. Having said that, the more popular plans over the last 24 months are Plan F, Plan N , Plan L and High Deductible Plan F. United AARP and Anthem BCBS currently have the lowest costs in CT which makes it easy to find the lowest cost company once you determine which supplement you want.

ABOUT MY AGENCY AND HOW I CAN HELP YOU:

My agency (Crowe and Associates) is independent and is based in Brookfield CT. The agency is A rated with the BBB and I have been in this business for 14 years. We are contracted to sell just about every Medigap plan in CT including, AARP , Anthem BCBS, Humana, Mutual of Omaha, Aflac, etc…. The companies pay me commission directly and I charge my clients nothing. I sit down with clients (in person, over the phone or by email) and help them determine which plan is going to work best for them. I also let them know if a new company comes out with the same Medigap they have at a lower price. I can help you understand Medigap and help you determine which plan is best for your specific situation. Feel Free to call my office at 203-796-5403 or email me at Edward@Croweandassociates.com

Would you like to learn More? Register for our “How to choose a Medicare plan” Webinar by clicking this link

Medigap Connecticut

By Ed Crowe | Medicare | 0 comment | 18 March, 2013 | 0

Medigap plans in Connecticut (Also called Medicare Supplement) confuses many people but it is actually very simple to understand once you understand the key points. This post is intended to provide a general overview of “Medigap” to help consumers make an educated decision when choosing one. We will start with the basics of the things you need to know about Medigap plans and then touch on the basics.

HOW A MEDIGAP PLAN WORKS:

The first thing to understand is how a Medigap plan works. A medigap plan works as a secondary coverage to Medicare A and B (also called original Medicare). Original Medicare parts A and B provide coverage for Medical Services. In general, original Medicare coverage 80% of medical costs. The Medicare supplement plan covers what original Medicare does not. As a result, medical providers will bill orginal Medicare and the cost share (patient responsibility) is then sent over to the Medigap company.

WHAT MEDIGAP COVERS:

Medigap plans will only provide coverage on benefits that original Medicare covers to some extent. If Medicare does not provide any coverage for a procedure, the Medigap plan also will not provide coverage (There are some exceptions to this). There are a number of different plan in CT with plans A – M offered. Each lettered plan covers a different percentage of the costs that original Medicare does not cover. Some plans cover everything that Medicare doesn’t such as Plan F. Others only cover 75% such as plan L.

Supplements in the state of Connecticut are standardized which makes life much easier when choosing a plan. This means that they plans can not vary in the benefits they provide. For example, if you purchase a Plan F supplement, the coverage will be the same regardless of the company you choose. The only difference will be in the monthly cost of the plan. Some companies will add additional, value added benefits such as Silver Sneakers or other programs but the mandatory coverage must be the same for every plan.

Medicare Supplements do not cover drugs. If you want drug coverage, you must purchase it separately. (Called a Medicare Part D plan or “PDP plan)

WHO CAN BUY A MEDIGAP PLAN:

Medigap plans are guaranteed issue in CT. This means that you can enroll in any available plan regardless of your health or age. The only requirement is that you are on Medicare A and B. If you are willing to pay the monthly premium, you can have a plan. For people age 65 and older, the price is the same for everyone regardless of how old you are. (Example: If the AARP plan N costs $152.00 a month for a 65 year old, it costs the same for an 85 year old) People on Medicare under the age of 65 are also eligible for a supplement but they can have fewer choices if they are under the age of 50.

POPULAR PLANS AND COMPANIES:

Medigap comes down to plan type and price. If one company offers a plan L Medigap for less than the other companies, you should go with the one offering it for the least. Benefits are standardized so they can not be cutting out any benefits. They just have the best price. Having said that, the more popular plans over the last 24 months are Plan F, Plan N , Plan L and High Deductible Plan F. United AARP and Anthem BCBS currently have the lowest costs in CT which makes it easy to find the lowest cost company once you determine which supplement you want.

ABOUT MY AGENCY AND HOW I CAN HELP YOU:

My agency (Crowe and Associates) is independent and is based in Brookfield CT. The agency is A rated with the BBB and I have been in this business for 14 years. We are contracted to sell just about every Medigap plan in CT including, AARP , Anthem BCBS, Humana, Mutual of Omaha, Aflac, etc…. The companies pay me commission directly and I charge my clients nothing. I sit down with clients (in person, over the phone or by email) and help them determine which plan is going to work best for them. I also let them know if a new company comes out with the same Medigap they have at a lower price. I can help you understand Medigap and help you determine which plan is best for your specific situation. Feel Free to call my office at 203-796-5403 or email me at Edward@Croweandassociates.com

Would you like to learn More? Register for our “How to choose a Medicare plan” Webinar by clicking this link

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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800 MEDICARE to get information on all options.

Not affiliated with the U. S. government or federal Medicare program. This website is designed to provide general information on Insurance products, including Annuities. It is not, however, intended to provide specific legal or tax advice and cannot be used to avoid tax penalties or to promote, market, or recommend any tax plan or arrangement. Please note that [Agency Name], its affiliated companies, and their representatives and employees do not give legal or tax advice. Encourage your clients to consult their tax advisor or attorney.

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Online Enrollment- Enroll prospects online without the need for a face to face appointment. Access to all major carriers with the ability to compare plan benefits and prescription drug costs. Link to recorded webinar https://attendee.gotowebinar.com/recording/2899290519088332033

All agents receive a personalized enrollment website. Prospects can use the site to compare plans, check doctors, run drug comparisons and enroll in plans. Agents are credited for all enrollments. Click Here

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