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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:

Medicare Part B:

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

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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 [email protected]

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 ([email protected]) with any additional questions or concerns.

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

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 [email protected]

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 [email protected]

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

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 [email protected]

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

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 [email protected]

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

If you are already enrolled in original Medicare or will be enrolling soon, you have a decision to make about your secondary coverage.   Many people find choosing a Medicare plan to be a daunting task but it really does not need to be complicated.   With a basic understanding of the options, you will be able to make a logical decision about the type of plan or company you choose.  This post will break down the choices and help provide a little insight about each.

So, what choices to you have?  There are really only 4 and we will go over each…..

Original Medicare A and B only-   Original Medicare A and B provides medical coverage on a basic level.  Some people choose to simply use original Medicare as the only coverage.  With A and B you are covered at 80% for doctors visits, testing and just about any other outpatient procedure. (after a $140 deductible for the year) Providers will bill original Medicare and you will pay what original Medicare does not cover.  You will pay the 20% that Medicare does not pay but you only pay 20% of what Medicare allows which is a much lower number than paying 20% of retail charges.  Hospital coverage is provided at 100% for 60 days after a deductible of $1,100.00.  A daily cost share is taken on after day 60.  Drug coverage is not included with A and B only.

Overall:  This option can be risky in the event that long term high volume/frequency care is needed. Not having drug coverage in place will lead to a potential penalty down the road in the event a drug plan needs to be purchased.

Original Medicare A and B and a stand alone Part D drug plan-  You may choose to have original Medicare  A and B for your medical coverage and then purchase a stand alone part D drug plan.  A part D drug plan is simply a plan you purchase from an insurance company to provide drug coverage.   The government or Medicare do not offer a plan you can buy.  The plans are only offered by private insurance companies.  Average part D Rx plans cost from $15 to $50 a month depending on the plan.   The key is to find the plan that covers your drugs at the lowest copay amounts.

Overall:  Still leaves risk on the Medical side but the drug coverage is in place so there will not be a future penalty.

Original Medicare with a Stand alone drug plan and a Medicare Supplement- This is  the same as above but in this approach a Medicare supplement plan is also purchased.  The Medicare supplement plan covers the medical expenses not covered by original Medicare.  It is secondary to original Medicare.  The provider bill Medicare first and the supplement picks up the difference. (or a portion of it depending on which supplement you choose).   A part D drug plan could also be purchased to provide drug coverage.   Supplements are standardized in most states.  This means that if you choose a plan F supplement, the benefits will be exactly the same no matter which company is offering it.  The only difference will be in the monthly premium.

Popular Medicare Supplement plans are Plan F, Plan N, Plan L and High Deductible F. Prices vary by state and company.  Supplements are very predictable and can cover 100% of Medical expenses if plan F is chosen.  They also do not have any type of network which is a common reason many people choose them.

Overall:  Supplements are a good choice. They offer very strong coverage and let you go to any doctor that accepts Medicare.   Supplements tend to be very popular with people that have health conditions.   The drawbacks to a supplement are that the monthly premium can be substantial and you need to buy drug coverage separately.

Medicare Advantage Plans– A Medicare Advantage Plan (called an MA or MAPD) is a plan offered by a private insurance company.  The Advantage plan offers Medical and Drug coverage with one program.  The plan is also primary and replaces original Medicare.   Advantage plans have providers networks and look similar to a group based under 65 health plan.   A copay structure is used  in these plans which is why they are sometimes called “pay as you go” plans.  When you go to the provider for services, they charge a set copay for each type of service provided.  There is no need to buy RX coverage with a Medicare Advantage Plan as the drug coverage is included.   Many companies offer the plans for no additional premium. (You still pay your Medicare Part B premium of $104.00 a month) The term $0 premium plan is often used.

Some MAPD plans are HMO type plans that are in network only plans.  Others are set up in a PPO or POS format which allows the member to go out of network.  There is a higher cost share/copay for using non participating providers.  Referrals for specialists are no longer required by most plans.

Overall- You need to check you plan network for your doctor and determine if you want plan with out of network coverage or not.  MAPD plans are very popular no and represent a larger share of enrollments than the other options above.  These plans are a good choice for people in relatively good health.  The copays can add up when there I a high volume of care being received.

Consider your own health and care needs when trying to determine which type of plan you would like.   Our agency is independent which allows us to hold contracts with a number of companies working with all three types of plans listed above.  We can help you determine the type of plan you want and then find the company that is the best fit for you.  The companies pay us a commission directly so we do not bill clients for our services.  Feel free to call or email us if you would like to discuss options further.

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

Crowe & Associates will holding a number of seminars for Untied Health Care Medicare Advantage plans and AARP branded Medicare supplement plans. The meetings will run from 10:00 am to 11:30  am and will provide a review of the Medicare offerings by United Healthcare for 2013. The review will include basic information on Medicare A and B and, reviews of the United products and the enrollment rules for 2013

The sessions will be presented by Edward Crowe and Paul Smith of Crowe & Associates. There will be ample opportunity to ask questions before and after the presentation. The meeting dates, locations and times are listed below. We recommend that you call to register for a meeting. (Recommended not required)

You may call one of two numbers 860-992-4494, 203-241-7261 or email [email protected] to reserve your seat.  Our office is located at 304 Federal Road, suite 107  Brookfield, CT 06804.  You may park behind the building and walk into the back entrance.

Wednesday  March 20, 2013 – Wednesday April 3, 2013 – Wednesday April 17, 2013 – Wednesday May 1, 2013 – Wednesday May 15, 2013 – Wednesday June 5th, 2013 – Wednesday June 19,  2013 – Wednesday July 10, 2013 – Wednesday July 24, 2013 – Wednesday August 7, 2013 – Wednesday August 14, 2013 – Wednesday September 4th, 2013 – Wednesday September 18th, 2013

Time: All meetings are from 10:00 am to 11:30 am

WOULD YOU PREFERE TO ATTEND A WEBINAR?  CLICK HERE TO REGISTER

Call or email to reserve you seat(s) today!

AARP Medicare Complete is a United Healthcare MAPD plan “Medicare Advantage with Prescription Drugs”.  United offers 4 different versions of Medicare Complete in the state of Connecticut. They have 2 HMO (in network only) plans a PPO plan (That is the AARP branded plan) and a POS plan. (only in New Haven county)  A link to a plan comparison of the plans is provided  below.

United HealthCare Medicare Complete HMO Plan 2-  This is a $0 monthly premium plan with in network coverage only.  United has a substantial network in CT but you must use participating providers on this plan unless it is an emergency.  There are no referrals required to see specialists. The benefits of this option have lower copays and will result in less out of pocket compared to the AARP Medicare complete PPO plan.   If your doctors are in network, this plan will probably be a better value than the PPO.

United HealthCare Medicare Complete HMO Plan 1-  This plan is $99 dollars a month.  It is essentially the same as the HMO plan 2 but has slightly lower copays.  If you do the math on this plan, you will conclude that it is not a good value compared to the plan 2.   It is very difficult to get your $99 a month worth out of this plan because the copays are only slightly lower.

AARP Medicare Complete Regional PPO- The regional PPO is a United Healthcare plans that has the AARP branding.  This plan has in network benefits that are similar to the HMO 2 but it has slightly higher copays, offers out of network coverage and costs $24.00 a month.  The main reason someone would select this plan instead of the HMO 2 is to have the out of network coverage.  This plan will still provide coverage when you visit non participating providers.   This plan should not be confused with the AARP Medicare Supplement plans.  For more info on Medicare Supplement plans CLICK HERE

Please feel free to call our office at 203-796-5403  in the event you need more detail or would like to discuss other plans.  You may also email me at  [email protected]

United HealthCare Med Complete Plan 1 and 2 Comparison   (This summary has both CT and MA plan comparisons)

United AARP Med Complete RPPO Summary  (Connecticut only)

LOOKING FOR MORE INFO?   CLICK TO REGISTER FOR OUR “HOW TO CHOOSE A MEDICARE PLAN” WEBINAR