Blog

Extra help Medicare

Medicare provides programs and benefits to many people. This includes the Extra Help Medicare program that provides qualified beneficiaries help paying their Medicare Part D monthly premium, annual deductible, coinsurance and copays for their prescription medications.
To qualify for this program, individuals must meet income requirements.  Individuals who are accepted into this program do not have to pay any Part D late enrollment penalty they may have acquired.

How to apply for extra help

If you do not automatically qualify for Extra Help, you will need to apply.  You must meet the following qualifications to be eligible for Extra Help.

1. Applicants must have Medicare Parts A and B.
2. They must reside in the U.S. or the District of Columbia.
3. They do not have more than $34,360 in assets that include savings, investments & real estate if they are married, or $17,220 if they are single or not living with a spouse. If your assets are more than that, you are not eligible for Extra Help. Important; this amount does not include your home, cars or personal possessions.  It also does not include life insurance, irrevocable burial contracts or back payments from Social Security or SSI.

If you meet the qualifications specified above, you can apply for Extra Help online.

Click here to apply for Extra Help online

For help with the online application, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Please note: Some people do not need to apply for Extra help.  If you have either Medicare and SSI (Supplemental Security Income) or Medicare and Medicaid, you do not need to apply for Extra Help.  You will automatically be enrolled.

Extra Help isn’t available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. But there are other programs available in those areas to help people with limited income and resources. Programs vary in these areas. Call your State Medical Assistance (Medicaid) office to learn more

Who can get Extra Help

If you think you meet the financial requirements and have Medicare A & B as well as are a resident of the U.S. or District of Columbia, just complete the online application.  You will receive a letter notifying you if you are accepted into the program.

Important:  residents of Guam, Puerto Rico, the US Virgin Islands, Northern Mariana Islands or American Samoa are not eligible for the Extra Help program.  To find alternative programs in those areas, check your state’s Medicaid eligibility at Medicaid.gov to find resources.

Additional financial resources

Individual states also have financial resources available through Medicare Savings Programs for those who meet the income qualifications. Use this link to find additional information for financial help in your area.

Beneficiaries can also go to Medicare.gov  or call 1-800-medicare (TTY 1-877-486-2048)to find information on financial assistance programs.

Please be aware:  Extra Help is not a prescription drug plan.  Beneficiaries must enroll in either an MAPD plan or a stand alone PDP plan to have coverage for prescription medications.

Agents, learn how to run a Medicare PDP or MAPD plan quote using Sunfire or Connecture.  Watch our quick YouTube video

If you want to view more images by this artist, click here

Medicare Part B eligibility

How to compare Medicare supplements

It is important for Medicare insurance agents as well as Medicare enrollees to understand how to compare Medicare supplements.  Medicare supplements (Medigap) insurance provides coverage to fill the gaps after Original Medicare pays its share of covered medical expenses.

Medicare supplement plans are standardized

Because CMS standardizes all Medicare supplement plans, they must provide the same benefits.  It does not matter which company offers the plan or what state you live in. In many states, beneficiaries have a choice of ten different plan choices.  The plans are named by the letters: A, B, C, D, F, G, K, L, M & N. Please note, plans with the same letter name only differ by price.  Insurance companies decide the pricing of their plans based on letter name and coverage area.

Comparing Medicare supplement plans

Before a Medicare beneficiary signs up for a Medicare supplement plan, it is important to consider your health care needs and your budget.  When possible, future healthcare needs as well.  Choosing the right plan can save you money as well as provide peace of mind.

Because the cost for plans varies so greatly, it is a good idea to work with a licensed Medicare agent who has access to the most competitive plans in your area.  Licensed agents can provide a cost comparison and go over coverage details that you may not consider.

Find out the value of using a Medicare agent

Although friends and relatives are often a great help with many things, please remember, each individual has their own health care needs.  What works for one person may not be good for another.

Consider the customer satisfaction record of each carrier

Additionally, in some instances, it may be worth a few extra dollars to have peace of mind and feel confident with your choice of insurance carriers.

Because health care coverage is such an important decision, beneficiaries need to consider all their needs and the options available.

If you want to join the team at Crowe and Associates, click here for online contract.

If you want to view more images by this artist, click here

Get Started With Medicare

Medicare is its own universe  with its own jargon, terms, rules, and regulations. This can be intimidating, especially for those of us just starting out. However, signing up for Medicare is a vital step in making sure that you and your family have access to the essential healthcare you need in your golden years. Beware of Medicare scams!   Protect your Medicare ID and enrollment information.    Read on to learn how to get stared with Medicare.

 Learn the Basics

Original Medicare has two parts: Part A and Part B. Part A is hospital insurance, and Part B is medical insurance. Within these two parts, many of the basic health care you will need is covered. There is also Part D, which are prescription drug plans that are purchased separately. Medigap, or Medicare Supplemental Insurance, refers to additional coverage purchased from private insurance carriers that helps pay for the out-of-pocket costs of Medicare. Another name for Medicare Part C is  Medicare Advantage.   Part C is an alternative to Original Medicare.  Private insurance companies offer MAPDs.   The federal government does not offer these plans. These are bundled plans that usually include hospital, medical, and prescription coverage.  You must enroll in Medicare to qualify for one of these plans.

Prepare to Sign Up – Enroll

Get started with Medicare.   Most become eligible at age 65. And, promptly sign up.  Individuals receiving benefits from Social Security are automatically enrolled in Part A of Original Medicare.   Part A is hospital insurance. When they sign up for Social Security benefits, they have a choice about whether or not to enroll in Part B (medical insurance). Therefore, individuals not receiving Social Security benefits, must enroll in Part A.  Enrollment is not automatic for these persons. Here are the easiest ways to sign up:

• Online, at Social Security. The website is the easiest, fastest way to sign up and access any financial help you may qualify for.

• Call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.

• You can contact your local Social Security office.

• If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

Regardless of method used to get stared with Medicare,  beneficiaries receive a welcome packet.     The welcome packet includes a Medicare card.   After enrollment, it takes about   2-3 weeks for the card to arrive.

Using Medicare

New enrollees will receive their Medicare card and start their coverage. It is a good idea to keep the Medicare card private, and only share it with medical professionals if necessary, as there are many scams around filing false claims to Medicare. The majority of doctors and service providers in the nation accept Medicare – about 93%. The most commonly excluded health care professionals, those who opt out of Medicare assignment, are psychiatrists and mental health practitioners, as well as pediatricians. It may also be helpful to give Medicare permission to share your information with someone you trust.  They can help if there is ever a medical emergency and you are unable to discuss treatment.

With these three simple steps, you will be well on your way to using Medicare successfully.

After Enrollment

The rise of automated and exclusively-online enrollment means that it can be easier to use technology to scam the unsuspecting.  Beware of Medicare scams!   Protect your Medicare ID and enrollment information. Medicare beneficiaries should always remember that Medicare will not reach out to beneficiaries via call or email unless they are answering their inquiry. Medicare will also never offer free gifts, medical equipment, or any other service for free.

Additionally, beneficiaries on an advantage plan do not need to show their Medicare card to providers.   Therefore, best if this card remains in a secure location not on them.

Licensed Agents

Are you a licensed certified Medicare agent?   Work with a better FMO.   Click here to see what Crowe and Associates has to offer. 

Keep up with all of our current events by clicking here. 

Ready to contract?   Begin here.

Subscribe to our YouTube channel.   We provide weekly training.  We cover up to date topics on webinars.   And, we host weekly zoom calls.  Additionally, use this opportunity to network with other agents.

Click here to view more images by this artist

Understanding Medicare Supplements: The Basics of Medigap

Medicare covers many health essentials for citizens sixty-five and older but it does not cover everything. Particularly for those with more complex medical histories (or futures), Original Medicare (Parts A and B) is often not enough as they move into their golden years of retirement. This is where understanding Medicare Supplements, or Medigap insurance policies come into play.

What is it?

Medigap is essentially extra insurance. Beneficiaries can buy extra insurance policies from private carriers to help pay their share of the out-of-pocket expenses that come with Original Medicare. Original Medicare is funded by the federal government.   The federal government also contracts with private carriers to ensure that their Medigap policies are safe, uniform, and sufficient. Beneficiaries must have Original Medicare in order to buy a Medigap policy. This means they must sign up for Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) to be eligible to purchase Medigap.

As previously mentioned, the insurance carriers that provide Medigap policies are contracted with the United States government. This means that the carriers must meet certain guidelines in order to keep their contract each year and continue to sell these policies. All Medigap policies are standardized, meaning that they all cover the same basic health benefits regardless of which company they were purchased from or which state the beneficiary lives in. There are ten different types of Medigap policy, and they are distinguished by letters (A, B, C, etc.). Price is the only difference between carriers’ plans of the same letter. This means that plans with the same letter offer the same coverage regardless of carrier. It is important to note, however, that in Massachusetts, Minnesota, and Wisconsin, the plans are standardized in a different way. Despite this, every Medigap policy must follow state and federal laws to protect their beneficiaries.

What does it cover?

The benefits of each Medigap plan differ (again, usually by letter, or tier), but they are all designed to do one thing: help cover the beneficiary’s share of costs from Medicare Parts A and B. This means Medigap policies can help cover co-payments, coinsurance, and deductibles. Some Medigap policies can cover services that Original Medicare doesn’t cover, like emergency medical care outside of the United States.

What’s not covered?

Medigap can’t cover everything that Medicare Parts A and B doesn’t. Some of the services that are not covered under Medigap policies are long-term care, vision or dental care, hearing aids, eyeglasses, and private nursing. Medigap plans that were sold after 2005 do not include prescription drug coverage, and beneficiaries can opt in to Medicare Part D for that kind of coverage.

Understanding Medicare Supplements – Agent Resources

Every agent gets $500 to cover monthly lead costs. – No gimmicks!  No production requirements to start.

Learn why to work with a better FMO.  If you are currently appointed with another upline and looking to change, instructions are here.

Click here to begin contracting. 

Subscribe to your YouTube Channel.

Who Needs Medicare Supplemental Insurance

One of the most common questions you will have to answer from your clients will be, “why do I need supplemental insurance?” This is a good question, and will allow you to explain exactly why supplemental insurance and/or Medicare Advantage plans make financial sense for many seniors.   Seniors have the option of adding Medicare Supplement or Medicare Advantage plans to fill the coverage gaps.

Medicare Part A and B cover many of the typical medical expenses of senior citizens. Some of these include visits to primary care doctors or specialists, laboratory tests, or hospitalization. These original parts of Medicare also cover stays in skilled nursing facilities, surgical procedures, and outpatient procedures.

However, Parts A and B do not cover all of a typical senior citizen’s expenses. For example, despite the near ubiquitous use of hearing aids in old age, Medicare does not cover hearing care, hearing exams, or hearing aids. Also not covered are dental care, dentures, vision care, routine foot care, or long-term care. Additionally, prescription drugs, for the most part, are not covered under the original Medicare but by Part D, which has to be purchased separately as supplemental insurance.

Therefore, if a senior citizen knows or anticipates that they will need any of the typical healthcare used by their demographic, such as hearing aids, glasses, dentures, or prescription medication, they would benefit from purchasing a supplemental insurance plan.

This video will help you determine whether a Medicare Supplement or Advantage plan best suits the needs of your client.   Click here to view. 

Already a licensed health insurance agent appointed to sell Medicare?   Learn what we offer our agents.

Interested in marketing Medicare Supplements and Advantage plans?   Click here to learn how to get started.

What is the difference between Part A and Part B of Medicare?

In order to help your clients choose the best healthcare coverage for their needs, you need to understand the coverage they already have: Medicare. There are four parts to Medicare.  Medicare Part A and Medicare Part B are provided by Medicare.  Those two parts make up the original federal health program.  Part A and B are referred to as Original Medicare.  Remember, Medicare is a US government entity.   Part C and Part D are purchased from private insurance carriers.

Medicare Part A is hospital insurance.  As hospital insurance,  Part A generally covers the following.

• Inpatient hospital stays

• Prescription drugs administered in the hospital

• Skilled nursing facility stays

• Mental health inpatient stays

• Hospice care

• Limited or temporary home health care

Medicare Part B is medical insurance.  As medical insurance, Part B generally covers the following.

• Annual wellness exams

• Doctor and specialist visits

• Preventative services (flu shots, etc.)

• Bone mass measurements

• Tests and screenings for certain diseases

• CPAP machines for sleep apnea

• Certain diabetes equipment and supplies

• Limited home health visits

• Durable medical equipment (walkers, wheelchairs, etc.)

This is not a complete list of the medical services covered by Medicare Part B.  However, it is a starting point to help your clients understand where their gaps in coverage are and how to choose supplemental insurance to address those gaps.

Click here to learn how to compare Medicare Advantage plans.

Click here to learn how to compare Medicare Supplement plans.

Medicare Advantage and Supplemental Sales Video

What is Medicare?

This blog will attempt to answer “what is Medicare?” by  providing a basic understanding of the Medicare program and how it works. In addition, it will detail the other parts of Medicare such as C and D.  First of all lets start with the official definition:   Medicare is the federal health insurance program for people who are 65 or older. It is also for certain younger people with disabilities and with End-Stage Renal Disease.  Most people are eligible for Medicare at age 65.

Medicare is made up of four components which can cause confusion.  Original Medicare (Red, White and Blue care with a Medicare ID on it) is Medical coverage with parts A and B.    This is what provides basic medical coverage for those on the program.   Medicare Part C is different than Original Medicare.   Part C is a Medicare Advantage Plan and is something a member can enroll in if they want.  Medicare Part C replaces Medicare A and B for those that enroll in it.   Another part of Medicare is part D which is prescription drug coverage (Also called a PDP). You can enroll in Medicare part D using a stand alone drug plan or access Medicare part D through the drug benefits on an Advantage plan.

Medicare Part A (Hospital Coverage)

Medicare Part B (Medical Coverage)

Medicare Part C (Medicare Advantage Plans)

Medicare Part D (prescription drug coverage)

We receive a lot of questions about original Medicare, Medicare Supplement, Medicare Advantage and Medicare part D plans.  A Q and A of the more common questions has been provided below.

Question:  When does my original Medicare A and B plan start?

Answer: Generally, Medicare A and B starts the first of the month you turn 65.  It never starts on the day you turn 65 unless your birth day happens to be on the 1st.  Example:  Bob is 65 on July 18th 2013.  His Medicare A and B will start on July 1, 2013

Question:  Do I need to sign up for Medicare A and B

Answer:  If you are currently taking Social Security payments, you will automatically be enrolled in Medicare A and B.  If you are not taking Social Security payments, you need to call the social security office and sign up for part B of Medicare or enroll online.

Question: How will I be billed for Medicare?

Answer: If you have elected Social Security payments, the part B premium will be taken out of your check automatically.  If you have not elected Social Security, you will be billed quarterly.

Question: How much is Medicare A and B?

Answer:  Part A cost nothing if you or a spouse worked at least 40 quarters (10 years) and contributed toward payroll taxes.  Part B cost $104 per person (will go up in 2014) and increases for those earning higher incomes.

Question: Do I have to enroll in Part B?

Answer: No, you do not need to enroll in part B of Medicare but you will pay a 10% penalty for every year you are eligible and do not enroll.  The exception to this is if you are actively working  and receiving health benefits through your employer.

Question: Do I need part B if my employer gives me retiree benefits?

Answer:  Its a trick question.  If you are retired and getting retiree benefits, you do not have to enroll in part B BUT, you will still have a penalty if you need to enroll in part B down the road. (for example: The employer drops your retiree coverage)  The only valid waiver to the penalty is if you are getting benefits and are actively working.

Question: Does Medicare A and B give me drug coverage?

Answer:  No, Medicare A and B is for medical only.  Drug coverage needs to be purchased through a Part D plan offered by a private insurance company.

Question: What levels of coverage do Medicare A and B provide?

Answer: Generally speaking, Medicare Part A provides hospital coverage and Medicare Part B provides coverage for physicians, testing and other outpatient care.  For a full summary click the link MEDICARE A AND B BENEFITS

Question: How do people cover the things that Original Medicare does not cover?

Answer: They can purchase a Medicare Supplement plan (Also called Medigap) and a part D rx plan or they can purchase a Medicare Advantage plan (MAPD plan). Some people stay on A and B only and simply purchase a stand along Rx plan. (More often they take a supplement or MAPD plan however)

Review our MEDICARE FOR DUMMIES blog for additional information

The majority of people turning 65 will be signing up for Medicare A and B. (Also called original Medicare)  Those that are receiving Social Security payments will be signed up automatically while those that have not elected Social Security will need to call the local social security office.  There is an easier way to sign up that most people are not utilizing.

Read more