C IN THE MEDICARE ALPHABET

Mature couple on benchby Bob Evenson, Contributor

Medicare Advantage Plans, also called ‘Part C’ Plans, are private insurance Plans approved by Medicare. With a Part C Plan, Medicare pays a fixed amount to the insurance company each month and the insurance company assumes all the risk associated with your healthcare.  If you join a Medicare Advantage Plan, you are still enrolled in Parts A and B, or Original Medicare. However, your coverage will be through the Medicare Advantage Plan and not Orginal Medicare.

Medicare Advantage Plans must follow all the rules set by Medicare and must contain all the benefits of Part’s A and B. Medicare Advantage Plans may offer additional benefits such as dental, vision, hearing coverage and gym memberships. Prescription drugs may or may not be included in the plan. Like Original Medicare, your Plan will most likely have deductibles and co-payments.   In addition, there is usually some kind of provider networks as well.

Medicare Advantage Plans may have a monthly premium and contain an out of pocket limit on claims. Out of pocket amounts can be different for in network and out of network providers. However, you’re always covered for emergency and urgent care.

Part C, just like Part D, has an open enrollment period each year. This gives the beneficiary the opportunity to evaluate the plans available for the up coming year. The Medicare Advantage Plan can make adjustments from year to year concerning premiums, benefit coverages, participating physicians and pharmacies to name a few.

Medicare Part C, another option for beneficiaries to choose. With the help of a qualified advisor, a Medicare Advantage Plan may be the choice for you.

Century Health Solutions is a subsidiary of Stormont Vail Health, Topeka and provides free Medicare Educational Seminars. We are your local expert in Medicare insurance planning and will help you find the best option for your personal situation. Call us at 785-270-4593 with questions or to sign up for a free seminar. Our business hours are Monday-Friday, 8:00am-4:30pm.

Go to: http://www.centuryinsuranceagencyks.com or email info@century-health.com for more information.

Medicare Part A

DTS_farm_10 SunsetDo you know and understand Medicare? Let’s talk about the first part of Medicare, Part A.  How well do you know it? Check out the mini-quiz below.

1) What does Medicare Part A help cover?

  • Hospital costs
  • Routine dental visits
  • Long term care
  • All of the above

2) How much does Part A cost for most people?

  • $0.00
  • $33.33 per month
  • Depends upon your income
  • Trick question

3) You may not qualify for Social Security until you are 66, but you still qualify for Medicare at age 65.

  •  True
  • False

Medicare Part A is piece of what is known as Original Medicare (which also includes Part B). If you said Part A covers hospital costs, you are right. Part A only covers hospital costs (less deductibles and coinsurance). Part B covers doctor visits and outpatient services, and Part D deals with prescription drugs. Part C, also known as Medicare Advantage, covers a combination of B and D and often a few other things as well.

Question two was a trick question, so if you answered anything except the second choice you were correct. 1.65% (or double that amount if you are self-employed) of your salary is paid into the Medicare fund every paycheck during your entire working career. The more you earn, the more you pay in. However, Medicare does not charge recipients of Part A one cent to receive benefits.

Final Answer: True. Medicare eligibility begins at age 65, regardless of whether you enroll in Social Security or continue working (or do both). In fact, certain penalties may apply if you fail to apply for Medicare at your earliest opportunity. Talk to a Medicare specialist for specific details if this may impact you.

Century Health Solutions is a subsidiary of Stormont Vail Health, Topeka and provides free Medicare Educational Seminars. We are your local expert in Medicare insurance planning and will help you find the best option for your personal situation. Call us at 785-270-4593 with questions or to sign up for a free seminar. Our business hours are Monday-Friday, 8:00am-4:30pm.

Go to: http://www.centuryinsuranceagencyks.com or email info@century-health.com for more information.

 

Bringing in the Heat

CenturyE02

Renea Dennison

Growing up I longed for the Dog Days of Summer. Few of us had the luxury of air conditioning, but a cool clothe on the forehead at night helped you drift off to sleep. It was even hotter during the day, but who cared when you could play in the sprinkler and occasionally go swimming in the creek or the pool at the park?

I still enjoy the summer, but now I am much more aware of the health dangers. The truth is that heat kills. Every year more than 600 people die from heat in the U.S. Fortunately, or unfortunately, these deaths are preventable.

The most at-risk group are people over 65, but infants, people who work outdoors, athletes, people with chronic illnesses, and lower income households are all high risk groups too. Finally, pets are also at risk during high heat periods. If you are in one of these groups you are at risk because your activity or health might prevent your body from communicating the danger you are in, or you just might be more susceptible to heat.

Know the signs of heat stroke and heat exhaustion and other heat related health dangers.  Go to the Centers for Disease Control and Prevention to see the warning signs: (https://www.cdc.gov/disasters/extremeheat/warning.html) what to look for and what to do if you have them . READ them and learn them! Pay attention to these signs to avoid serious danger, and seek help immediately if you have any.

Prevent these deadly reactions by staying hydrated, avoiding extreme temperature changes, wearing loose, lightweight clothing, slowing down and staying indoors during the hottest part of the day. Take cool showers or baths to cool down, and try to avoid cooking with the oven or stove top.

Check on your neighbors and family and have them check on you. Share air conditioned spaces (libraries, theaters and malls work) during the hottest part of the day, and make sure pets have water and a shady, cool space.

Heat can kill. Enjoy your summer, but be aware and be safe. It’s good to be a ‘Hottie,’ just be the right kind.

Century Health Solutions is a subsidiary of Stormont Vail Health, Topeka and provides free Medicare Educational Seminars. We are your local expert in Medicare planning and will help you find the best option for your personal situation. Call us at 785-270-4593 with questions or to sign up for a seminar. Our business hours are Monday-Friday, 8:00am-4:30pm.

Go to: http://www.centuryinsuranceagencyks.com or email info@century-health.com for more information.

Cataract Awareness Month

DTS_hands_5 Glasses with notesWe cannot leave the month of June without noting that it is Cataract Awareness Month. Why is it so important? Over 24 million Americans over the age of 40 have cataracts. Cataracts are one of the leading causes of blindness both in this country and worldwide. A cataract is when cells build up on the lens of the eye causing it to cloud. Light has trouble passing through, and it becomes difficult to see.  While anyone, even children, can develop cataracts, most are age-related. Therefore they affect seniors the most.

Cataracts are also one of the simplest causes of blindness to treat. The clouding of the eye lens can be repaired in as little as 20 minutes with outpatient surgery. In fact, over 3 million Americans have this surgery each year. The treatment consists of removing the clouded lens and replacing it with an artificial one. The replacement, known as an intraocular lens, or IOL, has a 95% success rate. It is one of the safest and most successful surgeries in the country.

If you think you have cataracts see your opthamologist. In the meantime, avoid or delay cataracts by avoiding smoking, protecting your eyes from UV rays or injury, and eating healthy foods.

Cataract surgery with basic lens implants is covered by Medicare. There is even an exception to one of Medicare’s rules-after you have the surgery Medicare will cover one pair of eye glasses or contacts! Contact your Medicare representative for details to find out the specifics regarding your Plan, and make sure you get your glasses or contacts from a supplier that accepts assignment. Again, talk to your representative to avoid any pitfalls such as the possibility of having advanced implants not being covered, or having to pay for your glasses or contacts up front then submit for reimbursement (and then possibly having to appeal a denial.)

If you don’t have a representative, we always recommend having an agent to help you with those little bumps in the road and questions. Feel free to call us at 785-270-4593 or you can get a list of agents from your state insurance commission.

Questions? Please contact Century at 785-270-4593 or 1-800-227-0089 for assistance or to make an appointment.

Go to: http://www.centuryinsuranceagencyks.com or email info@century-health.com for more information.

In-Network vs. Out-of-Network

Death_to_stock_Dinner_damo_7Health insurance can be confusing. Networks, deductibles, and out of pocket maximums are just some of the terms you should learn before you buy health coverage. Not knowing and understanding these terms can cost you hundreds, if not thousands, of dollars. One of the most important things to understand is the difference between In-Network and Out-of-Network.

Health insurance companies contract with a network of health care providers in order to keep costs down and assure better outcomes. Providers In-Network go through a credentialing process to affirm they are fully educated, licensed, insured and in good standing. The providers agree to offer a discount (write-off) for their services. The insurer agrees to pay claims quickly, and to send the provider people covered by their insurance. The provider cannot collect the write-off from the patient, but they make up for the discounts in increased volume.

If you go to a physician not in your carrier’s network, the insurance company will not receive a discount for your services, and the provider may not have been through a credentialing process. Out of network providers can charge a patient whatever fee they want, even if the amount is twice what other providers in the area are charging for the same service. Insurance companies take steps to try to counter these high expenses.

Usual, Customary & Reasonable (UCR) is a term known in the health insurance field that relates to what a provider should charge for a specific service. If the average doctor charge in your area is $95 for an office visit, then $95 is the UCR amount. Your health insurance will only pay UCR. If the Out-of-Network physician charges $150, you may be billed for the difference.

Health insurance companies also may set higher deductibles, copays, coinsurance, and out of pocket maximums for Out-of Network providers. I will discuss these terms more in-depth in a later article.

When you buy a health insurance policy, it pays to check out the carrier’s network first. Is your regular doctor in network? If not, will they be willing to join? Are there many specialists in your area, or will you need to travel 50-100 miles to go to one? That $10 you save in monthly premium may cost you hundreds in Out-of-Network expenses. Know the In-Network and Out-of-Network provisions before you buy.

Questions? Please contact Century at 785-233-1816 or call Toll Free 1-800-227-0089 for assistance or to make an appointment.

Go to: http://www.centuryinsuranceagencyks.com or email info@century-health.com for more information. (Updated from 6/26/15)

 

I Can See You

CenturyE02March is National Save Your Vision Month. It’s also Workplace Vision Wellness Month. As you can see (pun intended), in March the eyes have it going on.

Seriously, vision is extremely important. You need to protect it. Follow these steps for healthy vision:

  • Schedule a comprehensive eye exam every year. Your eye doctor can do more than give you a prescription for a new pair of glasses. Optometrists are usually the first to find eye disease. Your chances of recovery, or at least reducing the damage, increases significantly when disease is found early. Your eye doctor might also discover you have a life threatening illness like high blood pressure or diabetes. Get those peepers checked regularly!
  • Maintain a healthy diet. Remember, those five servings of fruits and vegetables are better for your eyes if they contain lots of leafy greens.
  • Wear sunglasses. Give your eyes some protection from UV rays and look cool at the same time.
  • If you wear contacts, observe safe wear and care.
  • Finally, practice the 20-20-20 rule: every 20 minutes look at least 20 feet away for at least 20 seconds. Technology is not always our friend. If you use a monitor all day or stare at your phone for long periods of time, then this is especially important. You should also make sure the brightness of your monitor, as well as its height, is set at an appropriate level.

DSCF1245The 20-20-20 rule is a nice segway into the Workplace part of this article. In addition to protection from damage due to monitors, here are several other items to consider:

  • Wear protective and appropriate eyewear safety equipment.
  • Keep your safety gear in good condition. Check it frequently for damage and wear.
  • Be aware. Know what kinds of eye injuries might occur on your job, and watch out for them.
  • If you think you might need safety equipment or guards of some kind, ask for them. Prevention outweighs treatment every time.

There you have it. I hope you see the importance of taking care of your eyes. Now, go set up your eye appointment.

Insurance questions? Please contact Century at 785-286-6402 or call Toll Free 1-800-227-0089 for assistance.  The office is located at 2951 SW Woodside Drive in Topeka and walk-ins are welcome.

Go to: http://www.centuryinsuranceagencyks.com or email info@century-health.com for more information.

 

Why Disability Insurance?

Ty Hysten

by Ty Hysten, Guest Blogger

According to the National Association of Health Underwriters (NAHU), Disability Insurance is a Plan “that provides for periodic payments of benefits when a disabled insured is unable to work. The insurance product is designed to replace anywhere from 45 to 65% of your gross income on a tax-free basis should illness keep you from earning an income in your occupation.”

Disability Insurance essentially protects your paycheck, and the income that it provides, from a tragic long-term disability.  If you are entering the workforce today, your chances of being disabled before retirement are 3 in 10.  Disability may be caused by an accident, but is often the result of serious health conditions.  The Health Insurance Association of America has stated that you are 3 times more likely to need Disability Insurance than you are to need Life Insurance.

What are your options? Just 39% of those who applied for Social Security Disability Insurance benefits in 2005 were approved. Workers’ Compensation only covers accidents and illnesses directly related to your job. Medical Insurance will cover your medical services and prescriptions, but does not replace income. Only Disability Insurance replaces a portion of your income to help pay your mortgage, car payment or your child’s college tuition.

In most disability insurance programs you will be paid benefits at a predetermined amount. If you have short term disability coverage, benefits will replace a portion of your income up to 90 or 180 days. Long-term disability will replace a portion of your income starting 90 or 180 days (known as the elimination period) and could continue until you’re 65 years old.

Disability Insurance offers income flexibility. If you receive a raise or take a higher paying job you can increase your benefits. Disability Insurance will even pay you for a partial disability.

Everything you have today probably comes from your ability to produce income. Disability insurance policies are unique in that they can be tailored to an individual’s needs. This uniqueness means makes it important to work with a licensed professional.  If you are interested in learning more, please contact an expert at Century Health Solutions.

Questions? Please contact Century at 785-286-6402 or call Toll Free 1-800-227-0089 for assistance.  The office is located at 2951 SW Woodside Drive in Topeka and walk-ins are welcome.

Go to: http://www.centuryinsuranceagencyks.com or email info@century-health.com for more information.