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 B

DTS_hands_1 Post-it notesHow well do you understand Medicare, particularly Part B? Do you know the answers to the following questions?

What does Part B cover? While Part A covers hospitalization, Part B covers doctor visits and outpatient services. Like Part A, there are deductibles and coinsurance amounts to consider, based upon the services you have.

Do you have to pay for Part B? Yes. Unlike Part A, when you sign up for Part B you will pay monthly for your coverage. The amount will depend on such factors as your family income and if you signed up at first opportunity. Premiums may be deducted from your social security check, but can also be paid directly or by arranging for an automatic draft from your bank account.

Can I be penalized if I delay or do not take Part B coverage?  YES!  There are penalties if you delay signing up for Part B coverage. Also, by law Medicare is always primary with the one exception below so most other insurance, including most COBRA, will not pay the portion Medicare B would have paid even if you do not have Medicare.

Exception: If you or your spouse have coverage through an employer you may be able to postpone Part B without penalty while you are still actively employed. The good news is that you will still be considered coming in at first opportunity even if you postpone signing up until you (or your spouse) retire. You will then have a short window to sign up before Medicare will penalize you. Technically, Medicare B is optional, but the penalties can make it feel mandatory.

How did you do? Could you respond correctly to all the questions before reading the answers? Medicare eligibility begins at age 65, regardless of whether you enroll in Social Security or continue working (or do both). Medicare Parts A and B are considered Original Medicare. Talk to a Medicare specialist if you have questions about how Medicare 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.

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

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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.

MYTH – LOSING YOUR MEDICARE SUPPLEMENT PLAN F

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Bob Evenson

If you have been approached by an insurance agent or company telling you Plan F is going away in 2020 and not to purchase one now or to change your existing coverage BEWARE. Medicare Access CHIP Reauthorization Act (MACRA) of 2015 prohibits the sale of Medigap Plan F and C beginning in 2020. That prohibition only applies to newly eligible Medicare beneficiaries. Congress did not prohibit the sale of these policies to people who were already eligible or enrolled in Medicare before 2020.

Many seniors like Plan F because it pays the Part A and B deductibles of Medicare. All they need to remember is to pay their premium and make sure the claim is an approved claim from Medicare. Marketing of other supplement plans like Plan G is being done heavily because, for some insurance companies, Plan F premiums are too expensive in the marketplace. For these insurance companies, only their Plan G premium can compete. Or, maybe a sales representative only sells price and not benefits. Remember, saving a penny today could cost you a dollar tomorrow.

Again, beware, only people who become eligible for Medicare on or after 1/1/2020 are affected by the change. If you already have Plans C or F on that date, you can keep it.

Century Health Solutions is a subsidy of Stormont Vail Health 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. Please feel free to call us at 785-270-4593 with questions or to make an appointment. 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.

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.