What is Extra Help with Medicare prescription drug plan costs? Anyone who has Medicare can get Medicare prescription drug coverage. Some people with limited resources and income also may be able to get Extra Help with the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan.
Vaccines are getting increasingly more available. Are you wondering how it will be coverage if you have Medicare? Administration and vaccine cost are covered by Part B of Medicare.
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| Note |
| Medicare Advantage Plans can’t charge copayments, deductibles, or coinsurance for clinical lab tests to detect or diagnose COVID-19. |
Stay up to date & more information on COVID-19 & Medicare. CLICK HERE
It is never easy for a patient to receive a diagnosis with a serious illness. Patients and their loved ones must navigate treatments, planning, setbacks, and numerous challenges while dealing with complicated emotions and fears. Recognizing the difficulties of serious illness, health insurance providers have set out to help, support, and ease the journey for patients, caregivers and loved ones. Ensuring access to tools, education, and services for patients and their loved ones during a difficult time can provide the opportunity to plan, allow patients to maintain their dignity and choice, and support loved ones to know their role and how best they can help.
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Trends of enrollment and demographics of Medicare Supplements plans.
What Is Medicare Supplement? Medicare Supplement (also known as Medigap) is a key source of additional coverage for Medicare enrollees to further protect their health and financial security. Seniors purchase Medigap coverage to protect themselves from high out-of-pocket costs not covered by traditional Medicare, to budget for medical expenses, and to avoid the confusion and inconvenience of handling complex bills from health care providers.
Part B – Premium and IRMAA* (*Income-related monthly adjustment amount)
Part B covers 2 types of services
Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
Some people automatically get Medicare Part B (Medical Insurance), and some people need to sign up for Part B. Learn how and when you can sign up for Part B.
If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty.
Click here for cost of Part B – https://www.medicare.gov/your-medicare-costs/part-b-costs
Part D – IRMAA
All plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected classes,” like drugs to treat cancer or HIV/AIDs. Information about a plan’s list of covered drugs (called a “formulary”) isn’t included in this handbook because each plan has its own formulary. Many Medicare drug plans and Medicare health plans with drug coverage place drugs into different levels called “tiers” on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier.
COVID-19 has dramatically accelerated the adoption of digital health, and a new analysis from Deloitte finds that trend extends similarly to Medicare Advantage (MA) beneficiaries.
Deloitte researchers surveyed executives at MA plans, as well as digital health companies, and found that through April 2020 more MA members used telehealth than did so in all of 2019.
Through April, 26% of beneficiaries said they used telehealth or had a virtual visit for any reason, compared to 13% saying the same across all of 2019.
As open enrollment for Medicare continues, insurers that are embracing digital are getting a leg up on the competition, the analysis found.
“COVID has been a game changer. None of this was table stakes six months ago,” the Medicare sales lead at one MA plan said. “As we go into the next open enrollment, if you don’t have telemedicine, you’re going to hurt.”
Sarah Thomas, managing director of Deloitte’s Center for Health Solutions, told Fierce Healthcare that members are taking notice of plans that operate with an “old-school approach” to technology.
The interest among beneficiaries extends to digital ways to enroll in new plans in lieu of meeting a broker in person, Thomas said.
“There’s a significant and growing portion of people who are beginning to expect to get enrolled virtually,” she said.
The researchers also found that providers, who are critical partners in growing the use of these benefits, are also “surprised” by how effective these tools are.
Deloitte analysts surveyed physicians prior to the pandemic and found that these tools were making their work more efficient and a bit easier. They’re also finding it an effective way to deliver care in many circumstances, Thomas said.
“We have a primary care provider-centric view of technology. That’s our tech strategy,” the chief technology officer at one plan told Deloitte. “We arm our PCPs with as much tech as possible. The best product or tool to engage the seniors are the PCPs.”
The pandemic’s impact on digital health has included insurers’ supplemental benefits that target MA members’ social determinants of health. The Centers for Medicare & Medicaid Services allowed MA plans to make midyear adjustments to their supplemental benefits, which provided the opportunity to offer members a smartphone for virtual visits and other options that harness the virtual space.
RELATED: Why Papa, Humana think it’s crucial to ‘make noise’ about the impacts of loneliness amid COVID-19
Insurers pointed to several key areas where they’ve focused amid the pandemic: transportation, home drug delivery, food and nutrition and social isolation. All of these get at one of the main challenges under COVID-19: the push for people, especially populations at high risk like seniors, to stay home to avoid exposure.
MA plans are offering transportation benefits to assist members in getting to their doctor’s office or to buy groceries and are also partnering with local food banks and other services to provide food delivery.
In addition, they’re offering programs to provide companionship and help members secure medications from their homes, according to the report.
The demands of the pandemic have taken these concerns from “the back seat to the passenger seat,” according to the report.
“The direction and the emphasis on digital—there is no turning back,” Thomas said. “Health plans that are sort of waiting on the sidelines and hoping to be a fad follower will get left behind.”
Full article – https://www.fiercehealthcare.com/payer/deloitte-medicare-advantage-plans-don-t-embrace-telehealth-will-get-left-behind
Medicare annual open enrollment has begun. This is the time to review all your options, for the choice that best meets your current need. Reviewing items like your out of pocket cost, check with your providers, review your medications. The time is now. We can begin enrollment from October 15th – December 7th. You can reach us, to discuss your options @ 201-644-8502. And you can email us at [email protected]. We can set up either a conference call or virtual meeting whichever you are comfortable with.
Learn more about Medicare at the link below.
Medicare is a federal program that offers health insurance to American citizens and other eligible individuals. The program is often called Original Medicare. It has two parts — Part A and Part B.
Part A – Part A covers in-patient hospital and skilled nursing care.
Part B – Part B covers doctor visits and outpatient care.
Part C – Medicare Advantage plans (Part C) combine Part A and Part B coverage. They often include Part D coverage and other benefits you don’t get with Original Medicare, e.g. glasses, dental, meals, OTC items and so much more. Some plans cost as low as $0 for a monthly premium.
Part D – Medicare prescription drug plans (Part D) help pay for medications. You can get a standalone Part D plan or get a Medicare Advantage plan that includes drug coverage.
Medicare supplement insurance (Medigap) helps pay some or all costs not paid by Original Medicare (deductibles, copays and coinsurance).
Many questions and things to consider. Your health, your budget, your preferences. Have more questions.
If you would like to speak with a licensed and certified professional and receive a FREE review Medicare Programs available do not hesitate to contact us.
You may already be taking steps to protect your health during the COVID-19 emergency. Be sure to also protect your identity from scammers by guarding your Medicare Number.
It’s easy to get distracted and let your guard down during these uncertain times. Scammers may try to steal your Medicare Number. They might lie about sending you Coronavirus vaccines, tests, masks, or other items in exchange for your Medicare Number or personal information.
Protect yourself from scams:
Visit Medicare.gov/fraud for more information on protecting yourself from fraud and reporting suspected fraud.
Sincerely,
| The Medicare TeamNote: You can learn more about COVID-19 and your Medicare coverage on Medicare.gov. |
Oral Health
The House of Representatives passed H.R. 3, a bill that would lower prescription drug prices and use the savings to add an oral health benefit to Medicare. If you have questions on what a Medicare dental benefit would entail, check out our FAQ about adding an oral health benefit to Medicare Part B. You can access earlier oral health resources on this topic. The Miami Herald also published a story about the difficulties older Florida residents facebecause of a lack of oral health coverage.
If you will be entering the Medicare program or have been on Medicare already and would like to use your benefits, it can be over whelming.
Deciding when do I apply for Part A, Part B, Part C & Part D.
What does it all mean? Your choices about your health care is very important and to make an educated decision can be confusing.
Come to explore what your options may be and get answers to questions you may have. There are several meetings scheduled.
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