Short Term Medical gives you the flexibility to get the coverage you need when you need it most. Short term medical provides all of the options you need to protect you and your family when you are out of work, furloughed, or in-between plans and left without health insurance. Short term medical insurance in Kentucky is provided on an initial term for between 30 and 364 days but can be renewed for up to three years.

At Braden Insurance, we sell Short Term Health Insurance through National General and United HealthOne. The federal laws that apply in Kentucky and Indiana also require that insurers must make the terms and provisions of short-term medical insurance clear to consumers. At Braden, we break down short term health insurance to make it simple and easy to understand. We want you to know what it is, who needs it, what’s covered, how to get it, and how much it will cost.

WHAT IS SHORT TERM HEALTH INSURANCE?

Short term health insurance is designed to provide you with temporary medical coverage. Your policy will be sold with a term limit of up to 364 days. However, if necessary, your policy can be automatically renewed for up to 36 months (3 years). Short term health insurance is commonly used when you are between health plans, outside enrollment periods, or need some coverage in case of an emergency.

WHO NEEDS SHORT TERM MEDICAL COVERAGE?

To be eligible for short term health insurance, you must be under 65 and live in a state where it is available. It’s a viable option for many who may be without health insurance for a variety of reasons including:

• You’ve got a gap in coverage due to a new job
• You don’t qualify for a special enrollment period
• Losing a job
• Furloughed and left without health insurance
• Aging off of parents’ health insurance plan at 26 years old
• Early retirees who don’t yet qualify for Medicare
• College students who need coverage during the school year, or don’t yet have a job
• People who don’t qualify for an ACA Special Enrollment period/missed the enrollment period
• New US immigrants
• US citizens returning from living abroad

WHAT IS COVERED BY SHORT TERM INSURANCE?

Short term health insurance coverage varies greatly depending on the plan and the insurance company you buy from. This is partly because temporary health coverage is not required to meet the same standards as the Affordable Healthcare Act. There are no minimums or required levels of coverage, so it’s important to understand your plan completely and read through the “exclusions and limitations” information thoroughly.

Short term medical insurance typically provides some level of coverage for:

• Preventive care
• Doctor visits
• Urgent care
• Emergency care
• Prescriptions

Here is a breakdown of the types of coverage that is available.

To help find the best temporary health care policy for you, give Braden Insurance a call today.

HOW MUCH DOES SHORT TERM HEALTH INSURANCE COST?

No two short term insurance plans are the same. Even if your neighbor is in a similar situation and they have a short term health insurance plan, yours will likely look (and cost) very different. The cost of your temporary medical coverage includes five areas you may already be familiar with:

• Premium: This is the monthly fee you pay for having coverage.
• Deductible: This is what you will pay for services until you meet your deductible. Then your plan starts sharing costs. The deductible for short term health insurance is typically much higher than traditional insurance coverage.
• Coinsurance: This is the percentage of costs you share with your plan after you meet your deductible.
• Copay: This is a fee you may have to pay when you visit a doctor regardless of deductible or coinsurance. Some short term plans have a copay, but not always.
• Other out-of-pocket costs: There may be some health care services that aren’t covered by your short term plan, and you are responsible for all costs. This may include maternity care, mental health, substance abuse services, vision, or dental care.

To figure out the exact cost of a specific plan, give Braden Insurance a call. One of our independent agents will be glad to help.

PROS AND CONS OF SHORT TERM HEALTH INSURANCE

SHORT TERM HEALTH INSURANCE BENEFITS:

• Fast Coverage. Get health coverage as soon as the day after applying, sometimes even within minutes of applying you can be approved and have working coverage.
• Several Options. You choose how much you want to spend per month on your premium and what deductible you are comfortable with.
• Pick your length of coverage. Whether you need coverage for just a few weeks or several months, your plan can be renewed or cancelled anytime.
• Drop coverage with no penalty. When you receive more permanent health insurance you can cancel coverage with no penalty.
• Vast list of doctors to choose from. Short term insurance is widely accepted among doctors so you can still go to the doctors you already know and trust with no restrictions.
• Emergency Coverage. Short term insurance is there for emergencies and unexpected illnesses.
• Fill in the gap. Designed to fill short-term gaps in coverage should you need it, so you don’t have to worry about losing health insurance when you need it most.
• There’s no enrollment period. You can enroll anytime you need it and get coverage as soon as the next day.
• They’re a security blanket. Short term insurance gives you the peace of mind knowing you have coverage in case of major accident or unexpected illness.
• Flexibility. You can choose how much coverage you need, and for how long you need it.
• Affordable. Short term health insurance is often cheaper than COBRA options. In addition, some doctors have preferred pricing for those with short term insurance, so your overall costs are lower.

DISADVANTAGES OF SHORT TERM INSURANCE PLANS

• Limited Coverage. There is usually no coverage for pre-existing conditions and limited coverage for some services.
• Can be denied. A medical questionnaire may be required to be approved for coverage.

WHAT’S THE DIFFERENCE BETWEEN SHORT-TERM HEALTH INSURANCE AND OBAMACARE?

All ACA individual health plans must have the “10 essential health benefits.” Short Term Medical Insurance plans, in comparison, do not have a standardized set of benefits.

Standard benefits include maternity coverage and preventative care, mental health, and substance abuse benefits. Short term health insurance typically doesn’t cover any of these areas. Short-term insurance plans usually offer “major medical” type benefits that cover healthcare costs in the event of unexpected accidents and illnesses.

HOW TO CHOOSE SHORT TERM MEDICAL INSURANCE

Thinking of buying a short-term health plan? Here are some things to keep in mind:

* Read the fine print of what the plan covers, and especially what it doesn’t cover.

* Understand how much you’ll pay out of pocket.

* How much is the deductible?

* What percentage of covered medical expenses do you pay after the deductible?

* What is the maximum amount you will have to pay out of pocket?

* What is the dollar cap on coverage?

* If the plan has a network of medical providers, make sure the network includes doctors and hospitals you would use.

* Understand that if you enroll in a short-term plan instead of choosing COBRA coverage, you will lose eligibility for COBRA after the short-term plan expires.

SHORT TERM INSURANCE FROM NATIONAL GENERAL

At Braden Insurance, we provide coverage through National General Insurance. National General is one of the top 10 providers for home, auto, and short term health insurance. These short term insurance options work through Aetna or Cigna’s Open Choice PPO Network, which provides a range of over 5,000 doctor and specialist options. This makes it easy to see your favorite doctor without worrying about an additional out-of-network fee imposed by some competitors.

Co-pays for National General short term insurance range between $50 and $250 per month, which is significantly more affordable than COBRA or other short-term plan options. Your deductibles can be set between $1,000 and $25,000. National General’s insurance policies cover emergency care, ER visits, and ambulance fees so you know you’re taken care of if the unexpected happens.

FREQUENTLY ASKED QUESTIONS

HOW DO YOU BUY A SHORT-TERM HEALTH INSURANCE PLAN?

• Short-term health plans are sold through Braden Insurance. We offer short term insurance provided with coverage through National General. To buy a short term medical plan you can simply contact our office and we’ll walk you through the entire process to ensure you get the coverage that fits your needs and your budget.

IS HEALTH INSURANCE REQUIRED?

• No, the federal mandate that required health insurance has been lifted. Insurance is no longer required in the state of Kentucky. You still have to report your coverage status on your tax return, but you won’t have to pay a penalty. However, even when it’s not required, health insurance can protect your family against catastrophic healthcare costs that can drive a family into bankruptcy.

IS SHORT TERM HEALTH INSURANCE AVAILABLE FOR FAMILIES?

• Yes, spouses and dependents can be covered under a short term insurance plan. However, all family members will need to meet the medical requirements of the plan.

DOES SHORT TERM HEALTH INSURANCE PROVIDE COVERAGE FOR PREEXISTING CONDITIONS?

• Maybe not. Insurers will often review up to five years of your health history and can deny your application based on your current and past health conditions.

IS SHORT TERM MEDICAL INSURANCE LIMITED TO ANNUAL ENROLLMENT PERIODS?

• No! Short Term health insurance plans can take effect as soon as the day after your application is received.

WHAT IF I DON’T NEED MY TEMPORARY INSURANCE COVERAGE FOR AS LONG AS I HAD PLANNED?

• No problem. Your short term health insurance plan can be canceled at any time without penalty. If you need coverage longer than anticipated, it can also be renewed.

CAN I PAIR OTHER PLANS WITH A TEMPORARY HEALTH INSURANCE PLAN?

• Short Term is often combined with other supplemental health insurance plans to help provide adequate coverage.

IS TEMPORARY HEALTH COVERAGE RIGHT FOR ME?

The right coverage for you depends on your individual situation, health, and needs. Ask yourself a few questions to see if this might be a good option for you:

• Do you qualify for a short-term health insurance plan?
• Are you in good health, with no pre-existing conditions?
• What monthly premium can you afford?
• Do you qualify for Medicaid in your state?
• How long do you need coverage for?
• Do you need additional benefits like maternity care, dental, or vision?
• How quickly do you need coverage?

The answers to these questions can help the specialists at Braden Insurance guide you to the next step. We can sit down with you, discuss your needs, and find the best short term health insurance policy for you and your family. Give us a call today!

The post How To Get Short Term Health Insurance In Kentucky & Indiana appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map/
https://www.bradeninsurance.com/info/

The world of Medicare Supplement Plans, or Medigap Insurance Plans, can be one confusing roller coaster. There are so many options, combinations, and companies to sift through.

To make the process of applying for Medigap Plans in just a bit easier, we have compiled the twelve questions we receive from our Louisville, KY clients the most often and put them into this one, easy to read article.

After you are finished reading, be sure to schedule your free, unbiased consultation. Our independent agents can help you find and apply for one of the Medigap Insurance Plans that is perfect for you.

QUESTION #1 – WHAT IS A MEDICARE SUPPLEMENT PLAN?

A Medicare Supplement Plan is a type of Medicare health insurance that helps pay for, or supplement, some of the costs that Original Medicare Part A and Part B do not cover. These costs include things like copayments, coinsurance, and deductibles.

There are ten standardized Supplement Plans, also referred to as Medigap Insurance Plans, that can be purchased by those who already have Original Medicare Part A and Part B. Not all Medigap Plans are available in every state, but those Medicare recipients in Louisville, KY and throughout Kentucky have access to all ten plans.

The ten plans are…Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan H, Plan L, Plan M and Plan N.

Each of these plans helps fill in the cost gaps for things like…

• Medicare Part A coinsurance and hospital costs
• Medicare Part B coinsurance or copayment
• First 3 pints of blood that may be needed during an operation
• Part A hospice care coinsurance or copayment
• Coinsurance for skilled nursing facility
• Medicare Part A deductible
• Medicare Part B deductible
• Medicare Part B excess charges
• 80% of foreign travel emergency care; if you are traveling abroad and need medical attention, some plans will cover 80% of your bills.

Medigap Insurance Plans are offered through private Medicare Supplement Insurance companies and while the coverage for each plan does not differ from company to company, the cost of each plan could vary.

QUESTION #2 – AM I ELIGIBLE TO APPLY FOR A MEDIGAP INSURANCE PLAN?

All Medicare eligible recipients who are already enrolled in Original Medicare Part A and Part B are eligible to apply for any of the ten standardized Medigap Insurance Plans.

When you turn 65 and enroll in Original Medicare Part B, you have a guaranteed right to buy a Medicare supplement policy for six months starting from the first day of your birth month that you turn 65. During this time, you can not be refused application for any reason.

If you miss this window, you can apply later at any time, but run the risk of being denied coverage altogether or charged a higher premium than if you had applied during the Medicare Supplement Open Enrollment Period.

QUESTION #3 – DOES A MEDIGAP POLICY REPLACE MEDICARE PARTS A AND B?

No. All Medigap Insurance Plans are intended to be used in conjunction with the benefits you are already receiving by having Original Medicare Part A and Part B. These plans are just meant to help supplement the costs associated with Original Medicare.

Medigap Plans also do not replace Medicare Advantage Part C. You can have Original Medicare Part A and Part B with a Medigap Insurance Plan OR Medicare Advantage Part C, but not both.

QUESTION #4 – DO I HAVE TO USE CERTAIN DOCTORS?

One of the many benefits of having Original Medicare Part A and Part B with one of the Medigap Insurance Plans is you have the ability to see any doctor or go to any hospital who accepts Medicare and is taking on new Medicare patients.

To find out if a doctor accepts Medicare, you can either call the office and ask or simply go online to find the nearest Medicare doctor who can help you with your health concerns.

QUESTION #5 – HOW DO I KNOW WHICH MEDIGAP PLAN IS RIGHT FOR ME?

Trying to pick the best plan out of the ten Medigap Insurance Plans for your health needs and budget would give anyone a headache. Each plan offers different coverage options and different insurance companies have different prices for each plan.

The best course of action would be to set up a completely free, unbiased consultation with the independent agents at Braden Insurance Agency. We have the ability to sell Medigap Plans from several different Medicare insurance companies so you can be sure you are getting the best plan for your health needs and pocketbook. Give us a call today to schedule your free consultation!

QUESTION #6 – DOES MEDIGAP INSURANCE PROVIDE NURSING HOME COVERAGE?

Basically, nursing home coverage is very limited. Medicare only covers specific situations where a nursing home is needed. For example, Medicare will only cover the costs of Skilled Nursing Facility Care after you became ill or injured, was admitted to the hospital for at least three days, and then was later moved to a nursing home for thirty days of continuing recovery and rehabilitation.

Generally, patients in nursing homes receive either intermediate or custodial care, which includes services like bathing, eating, dressing, toileting, transferring from bed to wheelchair or wheelchair to bed and moving around. These types of care services are not covered under Medicare or any of the Medigap Insurance Plans.

QUESTION #7 – CAN I SHOP AROUND FOR A DIFFERENT SUPPLEMENTAL INSURANCE PLAN?

Yes. In fact, we encourage it. Medicare eligible recipients are not required to purchase specific Medigap Insurance Plans from a certain private insurance company. It is best to purchase the one that best fits your health needs and pocketbook.

The ten standardized plans have the same coverage no matter who you purchase from, but different companies have different premiums for their plans. So be sure to talk to an independent Medigap Insurance Plan agent who can help you compare all your options.

QUESTION #8 – CAN MEDIGAP INSURANCE POLICIES BE TERMINATED?

No. The private insurance company in Louisville, KY that you purchase your Medigap Insurance Plan from can only cancel your plan if one or more of the following situations happen…

1. You fail to make your premium payment
2. Material omission or misrepresentation on your application
3. The insurance company you purchased from goes out of business

QUESTION #9 – HOW LONG DOES IT TAKE TO APPLY FOR MEDIGAP INSURANCE PLANS?

The hardest part of applying for Medigap Insurance Plans is deciding which of the ten plans is best for you. After that, the process is quick and painless. The actual act of applying can be completed in under 20 minutes. Once everything is submitted, the approval process can take up to 3 weeks.

QUESTION #10 – DO I HAVE TO TAKE A PHYSICAL EXAM?

Most likely, no. Since several private companies offer Medigap Insurance Plans and each company has their own way of handling supplement plans, there is a small chance you may have to complete a physical exam. Talk to one of the independent agents at Braden Insurance Agency to find out which companies require physical exams.

QUESTION #11 – WHAT IF I HAVE A PRE-EXISTING CONDITION? WILL THE PLAN ACCEPT ME?

First of all, pre-existing conditions are very common and are defined as health conditions that existed prior to the application of a Medigap Insurance Plan. Some examples include cancer, heart disease, diabetes, and asthma.

Medigap Plans are sold by private insurance companies who are allowed to make judgments based on an applicant’s health history. They are NOT allowed to make such judgments during the Medicare Supplement Open Enrollment Period, which lasts six months from the first day of your birth month in which you turn 65 and enrolled in Original Medicare Part B.

During this window, you can not be denied a Medigap Insurance Plan based on your pre-existing condition. If you apply for a Medigap Insurance Plan after this six-month window, you could be denied coverage or charged a higher premium based on your pre-existing condition.

QUESTION #12 – AFTER ENROLLING, CAN I SWITCH FROM ONE MEDIGAP PLAN TO ANOTHER?

You can switch your plans anytime during the year and all you have to do is submit a new application.

The best time to switch from one plan to another is during the Medicare Supplement Open Enrollment Period. During this time you can not be denied coverage based on your medical history or charged a higher premium than someone else. Once this window has passed, if you want to change your Medigap Insurance Plan, you may have to answer medical history questions that could prevent you from changing or force you to pay a higher premium on the new plan.

KNOW WHAT IS BEST FOR YOU

We hope you feel a little more relaxed about signing up for Medigap Insurance Plans after reading through these helpful answers.

Is there a question you have that we didn’t answer?

We do not want to leave any stone unturned. If you have more questions, please do not hesitate to give us a call to schedule a free consultation with one of our independent agents. We want to make sure you are 100% confident in your decision.

At Braden Insurance Agency, we are your Medigap Insurance Plans experts.

The post Medigap Insurance Plans: 12 FAQs to Help Find the Best Medicare Supplement Policy For You appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map/
https://www.bradeninsurance.com/info/

You have worked hard all of your life. You have taken care of your family, your home, and have been a dedicated employee in Louisville, KY for many years. It is time now to slow things down a bit and take care of yourself for a change.

The truth is, getting older can sometimes bring on unwanted stress. The three big stress points are your health, financial situation, and overall well-being. As you approach the young age of 65, the first big point to understand is the importance of managing your health. Your health can have a domino effect on all the other aspects of your life.

Everyone has heard of Medicare, but fewer people know the benefits of adding Medicare Supplements to their Original Medicare Part A and Part B. We are about to dive into the basics of what Medicare Supplements are and discuss the increasing importance of adding it to your Original Medicare Part A and Part B.

WHAT IS MEDICARE SUPPLEMENT INSURANCE?

Medicare Supplements, also referred to as Medigap Plans, fill in the gap of what Original Medicare Part A and Part B does not cover. Original Medicare does not pay for 100% of your medical needs and what Medigap Plans do is they essentially pick up the rest of the slack from your Medicare coverage.

Original Medicare only covers about 80% of medical bills and adding Medicare Supplements can pick up the remaining 20% of the cost. There are ten standardized plans and each one covers a different portion or percentage of your Original Medicare copayments, coinsurance, and deductibles. The ten Medicare Supplements are Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan H, Plan L, Plan M and Plan N.

While they are named with letters, they are in no way related to the letter names given to Original Medicare Part A and Part B, Medicare Advantage Part C, and Prescription Drug Coverage Part D.

Medicare Supplements are sold from a variety of private insurance companies. The companies that Braden Insurance Agency in Louisville, KY sells plans from include:

• Humana
• Aetna
• Cigna
• United Healthcare
• Anthem
• Many more

Regardless of which company you purchase from, the Medicare Supplements are the same. The only difference lies in the price of the monthly premium. So it is important to compare plans and their premiums against other companies, so you are getting the right plan for you at a price that won’t hurt your pocketbook. Your best bet is to compare plans with your licensed independent Medicare agent.

Don’t have an agent yet? Call Braden Insurance Agency today and schedule a free, unbiased consultation with one of our friendly independent agents to discuss Medicare Supplement Insurance.

WHY IS MEDIGAP INSURANCE SO IMPORTANT?

Everyone knows how important their health care is to their overall quality of life. But with the ever increasing costs of living expenses, including medical care, many elders are having to choose between medical care and groceries. And sadly, this choice can diminish their quality of life or even their life-span. This reality is not only nation-wide, but this problem exists for many aging citizens right here in Louisville, KY.

Medigap Insurance Plans are available to all Medicare eligible recipients to help decrease or even eliminate the out-of-pocket expenses left over from Original Medicare. They often increase the quality of health care because it gives you the option to see the specialist you need, receive the outpatient care necessary, or participate in preventative treatments that might otherwise not be covered by Original Medicare and you may be unable to pay out-of-pocket for.

Those enrolled in a Medicare Health Maintenance Organization (HMO) or other Medicare Advantage plan are not eligible to also enroll in Medigap Plans. But for those relying on Original Medicare alone, a Medigap policy provides peace of mind knowing that they are covered, regardless of what the future holds. Medicare Supplements provide a safety net so you and your loved ones can be sure you are getting all the care you need, without having to live on rice and beans during the process.

MEDICARE SUPPLEMENT INSURANCE: HOW TO GET STARTED

First things first. Before any of this process gets going, the first thing that has to be eligible is for you to be turning 65. The next step, once you reach 65, is to enroll in Original Medicare Part A. Part B can wait until you are no longer employed and covered under their health insurance. Once you officially retire, you can enroll in Original Medicare Part B, as well as any of the Medicare Supplements.

Open Enrollment for Medigap Plans last six months and starts on the first day of the month you turn 65. During this enrollment period, you can not be charged higher premiums or be denied coverage due to any pre-existing health condition. Once this enrollment period is over, you can still enroll in Medicare Supplements but could potentially be denied coverage or charged a higher premium than if you had enrolled during the enrollment period.

WHAT DO MEDIGAP PLANS COVER?

The main aspects that Medicare Supplements cover are Original Medicare copayments, coinsurance, and deductibles. In addition, they provide an additional 365 days of hospital stays after the Original Medicare benefits are used up.

This means that any of these Medicare Supplements will pay for all or some percentage of your Original Medicare copayments, coinsurance, and deductibles, eliminating the need for any out-of-pocket payments. In addition, there are certain Medicare Supplements that can be purchased that can assist with or completely cover the costs associated with at-home help for recovery, physical assistance, and in-home visits, or preventative care.

Our guide to Medicare Supplement Insurance takes a more in-depth look into each Medigap policy and spells out what each one covers specifically.

SUPPLEMENT PLANS: LET THE GOOD TIMES ROLL

We have to face the facts that retirement and aging are expensive and many are not adequately prepared. When individuals and couples and not prepared for their increased health care costs, their health care suffers and in turn, they do not receive the care they need. With Medicare Supplements, this does not have to be the case.

When you enroll in one of the Medicare Supplements, you are securing your financial situation, so you can focus on what matters most to you.

For more information or to enroll in one the Medicare Supplements, call on the independent agents at Braden Insurance Agency in Louisville, KY to help you get started. Our free, unbiased consultations will ensure you get all of your questions answered so you can rest easy knowing your health and quality of life is protected.

The post Medicare Supplements: Filling In The Insurance Gaps appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map/
https://www.bradeninsurance.com/info/

The pocketbook is almost always the bottom line, especially in your retirement years. With so many aspects of Medicare, it’s impossible to keep straight on what’s covered, what’s not, and how much it’ll end up costing you in the end. Medicare supplement insurance is available to fill the gaps left behind from Medicare. Within these supplement plans, there are a myriad of options to choose from, so how do you know what’s right for you? Our Medicare advisors will break it down and make it simple so you get what you need without overpaying.

WHAT IS A MEDICARE SUPPLEMENT PLAN?

Medicare supplement plans are also referred to as “Medigap” or “Medsup” policies. Many Medicare eligible individuals choose to add a supplement plan to their Original Medicare plan to help offset their out of pocket costs for copayments, coinsurance, and deductibles.

Unlike Original Medicare, which is provided by the government, Medicare supplement insurance is provided by private insurance companies. This can make individual plan costs and coverage vary from company to company in Louisville, KY.

There are ten standard Medicare supplement insurance plans currently available: A, B, C, D, F, G, K, L, M, N. Because Medicare is a state-issued program, not all plans are available in every state, however residents of Kentucky are fortunate to have access to all ten options. The plans are lettered for convenience, but the letters have no relationship to the letters of Medicare Part A, B, C, and D.

Who is eligible for Medicare supplement plans?

To be eligible for a Medicare supplement insurance, you first have to be enrolled in Original Medicare Part A and Part B and a citizen of the United States or permanent legal resident for at least five continuous years. In addition, you must meet at least one of the following requirements:

• Age 65 and older
• Diagnosed with end stage renal disease (ESRD – permanent kidney failure requiring dialysis or transplant)
• Receiving disability benefits from the Social Security Administration or the Railroad Retirement Board
• Diagnosed with Lou Gehrig’s disease (ALS)

WHAT IS THE DIFFERENCE BETWEEN MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENTS?

Medicare Advantage and Medicare supplements are both ways you can enhance your Original Medicare coverage through private insurance companies. That’s where the similarities end. They are very different in their costs, coverage, and function.

You cannot enroll in both Medicare Advantage and Medicare supplement insurance. This is why it’s important to know the difference and make the best choice for you.

Medicare Advantage

Medicare Advantage completely replaces Original Medicare with more thorough coverage. It is still part of the Medicare program, but it is provided through private insurance companies, not the government. It includes all of your medical and hospital costs as well as additional benefits such as dental, vision and hearing. However, Medicare Advantage does not provide coverage for hospice care (while Original Medicare does).

Medicare Advantage insurance plans typically require a monthly premium payment, annual deductible, coinsurance, and copayments. To enroll in Medicare Advantage, you must first sign up for Original Medicare Part A and Part B and then switch during the Disenrollment Period.

Medicare Supplement Policies

Medicare Supplement insurance complements Original Medicare, it is not comprehensive medical coverage. It is often referred to as Medigap insurance, and is designed as a secondary insurance to your coinsurance, copayment, and deductible costs.

There are 10 standard plan types, and each one offers different benefits. Some may offer international insurance coverage, others may offer coverage specifically for blood transfusions, or specifically for skilled nursing facility care. Every Medigap plan covers up to one year of Medicare Part A coinsurance and hospital costs after Medicare benefits are used up.

While benefits are standardized across the ten plans, the costs are not, meaning they could fluctuate depending on the private insurance company offering the plan and the state you live in.

You can choose Medicare Supplement insurance or Medicare Advantage, but you can’t have both. This is why it’s important to research all of your options carefully before deciding which is the best option for your health needs and budget.

The best way to decide is to talk to a licensed Medicare insurance agent. The independent Medicare agents at Braden Insurance Agency are always available to give free, unbiased Medicare advice. Give us a call today to set up your Medicare consultation.

WHAT DOES A MEDICARE SUPPLEMENT PLAN COVER?

While all Medicare supplement plans provide an additional 365 days of hospital care during your lifetime, each of the 10 options is unique and cover a different aspect of your healthcare.

All supplemental plans provide coverage across the United States, regardless of the state you live or the state where you purchased the plan. However, only a specific international supplement will provide coverage outside of the United States.

The 10 options for supplemental plan coverage include the following:

1. Part A deductibles
2. Part B deductibles
3. Coinsurance and providers’ excess charges
4. Cost of blood transfusions
5. Cost of additional hospital days after you have used up your Part A benefits
6. Hospital and skilled nursing facility coinsurance
7. Some preventive care benefits
8. Foreign emergency medical benefits
9. Some drugs the provider must give you
10. Out-of-pocket limit

For a specific list of what each plan covers, read our article about Medicare Supplement Plans.

WHAT MEDICARE SUPPLEMENTS DON’T COVER

In general, Medicare Supplement insurance is a cost-sharing program, and does not provide additional medical conditions. It is designed to help you pay for the coverage provided by Medicare, not to add additional coverage. Medicare Supplement insurance does not cover any of the following:

• long term care (like nursing home care)
• routine vision
• dental care (unless incurred during hospitalization)
• hearing care
• hearing aids
• eyeglasses

HOW MUCH DO MEDICARE SUPPLEMENT PLANS COST?

Medicare Supplement insurance is offered through private companies. This means the costs can vary depending on your location within Louisville, KY and the company. Each of the Medigap Insurance plans will have a different monthly premium.

To give you a ballpark of what you could be paying monthly, here is a chart of the average monthly prices for each plan.

If you would like a more comprehensive price breakdown of each plans’ cost, schedule a Medicare supplement consultation with one of the independent agents at Braden Insurance Agency. We provide free, unbiased advice so you get the best plan for you.

WHEN CAN I SIGN UP FOR A MEDICARE SUPPLEMENT PLAN?

You can enroll in Medicare Supplement insurance during the Medicare Supplement Open Enrollment Period. This begins the first month that you are age 65 or older and enrolled in Medicare Part B. The Supplement Open Enrollment Period lasts for 6 months and guarantees your right to buy a plan during this time. The insurer cannot deny you coverage based on your medical history or current health if you apply during this period.

If you miss the open enrollment period, you may still apply for Medicare supplement insurance but if it’s outside of the Open Enrollment Period you could be denied coverage or charged a higher premium based on your health history.

WE ARE YOUR MEDICARE SUPPLEMENT INDEPENDENT AGENTS

We know deciding on a Medicare Supplement insurance policy can be daunting. Don’t let it scare you. The independent Medicare agents at Braden Insurance Agency in Louisville, KY represent several different insurance companies to ensure you understand your options and get the coverage you need. Some of these companies include…

• Humana
• Aetna
• United Healthcare
• Anthem
• Cigna
• and more!

Call us today to schedule a no-pressure consultation where you will get free, unbiased advice. We are here for you.

The post Medicare Supplement Insurance: Finding The Best Medigap Plan For You appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map/
https://www.bradeninsurance.com/info/

Medicare supplement plans are a great way to help fill in the gaps and supplement the costs of Original Medicare. Supplemental policies are not comprehensive medical insurance, but they can be invaluable at alleviating out of pocket expenses for aging adults. To help you understand your options, we are going to give an in-depth look at each Medicare supplement policy and what it covers.

COMPARING DIFFERENT MEDIGAP PLANS

There are ten standardized Medicare supplement plans, also known as Medigap policies. Not all policies are available in each state. However, Louisville, KY and throughout the state of Kentucky, all residents are fortunate to have access to all 10 plans.

Medicare Supplements are named with letters for simplicity purpose but have no correlation to the letter names of Original Medicare Part A and Part B, Medicare Advantage Part C, and Prescription Drug Coverage Part D. Here is the breakdown of each policy and how it works.

PLAN A

Plan A is not to be confused with Medicare Part A, the two have no correlation. Medigap Plan A has the fewest benefits out of the 10 Medigap plan options. Because Medigap is offered through private insurance companies, the cost can vary but Plan A tends to be the most affordable.

Plan A helps to cover the hospital costs and coinsurance for Original Medicare as well as the first 3 pints of blood if a transfusion is necessary.

PLAN B

Plan B is not to be confused with Medicare Part B, the two have no correlation. Plan B is only marginally more popular than Plan A and includes only one additional benefit: the payment of your Part A deductible. Other than that, Plan B is identical to Plan A.

PLAN C

Plan C is one of the mid-range Medicare Supplement plans that is marginally more popular than either Plan A or B. Plan C covers 8 out of the 9 available Medigap benefits. The only other Medigap plan option with more benefits is Plan F. The only Medigap benefit that Plan C does not include is coverage of Medicare Part B excess charges. Again, Plan C is not to be confused with Medicare Part C, the two have no correlation. Medigap Plan C covers the following:

• Medicare Part A coinsurance and hospital costs
• Medicare Part B coinsurance or copayment
• First 3 pints of blood
• Part A hospice care coinsurance or copayment
• Coinsurance for skilled nursing facility
• Medicare Part A deductible
• Medicare Part B deductible
• 80% of foreign travel emergency care

PLAN D

Medigap Plan D should not be confused with Medicare Part D, which is the prescription drug coverage option for Medicare beneficiaries. Plan D covers 7 of the 9 possible Medical benefits including everything Part C has with the exception of your Medicare Part B deductible.

PLAN F

Plan F is the most popular option available today and also covers the most Medicap benefits. It may also be one of the most expensive options, but has a high-deductible option that can lower your premiums. If you choose the high-deductible Policy F, you must meet a yearly deductible of $2,300 before it covers anything. Medigap Plan F covers all 9 of the available Medicare Supplement Insurance benefits which includes:

• Medicare Part A coinsurance and hospital costs
• Medicare Part B coinsurance or copayment
• First 3 pints of blood
• Part A hospice care coinsurance or copayment
• Coinsurance for skilled nursing facility
• Medicare Part A deductible
• Medicare Part B deductible
• Medicare Part B excess charges
• 80% of foreign travel emergency care

PLAN G

The only difference between Medigap Plan F and Plan G is the Medicare Part B Deductible. This is covered in Plan F, but is not covered in Plan G.

PLAN K

Plan K is a cost-sharing policy. That means that it reduces your costs, but doesn’t offer full coverage. For example, instead of covering the entire Medicare Part A deductible, it only pays 50%. Plan K does include an out-of-pocket limit, and if you hit that limit your Plan K will start paying 100% of covered costs. In 2019, the out-of-pocket limit was $5,560.

Plan K is not a very popular option because it requires more out of pocket costs than any other policy.

PLAN L

Medigap Plan L is also a cost-sharing policy, similar to Plan K – but works a little different. Plan L pays for 75% of covered services, and you pay the other 25%. The out-of-pocket maximum in Plan L is also much lower. In 2019, the out-of-pocket limit is $2,780 rather than $5,560 in Plan K.

PLAN M

This is one of the newer Medigap policies, introduced in 2010. It is a mid-range policy, similar to both Plan N and Plan D. It offers partial coverage for 7 out of 9 benefits including:

• Medicare Part A coinsurance and hospital costs
• Medicare Part B coinsurance or copayment
• First 3 pints of blood
• Part A hospice care coinsurance or copayment
• Coinsurance for skilled nursing facility
• 50% of Medicare Part A deductible
• 80% of foreign travel emergency care

PLAN N

Plan N was also introduced in 2010, alongside Plan M. Plan N is identical to Plan D, except for the Medicare Part B coinsurance coverage. Plan N is also subject to two copayment structures, requiring up to $50 for certain emergency room visits and up to $20 for physician office visits.

If your brain feels a little bit like alphabet soup, we understand. This is a lot of confusing information. Each of the Medicare Supplement plans is similar with just slight (but important) differences. To make things even easier, here is a chart that puts all of this side by side.

MEDICARE SUPPLEMENTS IN KENTUCKY: HOW DOES IT WORK?

The state of Kentucky offers all ten standardized Medicare supplement plans through private insurance companies like Humana, Aetna, United Healthcare, Anthem, and Cigna. Regardless of which private insurance company you purchase it from, Medicare Supplement plans with the same letter have the same coverage.

However, each insurance company can determine its own monthly premium. So costs may vary from plan to plan, even for the same benefits.

Your location can also affect your premiums. If you live in Louisville, KY in Jefferson County, you may pay more or less than someone who lives in LaGrange, KY in Oldham County for an identical Medicare Supplement plan.

With so many plans to choose from in Kentucky, it can be confusing or even frustrating to narrow down which policy is best for your needs and budget. That’s where the independent Medicare agents at Braden Insurance Agency come in. We know everything there is to know about Medicare supplement plans in Louisville, KY and throughout the state of Kentucky. So let us help find the best policy for your needs and budget. Schedule a free, unbiased consultation today.

CHOOSE FROM DIFFERENT MEDICARE SUPPLEMENT COMPANIES

Medicare supplement plans are offered by private Medicare insurance companies, not the government. However, each policy is standardized and the coverage is identical regardless of which company you purchase from.

Since Braden Insurance is an independent agency in Louisville, KY, they can offer Medicare supplement plans from any of the companies at the best price. We work with all the major players in Medicare Insurance including Humana, Aetna, United Healthcare, Anthem, Cigna and more.

The independent agents at Braden Insurance Agency are on standby to answer all of your questions. Call today to schedule your completely free and unbiased Medicare supplement plan consultation. We will help you find the right plan for you.

ENROLLMENT PERIOD WINDOW FOR MEDIGAP POLICIES

You are eligible to purchase a Medigap policy as soon as you are eligible for Medicare when you turn 65. Within the first six months, you have a guaranteed right to buy a Medicare supplement plan and cannot be refused for any reason.

If you miss the first six month window, you can apply later at any time but may be charged a higher rate or rejected based on your health history.

MEDIGAP POLICIES: YOU DON’T HAVE TO MAKE THE DECISION ALONE

During your free, no pressure, unbiased consultation at Braden Insurance, we cover all aspects of your Medicare needs including:

• We will discuss your coverage needs.
• Talk about what kinds of plans you can afford.
• Our agents will shop around at different companies for the Medigap plan you want at a price that fits your budget.
• Together, we will review different plans’ pricing structure so you understand how costs may change as you age.

Understanding Medicare supplement plans can be difficult and choosing the right one can be even worse. Our independent agents here to help you make sense of your options and guide you along the path to make the right decision.

When you are ready to purchase Medicare supplement plans, work with a company who truly cares. Braden Insurance Agency will make sure you get exactly what you need.

The post Medicare Supplement Plans: Compare Different Policies Side-By-Side appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map/
https://www.bradeninsurance.com/info/

As if figuring out which type of Medicare Plan wasn’t confusing enough, now you realize you need to make changes or swap plans. When can you do this?

Different types of Medicare plans have different open enrollment windows based on the specific characteristics of that plan and the needs of those eligible for that plan.

Don’t worry about trying to figure it out for yourself. The independent agents at Braden Insurance in Louisville, KY have the answers to when the Medicare Annual Enrollment Period is and everything you need to know surrounding it.

WHAT IS MEDICARE ANNUAL ENROLLMENT?

The Medicare Annual Enrollment Period, also referred to as AEP, is the time for those who are already enrolled in Medicare to make decisions regarding whether to join, switch, or drop Medicare plans. Some of the things you can do during this open window include:

• Drop Original Medicare and enroll in a Medicare Advantage plan
• Drop your Medicare Advantage plan and enroll in Original Medicare
• Change from one Medicare Advantage plan and enroll in a different Medicare Advantage Plan
• Change from one Prescription Drug Plan (PDP) to a different one

In addition to the Medicare Annual Enrollment Period, there are other enrollment windows that are specific to different Medicare plans and situations. These other open windows include:

• Initial Enrollment Period
• General Enrollment Period
• Medicare Open Enrollment Period or Annual Election Period
• Special Enrollment Period for the Working Aged and Working Disabled
• Medicare Advantage Disenrollment Period
• Medigap Open Enrollment Period

We will touch more on these open enrollment windows in the following sections.

Simply put, the Medicare Annual Enrollment Period is designed for individuals who are already enrolled in Medicare to make changes to their current policy. You will want to take advantage of the Medicare Annual Enrollment period to review, change, or adjust your Medicare plan.

WHEN DOES ANNUAL ENROLLMENT FOR MEDICARE START?

The Medicare Annual Enrollment Period is a six week window that lasts from October 15th through December 7th. Any changes or new policies will take effect January 1st of the following year.

The other annual open enrollment periods each have their own dates for eligible recipients to sign up and make changes. Here is a quick reference chart that has the type of enrollment period, when the period is, and when changes/enrollments will take effect.

CHANGES YOU CAN MAKE DURING THE MEDICARE ENROLLMENT PERIOD

Are you a Medicare recipient in Louisville, KY, but find that the plan and choices you previously made are not currently suiting your needs? Then during the Medicare Annual Enrollment Period is your opportunity to make changes to your current policy.

During the Medicare Annual Enrollment, or AEP, you can make any of the following changes, unless you qualify for an exception throughout the rest of the year:

You may add, drop or change your Medicare Part D prescription drug coverage

Medicare prescription drug plans can change the drugs it covers during the course of the year with 60 days notice to affected parties. While your plan will continue to cover the drug until the end of the calendar year, you might lose coverage in January.

You may add, drop or change Medicare Advantage plans (Part C)

During the Medicare Enrollment Enrollment period, you enroll in Medicare Advantage, make changes to your current plan, or sign up for a different plan. If you wish to disenroll and swap back to Original Medicare, you can do so during the Medicare Advantage Disenrollment Period. We will discuss this in a later section.

Switch from Original Medicare (Medicare Parts A and B) to a Medicare Advantage plan.

Or

Switch from a Medicare Advantage plan to Original Medicare

Original Medicare covers hospital and doctor visits including emergency and urgent care. Medicare Advantage is provided through an HMO or PPO. Medicare Advantage Plans cover vision, hearing, dental and general healthcare but require you to choose a primary care physician and use only doctors, hospitals, and other medical facilities that are part of that health plan’s provider network. Medicare will pay for your advantage plan up to a fixed amount, but it may require an additional co-payment, premium or out-of-pocket expense.

HOW TO PREPARE FOR THE MEDICARE ENROLLMENT PERIOD

As the Medicare Annual Enrollment Period draws near, it’s important to review your current Medicare plan options. You may consider the following questions to determine if you have the right coverage for your needs and budget.

1. Has your health status changed in any way that will require more, or fewer, health care services in the coming year? Do you foresee needing any procedures or surgeries in the coming year?

Anytime you have surgery, a procedure, or new diagnosis, your prescriptions and the services you might need may change. You should definitely take a careful look at your current plan to make sure that it covers everything you may possibly need in the coming year. If you are in good health and you don’t foresee any major changes, great! But it might be a good idea to ensure you have adequate coverage for the “just-in-case” scenarios.

2. Does your current plan cover all the services you use or did you have to pay for things that you’d like to have coverage for?

Talk to you insurance agent in Louisville, KY about the services that you use that are not covered and which plan would provide the best coverage for those services. If you think your plan fits your needs, you are probably good to stay where you are, but be sure to consider any services you might need in the future. Any changes can be made during the Medicare Annual Enrollment.

3. Does your current plan cover services that you don’t use or no longer need?

If you’re paying for services that you don’t need, you might consider changing to a plan that offers less coverage so that you aren’t paying for extra coverage that you are not using. Nobody wants to pay for things they don’t need so take a look at your current plan and evaluate whether it’s still the right one for you.

4. Are there changes being made to your current plan in the coming year, such as adding or deleting services or an increase in price?

Be sure you are educated about what changes are being made to your current Medicare plan. Review your prescriptions and your prescription coverage to see if any of your drugs are no longer covered in the coming year.

5. What were your out-of-pocket health care costs this year? Are you comfortable with your current plan premiums, deductibles, co-pays, and coinsurance? Would a plan with a higher or lower premium or deductible better meet your needs?

It is always a good idea to double check your budget, and run the numbers on your income and expenses in the coming year. Unexpected changes can always occur, but it is a good idea to be sure your budget can handle your Medicare costs. It’s important to have all this information worked out before the Medicare Annual Enrollment period happens.

WHAT HAPPENS IF YOU MISS THE MEDICARE ANNUAL ENROLLMENT DEADLINE?

You may be the most organized person in the world, but for some unforeseeable reason, the Medicare Annual Enrollment just flies past you. Many life events can cause you to miss the Medicare Annual Enrollment deadline.

• An unexpected trip
• Family emergency
• Death of a family member or friend
• Sudden work crisis

For most Medicare recipients, you will have to remain with your current plan and wait until the following year when the Medicare Annual Enrollment Period rolls around again. For some qualified Medicare individuals, there are other open enrollment periods in which you can add, drop, or make changes to your current plan.

Medicare Special Enrollment Period (SEP)

You can qualify for SEP if you experience one or more of the following situations:

• You moved outside of your current plan’s service area
• You moved to an area inside your current plan’s service area, but this area offers access to new plan options
• You moved back to the U.S. after living outside the country
• You just moved into or out of a skilled nursing facility or long-term care hospital
• You were just released from prison
• You were affected by natural disasters specified by the Centers for Medicare & Medicaid Services
• You left coverage from your employer
• You have a new opportunity for coverage through an employer or union
• Medicare has taken official action (“sanction”) against your current plan or terminates their contract with Medicare
• You are diagnosed with a chronic illness or condition that qualifies you for a Special Needs Plan (SNP) that serves Medicare beneficiaries with that specific condition

These different scenarios can have different lengths of enrollment periods, so it’s important to talk to an independent Medicare agent in Louisville, KY who can help you through the process.

5-Star Special Enrollment Period

Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to plans. Plans can receive a rating from 1 to 5. A 5-star rating is considered to be the top rating and is awarded a label of excellence. These ratings can help individuals compare different plans based on quality and performance. Each autumn, the ratings are re-evaluated and could change for the upcoming year.

This enrollment period lasts from December 8th, the day after AEO is over, through November 30th of the following year.

You can only switch to a 5-Star Medicare plan is one is available in your area. So talk to an agent at Braden Insurance to see if you can sign up for a 5-Star plan.

Medicare Supplement (Medigap) Enrollment

Medigap plans may have a separate enrollment period in some states. These open enrollments allow you to update or change your MediGap health coverage without medical underwriting. This option may change from state to state, so it’s important to understand the individual rules in your state in order to make a change outside of AEP by contacting an independent agent.

In Louisville, KY, the enrollment window is six months and starts the month you turn 65 and are enrolled in Medicare Part B.

Special Needs Plans (SNPs)

Medicare SNPs are a type of Medicare Advantage Plan for people with specific diseases or characteristics.

If you qualify for a SNP, you can enroll at any time, provided one is available in your area.

THE MEDICARE ADVANTAGE DISENROLLMENT PERIOD

The Medicare Advantage Disenrollment Period is commonly referred to as MADP. This is the time when those who are enrolled in the Medicare Advantage plan have the option to switch back to Original Medicare.

This period is only six weeks long and it runs from January 1st through February 14th. Depending on what you plan to do during this time, there are some important things to remember.

For those who want to swap from a Medicare Advantage Plan to Original Medicare:

This time period is designed specifically for those who want to switch from Medicare Advantage or Original Medicare. It is not designed for any other changes to your policy.

In order to disenroll during MADP, you must make a request. All requests are processed the first of the following month. Meaning, if you want to disenroll on January 1st, you must make a request by December 1st. If you make a request in January, you will still have time to disenroll on February 1st.

It’s important to note that this time is not an additional enrollment period, which means that you cannot enroll in Medicare Advantage or switch between Medicare Advantage options. However, if you are planning to disenroll from Medicare Advantage, you may use this opportunity to enroll in a Medicare Supplement policy upon returning to Original Medicare.

For those who want to make changes to Prescription Plans:

Although this is not an additional enrollment period, you can make the necessary changes to your prescription plan if you choose to disenroll from Medicare Advantage. Those enrolled in a Medicare Advantage Prescription Drug plan, also called MA-PD, may disenroll from MA-PD at this time as well.

This gives you the opportunity to enroll in a stand alone Prescription Drug Plan. However, those members with a MA-PD plan who choose to enroll in a stand alone Prescription Drug Plan during this time will not have the option of enrolling in another Medicare Advantage Plan.

All changes to your prescription plan must be complete by February 14th, so it’s important to talk to an independent Medicare agent in Louisville, KY so you don’t find yourself without coverage. If you currently have a stand alone Prescription Drug Plan, you cannot make changes to your plan during this time. Those changes can be made during the next open enrollment period.

BRADEN INSURANCE CAN GUIDE YOU THROUGH THE MEDICARE ENROLLMENT PERIOD

As the Medicare Annual Enrollment Period rolls around, it can be a stressful couple of weeks. When it comes to their Medicare coverage, not everyone knows exactly what that have, what they need, and what they don’t need. Having everything organized ahead of time will make you feel better about your decision when Medicare Annual Enrollment knocks on your door.

Regardless if you are a Medicare pro or have no clue what you are doing, then talking to one of our friendly independent agents at Braden Insurance in Louisville, KY can put your mind at ease. Give us a call today and we will get you prepared for your next Medicare Annual Enrollment window.

Our licensed, independent agents in Louisville, KY will do the shopping for you. We will compare plans from multiple insurance companies like Humana, Aetna, United Healthcare, Anthem, Cigna, and more. We will find the perfect Medicare plan for you.

The post Medicare Annual Enrollment Period: What You Need To Know To Get Started appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map/
https://www.bradeninsurance.com/info/

You may or may not have heard the term “Medicare Donut Hole,” but it is something that is important in understanding how Medicare coverage and Prescription Drug coverage works.

Our Louisville, KY agents are going to give you an easy to understand definition and some examples so you are better prepared when you enter the Medicare Donut Hole.

DONUT HOLE DEFINITION

The Medicare Donut Hole refers to the hole, or coverage gap, in Medicare Part D prescription benefits. This is one of the most controversial parts of the plan and of concern to many people who have joined a Part D drug plan.

Although all prescription drug plans must explain the coverage gap in their literature and advertising, it’s often a surprise to enrollees who didn’t read the fine print and find themselves going from making copayments to paying 100% of the cost. Yikes!

HOW THE DONUT HOLE WORKS

The Medicare Donut Hole begins after you and your drug plan have spent a certain amount for covered drugs. In 2019, once you and your plan have spent $3,820 on covered drugs, you’re in the coverage gap, or donut hole. Now here is where it gets tricky.

This amount is the total retail cost of the covered medications, not what you spend personally at the pharmacy. The total retail cost of prescription medications is calculated from your Medicare Part D plan’s negotiated retail drug price – and every Medicare Part D plan can have a different negotiated retail drug price. So it is possible that some may reach this amount before others with identical prescriptions.

Previously, enrollees had to bear the full cost of prescription drugs. In 2019, this changed to enrollees paying 25% on covered brand-name prescription medications and 37% of generic medications. These are your out-of-pocket expenditures.

Some of the cost of the drugs do not count as part of your out-of-pocket expenses. These include:

• What the drug plan pays toward the drug cost (5% of the price in 2019)
• What the drug plan pays toward the dispensing fee (75% of the fee in 2019)

HOW DO I GET OUT OF THE DONUT HOLE?

Once enrollees max out the $5,100 out-of-pocket requirement, the coverage gap ends and the drug plan pays most of the costs for the remainder of the year. From this point on, the Medicare Part D enrollees return to paying 25% of name brand drugs and 37% of generic drugs.

MEDICARE PART D COVERAGE GAP EXAMPLES

All of that information can be confusing. Here are some examples of two people needing different types of medications.

Here is an example of someone who needs brand name medications.

In 2019, Mrs. Anderson reaches the coverage gap in her Medicare drug plan. She goes to her Louisville, KY pharmacy to fill a prescription for a covered brand-name drug. The price for the drug is $60, and there’s a $2 dispensing fee that gets added to the cost. Mrs. Anderson pays 25% of the plan’s cost for the drug and dispensing fee ($62 x .25 = $15.50).

The amount Mrs. Anderson pays ($15.50) plus the manufacturer discount payment ($42.00) count as out-of-pocket spending. So, $57.50 counts as out-of-pocket spending and helps Mrs. Anderson get out of the coverage gap. The remaining $4.50, which is 5% of the drug cost and 75% of the dispensing fee paid by the drug plan, doesn’t count toward Mrs. Anderson’s out-of-pocket spending.

Here is an example of someone who needs generic medications.

In 2019, Mr. Evans reaches the Medicare Donut Hole in his drug plan. He goes to his pharmacy to fill a prescription for a covered generic drug. The price for the drug is $20, and there’s a $2 dispensing fee that gets added to the cost. Mr. Evans will pay 37% of the plan’s cost for the drug and dispensing fee ($22 x .37 = $8.14). The $8.14 he pays will be counted as out-of-pocket spending to help him get out of the coverage gap.

THE PRESCRIPTION DRUG COVERAGE GAP AND YOU

The Medicare Donut Hole is a major problem in the Medicare plan because many enrollees can’t afford to get through it. The U.S. Department of Health and Human Services estimates that more than a quarter of participants simply stop filling their prescribed drugs when they hit the donut hole.

There are enhanced plans that provide additional benefits to help with donut hole coverage, but everything comes at an additional cost.

For more information about how the Medicare Donut Hole could affect you, talk to a Medicare agent at Braden Insurance today.

Our licensed, independent agents in Louisville, KY will do the shopping for you. We will compare plans from multiple insurance companies like Humana, Aetna, United Healthcare, Anthem, Cigna, and more. We will find the perfect Medicare plan for you.

The post What Is the Medicare Donut Hole? appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map/
https://www.bradeninsurance.com/info/

Taking care of your health is a critical part of your overall well-being. Having the right health coverage in Louisville, KY, or Medicare insurance for those over 65, will help you get the medical attention you need to stay healthy and active.

If your current Medicare Advantage Plan is not meeting all of your needs or you have too much coverage for your current state of health, then it may be a smart decision to change your policy. This will ensure you have exactly what you need at a price you can afford.

WHAT IS AN ADVANTAGE PLAN?

A Medicare Advantage Plan (usually a HMO or PPO) is an additional choice you have as a Medicare health plan. Medicare Advantage (MA) Plans, also referred to as Medicare Part C Plans, are offered through private companies approved by Medicare.

A typical policy will provide the same coverage as Original Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most plans also include Medicare prescription drug coverage, also called Medicare Part D.

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each company can charge different out of pocket costs for their policies. They also can have different rules for how you get services (like whether you need a referral to see a specialist) and these rules can change from year to year.

REVIEWING YOUR ADVANTAGE PLAN

If you have a Medicare Advantage Plan, it’s important that you review your plan each year to ensure that the plan is still the right one for your health needs and budget. Some people discover that from year to year, their policy changes and will no longer fit their needs in the following year. Here are a few things to consider when reviewing your plan:

• Is your plan reducing its benefits or increasing its costs for the upcoming year?
• Will your doctor(s) and preferred hospital still accept your current plan in the following year?
• If your plan includes prescription drug coverage, will all your medications still be covered next year?
• Are you spending more than you anticipated on co-pays, deductibles, or premiums?
• Are you having trouble finding convenient doctors or specialists within your plan’s network?

MAKING CHANGES TO MEDICARE ADVANTAGE

If you’re not satisfied with the company providing your Medicare coverage, you are looking for a replacement for your current plan, or your current Medicare Advantage Plan is not being renewed you only have one opportunity each year to change your policy.

You have two opportunities to make changes to your Advantage Plan:

1. Medicare Annual Enrollment Period – AEP

This opportunity lasts from October 15th through December 7th. During this period you can add, drop, or change your Medicare Advantage Plan (Part C). Or you can choose to disenroll from an Advantage Plan and enroll in Original Medicare (Part A and Part B). Any changes you make will take effect January 1st of the following year.

2. Medicare Advantage Open Enrollment Period – MA OEP

You can switch from your Medicare Advantage Plan to another Medicare Advantage Plan, or to Original Medicare with or without a stand-alone prescription drug plan during this period. The MA OEP occurs each year from January 1 through March 31. Changes made during this period take effect the first of the month following the month you enroll. For example, if you switch to a new Medicare Advantage Plan in January, your new coverage begins February 1st.

If you have questions about your current plan, would like to explore your other options, or just want to make sure you have the best plan, call our office and speak to one of our independent Medicare agents. We can help you compare plans and make an informed decision about your Medicare coverage to make sure you get the best coverage for you.

WE ARE YOUR MEDICARE ADVANTAGE EXPERTS

Our licensed, independent agents in Louisville, KY will do the policy shopping for you. We will compare plans from multiple insurance companies like Humana, Aetna, United Healthcare, Anthem, Cigna, and more. We will find the perfect policy for you.

You have limited opportunities to make changes to your Medicare Advantage Plan, so don’t wait! Call us today to schedule your free Medicare consultation.

The post Changing Your Medicare Advantage Plan appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map/
https://www.bradeninsurance.com/info/

Original Medicare, Medicare Advantage, and the maze of alphabet options can be hard for anyone to understand. It is difficult to get a clear comparison of what benefits each has to offer with the costs associated.

Our Louisville, KY agents will help you focus on choosing between Original Medicare and Medicare Advantage based on six areas: premiums, prescription costs, extra benefits, overall plan costs, co-pays and access to doctors and hospitals.

1. Premiums

Your premium is how much you pay in order for the plan to cover you – this does not include how much you will pay for your care or prescriptions.

Original Medicare:

Most people don’t pay a Original Part A premium because they paid Medicare taxes while working. If you don’t get premium-free Part A, you pay up to $437 each month

The standard Part B premium amount in 2019 is $135.50 or higher depending on your income.

Medicare Advantage:

Since Advantage plans come from private insurance companies, the cost can vary from company to company. In most states, there are Advantage plans that cover drugs at no additional cost, but it requires you to pay the Part B premiums.

2. Drug Costs

The drug cost entails how much you can expect to pay for your actual prescription when you go to the pharmacy.

Separate but Equal: Both Original Medicare and Medicare Advantage are similar in the out-of-pocket costs associated with prescription drugs. With Original Medicare, you can add Medicare Part D prescription drug coverage to your plan and many Medicare Advantage plans come with drug coverage. The 2019 Part D National Base Beneficiary Premium is $33.19

After any necessary deductible, you are responsible only for a co-pay, which varies from plan to plan.

3. Extra Drug Benefits

There are a variety of extra benefits available in Original and Advantage plans that are worth asking about with your specific representative.

Other types of extra drug benefits might be plans who cover some of the costs of generic or brand name drugs in the coverage gap or a plan might cover “excluded” drugs that Medicare drug coverage normally would not pay for.

For example, some plans might offer a coverage gap, which means you will pay a percentage of the costs of your drugs. In 2019, enrollees pay 25% for name brand drugs and 37% for generic drugs.

4. Overall Plan Costs

In addition to the cost of drugs, you should also think about how much the plan you choose will cost overall.

Original Medicare:

Original Plans has no premium for Part A, but Part B does have a minimal premium cost, as mentioned in the first section.

Medicare Advantage:

Advantage Plans often include a premium for health care coverage, on top of your Part B premium. To figure out your overall costs, you need to include premiums, deductibles, and copays included in your plan.

5. Copayments

Copayments are what you will be required to pay for medical services at a doctor’s office or hospital.

Original Medicare:

For doctor visits and other medical services, you pay 20% of the approved charge after you meet your annual deductible.

Medicare Advantage:

Medicare Advantage plans have lower co-pays for visits to doctors in their network. However, there is a higher co-pay for doctors outside of the network.

6. Access to Doctors and Hospitals

Your access to doctors and hospital may vary from plan to plan. It is important to understand how much choice you have about which doctors and hospitals you use based on your Medicare policy coverage.

Original Medicare:

You have the ability to choose your doctors and hospitals.

Medicare Advantage:

You choose your doctors from a network of available options. If you use a doctor who is not in your network, you may have to pay more out of your pocket.

KNOW YOUR OPTIONS BEFORE YOU MAKE A DECISION

Deciding between Original Medicare and Medicare Advantage can be a stressful decision. With so many options and prices, it’s important to know exactly what you need.

Our licensed, independent agents in Louisville, KY will do the shopping for you. We will compare plans from multiple insurance companies like Humana, Aetna, United Healthcare, Anthem, Cigna, and more. We will find the perfect Original Medicare or Medicare Advantage plan for you.

Talking with an independent agent at Braden Insurance can get you on the right track. With our free, unbiased consultations, you will help you make the best decision for you and your pocketbook.

The post Original Medicare vs Medicare Advantage: Which Is The Best Plan For You appeared first on Bradeninsurance.com

Braden Insurance Agency Inc.
3069 Breckenridge Ln
Louisville, KY 40220
502-454-9191
https://www.bradeninsurance.com/map
https://www.bradeninsurance.com/info