Just the thought of trying to choose a Medicare supplement plan can give you a headache and feeling of dread. Plan A in the Medicare group has the fewest benefits and is the least expensive and Plan J has the most benefits and is the most expensive. Somewhere in between, you should be able to find a plan that’s right for you.

The best way to look for a plan is to go to www.medicare.gov, the official government website for Medicare and peruse the wealth of information available to find out about eligibility, what you get with basic Medicare coverage and the types of plans that you’ve got to choose from. The site also offers a telephone number if you want to talk to a representative about which plan is right for you.

Medicare supplement plans are only available for one person, not a family or husband and wife. Try to find a plan during the first six months after you enroll in Medicare, Part B. Insurers have to accept you into their plan during that time even though you may have had preexisting conditions. After the six month time period, policies could cost more.

You should know that Medicare Supplemental plans which charge higher premiums don’t get you any more coverage than you’d get for the same plan with a lower premium – and, procedures for filing claims are exactly the same. Medicare’s Medigap plans increases the amount of health insurance if you’re eligible and have enrolled in Part A and B. Also, Medicare’s Medigap plans usually increase every year on January 1st, the same time that benefits are adjusted.

Along with the raises to Medicare plan premiums each year, you should know that Medicare also adjusts rates for “attained age.” So, between about 80 and 90 years old, the premiums are at their highest – just when they’re least affordable. Medigap policies are also adjusted according to others in your geographic area, so that everyone is paying the same premium.

You can purchase an issue-age or community-rated Medigap policy that charges the lowest premium. It may be a bit more expensive at first, but your premiums aren’t raised every year as you age. Medigap policies are provided by companies like Blue Cross, Blue Shield and Humana and offers extra coverage that might help healthcare deficiencies offered under the Original Medicare, Part A and B.

Some questions you should ask before you sign up for a Medicare Supplement plan are what the coverage is on the services you know you’ll need, how does the supplement work with other health care coverage you might have – such as from an employer — and how much you’ll pay out of pocket for hospital stays and doctors’ visits. Other questions might concern drugs and prescriptions you’ll need and whether or not you’ll be covered elsewhere if you travel a great deal.

Medicare and Medigap sounds complicated and can be confusing, but one of the professional health insurance representatives at Medicare can work with you and help you to find the best possible policy and premium for you.

You may not be aware of the differences between Medicare Supplements and Medicare Advantage, and you certainly would not be alone if you didn’t.  These differences are important though, and you need to understand so that you can make the best possible choice for yourself.

Yuma Insurance can help you find the answers to all your health insurance questions.

Medicare Supplement Plans

Medicare Supplement plans are also known as “Medigap” plans due to the fact that they fill in and cover “gaps” in coverage that Original Medicare may not cover.  There are 12 different plans that range from A to L and they all provide a different amount of help and coverage.

These Supplement plans are provided by private health insurance companies, so they do not usually have a monthly premium and they vary in pricing by coverage, zip code and age in much the same way that other health insurance does.  The majority of these Supplement plans are also subject to yearly price increases, so while you may purchase the policy at one price, it may very well go up as the years go by.

Keep in mind that, while there are guaranteed enrollment periods, there may be other times or circumstances where a person may still be subject to normal health insurance underwriting, just like any other individual policy.  Be sure you understand how this may affect you before you drop another plan for a Supplement plan.

It is important for you to remember that when you are insured, you will still use your government issued card as well as the ID card issued by the insurer.  These two parts are meant to work together in order to provide the desired health coverage.

Medicare Advantage

Medicare Advantage plans vary in that they actually take over the health coverage for a person.  The member only needs to use their Medicare Advantage (MA) plan card to verify coverage.  There are different types of these plans as well, and they are provided by private insurance companies, too.

There are PPO, HMO or Fee For Service plans depending on what is available in your particular zip code and what you are looking for.  There are plans that come bundled with Part D (Prescription) coverage, some plans that require an additional premium and some plans that rebate part of the Part B premium that most Medicare beneficiaries have debited from their social security checks.  Many of these Medicare Advantage plans were shut down in 2009, so understand how these plans will serve you going forward.

There is no ‘one’ right plan for everyone and you will need to do some research to find the best fit for you.  Many seniors are more than happy with the flexibility of their Medicare Supplement (Medigap) plan, while others feel better with an MA.  Your budget will also play a role in your decision, so you will need to know what your budget is from the beginning.

While Original Medicare is supplied to help with basic medical care…it only helps with basic medical care.  Meaning that, when you really need medical attention, Medicare will only cover a small portion of what you could be charged for.

That’s where the Medicare Supplement plans come in.  They fill in the gaps that are left over from Medicare and help to cover you in times of need.  Original Medicare does provide coverage for mostly serious occurrences, but, more often than not, there are wide open areas between the coverage Medicare provides and the health care services charged to most patients.  When this happens, that difference comes out of your (the patient) pocket.

Medicare insurance is divided into two main categories: Medicare Part A and Medicare Part B.  There are gaps in coverage for each category.

Medicare Part A mainly covers inpatient hospital costs, inpatient nursing facilities, home health care and hospice services.  There are gaps in this coverage regarding hospital deductibles, coinsurance payment and hospital stays over 150 days, nursing facility coinsurance payments and stays over 100 days, as well as particular home health aide services.  These gaps can certainly affect you when you need it the most and add up to many out of pocket expenses that could change your savings balance in an undesirable way.

Medicare Part B is provided for outpatient and physician services, medical equipment, prosthetic devices and ambulance transportation.  Gaps that can be seen in Part B coverage relate to the annual deductible, the 20% coinsurance charge and fees that can result when the doctors charge more than Medicare actually covers for services.

This is where the Medicare Supplemental plans can really come in handy and help in times of needed medical care over long periods of time or in times of serious medical emergencies.  Without the added coverage, many people find that the endless, serious medical bills that can result from an unexpected illness or accident cause serious financial strain and can change their quality of life for years to come.  Of course, you never expect that you will really need this Supplemental coverage, but not being prepared could cost you more than you think.

As with all insurance, it’s hard to be over-prepared for a disaster.  It is recommended that Medicare recipients purchase Supplement plans to help avert the financial repercussions of a true emergency.  If you are a senior who is a Medicare beneficiary, you are guaranteed by law to be insured by Medicare Supplemental policies of your choice.

Seniors also cannot be made to prove insurability, meaning that you do not have to pass a physical exam in order to identify pre-existing conditions.  Medicare Supplement plans are the smart choice for those seniors that want to cover their bases, have peace of mind and know that, in times of need, they have more than the standard Medicare coverage and will be taken care of during and after a medical emergency, no matter what.

Steve Meinhardt – Yuma Health Insurance Expert

Medicare Supplement plans are a kind of private health insurance policy that is designed to fill in the gaps that are left in the Original Medicare plan coverage.  These plans work similarly to coinsurance and deductibles, although some plans cover costs that are not at all addressed by the Original Medicare plan.

Because the Supplemental plans cover the gaps between the Original coverage and the actual cost payable, they are known as “Medigap” policies.  You should keep in mind that in order to purchase and be covered by a Supplemental plan, you must first have signed up for the Original Medicare plan Part A and Part B.  Medicare Supplement plans (Medigap) cannot be sold independently.

These Medicare Supplement plans are privately administered health insurance plans and only private insurance companies may sell them.  No government organization can sell them.  While only private insurance companies can sell them, they are also required to provide the exact same benefits under each plan type.  There are 12 plan types, labeled A through L.  They all have their individual and separate coverage, but the plans under the same plan letter must, by law, provide the same benefits no matter which carrier is offering them.  This means that, it does not matter which insurance carrier you choose to deal with – each Supplement plan type (designated by its letter) will provide the same benefits and coverage to you, nothing more and nothing less.

It can be confusing to know which insurance carrier to select, as well as be confusing to know which Medicare Supplement plan will suit your needs best.  Because of the complexity of this decision, it can be a great idea to meet with an insurance broker who can help you to compare and contrast the different insurance companies as well as go over what each Supplement plan entails.  An insurance broker can also help you sort out the varying pricing and value added benefits in choosing different companies.

That’s right, although the law requires that the insurance companies all offer the same basic coverage inside each of the 12 Supplement plans, they are not required to offer the same pricing.  You will also want to be aware of the insurance company’s policies and value added benefits, such as locations and customer service.

Be sure to ask your Yuma Insurance Agent about the extra benefits provided by plans B through J.  Some of the plans can save you quite a bit of money in terms of the premium or in terms of the deductible.  Ask plenty of questions so that you understand how to get the most cost effective plan to suit your needs.

You may also know catastrophic health insurance as High Deductible Health Plans (HDHP), but do you know what they cover and who are good candidates for this kind of health insurance?

If you answered, “No” you are not alone.

High deductible health insurance plans were created to lower the overall medical costs to an individual by providing a lower monthly premium in exchange for a higher yearly deductible.

High Deductible Health Plans

When you have a high deductible plan, you are required to pay out of your own pocket for just about all of your medical bills until the total of your payments reaches the amount of the yearly deductible.

Once that has been reached, the catastrophic health plan will then cover most medical expenses, although it may be necessary for you to pay co-insurance until you reach the total out of pocket maximum.

You will want to check and see if your plan is eligible for a Health Savings Account (HSA), as then you can use the HSA funds to pay towards the deductible as well as out of pocket expenses. If you do not have a HSA, then you should still put aside funds each month for future medical bills that may come up.

HDHP’s can also have a high lifetime maximum benefit payment limit or “cap.” This is normally between $1 million and $5 million and should you reach the cap, the health insurance company will not pay for any additional medical expenses and the policy will be canceled.

Getting Catastrophic Health Insurance

You can get high deductible health insurance by purchasing an individual plan or a group plan. There are particular pre-existing health conditions (like diabetes or mental health disorders) that may disqualify you for this kind of health plan.

If you are applying for coverage under a group plan, then they are subject to HIPPA regulations and cannot deny you enrollment or coverage, but you may have to wait for coverage of pre-existing conditions. This depends on the prior health insurance coverage, so be sure to ask questions and that you understand what will be covered or not.

Catastrophic Health Insurance Considerations

Please realize that the reason the premiums are lower with this kind of coverage is because the health insurance company knows that, when you need medical care, you will be paying a larger portion of your costs. You will need to pay out-of-pocket for the majority of medical expenses before you reach your annual deductible.

If your main attraction to high deductible health insurance is the money you will save, you will need to consider the higher (and sometimes much higher) fees you will have to pay before the insurance coverage begins. You will need to weigh this possibility against your monthly savings.

If you are sure that you can cover the deductible and would like to save monthly on the premiums, then this could be a plan that would work very well for you.

Of course, if you have a HSA, then you can use that to pay for out-of-pocket medical expenses while still saving on the premium.

Catastrophic health insurance is best for those who are young and healthy or for those (possibly older) individuals who have enough money to pay for medical care until a serious illness or emergency comes up.

Really, the high deductible plans are best for those who do not have frequent doctor visits or need regular prescriptions.

Yuma Insurance – Steve Meinhardt – Health Insurance Expert

Talk about Health Insurance and Yuma Health Insurance options is all over town. We are all looking for a way to save money on our health insurance and health care costs.

There are ways to claim deductions for health insurance when you file your taxes. Currently there are a few significant tax deductions for people who are covered by an individual health insurance policy.

Flex Spending Accounts and Health Savings Accounts

Flex Spending Accounts and Health Savings Accounts allows an individual to deposit earnings before taxes into an account and then make a draw on the money for medical related issues. The tax savings happens because you are reducing your income before taxes come out of your check.

Other tax deductible benefits may include the “extras” on your Yuma health insurance policy.  These extras may include dental coverage, life insurance and even prescriptions. These are tax deductible because the rates come out of pre-tax dollars, thus reducing your taxable income and possibly putting you in a lower bracket.

Unlike pensions and stock options, medical expenses, with few exceptions, do not count towards your taxable income as benefits. Make sure you speak with your tax professional in order to decide which route is the best to take to get the maximum deductions possible.

Self Employed Health Insurance

Those individuals who are self-employed can take advantage of a tax break.  Self-employed persons should look into the deduction available for their Yuma health insurance premiums before filing another tax return. This may be available to self-employed individuals who do not itemize their deductions as well as those who do.

Income Percentage

People who itemize their expenses may deduct all of their medical expenses, including premiums paid, up to a certain percentage of total income threshold. This deduction works well for people who are paying for medical expenses and insurance premiums with after-tax income.

Health Coverage Tax Credit

The Health Coverage Tax Credit is a refundable tax credit, granted to those people eligible for Trade Adjustment Assistance.

This tax credit is issued in order to purchase certain types of insurance.

The HCTC is a federal program, which allows individuals to pay only around 20% of an individual policy’s rates for themselves and their families.

The types of insurance allowed are COBRA (Consolidated Omnibus Budget Reconciliation Act), state-qualified health plans, spousal coverage through a spouse’s current group health insurance plan, non-group/individual health plans, VEBA (Voluntary Employees’ Beneficiary Association) and in some instances, ATAA and RTAA Recipients.

Yuma Insurance – Steve Meinhardt

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) happens to be a law that can directly affect those looking for personal health insurance (Yuma Insurance) – and that have a pre-existing condition.

If this sounds like you, or a member of your family, then you need to be aware of the laws and your legal rights within them.  Having this information can help you to select the right coverage and keep your family safe.

Before this law was passed, if a person had to change jobs, they were often refused coverage under the new employer’s health insurance if there was a pre-existing condition present.  The new insurance company did not want to take on the liability and would deny coverage to the individual.  With only their bottom line in mind, they sought to protect their assets only, and would leave the family vulnerable.

Under HIPAA

With the passage of HIPAA, insurance companies now are required to honor prior coverage for individuals who did not have a lapse in coverage.  It also protects families by limiting the exclusions for pre-existing medical conditions and provides a process that allows individuals to enroll for health coverage when they lose other health coverage, get married or need to add a new dependent.

HIPAA also prohibits discrimination in enrollment and premiums charged by insurance companies based on health status-related factors.  The law also guarantees availability of coverage for small employers and preserves the states’ role in regulating health insurance.

Preexisting Condition Exclusions

As a definition for “Pre-existing condition” the law states that it is, “one for which medical advice, diagnosis, care or treatment was recommended or received during the 6-month period prior to an individual’s enrollment date (which is the earlier of the first day of health coverage or the first day of any waiting period for coverage)*.”

For group health plans, the issuer cannot exclude the individual’s pre-existing condition for more than 12 months after the enrollment date and the new employer’s plan has to give individuals “credit for the length of time they had prior continuous health coverage, without a break in coverage of 63 days or more, thereby reducing or eliminating the 12-month exclusion period (18 months for late enrollees)*.”

There are also special enrollment rights that are for individuals who have lost coverage due to particular situations, such as: separation, divorce, death, termination of employment or a reduction in hours.  These special rights are provided if the employer contributions toward the coverage are terminated, and are extended to those who need to add dependents because of marriage, birth, adoption or placement for adoption.

Perhaps the most important part of the Act is that it has stopped the discrimination by insurance companies.  It does not allow exclusion from coverage, a denial of benefits or the charging of more money for coverage by the plan or issuer based on health status-related factors.

The HIPAA laws are worth knowing and will supply you with the information you will need when it comes to questioning health insurance companies about their HIPAA policies.

Before you begin your search for any individual health insurance coverage, be sure to study up on the HIPAA laws so that you are aware of the questions to ask and to make sure your personal information will be safe.

http://www.dol.gov/ebsa/newsroom/fshipaa.html

There are, unfortunately, some misconceptions regarding COBRA and its rules.  To begin with, COBRA is not a type of health insurance, but a law regarding health insurance coverage.  COBRA health insurance, then, is addressing the rules regarding the health insurance coverage under your (previous) employer.

When you have been laid off or leave your current employment, you may be eligible for continued coverage under the COBRA rules.  The rules state that the company is required to offer you the option to pay for the extension of your health insurance for at least 18 months.  COBRA is an acronym that stands for Consolidated Omnibus Budget Reconciliation Act, and was put into law in 1986.

If you are laid off, your employer has to let you know in writing about your rights under COBRA.  This includes the fact that you have 60 days from the notice date or the date your insurance ended to sign up for the coverage.  The one exception is if the company you worked for went out of business or bankrupt – in that case COBRA is not be available to you.

Signing up for a COBRA health insurance extension means that you will have similar health insurance and the same basic health plan benefits that you enjoyed during your employment.  The downside is that you will have to pay the entire health insurance premium that you previously only paid a portion of.  Before, your employer paid the majority (in most cases) of that monthly fee.  Now you will be responsible for the entire monthly premium and it can be very expensive.

Depending on your particular situation, you may not be able to afford the monthly premium as it can end up being 60-70% of your monthly unemployment check.  There are many workers that have been laid off that cannot take advantage of COBRA health insurance coverage extension because of the cost.

If this happens to be the case for you, there might be other health insurance options that you can utilize for you and your family.  As an example, if you and your family are healthy, then you should be able to find a high deductible health plan.  The good news is that you have 60 days to make a decision about taking the COBRA health insurance extension, so you have a little time to do some research online or make an appointment with your insurance broker to learn about options.

You can get more information regarding COBRA health insurance rules and regulation from the U.S. Department of Labor website or by calling 866-444-3272.  There is a FAQ page there that lists the latest update and has plenty of helpful information regarding COBRA.

Yuma Insurance – Steve Meinhardt

Options for Health Coverage at College

Whether you are just heading off to college or are there already, you should know that going without student health insurance coverage is not really an option.  If something should happen, such as an illness or an injury, what will you do?  It’s always better to be prepared and plan ahead than have to react on the spur of the moment.  After all, large medical bills could cause havoc on your carefully laid out plans for college and after.  Don’t get caught unaware; know your options for health coverage.

To begin, know that if you are currently on your parent’s health insurance that is a great place to be.  If it is possible, stay on their insurance as long as you can.  Recent legislation has made it possible for students to stay on parent’s or guardian’s health insurance up to the age of 26 unless you are also eligible for employer health coverage.

Depending on whether your parent’s coverage is a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO), there may be limitations on the coverage for you.  For one, full coverage might only be available within a certain radius or through certain providers.  In order to get the lowest copayments and coinsurance, you might need to receive treatment in your home town.  Be sure to ask questions about what your coverage is and any limitations or special circumstances that could affect you at school.  Usually, though, medical emergencies are required to be covered from any provider in any facility (think “emergency room”).

COBRA may be an option for your student health insurance if you recently left a job that had provided health insurance.  COBRA allows you to stay on the same plan for 18 months, but you have to pay the full premiums.

If you happen to be over 26 and are still in college, then you may lose the health insurance that your parent’s were providing you with.  In some cases, you may be eligible for COBRA continuation coverage although the time period could vary.  Check with your parent’s insurance agent or with the benefits manager where they work to see if you are eligible.

Another great option is to get student health insurance from the college itself.  There are many that offer low-cost health plans and it’s worth asking in the admissions office to see if your school does, and if so, what kinds of coverage they offer.

There is a good possibility that they offer several types of student health insurance policies that could range from simple accident policies to larger ones that cover major medical needs.  If they have it, the best choice would be a comprehensive medical policy that covers visits to a student health clinic, specialists, diagnostic testing and medically necessary procedures.

If all else fails, you will probably need to buy an individual health insurance policy, see if you qualify for coverage through Medicaid or find a community health center that provide care to those without health insurance and have sliding fee scales based on income.  There are plenty of options for you to get some kind of student health insurance, so explore all the options to find the best one for you and your needs.

Yuma Insurance Health – Steve Meinhardt – Agent

Many times there are circumstances that make finding low cost health insurance plans necessary.  Changing jobs, graduating college or needing to supplement existing coverage all make it necessary to try and find the best health coverage at the lowest price possible.  When it comes to your health, finding the right plan can make a big difference.

When changing jobs, you can take a look at short-term health insurance policies to fill the time between employer sponsored coverage.  These are often also referred to as gap or temporary insurance and are designed to provide varying levels of coverage for specified periods of time.

These kinds of low cost Yuma health insurance plans can be very helpful in covering certain kinds of care, but often do have limitations that you will need to be aware of.  Make sure you understand exactly what is covered, and what is not.

If your circumstances have changed dramatically and you are no longer able to afford health insurance, you may be eligible for local, state or federal programs.  Start your investigation at the Foundation for Health Coverage Education, which is a not-for-profit organization that provides tools to assist you in finding low cost health insurance or alternative options in your state.  They have an Uninsured Hot Line at 800-234-1317 where you can speak to a live operator 24 hours per day and 7 days a week.

Other resources for low cost health insurance plans or free care are:

State-sponsored High Risk Pools – check with your state’s insurance department or consumer services for more information.

Community Health Centers – these are regulated by the federal government and provide care to those without health insurance have sliding fee scales based on income.

Free Clinics – are often staffed by volunteer physicians and nurses and also depend on donations from the community to run.

Yuma Health Insurance Plan Options

Call Steve Meinhardt for Yuma health insurance plan options – 928-217-3621

More than anything else, make sure that you are taking care of yourself.

Losing your job and having to investigate low cost health insurance can be stressful and frustrating.

Taking control of the situation can be helpful but you don’t have to do everything by yourself.

Ask friends and family for support, find local support groups for those who have been laid-off or talk to your doctor about your health insurance situation.  He or she might have ideas about cost saving measures for you.