Medicare drug plan changes?
Medicare drug plans in 2012 are generally like any other year with the exception of the varying costs on certain plans. Regardless, there are two ways to get Medicare prescription drug coverage:
Medicare prescription drug plans (sometimes called “PDPs”) and Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage.
The Medicare PDPs add drug coverage to Original Medicare, some Medicare cost plans, some Medicare private fee-for-service (PFFS) plans, and Medicare medical savings account (MSA) plans.
In those Medicare Advantage plans and other Medicare health plans that cover prescription drugs, all of Parts A and B are covered, along with prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” Enrollment in Parts A and B are required to join a Medicare Advantage Plan.
Some Medicare changes
Some of the changes for the Medicare drug plans in 2012 involve an earlier enrollment period from October 15 to December 7, 2011 as well as various cost differences. For instance, the coverage gap will be $4,700 instead of $4,550 from the previous year.
The actual drug plan costs will vary depending on the following: the consumer’s prescriptions and whether they are on the plan’s formulary (drug list), the plan chosen, whether the consumer’s pharmacy is in the plan’s network, and whether Extra Help is received paying any of the Part D costs.
What is Medicare part F
Medicare part F is one of the many Medigap plans that cover any costs not paid by Medicare parts A and B, like any copayments, coinsurance, or deductibles. Here, it’s possible to sign up for both Medicare and a Medigap policy since both parts will contribute their responsibilities in paying their shares of any Medicare-approved costs.
Every Medigap policy must follow federal and state laws designed to protect their consumers, and the policy must be clearly identified as “Medicare Supplement Insurance.”
Medicare part F policy benefits
Medicare part F is one of those Medigap policies that offers several benefits and the only one that offers all of them. They include the following:
- Co-insurance for hospital costs of Medicare Part A and an extra 365 days after Medicare benefits are exhausted.
- Co-insurance coverage for Medicare Part A & B
- Co-payments for Medicare Part B coverage (coinsurance) not including preventative care services.
- The first 3 pints of blood.
- Coinsurance for approved skilled nursing facilities.
- Excess charges for Medicare Part B.
- Foreign Travel Emergency coverage.
- Medicare Part A hospice care copays and coinsurance.
- Medicare insurance preventative care co-payments (coinsurance) coverage
This plan also offers a high deductible option in the amount of $2,000 before the Medigap plan starts covering costs.
Choosing Medigap or Medicare advantage
There are plenty of things to consider when comparing Medigap and Medicare Advantage plans. Choosing the best plan relies on many factors including the costs (e.g. premiums, copayment, coinsurance, and out-of-pocket fees), eligibility, and provider choice and availability.
It also depends on whether the plan covers prescription drugs, if it’s renewable, any extras that come along with the plan, and whom it’s best for.
Generally, both are offered by private insurance companies, and both help to cover the gaps of regular Medicare. On the contrary, Medigap plans are offered as an addition to the regular Medicare benefits while Medicare Advantage is a separate entity from Medicare altogether. In fact, a purchase for a Medicare Advantage plan results in de-enrollment from Medicare.
The benefits of Medigap
The benefits of Medigap plans are standardized by the federal government, meaning that plans sold by different insurance companies all offer the same benefits. Also, they offer services from a large network of doctors and caregivers. However, Medigap always require an additional monthly premium, unlike some Medicare Advantage plans which may require no monthly premium at all.
For Medigap, prescription drug coverage is not included. In order to receive Rx coverage, any stand-alone (PDP) plan may be available. Also, Medigap only covers the same as Original Medicare with no routine dental, vision, physicals, or any alternative medicine.
What is Secure horizons and Medicare Direct?
Secure Horizons and Medicare direct is a company owned by UnitedHealth Group designed to assist patients with varying Medicare plans like Medicare Direct. While other private insurance companies only offer Medicare supplements, Secure Horizons has a contract with the government that allows them to actually offer Medicare based health plans.
In particular, they handle patients who make efficient usage of Medicare parts A and B by giving them different types of Medicare Advantage plans including Medicare Complete, Medicare Direct, Medicare Complete Choice, and Medicare Complete Special Needs.
What is Medicare direct?
Medicare Direct plans are based on the concept of private fee for service and work like AARP Medicare plans. Simply put, contracted doctors will have a different fee scale and level that they will charge patients on this type of coverage. Also, members can receive care from any Medicare approved provider that accepts the plan’s payment terms and conditions.
No network or referral from a doctor or hospital is required and it’s possible to purchase a stand-alone Part D drug plan (even from another company). On the other hand, finding a provider who will accept the plan will present a challenge. Also, providers have the choice to accept the plan on a visit-by-visit basis. A premium for Part D coverage must be paid as none are provided in Medicare Direct Plans.
What is Medicare part D?
Medicare part D, also known as Medicare Prescription Drug Coverage, simply covers all purchased prescription drugs. Two ways to sign up for this includes enrolling for Medicare Prescription Drug Plans (PDPs) alongside Original Medicare (parts A and B) or signing up for a Medicare Advantage plan or any other Medicare health plans that cover prescription drugs.
Medicare PDPs generally add drug coverage to Original Medicare, some Medicare cost plans, some Medicare private fee-for-service (PFFS) plans, and Medicare medical savings account (MSA) plans. Most Medicare Advantage plans include prescription drug coverage with complete coverage of parts A and B; in order to receive an MA plan, enrollment in parts A and B are required.
What is the cost of Medicare part D?
In Medicare drug coverage, certain payments are to be made throughout the year. They include a monthly premium, a yearly deductible, copayments or coinsurance, and those in the coverage gap. The monthly premium for the drug plan goes along with that of Medicare part B; a Medicare Advantage plan or any cost plan the cover prescription drugs may cover a set amount of that premium.
The yearly deductible is the amount to be paid each year for all prescriptions before the Medicare drug plan begins to pay its share of those covered drugs, which varies between drug plans; some of them may not even carry such a deductible.
What is medicare billing software?
Medicare billing software helps providers manage financial information and reduces errors on claims submitted to Medicare and many other insurance companies.
Medicare billing software can perform as a standalone function or integrate with other aspects of medical practice like patient Medicare records. This helps the Medicare company with calculating what they owe and what they have had done and can save you a lot of headaches.
How does Medicare billing software work?
Medicare billing software can help Medicare by having it set up where a person can go in and insert the amount of money owed by the patient into their file. This file also keeps their Medicare payment records and other documentation in the file. These Medicare billing software helps keep up with the amounts owed to the hospital or doctor instead of having vast amounts of paper work concerning the bills the computer can safely hold it in easy to find files for each person.
They also can form the Medicare bills that are needed to be sent with this software. This software can also track the payments that have been made by the patient and compare them to the amount of times the person has been in the hospital. This can greatly improve the function of Medicare centers and remove a few of the headaches associated with the billing of the patients. So where can you get this software?
What is Medicare advantage?
Medicare part C, also known as Medicare Advantage, is a plan that covers all of Original Medicare, or parts A and B, as well as some additional coverage offered by private companies approved by Medicare. These MA plans may also cover additional services like dental, vision, hearing, or health and wellness programs.
Most of them can also cover part D, which consists of primarily prescription drugs. Medicare pays a fixed amount for a client’s care every month to the companies offering MA plans; these companies must follow certain rules set by Medicare. However, the plans themselves can charge various costs and have differing rules for how services are received, which can change at any time.
What types of Medicare advantage are there?
There are also varying types of MA plans. The main ones are health maintenance organization plans (HMOs), preferred provider organization plans (PPOs), private fee-for-service plans (PFFSs), and special needs plans (SNPs), which are usually available each year.
Other secondary plans include the HMO Point of Service (HMOPOS) plan, which is an HMO plan that may allow receiving some services out-of-network for a higher cost, and a Medical Savings Account (MSA) plan, which combines a high deductible health plan with a bank account that Medicare deposits money into it.
It is very important to make sure that you are covered by Medicare and Insurance. However, just because you are covered does not mean that you can let your health routine become less stringent, as it is still paramount to take care of yourself. A very important aspect of your daily hygiene routine is the dental side of things. Good oral hygiene helps to prevent dental problems and improves the general feel of your mouth. Keeping your gums healthy is also very important to prevent tooth decay and avoid feeling any pain in your mouth.
So, how can you make sure that you take the best possible care of your teeth? There are a few simple steps that you can take, and as long as you do them regularly you should be fine. Firstly, brush your teeth every morning and every night. Even if you are in a hurry to meet a friend or check lovemoney.com for money-saving tips on the weekend, you should always take just a few minutes to grab that toothbrush. Brush thoroughly but gently, to avoid damaging the surface of your teeth. Then, floss in between each tooth in a gentle, see-sawing motion. If you have not flossed your teeth in a while, your gums may bleed slightly, however if you persevere regularly and gently, eventually this will stop and your gums will begin to look much healthier. You can also use mouthwash to freshen your whole mouth and give you minty breath.
Medicare 2012 handbook
Medicare and You 2012 is a handbook that is officially made by the US government and elaborates about many aspects of Medicare that one may need to know for the year.
Topics generally include the basics of Medicare, when to enroll for certain Medicare plans, how much these plans cost, what services are covered by these Medicare plans, possible choices to make when signing up for Medicare, assistance available to pay for any remaining services and other programs, all the rights and protection a member of Medicare has access to, and any resources and tools to use.
What the Medicare hand book offers
The handbook also offers many new things that Medicare may take a part of in 2012. One important thing to note includes the fact that the entire open enrollment period is earlier, running from October 15 to December 7, 2011. Also, the new special enrollment period allows the ability to switch to a Medicare Advantage Plan or Medicare Prescription Drug Plan that has a 5-star rating at any time during the year.
Medicare will allow for more preventative services like screening and counseling for alcohol abuse, depression, and obesity. Members may also qualify for savings on brand-name and generic drugs if they reach the coverage gap in their Medicare prescription drug coverage. Medicare will also take more action in the prevention of any possible fraud, waste, and abuse towards their clients.