Medicare Supplement / Medicare Advantage

Medicare and Prior Authorization – What You Need to Know

The purpose of this article is to explain how Prior Authorization works with Medicare. This is an important subject because the prior authorization process can factor into your decision about which type of Medicare plan you choose. Additionally, if you enroll in a plan that requires prior authorization, then it is vital to know how the process works, especially if your request is denied.

What is Prior Authorization?

Prior Authorization is a required process used by many health insurance carriers as a way to determine if they will cover a prescribed service,

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Medicare Advantage Provider Networks

Lighthouse

For most people accustomed to group or personal plans in the “under age 65” market, dealing with provider networks is an ongoing concern.  PPO or POS or HMO?  This concern is no different for those shopping for a Medicare Advantage plan.  These plans are “network driven”.

For people who do not want to worry about provider network restrictions (and don’t mind paying more premium dollars), then a Medicare Supplement (Medigap) plan is the preferable choice. 

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Over age 64? Don’t Get Caught in the Plan F Death Spiral

 

Don't get caught in the Medicare Death spiral _ doctor holding sign

The Most Popular Plan      Over half of all people who enroll in a Medicare Supplement plan (Medigap) select Plan F.  Plan F is the most comprehensive plan available and covers almost all out-of -pocket medical costs not covered by Medicare Part A and Part B.  Medigap plans are standardized, so a Plan F with United Healthcare is (as required by Federal law) identical to Plan F with Blue Cross Blue Shield,

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The Link Between Medicare and Social Security

It would seem logical to call Medicare when you’re first eligible for Medicare,  because of nearing age 65, losing employer coverage, or due to disability.  However, the first step is to call Social Security regarding enrollment in Part A and Part B of Medicare.

Lots of folks are suprised to learn that their Medicare Part B and Part D premiums are based on their income. In fact, Medicare beneficiares can pay more than three times the current standard Medicare Part B premium of $104.90/month. 

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Medicare Recipients and Identity Theft Protection

If you’ve lost your Medicare card, there’s a form on the Medicare ...

Yes, this post is geared mainly towards people on Medicare, but it’s good information you can share with a family member or friend regardless of your age.

Almost every Medicare beneficiary carries their red, white and blue Medicare card with them.  This card shows their social security number plus a letter — also known as the Medicare Claim Number.  It’s a good idea to make a copy of your Medicare card and then black-out the last four digits of your social security number.

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Paying Too Much For Your Medications?

Paying Too Much For Your Medications? - Rx bottle

People who have been prescribed expensive brand-name drugs know how much it can hurt their wallet.  The good news is that close to 80% of all brand-name medications have a generic counterpart. Oftentimes, generics are perfectly fine; other times a generic isn’t available or is not recommended by your doctor.  So, most people accept the higher cost brand-name drugs and figure there’s not much they can do.  Well, depending on the situation, there can be some very good ways to lower drug costs.

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Is Medicare Open Enrollment Really That Confusing?

Open Enrollment for Medicare is quickly approaching. Otherwise known as the “Annual Election Period” or AEP, the season to make changes to Medicare Advantage Plans and Prescription Drug Plans (Part D), runs from October 15 through December 7.

I read an article in the New York Times today that gives some good basic information about Medicare Open Enrollment (not to be confused with open enrollment for those under age 65), so I’m providing the link here. 

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By Far The Most Popular Medigap Plan In Georgia

The most popular Medicare Supplement (Medigap) plan in Georgia — and nationally — is Plan F. So, why is it the preferred choice of so many?  Well, it is the most comprehensive plan offered by Medigap carriers.  There are several standardized plan options, ranging from plan A to N, and insurance carriers will only offer some of the plans available.  However, almost all carriers offer Plan F.  Basically, Plan F pays whenever Medicare Parts A and B have gaps in coverage.

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People Overlook This Important Factor When Selecting A Medicare Supplement Plan

Making the Right Decision about Medicare Plans

I recently spoke with my friend’s dad who is 72 years-old and recently purchased a Medicare Supplement (Medigap) plan and Part D (prescription drug) plan. We’ll call my friend’s dad “Roger”. So, Roger had been on a retiree group medical plan for several years and was told last year that he had to purchase a Medicare plan through his company’s preferred agency.

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