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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,

Good Article about the New Medicare Open Enrollment Window

If you have a Medicare Supplement plan (also knows as Medigap), then you can switch plans anytime of year.   Many people mistakenly believe they can only switch Medigap plans or carriers during the Annual Election Period (from October 15 to December 7 each year).

The Annual Enrollment Period (AEP) is the time of year to switch (if it makes sense) to a new Prescription Drug Plan or Medicare Advantage plan.

Paying for Medicare Part B

Paying for Medicare Part B

If you’re new to Medicare, but are not yet receiving Social Security benefits, then you might want an easy way to pay your Medicare Part B premium.

If you are receiving Social Security benefits, then you will most likely select to have your Part B premium deducted from your monthly check. I highly recommend this payment method. However, if you are not yet receiving benefits, then most people will pay for Part B by quarterly direct billing.

For some people,

Two Medicare Enrollment Surprises to Consider

Two Medicare Enrollment Surprises to Consider

If you are in the process of researching your Medicare plan options, you have probably discovered there is a lot to learn. Some refer to the process as the Medicare Maze.

It’s not just a matter of deciding on the best plan options, but all the rules to follow and penalties to avoid.

You might have found us because you realize you need guidance from an expert.  You’re not alone!

This article will address two Medicare issues that many fail to consider. 

Short Term Medical Plans - Smart Move or Not?

Short Term Medical Plans – Smart Move or Not?

A recent article published by Kaiser Family Foundation provides helpful information on short term medical plans.  Whether you live in Georgia, California or Wisconsin,  you will find the information valuable.   You might be a great candidate for short term medical…or you might need to stay far away. This article will dispel a couple of myths.

Short Term Medical Plans – Limited Coverage

First off, short term medical plans (STM) are only intended for people under age 65. 

How to find an independent insurance agent. It's now always what you think!

How to Find a Good, Independent Insurance Agent

You might think that working with an experienced, independent agent is your best option when shopping for insurance.  Whether it’s life insurance or Medicare insurance, an independent agent should shop the market for you and help you find the best coverage.  However, there are some important items to consider when looking for an independent health, Medicare or life insurance agent.

Incentives to Place Business with Certain Carriers

It’s not surprising that insurance companies provide agents with incentive for selling their products.  

Best Dental and Vision Insurance Plan We Have Found

Best Dental and Vision Insurance Plan We Have Found

This article is intended for people who do not have access to an employer-sponsored (or group) plan. We offer group dental plans, but this article is geared towards individuals and families who need to purchase their own coverage.

I’m always on the lookout for the best plans available. Occasionally, I see a new plan marketed with “great benefits” or “no waiting periods for major dental work

Individual Health Insurance in Georgia 2017 - Blue Cross Blue Shield and Other Carriers

Health Insurance in 2017 – Blue Cross Blue Shield and Other Carriers

I’m writing this post in late August 2016.  By now, most people are aware of the big news – that Aetna decided to pull out of 11 states in 2017.  Some experts are saying this is the unraveling of Obamacare.  Regardless of the what the future holds, we now have a much different and more challenging health insurance landscape.

Aetna currently offers plans off the Exchange in Georgia.  They also offer plans through their subsidiary –

Clark Howard’s Misleading Commentary On The Health Insurance Marketplace

Clark Howard's Misleading Commentary On The Health Insurance Marketplace

I was listening to the radio today and I heard Clark Howard opine about what’s going on in the personal health insurance market. He was responding to the big news about Aetna and how they decided to withdraw from most of the states where they participate in the Marketplace. He went on to explain the reason why this is happening and I was surprised to hear some half-truths. Clark is usually better informed on issues like this.

Medicare Advantage Provider Networks


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.