medicare

SWFL Insurance

Health Insurance Options Now That Open Enrollment is Over

Can I make changes to my Medicare coverage? Annual election is January 1, 2021- March 31, 2021. During this time period you can: Return to original Medicare part A & B and purchase a Florida Blue Medicare supplement along with a stand alone drug plan Return to a Florida Blue Medicare Advantage plan Can I change my under 65 policy? Open enrollment is October 1- December 15 of each year. While this is the time to make changes for the coming year, there are circumstances that allow for a “special election period” (SEP) Marriage or divorce Adding a new member to the family Moving residences Coming off of group coverage with an employer Changes in income to remain compliant What if my under 65 policy doesn’t cover everything? Florida Blue offers critical illness, accident and hospital plans to fill the gap where coverage is not offered with your current health insurance plan. These add-on’s assist in covering copays, deductibles, emergency room visits, help pay the mortgage and even pay when you have your annual wellness check completed. Don’t forget to cash in on the Florida Blue Rewards for under 65!! Florida Blue rewards you for taking care of your health. Log in to your Florida Blue account and be sure to complete: Health Assessment- helps to create a Personal Health Journey Complete the self-guided activities to earn monies toward your monthly premium- up to $250. Educational videos for lowering out-of-pocket costs, managing your Florida Blue account, preventative care and HMO/PPO benefits- up to $200. Personalized rewards are geared for members with certain health conditions. Earn $10 to $250 toward the monthly premium based on your specific needs. HealthyBlue Rewards for Medicare Advantage Members! Stay your healthiest with the Florida Blue rewards program. Log in to your member account at floridablue.com/medicare to participate and earn gift cards for: Annual Health Risk (AHR), Annual Wellness Exams/In-Home Health Visit, breast cancer screening(women only), bone density(women only), flu shot, colon cancer screening, diabetic screenings, and reporting healthy activity. Also Read: Getting the Most from Medicare When Your New Benefits Start Get A Quote

SWFL Insurance

Getting the Most from Medicare When Your New Benefits Start

If you are going to become eligible for Medicare in 2021, then you are probably looking forward to finally receiving a benefit that has been promised to you for many years. Medicare is a great way for you to lead both a healthier life and keep your medical bills affordable. If you are new to the program, the options might seem confusing. It is easy to get started and we are here to help. Here at SWFL Insurance, we believe that every Medicare participant—whether they have Original Medicare, Medicare Advantage, Part D, Medigap or other benefits—should get the most out of their coverage from day one. Let’s look deeper into things you should keep in mind when you are new to the Medicare system. Finalizing Your Enrollment Even once your Medicare benefits take effect, there are still a few loose ends to tie up. A few last-minute steps to take include: Filing a disclosure form that will allow Medicare representatives to speak to another person you trust about your Medicare benefits. This might be a spouse, close family member, or adult child who you can trust to talk to Medicare on your behalf, if you can’t do so yourself. Determining your billing cycle and choosing how to make your premium payments. You must continue to pay your premiums to continue to receive coverage. If you have Original Medicare, then you can set up an account at Medicare.gov to pay your premium and receive paperless billing. Learning more about your chosen benefits. Each year, you will receive your Medicare & You handbook, which can advise you of how the system will change in the new year, and how these changes might affect you. Checking your Medicare card to make sure it includes the correct information, and putting it in a place where you will remember to take it with you whenever you visit the doctor. Visiting Your Doctor Once you qualify for Medicare, you will be able to receive care from a nationwide network of physicians, hospitals and other care providers. Doctors within the Medicare network accept Medicare as a form of payment, and your policy will pay its full share of costs when you visit one of these physicians. When your Original Medicare benefits start, you are entitled to a one-time Welcome to Medicare preventive health visit. At this time, you can see your doctor for a wellness exam, which will help them gather vital health data about you. Welcome visits are usually free, though you might have to pay certain costs, depending on the tests the doctor orders. This service is only offered during your first year on Medicare, so don’t wait to take advantage of this very helpful perk. Considering Expanded Medicare Benefits Original Medicare is the U.S. government’s primary insurance offering for senior citizens and other qualifying Americans. Still, there are many other Medicare benefits on the market that can help you expand upon your coverage. These include: Medicare Part D (Prescription drug benefits): Original Medicare doesn’t automatically cover prescription drugs. However, Part D plans are affordable policies that offer prescription coverage and can be added into your Medicare portfolio with your Original Medicare. Medicare Advantage Plans: Also called Part C plans, Medicare Advantage Plans are offered as an alternative to Original Medicare. These plans provide all the same benefits of Original Medicare, but also include expanded benefits like dental, vision and prescription drug coverage. Medicare Supplements (Medigap plans): Medicare Supplement Plans are offered in addition to Original Medicare Coverage (Parts A and B). Original Medicare might leave outstanding costs, like coinsurance and deductibles, which are the policyholder’s responsibility to pay. However, a Medigap plan will help you cover these costs. Each of these plans are offered by private insurance companies, but they must meet standards set by Medicare law. Still, they will include their own premiums, coverage networks and cost-sharing rules. Additionally, not all plans are available in all areas. You must have Original Medicare before you can enroll in any of these benefits, and each has its own enrollment qualifications and timelines. So, if you are interested in getting extra coverage alongside your Original Medicare, then you shouldn’t wait to get started. If you do not enroll in extra coverage during qualifying time periods, then you could be ineligible to buy a plan during other times of the year. To learn more about enrolling in expanded Medicare options, and for help making sure you get the plan that is right for you, you can rely on SWFL Insurance. Our focus is our customers, and we’re committed to helping every Medicare participant optimize their benefits to their advantage. Also Read: What is Included in a Medicare Advantage Plan? Get A Quote

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What is Included in a Medicare Advantage Plan?

Medicare Advantage plans are offered through private insurers and help offer coverage for important healthcare for certain individuals. These plans combine coverage available under Original Medicare with additional coverage and higher limits. There are sections of Medicare plans separated into parts. Original Medicare plans include Part A and Part B while Medicare Advantage plans are known as Part C. Part C, or Medicare Advantage plans, include both Part A and Part B. Part A Medicare Part A is considered hospital insurance. It covers inpatient hospital care, skilled nursing facilities, hospice, lab tests, surgery, home health care and more. This part comes with all Medicare plans and is required for enrollment before an individual can purchase a Medicare Advantage plan. Part B Medicare Part B concerns outpatient care such as doctor’s visits, durable medical equipment, health care provider’s services, home health care and some preventive services. This part also comes with all Medicare plans. While the name of these plans is the same between Original Medicare and Medicare Advantage, there are slight differences. Since Medicare Advantage plans are offered through private insurers, they can offer higher limits and more coverage options. Many Medicare Advantage plans may offer dental and vision coverage as well as Medicare Part D. Medicare Part D covers prescription drug costs and can be added to your Medicare plan. You must qualify and enroll in Part A and Part B Medicare in order to enroll in a Medicare Advantage plan. If you miss your open enrollment period for Original Medicare, you must wait for the next enrollment period. If you already have Original Medicare, you may be able to enroll in Medicare Advantage outside of the enrollment period. What is Not Covered Under a Medicare Advantage Plan? Original Medicare has several exclusions such as vision, dental and hearing, though these may be covered under a Medicare Advantage plan. Copayments, coinsurance and deductibles are generally not covered under even Medicare Advantage plans, however, although these can be covered under a Medigap policy. Also keep in mind the Medicare is not a group policy and will not cover family members or spouses. Medicare Advantage works as an individual health insurance policy. If one of your loved ones also needs Medicare, they will need to enroll in their own plan. If you have any questions about Medicare Advantage or your health insurance needs, be sure to speak with your insurance agent. Also Read: Medicare Advantage Plans 2021 Get A Quote

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Medicare Advantage Plans 2021

The Medicare open enrollment period is here, and this year will likely be a record for the number of people signing up for Medicare Advantage plans for 2021. New Advantage plans being offered are providing more and more benefits to Seniors and are very attractive for people who have a lot of healthcare needs. They can cover services for common, necessary medical procedures and diagnosis, and help to provide peace of mind. That is often worth the monthly premium for many seniors who currently struggle to pay their healthcare bills every month. And, there might $0 premium plans available in your area. Any changes made during this time will go into effect on January 1st of the following year. Medicare Advantage Plans in 2021 will provide at least as much coverage as both Part A and B Medicare together (Original Medicare), although some plans offer additional benefits. Many advantage plans in 2021 will have Part D prescription drug coverage built into the plan, as well as dental, vision, and hearing coverage also included. Medicare Advantage Plans 2021 – 3 Big Changes For 2021 Due to Medicare advantage plan benefits improving each year, along with the recent Covid-19 pandemic and an effort to improve overall medical services for Seniors, the Center for Medicare & Medicaid Service (CMS) has initiated some changes to Medicare advantage plans in 2021. The 3 Major Changes to Medicare Advantage for 2021 plans are: A Medicare Part D drug plan Coverage Level Change (including donut hole parameters changing) An expanded Telehealth service offered to patients Changes to End-stage renal disease (ESRD) applicants Medicare Part D Drug Plans For 2021 For years Medicare has had something called the “donut hole”. This is a time when the cost of your medications reach a certain level, and you are in what is called a coverage “gap”. Historically when this happened your drug costs would rise dramatically. The Medicare Part D change in 2021 is raising the amount of money it takes to reach this donut hole, causing some to get in later than usual which is always a good thing. The amount it took to reach this gap in 2020 was $4020, and it’s being raise in 2021 to $4130. Expanded Telehealth Services In 2021 Another great change taking place to Medicare advantage plans in 2021 is the extended telehealth benefits. Members of advantage plans can now receive care in a virtual format in the safety and comfort of their own homes. Internet and conferencing via video makes this all possible, and it became a necessity due to the COVID virus. In all honestly, this was long overdue and is especially important for those who have trouble leaving the home. Any check-ins to your doctor can be performed via: Phone calls Video conferencing Using Text message Using the provider/patient website portal End-Stage Renal Disease Applicants In 2021 In the past, Medicare advantage plans were only available to people who had ESRD if they enrolled in one during their open enrollment period or changed during the Medicare Annual election (AEP) period each October. Due to an act in Congress called the 21st Century Cures act, in January of 2021 beneficiaries who have ESRD may enroll into Medicare Advantage plans and be eligible.

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