Utah Medicare Plans, Pros & Cons

Utah Medicare Plans have many pros and cons depending on which option you go with, so today I wanted to discuss options and the positives and negatives of each.

Medicare supplement plans are exactly as described, they supplement your medicare and often pay all or part of what Medicare itself does not pay. As you may or may not know, Medicare Part A has a $1316 deductible. If you went to the hospital 5 times in a calendar year, you could potentially pay this deductible 5 times. senior Services of Utah usually recommend a Medicare Supplement plan that pay all of this deductible should something happen that requires hospitalization. Medicare Part B on the other hand has a $183 one time annual deductible and then you as the beneficiary are responsible for 20% while Medicare pays 80% after the deductible is met. Depending on the medicare supplement plan you choose, all of the 20% can be covered as well as the deductible should you choose. Choosing A Medigap Policy. The following are the pros and cons of this coverage

Pros:

  • There are no network restrictions. A medicare beneficiary can go to any doctor, facility or hospital that accepts medicare anywhere in the U.S. as long as they take Medicare. It really is that simple.
  • Most providers take Medicare. The numbers have been stated that around 95% of providers in the country accept Medicare
  • No primary care physician required. You can see who you want, when you want
  • Medicare handles all of the billing and crosses over claims to your supplement company. There is a lot less gray area.
  • Available in every county in the United States
  • Plans can be changed at any time throughout the year as long as you qualify.

Cons:

  • Medicare supplements or medigap do not cover prescription drugs. Typically you will want to purchase a separate stand alone PDP or prescription drug plan. * The caveat would be any type of infused medication, or drugs administered at the doctors office or hospital. These are often covered under Part B. Your medical provider will often know, but you can reach out to Medicare to see how something may be covered
  • Plan cost. Even though these plans offer great and extensive coverage, they are often expensive for those on a limited income.
  • Plans are fully underwritten. This coverage is usually fully underwritten outside of the medicare beneficiaries open enrollment period, so we suggest you speak with a licensed agent

Medicare Advantage Plans or Medicare Part C are completely different than a Medicare supplement plans. When a beneficiary enrolls into a Medicare Advantage plan, these plans take over for original medicare. The beneficiary gets all th right and privileges of original medicare, often with advantages. Here are the pros and cons of this coverage

Pros:

  • Often times no additional premium over and above the Medicare Part B premium. (plans vary by county and are not available everywhere)
  • Coverage looks very similar to what you may have had under a traditional healthcare plan through an employer group or standalone plan.
  • Often includes part D prescription drug coverage as well at No additional premium
  • Can include other ancillary benefits such as basic dental coverage, vision coverage including eye wear, gym memberships, and some even offer money toward transportation and over the counter items. These items and their availability will vary from plan to plan.

Cons:

  • Have co pays for services which tend to add up over time if you have major health concerns
  • Have annual maximum out of pockets up to $6700. What that means is if you have a horrible health year, you could potentially face that much out of pocket
  • Limited networks. Many of these plan are HMOs or PPOs and require that you choose a primary doctor. You are also required by many of the plans to get a referral from you primary care doctor to see a specialist. This can be limiting if you have a lot of health issues.
  • Changing coverage can usually only happen once per year, unless you are considered to be low income and receive extra help from social security. A beneficiary must make sure they make the right choice or have the right adviser to guide them through their options.

As you can see, there are certainly pros and cons of both medicare supplements and medicare advantage plans. Senior Services of Utah feels it is important that you understand all of your Utah Medicare plans,  so you can make an informed decision about what is best for you. Your health can often be a moving target, and we want to make sure you are prepared for what may come. Keep in mind, even though it might appear that once you get on a plan you are locked in, but often there are reasons why a plan can be changed. Don’t hesitate to contact us for more details and a comprehensive Medicare coverage review.

Contact Us Here or 801.979.6365

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Medigap Plan G

Medigap Plan G and why I recommend it. Medigap Plan g is like plan F except you are responsible for the annual Part B deductible of $183 for 2017. That is the only difference. By opting for Plan G clients save $300 to $5oo per year. the other reason we recommend this plan is because Plan F has been slated to no longer be sold to new beneficiaries as of 2020 and that means existing Plan F’s have the potential of seeing higher rate increases. For more details, reach out to us at 801.979.6365 or fill out the form to the right.

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Medicare Plan Questions

Medicare Plan Questions

When you are finally ready to decide on a Medicare Plan, you may have some Medicare Plan questions. These are the most common questions we see.

  • Is my doctor covered? This is answer really is based on the plan you choose. If you are on Original Medicare with a supplement, as long as your doctor accepts Medicare assignment, you can go see them, and your supplement will pay after Medicare. If you are choosing a Medicare Advantage plan, or Medicare Part C, you will want to make sure your provider is in the “network”. Most of the plans work in a traditional HMO or PPO model, so they will have a network of providers
  • Are my Medications covered? This question will be based on whether you go with a Medicare Advantage Plan or stand alone Part D or prescription drug plan. There are often dozens of either option available, and most cover the more commonly prescribed drugs on the market. It is important you look into your options to make sure the medication you are prescribed are covered.
  • Out of Network Coverage? Medicare itself does not really have a traditional network. As long as your providers accepts Medicare, you can go see them. That applies anywhere in the United States. Medicare Advantage on the other hand will typically tie you to a network and if you go outside of that, you may not have coverage. Traditionally, the emergency room is covered throughout the U.S., but other services may be limited or not covered based on your plan.
  • Dental & Vision coverage? If there is coverage for dental or vision, traditionally it will only be found as an extra benefit within a Medicare Advantage Plan. This includes eye wear, dental cleanings and other ancillary items. Medicare itself will cover items such as cataracts and glaucoma screening, but their dental coverage is limited at best.
  • Silver Sneakers. Many clients ask us about Silver Sneakers or a similar gym type benefit, where they can get a free membership to go to classes at the local gym or recreation center. These programs are typically included within a Medicare Advantage plan, but not on a Medicare Supplement plan. With that being said, we do have a few providers who offer this within the structure of their supplemental coverage. Often members will find that opting for the fancy extras of a Medicare Advantage plan, can leave holes in your coverage.

As you can see there are certainly pros and cons of each type of coverage whether Medicare Supplements or Medicare Advantage and it is important that you do your research of have a local licensed professional help you wade through all of your options. We would be happy to answer any questions and represent all the top Medicare Plans available in Utah.

Contact Us Here or 801.979.6365

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Medicare Utah. Plans and Options

 

Medicare Utah, plans and options.  Get advice on which Utah Medicare Plan works best for your situation. Everyone is different and we work with all supplemental Utah Medicare Plans and can help you navigate the ins and outs of each whether it be
* Medigap
*Medicare Part C (medicare advantage)
*Medicare Part D (drug plans)

and everything else concerning whether you are working and need medicare or not.
www.utahseniorservices.com
www.medigapspecialists.com
801.979.6365

 

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Turning 65, but still working. Do my clients need Medicare?

 

 

 

 

I get this question daily, and the answer is as clear as mud, but hopefully this will help.

At 65, you should always take Medicare Part A. If you are eligible, there is no cost, so you should take it.

Part B, on the other hand is a different animal. You have to know the following to best serve your client

·       Do they have a spouse they currently cover through work, and if so when do they get Medicare?

·       Is their coverage creditable to Medicare ?(more info Here)

·       How much does their current insurance cost through work?

Once we have these answers, we can best serve them. For example, if their current coverage is not creditable, they will want to take Part B so they don’t face any enrollment penalties. Most group coverage qualifies, so this is rarely an issue. If they have a trailing spouse, more often than not, they are best served to keep their group plan until said spouse reaches 65, or they decide to retire. Stand-alone under65 health plans outside of group coverage, are often very costly.

If they don’t have a trailing spouse, then the question comes down to what does their employer coverage cost, and how good is the coverage? Medicare Part B will cost a new enrollee $134 for 2017 generally speaking, unless they have higher than normal income, and supplemental Medicare coverage starts as little as $0 and can cost as much as an additional $150 to $200 per month for the best coverage available. All situations are different, but we have found that 80% of the time, options under Medicare are better than under their employer coverage. There are still many moving parts, which is why we recommend a Free Medicare consultation to determine a beneficiaries best course of action. Hopefully this cleared things up a bit.

Jimmy Hobson is a licensed Medicare insurance specialist who helps Financial Planners, as well as Tax & Insurance Professionals help their clients solve the Medicare puzzle. For a Free consultation and overview about how I can help you solidify as well as grow your older clientele, contact me,via email at jimmy@utahseniorservices.com, or telephone @801.979.6365

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Utah Medicare Plans

Utah Medicare Supplement Plans, is price really all that matters?

When it comes to choosing a medicare supplement or medigap plan in Utah, a lot of agents try to blindly lead you with the thought that all that matters is price. I am here to offer a different point of view. Now we know price is always a big deal and saving $15 or $20 can often be a big deal on a monthly basis, but what happens when that new discount Utah Medicare Supplement takes a 20% rate increase after the first year, and then again in year two. Did you realize you can often see two rate increases annually depending on when you sign up for your plan? Most agents don’t tell you this until it happens to you. Saving 10% to see a 30 to 40% increase over a couple years doesn’t make any sense, and if you have any major health concerns along the way, the option to change may not be there. At Senior Services of Utah, we understand Medicare and the companies that offer supplemental coverage. Our goal is to get you coverage that you don’t have to change or adjust every time the wind blows. Feel free to visit our page discussing Medicare Supplements, or Contact Us Today for a FREE QUOTE

Utah Medicare Supplement Plans &  Utah Medicare Advantage Plans

Choosing between the seemingly endless variety of Utah Medicare supplement and Medicare Advantage companies and plans can be quite complicated. The choice of Medicare supplement plans and Medicare Advantage plans, as well as their costs and coverage vary by county in Utah. Our goal is to make this process if not easy, at least understandable. We research and study all the available plans so you don’t have to. We believe an informed consumer is a better consumer. There is no cost or obligation to receive any of the help wading through all of the available information.

One only needs to be a Medicare beneficiary to apply for most Utah Medicare Supplemental Plans. Many people believe you must be at least 65 to receive Medicare but this is not always the case. Medicare provides benefits to permanently disabled people under age 65 as well. Not every person over 65 has to take Medicare Part B either. If you are still working, and have coverage through your employer, you certainly want to weigh all your options, and make sure you make the right choice for you. In the State of Utah, there are currently no carriers that offer Medicare Supplement coverage under the age of 65, so those on Medicare due to disability need to look at a medicare Advantage plan to help supplement their Medicare coverage.

Utah Medicare plans available include:

  • Medicare Supplement (Medigap)
  • Medicare Advantage (Part C)Part D (Prescription drug plans)
    • Medicare Advantage HMO
    • Medicare Advantage HMO-POS
    • Medicare Advantage PPO
    • Medicare Advantage PFFS
    • Dual Eligible
    • special needs plans

You would be well served to review your costs and coverage every year. As a Medicare advisor, it is also in our best interest to make sure you are on the right plan as well.  Utah Medicare Supplement prices usually go up annually and a good deal last year may not be a good price this year.All Medigap plans are standardized so the difference between companies boils down to cost.

The same is true for the Utah Medicare Advantage Plans, including HMO, PPO, SNP plans and extends to your drug plan. Typically when it comes to Medicare in Utah – benefits and costs will change every year. So we can help you review you coverage to make sure you still are receiving all the benefits Medicare has to offer at the lowest possible overall cost to you.

You can review your options on your own or turn this job over to a professional Utah Medicare insurance agent. Senior Services of Utah represent virtually every carrier doing business in Utah and will help you make the best choice for you. There is no cost for our services, so don’t hesitate to contact us. We have years of experience helping clients navigate through their insurance issues and are here to help.

Call us at 1-801-979-6365  at your convenience and let us help you find the right Medicare Supplement or Advantage Plan.
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Get The Best Utah Medicare Coverage At An Affordable Price

It is possible to get Utah medicare supplement or medicare advantage plan coverage at reasonable prices, if you are willing to spend some time and effort evaluating all of your possible options or you consult a local insurance expert. The best way for you to get the lowest possible rate on your private Utah medicare supplement or advantage policy is to shop around and compare premium and co-pay prices. A qualified local insurance expert in this area can help you locate the policy type and coverage that you are looking for without having to pay more for the policy you choose. At Senior Services of Utah we offer all the major insurance plans and are happy to take the headache out of choosing a plan.

Utah Medicare SupplementsUtah Medicare Advantage

Servicing all of Utah including: Salt Lake City, Bountiful, West Jordan, Layton, Brigham City, Logan, Provo, South Jordan, Lehi, St. George, Tooele, Magna, Cedar City, Morgan, Park City, Roosevelt, Duchesne, Ogden, Tremonton, Sandy, American Fork, Nephi, Price, Moab, Evanston, Wendover, West Valley City, Taylorsville, Farmington, Woods Cross, North Salt Lake, Rose Park, Glendale, Draper, Spanish Fork, Hyrum, Smithfield, Roy, West Point, Harrisville, Layton, Syracuse, Clearfield, Riverton, Herriman, Bluffdale,Saratoga Springs, Grantsville, Erda, Provo, Orem, Wanship, Paragonah

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Medigap Policies

3 things to know about buying a Medigap policy:

  1. You should buy a policy during your 6-month Medigap open enrollment period.
  2. If you don’t buy during your enrollment period, you may have trouble finding the right coverage. We work with all the major medicare supplemental insurance providers, so we can usually find you coverage.
  3. Sometimes if you are outside of your Medigap open enrollment period, you may qualify for Guarantee Issue rights. We can help answer that.

Buying a Medigap policy is a smart way to get coverage for the out-of-pocket costs not covered by Original Medicare (Medicare Parts A & B). If you’re not sure whether you’re eligible to buy a Medicare Supplement insurance policy we can help.

If you’re eligible and planning on purchasing a policy, you should do it during your Medigap open enrollment period. If you buy during this period, “you can buy any Medigap policy the company sells, even if you have health problems, for the same price as people with good health,” according to Medicare.gov. However, there are certain circumstances when you can buy outside of your open enrollment period with the same protections you’d have during the open enrollment period. These are called guarantee issue and trial rights.

Your Medicare Supplement insurance open enrollment period is different from Original Medicare open enrollment. Keep reading for details.

Buying during open enrollment

Your Medigap open enrollment period last for 6 months and starts the day you are both 1) 65 years old and 2) enrolled in Original Medicare (both Parts A & B). If you only bought Part A when you turned 65, the 6-month period starts the day you buy Part B.

Why buy during open enrollment? During this period, you have the following guarantees:

  • Insurers cannot deny you coverage.
  • Insurers cannot increase prices due to health issues.
  • You are able to switch plans within your 6-month open enrollment period.
  • You do not have to wait for coverage to begin.

Insurance companies must sell you a medicare supplement policy during open enrollment. They cannot deny you coverage, and they cannot raise your prices because of past health problems. You will get the same price as a healthy person during open enrollment, guaranteed.

If you buy a policy after open enrollment, things can get a little more complicated and expensive.

Buying after open enrollment

Technically, you can still buy Medicare Supplement insurance after your open enrollment period ends, but your health history can affect your options. At this point, it’s not guaranteed that you can buy a policy, and insurers can charge you higher rates because of your health history. That’s because after open enrollment, insurers are allowed to use underwriting to determine your eligibility. Underwriting lets them raise your rates or deny you coverage based on your medical history.

Guaranteed issue and trial rights

However, there are some situations where you can avoid underwriting after open enrollment. You can do so if you have a guaranteed issue right or trial right. These rights let you buy a Medigap policy after enrollment without penalty if:

  1. You have a Medicare Advantage plan & it’s leaving Medicare or ending coverage in your area.
  2. You have a Medicare Advantage plan & you are moving out of the plan’s service area.
  3. You have Original Medicare & you need to replace an employer health plan that will soon discontinue.
  4. You have Original Medicare and a Medicare SELECT policy & you move out of the policy’s service area.
  5. You joined an Advantage plan or PACE when you were first eligible for Part A at 65 and within the first year of joining you want to switch to Original Medicare.
  6. You dropped a Medigap policy to join an Advantage plan for the first time and within the first year of joining you want to switch back to Medigap.
  7. Your Medigap insurance company goes bankrupt or ends your policy through no fault of your own.
  8. You leave a Medicare Advantage plan or Medigap policy because the company misled you or didn’t follow the rules.
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New To Medicare

New to Medicare. Check out this video.

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Medicare Plans and Multiple Sclerosis or MS

Navigating Medicare plan coverage when you are on M.S. can be difficult. If you are under 65, often times the only available coverage is a Medicare Advantage Plan, and while being pretty good coverage, you still get stuck paying 20% of any infusion therapy you might undergo which happens often with a MS diagnosis. The reason is because any infused drugs such as Chemotherapy, remicade and others are considered Medicare Part B medications rather than part D, so your drug plan typically doesn’t pick up the cost. With that being said, we recommend the following. Even if you went on disability due to your MS, you still qualify for open enrollment at 65 just as if you had waited to get Medicare at that time. What this means is that you qualify without any health questions to go on a Medicare Supplement or Medigap Plan. We recommend Plan F, Plan G, and Plan N. With all three of these plans the most you would ever pay would be the Medicare Part B deductible of $166  ( Doesn’t aspply to Plan F) annually, and then Medicare and your supplemental coverage would pick up the rest. That means ZERO out of pocket for infusions you may have been paying $100’s out of your own pocket for. We offer both Medicare Advantage plans as well as medicare Supplement plans and are happy to discuss both options with you at anytime.

Contact Us Here or Call Today 801.979.6365

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Medigap Plan G & Cigna

There have been some recent adjustments and now we have a few more players in the Utah Medicare Market who are offering Medicare Supplement Plan G. Equitable Life, Aetna, United of Omaha, Philadelphia American are just a few of the companies competing on price to help save you money. If you are unaware of how Medigap Plan G works, we can help. Contact us at 801.979.6365

Cigna has released a new Medicare Supplement plan for those who may have been turned down previously. There have been few options within the Medigap market for those who have health issues, and Cigna has set out to rectify this. If you have been turned down previously, let us take another look for you.

Contact Us here!!

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