Great news, Medicare Advantage plan coverage for 2015 seems to be very similar to the plans this past year. That is great for beneficiaries and hopefully it means the $0 premium Medicare plans in Utah will continue to be as benefit rich as they are today. Some plans are even expanding their coverage area within the state. There are many great options of available, so there is no need to stay in a plan that doesn’t fit your needs.
Medicare Advantage Plan 2015 options are now available. Contact us today.
Medicare Advantage Plans or Medicare Part C are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through the Medicare Advantage Plan. This coverage can include prescription drug coverage. Medicare Advantage Plans include:
- Medicare Health Maintenance Organization (HMOs)
- Preferred Provider Organizations (PPO)
- Private Fee-for-Service Plans
- Medicare Special Needs Plans
When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, there generally are extra benefits and lower co-payments than in the Original Medicare Plan. Most Medicare Advantage Plans are managed care plans, usually a health maintenance organization (HMO) or a preferred provider organization (PPO) and you may have to see doctors that belong to the plan or go to certain hospitals to get services.
To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you may have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. Some of the benefits may include:
- Out of pocket maximums
- Set copay amounts
- Free Gym Membership thru Silversneakers
- Medicare Dental Benefits
- Vision Coverage
- Discounts on Services
As you can clearly see, these plans can offer more than Medicare alone, and are absolutely worth considering if you are looking for a Medicare Plan in Utah. Contact us here
When can I enroll?
Keep in mind that Medicare limits when you can join, switch, or drop a Medicare Advantage Plan. You can join a plan when you first become eligible for Medicare. This is anytime beginning three months before the month you turn 65 and ends three months after the month you turned 65.
For example, if you turn 65 on May 5, your eligibility period starts on February 1 and ends on August 31.
If you are disabled and have Social Security Disability Insurance, you can join an advantage plan three months before to three months after month 25 of your disability.
You can switch or drop your advantage during an enrollment period between October 15 and December 07 of each year. Some of the local Medicare Advantage carriers are:
*United Healthcare (AARP Medicare Complete)
*Regence Blue Cross/Blue Shield
*University of Utah
For more information visit www.medicare.gov
Do you need or qualify for extra help?
If you need help paying for your medications or your Medicare Part B premium, they provide options. When determining eligibility there are numerous ways to qualify for extra help, or the Low Income Subsidy (LIS).
If you qualify for extra help, Low Income Subsidy (LIS), to pay for your prescription drug costs, Medicare could also pay 75% or more of your Plan Premium, annual deductibles and co-insurance (if applicable). Additionally, those who qualify won’t have a coverage gap or a late enrollment penalty. Call Social Security or Medicare for details.
For 2012, in order to qualify your yearly income is limited to $16,245 for an individual or $21,855 for a married couple living together.
If your income and resources are slightly higher, you should still apply. You may still qualify if you meet one of the following conditions:
- You or your spouse support other family members who live with you.
- You or your spouse have earnings from work.
- You or your spouse live in Alaska or Hawaii.
Your resources are limited to $6,680 ($11,520 if married) for Full Low-Income Subsidy and $11,140 ($23,760 if married) for other low-income subsidies. This information is based on 2011 Federal Poverty Levels (FPL).
Most of these things can be confusing so we always suggest contacting us for more information. Molina offers three plan options along the Wasatch front depending on what level of LIS you qualify for.
Medicare Advantage plans vs Medicare Supplement Plans
This has been an oft debated question between amongst consumers and even agents over the years. Some agents feel that Medicare Advantage Plans or Medicare Part C are the greatest thing since sliced bread, yet there are many out there who won’t touch the things. I will attempt to lay out what I feel are the pros and cons of each, so you are able to get a better idea of what may be right for you. Let us first explore Medicare Advantage plans:
The biggest advantage to these plans is that they typically have a much lower overall premium cost than a Medicare supplement plan, and for those folks who are healthy, this can be a great deal. These plans also have the option of including Medicare Part D or prescription drug coverage within the same monthly premium. Throughout parts of the country these plans can have as low as $0 premium, so there is no additional costs to the Medicare Beneficiary other than their monthly Part B premium. These plans have gotten much better over the years and many of these even offer dental, vision, health club benefits and other great additional features.
There are however some negatives to these plans that many people may not like. One major thing is that typically these plans are HMO’s or PPO’s, and folks become tied to a specific network of doctors and hospitals. For those folks that don’t travel extensively this is rarely an issue, but if you intend to leave your home and see the country, you might want to consider a Medicare Supplement plan. A few other complaints some folks have is that when they enroll in these plans, they are now under the coverage of the insurance company rather than Medicare, which means claims are handled differently. I have folks on many different types of coverage and it really comes down to finding the right plan that works for you.
A Medicare Supplement plan, is just that, a supplement to Medicare. When one enrolls in these type plans, they are still on original Medicare, and all bills from the doctor are forwarded from Medicare to the supplemental insurance company once Medicare takes care of their part. These plans are standardized from A-N, and the only difference from one company to the next is price. Some of these plans cover all costs not covered by original Medicare and others work more like a Medicare Advantage plan and have co-pays or deductibles. There is usually a premium for these type of plans in addition to your Medicare Part B premium, but people often are very happy with their coverage. The one downfall I see about these plans other than the monthly premium is that the consumer must also purchase a stand alone Medicare Part D or prescription drug plan if they need that type of coverage. That can cost an additional $15 to $100 per month depending on the plan chosen.
In conclusion, Medicare and supplemental Medicare coverage have many different options that a consumer should explore in order to find the right plan for them. There are many expert agents out there that carry all Medicare options in order to help you find what works best for you.
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