| The following information will be pertinent: 1. If you are new to Medicare through Attaining Age 65, or 2. On Medicare through a qualifying Disability at any age, OR. 3. Already on Medicare and considering a change in plan or coverage Those of you changing be VERY careful of OPEN ENROLLMENT DATES |
CAUTION !!! CAUTION !!! CAUTION !!! Let's look at the rules for switching from a Medicare Supplement to a Medicare Advantage Plan. Yes, you can change to a Medicare Advantage Plan with Prescription Drugs included, for -0- Premium or a very low Premium. There is NO MEDICAL UNDERWRITING OR DECLINES, UNLESS YOU HAVE "END STAGE RENAL DISEASE". Changing your mind to get back your Medicare Supplement may be more complicated. Generally, if you want to go back to your Medicare Supplement, you must do so within 12 months of trying out a Medicare Advantage Plan to avoid pre-existing underwriting. And, you must return to exactly the same Medicare Supplement you had previously, same Insurer, same plan, and current premium rate. Some of you will be able to switch back to your Medicare Supplement even after the 12 month period, IF your health is good, and you have no decline type medical disorders. We also have at least one Medicare Supplement Carrier who will accept you with all pre-existing conditions except end stage renal failure, as long as you have had a Medicare Advantage Plan with no break in coverage. This may change for June 1, 2010. We are not sure that the Carrier will continue to ignore pre-existing for after June 1, 2010. Some of you simply are no longer able to afford a Medicare Supplement, and a separate Part D Drug Plan. For you, the decision between paying $3,000 per year versus -0- Premium is a no-brainer. The right Medicare Advantage Plan is SAFE, and 1000's of Americans are switching everyday. POSSIBLE GOVERNMENT CUTS TO MEDICARE & MEDICARE ADVANTAGE YES, WITH THE ADVENT OF OBAMA CARE BOTH MEDICARE AND MEDICARE ADVANTAGE MAY UNDERGO CHANGES. WE HAVE LITTLE IDEA OF THE CHANGES COMING, BUT WE DO KNOW THAT REGARDING THE ADVANTAGE PLANS, WHICH ARE OFTEN -0- PREMIUM, INSURERS IN THE FUTURE, PERHAPS EVEN IN 2011 WILL HAVE THEIR REIMBURSEMENTS FROM MEDICARE CUT. IF AND WHEN THIS HAPPENS THE INSURERS WILL HAVE TO CUT AT LEAST SOME OF THE BENEFITS FROM THESE ADVANTAGE PLANS. RIGHT NOW THEY ARE OFFERING DENTAL, VISION, HEARING AND GYM MEMBERSHIPS, WHICH WE BELIEVE WILL BE THE FIRST CUTS THE INSURERS WILL BE FORCED INTO. STRAIGHT MEDICARE PARTS A AND B DO NOT OFFER THESE EXTRA BENEFITS AT ALL AND CUTS TO STRAIGHT MEDICARE ARE ALSO PROPOSED. PERHAPS MEDICARE ADVANTAGE PLANS THAT CURRENTLY HAVE -0- PREMIUM WILL HAVE TO START CHARGING SMALL PREMIUMS AND/OR RAISING THE MAXIMUM OUT OF POCKET, OR VARIOUS COPAYS ON THESE PLANS. AS I WRITE THIS I AM THINKING OF MY OWN MEDICARE ADVANTAGE PLAN, WHICH HAS SMALL COPAYS, AND IS -0- PREMIUM. HOWEVER, IF STRAIGHT MEDICARE IS CUT, AND A MEDICARE SUPPLEMENT + A SEPARATE PRESCRIPTION PLAN COSTS AN AVERAGE OF $2,400 IN PREMIUM PER YEAR, I WILL CONTINUE WITH MY MEDICARE ADVANTAGE PLAN. WITH AN ADVANTAGE PLAN YOU PRETTY MUCH MAKE COPAYS FOR SERVICES RATHER THAN PAYING HEAVY PREMIUMS FOR A MEDICARE SUPPLEMENT WHETHER OR NOT YOU USE ANY SERVICES. PREMIUMS ON A MEDICARE SUPPLEMENT & A PRESCRIPTION PLAN ARE HEAVY DUTY, AND THEY WILL BE THEIR FOR EVERY MONTH OF YOUR REMAINING LIFETIME, CONSTANTLY RISING FROM YEAR TO YEAR. NONETHELESS, MEDICARE ADVANTAGE PLANS DO NOT SUIT EVERYONE. SOME PEOPLE HAVE SUCH HIGH USAGE, HOSPITALIZATIONS, DIAGNOSTICS, ETC., THAT THEY WOULD HIT THE MAXIMUM OUT OF POCKET ON AN ADVANTAGE PLAN EACH AND EVERY YEAR. THAT MAX OUT OF POCKET COULD BE AROUND $4000 PER YEAR, IN WHICH CASE THEY MIGHT AS WELL HAVE A MEDICARE SUPPLEMENT AS THEIR PREMIUM COST ON THE SUPPLEMENT MIGHT BE EQUAL TO OR UNDER THEIR OUT OF POCKET MAX ON A MEDICARE ADVANTAGE PLAN. THESE ARE CONSIDERATIONS THAT YOU ABSOLUTELY NEED HELP WITH. GIVE SERIOUS THOUGHT ABOUT MEDICARE ADVANTAGE, AND TALK TO AN AGENT WHO IS TRUSTWORTHY. SWITCHING CAN BE DONE. JUST BE SURE YOU UNDERSTAND THE RULES. CALL US AT 1-800-239-7553 OR GO TO THE BOTTOM AND EMAIL US |
| Alternatives to a Medicare Supplement Are Called MEDICARE ADVANTAGE MEDICARE ADVANTAGE PLANS ARE PLAN C OF MEDICARE THEY INCLUDE COVERAGE FOR INPATIENT/FACILITIES, OUTPATIENT DIAGNOSIS & TREATMENT, DR. OFFICE VISITS, SURGERY, AND PRESCRIPTIONS. THEY ARE COMPREHENSIVE PLANS THAT INCLUDE MEDICARE PART A, PART B, AND PART D (prescriptions). THERE ARE USUALLY NO DEDUCTIBLES OR COINSURANCE. RATHER YOU MAKE COPAYS FOR YOUR SERVICES. Many of these Plans have -0- Premium or Very Low Monthly Premiums They Also Offer Benefits Not Covered by Original Medicare SUCH AS GYM MEMBERSHIPS, DENTAL, VISION AND HEARING |
| TYPES OF MEDICARE ADVANTAGE PLANS 1. PPO PLANS GIVE YOU A LIST OF ALL PARTICIPATING PROVIDERS THESE PPO PLANS ALSO PAY BENEFITS OUT OF NETWORK, ALTHOUGH AT A LOWER REIMBURSEMENT, AS THE PROVIDER DOES NOT ACCEPT THE PLAN PAYMENT SCHEDULE. WE BELIEVE THAT PPO'S ARE MUCH SAFER WHEN A GOOD ONE EXISTS IN YOUR COUNTY. 2. HMO PLANS (YES, THEY CAN BE GREAT) THESE PLANS REQUIRE THAT YOU CHOOSE A PRIMARY CARE PHYSICIAN. SOME REQUIRE THAT YOU GET A REFERRAL FROM YOUR PCP TO SEE SPECIALISTS AND OTHER PROVIDERS. SOME OF THE HMO'S ARE "OPEN ACCESS", MEANING THAT REFERRALS ARE NOT REQUIRED. USUALLY YOU WILL RECEIVE NO BENEFITS FOR ANY OUT OF NETWORK SERVICES. YOU WILL BE ABLE TO AVOID THIS IF YOU SELECT AN HMO WITH A "POINT OF SERVICE" OPTION, WHICH MEANS AN "OUT OF NETWORK OPTION". AGAIN, HMO'S ARE FINE WHEN A GOOD ONE EXISTS IN YOUR COUNTY. 3. PFFS PLANS (WE WILL NOT WRITE THESE) OR "FEE FOR SERVICE". THESE PLANS ARE FAIRLY EASY TO UNDERSTAND. THERE IS NO PPO, HMO, OR POS. YOU ARE RESPONSIBLE FOR FINDING A PHYSICIAN, SPECIALIST, LAB, HOSPITAL, OR OTHER PROVIDER WHO AGREES TO THE PAYMENT TERMS OF YOUR PLAN. WE DO NOT RECOMMEND THESE "NO NETWORK" PLANS UNLESS ALL OF YOUR "MUST HAVE" PHYSICIANS, SPECIALISTS, AND A LOCAL HOSPITAL AGREE TO ACCEPT THE PLAN AND PAYMENT TERMS. EACH TIME YOU NEED A SPECIALIST YOU ARE "ON YOUR OWN" TO FIND ONE WHO AGREES TO TAKE PAYMENT FROM YOUR PFFS PLAN. BE SURE BEFORE CHOOSING A FEE FOR SERVICE PLAN (NO NETWORK OR CONTRACTED PROVIDERS) THAT YOU CAN DEAL WITH PHYSICIANS DECIDING NOT TO ACCEPT YOUR PFFS PLAN. MOST LIKELY, YOU WILL NOT BE ALLOWED TO SWITCH TO ANOTHER MEDICARE ADVANTAGE PLAN UNTIL JANUARY 1 OF THE NEXT YEAR, LEAVING YOU WITH NO PHYSICIAN. WE ARE VERY PLEASED WITH MEDICARE ADVANTAGE PPO'S, AND IN SOME CASES HMO'S. WE DO NOT FEEL COMFORTABLE IN ENROLLING OUR CLIENTS IN A PFFS PLAN AT THIS TIME. ANOTHER AGENCY MAY WILLING. |
| THE MALONE AGENCY 1-800-239-7553 |
| ALL INFORMATION FLORIDA RESIDENTS ONLY |
| MEDICARE ADVANTAGE PLANS IF YOU ARE ALREADY WELL VERSED ABOUT MEDICARE AND YOUR CHOICES AND THE RULES, YOU MAY WISH TO SKIP DOWN TO THE VERY BOTTOM, FILL OUT A SHORT FORM TO EMAIL TO US, OR SIMPLY CALL US AT 1-800-239-7553 PLEASE GET HELP WITH THESE RULES AND DON'T BE SORRY LATER. WHAT IS GOOD FOR YOUR NEIGHBOR MAY NOT BE AT ALL RIGHT FOR YOU. CALL US. THIS SITE IS FOR FLORIDA RESIDENTS ONLY !!! |
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