Category: Senior Insurance

Medicare Open Enrollment Period

Review Your Coverage: Take Advantage of Medicare’s Open Enrollment Period

Medicare Open Enrollment PeriodThings happen and things change including your health and sometimes your health plan as well. Take advantage of Medicare Open Enrollment Period (OEP) to review your current coverage and make sure it is still what you need from your health insurance plan.

Open Enrollment Period is October 15 to December 7. So right now is your opportunity to choose the best coverage for your needs. The choices you make now will be effective for all of the new year. You cannot make any changes until next Open Enrollment Period a year from now, unless you qualify for an exception or have Original Medicare with a Medicare Supplement Plan.

Information Checklist for Comparing Medicare Plans

Our information checklist will help you gather the information you need to reference when reviewing your current plan and comparing other available plans.

  1. How is your general health?
  2. Has your health changed considerably in the past year?
  3. Ongoing conditions such as high blood pressure or diabetes?
  4. Vision or hearing problems?
  5. One-time health needs such as illness or injury?
  6. How often do you visit the doctor?
  7. Do you see any specialist?
  8. Do you live in a long-term care residence or skilled nursing facility (nursing home)?
  9. Do you have a planned surgery or procedure coming up?
  10. Review your summary of benefits you periodically get from Medicare or your Medicare Advantage plan, this lists the services you received and the costs.
  11. Prescriptions Drugs (all formularies are different and may affect which plan is the best plan for you)

Factors That Apply to Your Healthcare Plan Usage

Now that you have gathered the items on this checklist, please keep in mind the following factors as it applies to your health and usage of your plan.

  1. Monthly Premium, if any
  2. Deductibles
  3. Co-payments
  4. Coinsurance
  5. Max Out of Pocket (this is your maximum risk if your health dramatically changes during the year)
  6. Does the plan reimburse the Part B Deductible?

Once you have gathered this information, you are ready to start comparing plans at

Are You Eligible for Medicare Yet Still Working? How Does This Affect Your Medicare Coverage?

Great news – whether or not you retire at age 65, you are still eligible for Medicare!

If you, or your spouse, are still employed you may have health insurance through that employer.  The first step you should take, before you enroll in Medicare, is to talk with your human resources department.  You will need to know which kind of health plan you are currently enrolled in and how (if at all) that health insurance will change if you enroll in Medicare.  This information will help you evaluate your Medicare choices and decide which plan is best for you.

Medicare Part A, which is hospital coverage, is premium-free for most people.  It’s a good idea to enroll in Part A as soon as you’re eligible, as long as you qualify for it premium-free.  However, if your employer plan is a Health Savings Account (HSA) – speak to your employer first.  They may stop contributing to your account if you enroll.  This is why it is very important to learn exactly how Medicare will change your current benefits.

Medicare Part B, which is doctor and outpatient coverage, does charge a premium.  For the year 2018, the premium starts at $134 per month with increasing premiums for people with higher incomes.  Many people who are still working and have group health coverage delay enrolling in Part B in order to postpone paying this premium.  Also, the Medicare Part B benefits may be of limited value to you as long as your group health plan is the primary payer of your medical bills.

Also, be aware that Original Medicare – Parts A and B – do not include coverage for your prescriptions, as does a traditional HMO or PPO plan from your employer. For this you’ll need to enroll in a Part D plan that’s available in your state. Medicare prescription drug plans start at less than $20 per month.

As with your employer’s health plan, Medicare does not cover all costs. Parts A and B have co-insurance and deductibles baked in, and they are pretty hefty. After you pay the deductibles, Original Medicare covers 80 percent of approved costs, leaving you on the hook to pay the rest. This can be devastating if you don’t buy supplemental insurance, called a Medicare Supplement or Medigap plan. They are called Medigap plans because they cover the insurance gaps. They can range from about $120 to $500 per month, depending on where you live and how much coverage you need.

PLEASE NOTE:  If you work for a small company (20 employees or less), speak to your employee health benefits administrator before making any decisions.  In this case Medicare is the primary payer and your group health insurance would be the secondary payer.


Optimizing Your Medicare Prescription Drug Plan

If you take regular prescriptions, you already know how expensive it can be. The older we get, the more chronic conditions set in, and our medications get even more expensive. That’s why having a prescription drug plan is so important.

For people with Medicare health insurance benefits there are two ways to get drug coverage. You can enroll in Original Medicare and opt for a Medicare Prescription Drug Plan (PDP). If you choose, you may enroll in a Medicare Advantage (MAPD) Plan, known as Part C, which includes prescription drug coverage.

Ideas to help you save out-of-pocket expenses:

  • Avoid the late enrollment penalty by opting for prescription drug coverage as soon as you are eligible.
  • Choose the right plan for you. Use the Plan Finder tool which can help you find out which plans are available in your area. Then you can compare the various options.
  • A formulary is a list of drugs your plan covers. Be sure your plan’s formulary includes the drugs you need, or you will have to pay for them out-of-pocket. Many plans also group drugs into tiers, with those in lower tiers costing less than those in higher ones. If you have been using expensive drugs in a higher tier, check with your doctor if there are generic drugs or equivalent lower tier drugs.
  • Use generic drugs if possible with your doctor’s approval. They are as safe and strong as brand-name drugs, and there is often little or no copayment.
  • Refill less often. Instead of buying the drugs you need every month, buy a two- or three-month supply. You’ll save money by buying in bulk, and you’ll only have to make one copayment to fill your prescription.
  • See if there’s a pharmacy with mail service in your plan; it’s often less expensive.
  • Find out if you qualify for Extra Help to help meet your prescription drug costs.

In conclusion, there are things you can do to help keep your prescription drug costs down, if you are diligent to attend to these details.

The Most Important Things to Keep Yourself Fit

Our organism needs like 40 kinds of nutrients in order to function properly. The most needed are amino acids, vitamins, minerals and essential fatty acids. As we need energy to function and receive it from processing food, our eating habits have great impact on our well being and body shape.

Habits, traditions, taste, cultural and social circumstances fundamentally determine our eating style. To set up a healthy eating habit, we need to focus not only on the basic elements, but also on quality and quantity of the food as well.

In order to keep our body fit and maintain a proper weight, besides the constitution, lifestyle, gender, age and inherited features, we can watch over the daily calorie intake with the help of a Calorie Counter . Whoever systematically consumes more calories than needed, most likely will gain fat in excess.

It is also recommendable to avoid too much stress and noise pollution as it increases tension and hinders the regeneration of the body. In stressful situations the blood pressure increases, the heart beats faster, the respiration is rapid and as the stress hormones are released, a whole chain of reaction takes place in the body. If the cause of the stress is eliminated, the body returns to its normal function. However, if the stress lasts too long and it is not followed by a recharging period, we can get exhausted and serious health problems may occur.

If it is possible do not miss a good night sleep, as during it growth hormones are released to help the tissues to regenerate and the body rests. But as a matter of fact nowadays almost everyone has to live a quite stressful life. You can also reduce the unwholesome effect of this with a healthy diet. This helps your body remain fit and strong and collaterally ease you to develop effective coping techniques with stress.

In order to keep our body fit and to maintain physical condition we need to exercise. Please remember that great physical condition is not always equal to good health but it certainly is a sign of it. If it is possible, choose something you like and what involves and works out all muscles types.

Exercising systematically will result in increased muscle and heart efficiency, improved blood circulation, easier respiration and the elimination of toxic substances will accelerate. We become more agile, flexible, our reflexes will sharpen and our immune system will be more resistant to different illnesses. Personal hygiene is also a base pillar in maintaining health as well as some exams and screenings by a health care provider should be done yearly, depending on age, medical and family history and individual choices. Exams and screenings should include a mammogram every 1-2 years (over 40 years of age); a Pap test every 1-3 years; and checks for blood pressure, sexually transmitted diseases, vision, dental, diabetes, depression and more.