Medicare Basics: An Introduction To Medicare

By |2020-08-13T06:40:20+00:00August 14th, 2020|Categories: Blog and News, NHIA Blog|Tags: , , , |

If you are an older adult, you have definitely heard of Medicare. Even if you are younger, you know the term, even if you do not know what it means. This week we are breaking down the Medicare basics. Read on to learn about what exactly Medicare basics are and who is eligible.

 What Is Medicare?

Medicare is a nation-wide insurance program for Social Security recipients. The recipients must meet one of two criteria: they are at least 65 years of age or they are permanently disabled.

Medicare Vs Medicaid

Medicaid is a welfare program, while Medicare is not. Medicaid is a program that provides medical coverage to low-income families and individuals.

Part Of Medicare

There are four parts of Medicare. While part A and B are the most substantial, all four cover different components of health. For more detailed explanation of the parts of Medicare, check our article here.

Part A

Part A is hospital coverage. Medicare automatically awards part A to everyone who earns coverage. This covers hospital stays, hospice care, and nursing homes.

Part B

Part B covers doctor services and outpatient care. In addition, part B takes care of lab work, screenings and medical equipment. However, part B does have an associated cost.

Part C

Part C combines Medicare with private health insurance. You might also hear part C as “Medicare Advantage”. It combines parts A and B as well as additional coverage options through private health insurance.

Part D

Insurance experts refer to part D as the prescription drug plan. This plan covers a portion or al of an individual’s prescription drug costs.

Medicare Eligibility

Medicare has more open eligibility than most people initially believe.

Firstly, the most common group of people that Medicare covers are individuals who earn Social Security in addition to an age qualification. That is, they must reach 65 years of age or older.

Then, the next most common are individuals who earn Social Security for at least 24 months.

In addition, there are many smaller groups of qualified individuals. Read more about those groups here.

Where To Enroll

Luckily, it is not too difficult to enroll in Medicare. Local Social Security Administration offices accept enrollment. In addition, Railroad retirees enroll through their Railroad Retirement Board. Finally, enroll online through the Social Security Administration website.

If You Need Assistance

Contact NHIA to learn more about Medicare coverage. Also learn about BlueMedicare supplements A, B, C, D, F, G, K, L, M, N as well as BlueMedicare Advantage plans.

The History of Medicare: An Origin Story

By |2020-08-12T02:13:42+00:00August 7th, 2020|Categories: Blog and News, NHIA Blog|Tags: , , , , |

Health insurance is a subject with a long history of debate in this country. The history of Medicare, in particular, is fraught with arguments and people on both sides of the political aisle have strong opinions. Read on to learn about the long history of Medicare and how the United States eventually reaches a (tenuous) agreement on the healthcare debate.

How Did We Get Medicare?

The Great Depression in the late 1920s and early 1930s revealed a gap in America’s health care. The need for health care is obvious, but experts argue on how to solve this problem even today. As unemployment skyrockets, people get more unwell. However, less Americans than ever have healthcare coverage. This is the first time the country considers healthcare as a national issue.

Truman Takes A Stand

In 1945, President Harry Truman proposes a national health insurance that he intends to cover the entire country. The proposal is for “health security for all, regardless of residence, station, or race – everywhere in the United States.”

When advocating for his legislation, Truman poses a question to the American people: “I put it to you, is it un-American to visit the sick, aid the afflicted or comfort the dying? I thought that was simple Christianity.”

Truman’s national healthcare plan has five goals.

  1. Look at the and attempt to solve the lack of healthcare professionals in certain communities.
  2. Improve and expand public health services.
  3. Put more money toward medical research and medical education.
  4. Reduce the cost of individuals’ medical care.
  5. Promote awareness of the economic impact of severe and chronic illnesses.

Ultimately, Truman emphasizes that health insurance coverage for America would shift from covering 33% of the national population to 90% of the population with his plan in place.

How Truman’s Plan Works

Truman’s intention to finance this plan works through monthly payments from Americans. Each person pays a certain amount of taxes and fees every month. His intention is to adjust the amount to fit what individuals can afford.

However, Republicans in Congress label this plan as “Communist”, a very unpopular label in the 1940s. After the general public buys into the label, it quickly falls through.

The Johnson Administration

After two decades of public and Congressional debate, President Lyndon B. Johnson signs the Medicare Act of 1965. This act establishes Medicare, providing healthcare to U.S. citizens who are 65 years of age or older.

Johnson invites President Truman and his wife to the signing. At the time of the signing, Johnson recognizes Truman’s work, dubbing him the “real daddy of healthcare”.

The Obama Administration

President Barack Obama signs the Affordable Care Act into law in 2010. The act further expands health insurance coverage for all Americans.

Medicare Parts Explained

By |2020-04-16T01:08:10+00:00April 15th, 2020|Categories: Blog and News, NHIA Blog|Tags: , , |

Medicare Parts can be difficult to understand. That’s why we are including it in our back to the basics month. Seniors all over the states participate in the Medicare medical plans. But, sometimes they don’t fully understand what is actually covered under these plans. In this article, we will explain the Medicare parts and talk about what is included in each.

Do you or a loved one have Medicare? Do you assist in medical care for an elder who has Medicare? Getting old and wondering what Medicare is? At the risk of sounding like a late night infomercial, these questions are actually more important than you think. Medicare is insurance coverage and benefits intended to help provide coverage for senior citizens. There are four Medicare parts to explain. Let’s get started.

This article does not cover all terms, conditions or benefits of the Medicare coverage system. For a full explanation of a policy, or if you are in need of insurance, please call us at National Health Insurance Agencies. One our policy service members would be happy to assist you.

Part A

Medicare Part A is hospital coverage. When you are accepted for Medicare, you automatically get Part A coverage. This part covers hospital stays, hospice care and nursing care related to rehabilitation even if it has to be completed in a nursing home. A semi-benefit of this plan is that there is no monthly premium. However, if you are unfortunately admitted to a hospital often, it may cost more from you than you expect. A high deductible is part of your out-of-pocket costs for this plan. The deductible changes each year, but can be between one to two thousand dollars per hospital admittance. Afterwards, Part A pays for nearly all other charges associated with your stay for 60 days.

Part B

Medicare Part B refers to doctor’s services and outpatient care.  Firstly, this part covers things like lab work, screenings and medical equipment. However, there are more costs associated with Part B including a monthly premium and an annual deductible. Many people choose to weigh their options with this plan despite its benefits. Speaking with an insurance agent about Part B coverage may help you make an informed decision.

Part C

Medicare Part C is also known as the Medicare Advantage (MA). This plan is often offered by private insurers managing Medicare coverages for seniors. Part C includes the benefits of A and B (which you’ll have to pay for) as well as the definition of a plan type. Meaning, Part C lumps A and B together with extra benefits that come with private health insurance. Part C coverage varies with the coverage provider. It is important to take time to research both the insurer and coverage options before making a selection.

Part D

Medicare Part D is most notably called the Prescription Drug Plan. As noted, this plan pays for some or all of your prescription drug costs. This plan is purchased through a private insurer. Some insurers may even include it in Part C. Coverage options and insurers should be thoroughly researched. There are several rules or exclusions that are associated with this plan. For more information, click here.

At National Health Insurance Agencies, we care about your health and safety. For assistance finding your best coverage, contact us today. Afterhours? Request a free quote!

Tips to Help Minimize Medicare Costs

By |2018-10-16T18:45:43+00:00February 18th, 2019|Categories: Blog and News, NHIA Blog|Tags: , |

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One of the lessons learned by so many newly retired Americans is just how expensive post-retirement healthcare coverage can cost. It’s one of the largest retirement expenses that you will face on retirement and a reason we see so many people working past the age of 65. In fact, most couples spend an average of $400,000 total on their healthcare after retirement. Needless to say that finding ways to save money in this area can be a critical part of your life after retirement.

The first thing you have to know is that you cannot do anything about the rising cost of healthcare every year so it’s best not to let it drag you down. Let’s focus on factors that you can control.

One factor that everyone must face is that the rules for Medicare are convoluted and complex. That means you will need to pay close attention to detail in order to maximize your savings.

Medicare Timelines that you Must Know

Timing can make a huge difference! Individuals will normally be eligible for Medicare upon reaching the age of 65. However, what a lot of people don’t realize is that the window to sign-up for Medicare will open three months before the month of their 65th birthday. Enrollment then ends three months after their 65th birthday.

Most people wait until they turn 65 to apply and end up pushing their deadline because of the time it takes to put through the paperwork. With that said, it’s also important to understand that while you can decline Part B of the coverage, there are penalties that ensue as a result of declining that coverage. Every year that you are eligible for Part B but do not enroll, you will incur a 10% penalty that is cumulative. Furthermore, applying for Part D late will result in a 1% monthly penalty. Both of these penalties can add up quickly.

HSA Becomes Complicated

Enrolling in Medicare Part A will make you ineligible to put money into an HAS. However, you will still be able to withdraw funds from this account tax-free.

What many people overlook is that when you start collecting Social Security benefits, you are automatically enrolled in Medicare Part A. That means you have to stop making any contributions to your HSA accounts. But if you want to keep working after 65, you can decline all Medicare coverage.

Income-Based Surcharges

At the time of this post, there are income-based rules that will increase the premiums for Medicare Parts B and D if your adjusted gross income goes over a specific amount. Furthermore, you will have a two-year look-back period that will be used to decide whether or not you have to apply income-based surcharges. That means wages you earned two years ago will determine your current income-based surcharges.

Conclusion

The rules surrounding Medicare are really complicated and the only way you can save money is to learn all of the language. Study your plan carefully and plan accordingly. You need to have a high attention to detail, otherwise you will end up adding to its already high cost.

Medicare Tips that All New Retirees Need to Know

By |2018-10-16T18:46:53+00:00February 10th, 2019|Categories: Blog and News, NHIA Blog|Tags: , |

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Swapping over to Medicare from the traditional employer health insurance plan can be a stressful transition. Most employers will only offer limited choices and those companies pay a large portion of those costs. When you swap over to Medicare, it’s easy to get overwhelmed by the sheer number of choices available. The prices can also be quite steep when compared to employer insurance. Those who go it alone usually end up overwhelmed and sometimes make the wrong choice.

Don’t panic! We’re here to help. Here are a few tips that will help you make this difficult transition

There is Not a Family Plan

Family plans do not exist in Medicare. While typical insurance covers you, your spouse, and your children, you will quickly learn that they will need to find an insurance plan of their own. You and your spouse will probably need different plans too since you probably have different needs.

Make sure that you understand both you and your spouse will have to sign up for Medicare when reaching 65 years of age. Of course, if your spouse still works at a job that has family coverage, then you might be able to stay on their plan until they retire.

Caps are Not Automatic

Caps on out-of-pocket expenses are not automatic. Most employer provided insurance comes with an annual limit on out-of-pocket healthcare expenses. On the other hand, Medicare will cover 80% of the costs but has no cap. It’s straight-up 80% from beginning to end.

This is not as bad as many people tend to think when they first see it. The major difference comes when an individual moves from a traditional employer plan to the Medicare Part D drug plan.

Strategically Schedule Certain Procedures

Yu should compare all of your expenses from your employer coverage with your new Medicare coverage to learn exactly what types of coverage you have. For instance, some people end up with much better hospitalization coverage with Medicare. This might cause you to look for a new place to get the next elective surgery.

On the other hand, if your employer provides really amazing coverage then you might want to get those elective procedures out of the way before moving over to Medicare.

Wellness Features are Likely Different

Wellness features are probably going to be much different when you swap over to your new Medicare plan. There are a ton of free wellness services offered by Medicare. Even though some traditional employer plans do offer wellness services, Medicare of usually superior on this regard. It’s usually designed to entice individuals to get their screenings in order to prevent health complications.

Medicare also tends to provide better coverage for in-person visits while commercial programs tend to lean more towards offering telephone advice. You should make sure that you compare both plans to see what new wellness services you have access to.

Swapping over to Medicare can be quite intimidating but hopefully you are better prepared now. Just remember that if you need help, then don’t be afraid to ask someone who has been through the process.

If for some reason your application is denied, here are some additional steps you can take.

6 Tips you Must Follow When Enrolling in Medicare

By |2018-10-16T18:40:42+00:00February 3rd, 2019|Categories: Blog and News, NHIA Blog|Tags: |

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In most cases, Medicare enrollment is open between October and December. The problem is that Medicare is a huge winding maze of uncertainty. It confuses most people to the point where they are just making their best guess as to what their next step is. So I am going to provide you with several tips that you must follow when enrolling in Medicare.

Let’s start off with two essential facts:

  1. Everyone who signs up is going to go through the Social Security Administration. That is the agency where you will direct all questions and complete the actual registration.
  2. If you are already receiving Social Security benefits before you turn 65, you’re not going to have to do anything at all. You will automatically be registered for Medicare Part A. Then you will be transferred to Medicare Part B at the start of your 65th birthday month.

Now let’s move onto to some tips to help you through this stressful time.

Start Early!

This is not an area where you should procrastinate. Begin the application process as soon as possible. You should start applying at least three months before your 65th birthday. Visit your Social Security office or sign up online. No matter what you choose, it’s important that you start now.

Understand the Different Types of Medicare

Study each plan carefully and try to get a clear understanding of all available plans. Here is a quick look at each Medicare plan:

  • Plan A covers medical facilities
  • Plan B covers medical Facilities
  • Plan C mimics private insurance plans and serves as an alternative to Plan A or Plan B.
  • Plan D is a prescription drug plan and used to supplement gaps in coverage.

You also need to start getting used to the language used in Medicare so that you are able to make better choices.

Get Research Assistance

You should get someone to assist in your research if you are having trouble. A trusted family member or friend can be a valuable aid. This is especially true if they have already dealt with issues related to Medicare. They are an amazing resource if you are confused or intimidated by the overall process.

Call the Social Security Office

Don’t be afraid to contact your local Social Security office if you have any questions. If there is anything you don’t understand, then they should be able to help. Do not sign or agree to anything without fully understanding it. Keep asking questions and stay on the line until all of your questions have been answered.

Call at the Right Time to Avoid Delays

Choose the right time to call and you will avoid long delays. Avoid calling anytime close to the first of the month or early in the morning on Monday or Friday. The best time to call is between Tuesday and Thursday.

Try Not to Get Stressed

Applying for coverage is not as scary as many people tend to believe. Sure, there is a lot of bureaucracy around it and the terminology can be confusing, but there are people who are willing to help. It’s a logical and precise system once you get the basics down. Don’t let it stress you out.

Working at 65 – Do I Need to Sign Up for Medicare?

By |2018-10-03T18:02:39+00:00November 15th, 2018|Categories: Blog and News|Tags: |

In this day and age, more Americans are reaching retirement age and still working. If you are looking at that 65th birthday, but still intend to keep working, there are some considerations to make. For Medicare, you are supposed to enroll at 65 when you retire, but if you don’t plan to retire, do you still need to enroll? The answer is a vague maybe that depends on several circumstances.

The Size of Your Company Matters

If you are working for a company with 20 or more employees, then you do not need not need to enroll at Medicare at 65. You can still keep your employer’s health insurance as your own until you retire. However, if your company is under 20 employees, you will want to enroll in Medicare as these sort of health insurance plans can decline to pay for care if you are past retirement age.

Corporate Retiree Health Benefits and COBRA

COBRA health benefits can cover you for several months after you leave your job, and in a similar vein some plans allow you to keep health benefits after you leave the company. However, if you are getting health care from either of these plans, they will be considered secondary plans and you will still need to sign up for Medicare. Often with these plans if you are past retirement age, you may find that they do not pay or cover every procedure. With Medicare, it can help be a safety net.

What If You Don’t Sign Up for Medicare?

In most cases, you will be employed by a large enough company that you don’t need to sign up for Medicare if you are still working. However, if you leave your job, the clock for sign up starts ticking the day you leave, not when your retirement health benefits run out. After you retire, you have eight months to enroll in a Medicare plan. If you fail to do so within the time limit, you could be without benefits for quite awhile.

Do you need help with Medicare or other health insurance needs, contact us today.

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Medicare Advantage vs. Medigap

By |2018-10-03T17:59:28+00:00October 23rd, 2018|Categories: Blog and News|Tags: , , |

Medicare subscribers have two options if they want to go beyond the basic coverage provided by original Medicare. You can either sign up for a Medigap plan or get Medicare Part C, also known as Medicare advantage. Here are the positive features of each option.

Reasons for choosing Medicare Advantage

  • premiums for Medicare advantage plans are typically lower than those of comparable Medigap plans
  • some Medicare advantage plans include prescription drug coverage, which can save you the need to get a Medicare Part D plan
  • you can get a Medicare Advantage plan or switch to a different plan during open enrollment at the end of each calendar year
  • unlike Medigap plans, Medicare Advantage plans can never deny you coverage based on pre-existing conditions

Reasons for choosing Medigap

  • Medigap plans usually have lower out-of-pocket expenses than Medicare Advantage plans
  • if you have a Medigap plan, you can see any doctor who takes Medicare; there are no physician networks to worry about
  • under Medigap, you don’t need referrals to see a specialist
  • Medigap plans pay the doctor directly, usually without any co-pay on your part – which can greatly simplify paperwork involved in your medical expenses

While there are many reasons for preferring one of these options over the other, if you have significant health issues that require frequent medical care, you’ll probably spend less money over the long-term if you have a Medigap plan. The higher premiums are more than compensated by the lower out-of-pocket costs for such patients.

Before you make a decision between Medigap and Medicare Advantage, use the Medicare Plan Finder to see which plans are available in your area. Often the availability of certain plans will trump the more general benefits available to holders of these two different types of plans. The most important criterion is to choose a plan that provides the benefits you need in order to stay healthy.

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3 Tips For Getting Signed Up For Medicare

By |2018-10-03T17:56:54+00:00October 8th, 2018|Categories: Blog and News|Tags: |

When you turn 65, you can qualify for Medicare. However, if you haven’t had any experience with Medicare or other federal health insurance programs, you may have no idea where to begin. This can be overwhelming and frustrating for you when it really doesn’t have to be. Thankfully, there certain things that you can do to make this process a successful one. Here are 3 tips for getting signed up for Medicare.

Start The Process Early 

While you can’t officially get on Medicare until the month that you turn 65 years old, you can begin the process of signing up for it earlier. In fact, you can start the process up to 3 months before you turn 65 years old. This gives you plenty of time to gather any type of documentation, make a visit to your local Social Security office, etc.

Choose The Right Plan

When you sign up for Medicare, you have four different plans to look at and choose from. Plan A will cover medical facilities, plan B covers medical providers, plan C is used instead of A or B and acts more like a private insurance, and plan D is for prescriptions and any gaps in coverage. If you are familiar with each of these plans and what they provide, you can choose the correct plan or plans for you.

Ask All Questions Before Signing Up

Before you officially sign up for Medicare, it is very important that all of your questions are answered and all of your concerns are put at ease. In order to make this happen, it is important that you call the Social Security Administration. They are the ones who can correctly answer all of your questions and otherwise assist you. However, because their phone wait times can be long, it is important that you have given yourself a chunk of time to make this phone call.

When it comes to signing up for Medicare, be sure that you begin the process early, you choose the right plan, and you ask all of your questions before officially signing up.

To learn more about Medicare, you can visit us here.

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Medicare A, B, C’s

By |2016-06-28T11:03:43+00:00June 28th, 2016|Categories: Blog and News|Tags: |

family2Signing up for Medicare requires you to re-learn your ABC’s, not to mention learning about Supplement and Advantage plans. Having someone available from the National Health Insurance Agencies will help answer questions and bring things into focus.

To get started, a quick tour of the Medicare informational site  lays out the basics of Part A and Part B, those sections of Medicare that deal with covered hospital and doctor benefits. Parts A and B covers part of your medical bills. There are also supplemental plans that are available to cover you no matter where you are in the country (A, B, C, D, F, G).  You can choose any doctor and any facility, anywhere in the country. These plans come with a set monthly premium that you pay along with your Medicare Part B expense. Plans K, L, M, N also let you choose whatever doctor or facility you want, but it has a higher member cost sharing factor. That translates into a lower premium per month, but a higher cost when you see a doctor. There is also supplements to B, C, D and M plans that require you to use certain hospitals, but you can choose any doctor. These supplements are perfect for people who spend certain parts of the year in different areas of the country.

If you stay in one location, you may find that Medicare Advantage Plans will more closely meet your needs. With an Advantage Plan, usually there is no monthly premium. These plans are either Preferred Provider Organization (PPO), Health Maintenance Organization (HMO) or Part D Plan (PDP). Each of these plans have certain restrictions associated with the choice of a physician or facility. If you stay with the doctor’s that subscribe to the plan, your costs are minimal. If you choose a doctor or facility that does not subscribe to the plan, you can still use that facility, but you may have to pay all of the bill.

Examine your options to find the plan that meets your lifestyle, budget and medical care needs.

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This Is A Custom Widget

This Sliding Bar can be switched on or off in theme options, and can take any widget you throw at it or even fill it with your custom HTML Code. Its perfect for grabbing the attention of your viewers. Choose between 1, 2, 3 or 4 columns, set the background color, widget divider color, activate transparency, a top border or fully disable it on desktop and mobile.
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