Medigap Plan G – An Alternative To Medicare Supplement Plan F

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As you get older, your priority should be your bucket list, not your medical bills. But what are the most comprehensive healthcare options available? Currently, Medicare supplement Plans F and G are looked at as the best ways to take the surprises out of medical costs. While you may have heard about the merits of Medicare supplemental Plan F as a necessary addition to standard Medicare, important shifts are taking place that are calling you to seek out another option—and that alternative exists in the form of a Plan G Medicare supplemental policy.

As a result of the Medicare Access and CHIP Re-authorization Act of 2015, Medicare Plan F will be phased out before January 1st, 2020. While coverage under Plan F will continue for those already signed up, new enrollees will no longer be accepted. The repercussions of this are twofold:

  • If you already have Plan F, an aging clientele will mean your premiums will only increase down the road.
  • If you don’t, the option to enroll in Plan F will simply not be available to you in the future.

Luckily, this is no reason for concern. Plan G can easily fill the void at lower rates  than what you might have expected to pay.

If you’re feeling overwhelmed, don’t worry. We’ll explain step-by-step why it’s important for you to enroll in a comprehensive supplement plan, as well as what the difference is between the available medicare options.

Do I need a Medicare Supplement Plan?

If you are over or approaching 65, then the answer is yes.

The last thing you want to deal with when you are ill or injured is the stress of having to fork out money you have not budgeted for. Unforeseen medical bills only serve to compound the stress of being ill. To ensure you do not have to suffer being hit with unexpected costs, you need to have a plan in place.

There are two options here:

  • Medicare Advantage (or Part C)
  • Original Medicare, plus a Part D prescription drug plan and a Medicare supplemental plan, also known as Medigap.

Medicare Advantage is private insurance. While many of these plans look as though they will save you money upfront, they can end up costing you far more in the future—both in terms of money and convenience. Hidden costs and limited networks of healthcare providers, to name but two issues, can lead to later financial regret.

The other option is to combine your original Medicare with a Medigap plan. If comprehensive coverage is what you are after, your options are Medigap Plans F and G. Both plans cover supplement benefits, inpatient and outpatient services, and foreign travel.

Diving into Medicare Supplements Plan F and G

So what is the difference between the two, and how should you choose the best plan to suit your needs?

Standardized insurance plans through private companies

The first thing to understand about both Medigap Plans F and G is that they are standardized. While the plans are offered at different costs through private companies, the benefits you receive are regulated. The primary piece of advice we can offer here is not to pay more for an identical policy that  you can get at a lower cost.

The differences between Medicare Plan F and G

The next step is choosing between the two plans. If you have already made this choice, it might be worth revisiting your decision. As we have already mentioned, Plan F is in the process of being phased out. Insurance rates decrease based on popularity, so it is not difficult to see that for this reason alone, it is advisable to move over to a more sustainable plan.

But what are the differences between the services the two plans offer? Will you still be receiving the same coverage if you move over? Are there any hidden costs attached to Plan G?

To answer these questions, let’s have a look at this table the Florida Office of Insurance Regulation issued of the various supplement plans available:

Source: https://www.floir.com/siteDocuments/MedSupPlanCharts.pdf

According to the chart, the difference between the two is that Plan G does not include the $185 Medicare Part B deductible, while Plan F does. If you have not heard of Part B before, it covers outpatient care that is deemed to be necessary. This can include doctor’s visits, diagnostic imagery, dialysis, ambulance rides, and treatments such as chemotherapy, to name a few.

The next question is whether not having the deductible covered is a smart financial move or not.

The financial case for choosing Medigap Plan G

Is not having to pay the extra Part B deductible a good enough incentive to stick with Plan F? The answer is no, it’s not. If you crunch the numbers, you will be able to see how quickly the extra cost is absorbed into the overall financial benefits of Plan G.

Here are five simple reasons to choose Plan G:

1. The Medicare Plan F cost is substantially higher.

While Medicare Part F rates include the Part B deductible, this annual fee by no means offsets the difference in price between the two plans. Shop around on our website for the cost of Plan G in your area and you will quickly see that it makes financial sense to pay the additional annual fee of $183 in addition to your supplementary insurance. The cost difference between Plan F and G options can be over $400. Spend $185 to keep $400? Makes sense to us.

2. The Medicare Supplement Plan G cost has a lower rate increase as it gains in popularity.

While Plan F has been the popular option for the last few years, this is set to change. As we look to the 2020 changeover, the popularity of Plan G is gaining traction. The result is lower future premiums for you if you choose to make the switch.

3. You will receive comprehensive hospital care.

Going to the hospital can be crippling in more ways than one. When you are fit and healthy, it is often hard to imagine lying in a hospital bed. Like it or not, unfortunately we all have to budget for this potential setback. With all you would have to deal with in this event, make sure your purse doesn’t suffer as well.

By choosing Plan G over Plan F, you are not forgoing any of your coverage. Plan G will fully insure you against any medical eventuality. If you’re wondering about how it will work together with Medicare, your standard policy will pay 80% of your bills, and Plan G will cover the remainder.

4. You no longer have to worry about foreign travel cover.

If you are using your twilight years to see the world, Plan G will ensure you do not have to worry while you do so. With up to $50,000 in foreign travel emergency benefits, you can focus on all those new sights and smells while Plan G serves as your invisible Armour.

5. Be ahead of the curve when it comes to industry changes

The reality is that the change is coming, and very soon. Why deliberate? You don’t want to be sitting five years down the line wishing you had made the decision earlier.

How do I get Plan G?

Are you as convinced as we are that this is the best move for your future health? We thought so.

The great news is, regardless of whether you already have a supplementary policy or not, getting on board with Plan G is simple and easy. Costs vary depending on factors such as your age, lifestyle and area you live in, so head over to the SecureCare65 website to get a quote that will take all the guesswork out of the decision.

To make sure you make an informed decision that will benefit you in the long term, we have included a comparison tool that will allow you to have a look at the various options.

Your golden years should be polished with tears of joy, not anguish. To make sure this happens, it is vital that you put the time in to research the health insurance options available so you can make a decision that benefits you in the long run.

If you would like to talk to an advisor about your options, feel free to give us a call at 1-800-354-1078. It might just be the call that changes the way you feel about healthcare.

AARP Medicare Supplement Insurance Plan

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What is an AARP Insurance Plan?

An AARP Medicare Insurance program is a supplement insurance plan that supplements original Medicare by providing additional benefits to the policy holder. The plans, labelled A thru N, come in various shapes and sizes, and will be appropriate to you depending on factors such as premium costs and the degree of coverage you are looking for.

What makes AARP insurance plans different from other supplement plans is not hard to figure out — they are endorsed by AARP. If you are not familiar with this crucial organization, now is your chance to get acquainted with them. Their mandate is to empower people over the age of 50, promoting individual agency and quality of life for the older sector of the American population.

When choosing supplemental medical insurance, wouldn’t you want to go with an option that is endorsed by an organization that has your best interests at heart? AARP Medical Insurance packages provide exactly that — comprehensive cover backed by a group that genuinely cares for your well being.

So what exactly do AARP Medigap Plans offer you? To understand this, it’s important to first explore what a supplement plan is, how it can be an indispensable part of your healthcare plan, and why the AARP name should influence your decision.

First, let’s have a look at Medicare Supplement plans and how they are structured.

What is a Medicare Supplement / Medigap?

Remember the words Shakespeare put into Juliet’s mouth, “A rose by any other name would smell as sweet?” Although slightly less poetic, he may very well have substituted “rose” with “Medicare Supplement Plans.”

Known as both Medicare Supplement Insurance or Medigap insurance, these plans are standardized by the government and offered by Medicare-approved providers.

If you are already familiar with Medicare, you will know that Medicare Part A deals with hospitalization and Medicare Part B with medical insurance. Supplement plans are intended to fill out your medical coverage where Medicare Parts A and B leave off. To be eligible for Medigap insurance, you have to be enrolled in Parts A and B.

Medicare covers approximately 80% of medical expenses in exchange for a deductible of $1,340 for Part A per coverage period and $183 for Part B per year in 2018. The aim of Medigap is to keep you covered for that remaining 20%. The benefits of supplementing your Original Medicare are multiple:

  • Easy-to-budget medical expenses
  • Choice of doctor and hospital provided they are Medicare approved. (This is a big one. Medicare Advantage plans — an alternative for comprehensive coverage — typically restrict you to a tight network of doctors and hospitals. Going outside of these bounds can lead to unforeseen out-of-pocket expenses. Not going outside of them can lead to having to go to hospitals and doctors that are inconveniently located, or simply not your providers of choice.)
  • Ability to see a specialist without a referral from your family doctor
  • Government-standardized plans, meaning you will not be taken for a ride by a private company.
  • Lifetime coverage provided you keep up with your payments
  • Your plan travels with you no matter where you go in the country, and in some cases, includes medical insurance for travel abroad.

When choosing a Medigap policy, many people are gravitating toward the AARP-approved plans — and with good reason. With a decision as important as your own health, wouldn’t you want to go with a choice endorsed by a body as respected as AARP?

We are going to take you on a journey through the history of AARP and let you into the values upon which they were founded on.

The History of AARP

Once upon a time, there was a forward-thinking retired high school principal named Dr. Ethel Percy Andrus. She saw the need to create an organization that would bind together retired teachers from all over the country based on her philosophy of productive aging. In this way of thinking, aging is not something to be feared. Seniors are important members of society with much to contribute. After all, aren’t they the ones with the life experience?

It was from this ideological basis that, in 1947, the National Retired Teachers Association (NRTA) was born.

Dr. Andrus was on a mission. She sought to bring healthcare to retired teachers who quite simply had none available to them at the time, either from government or private sources. Eventually, she found an insurance company willing to take on the task of insuring seniors.

Ten years later, and after numerous requests from people who had retired from other industries, Dr. Andrus realized the need for this service to extend beyond retired teachers. In 1958, she formed the American Association of Retired Persons, or AARP. Later, AARP blew onto the international stage, and ARPI (the Association of Retired Persons International) was formed.

Thanks to Dr. Andrus and her vision, AARP still serves millions of Americans today, with its numbers sitting at about 38 million members. It has offices across the country in 50 states. It remains committed to serving the aging population through an organization that is both nonprofit and nonpartisan.

The Core Principles of AARP

AARP’s mission is “to empower people to choose how they live as they age.”

While the structure of the organization has changed over the years, they still retain their initial commitment to promote independence and dignity for the elderly. They value the experience that older people bring into the world and believe it should be cherished.

Comprehensive medical coverage is a vital component of their mission, as their endorsement empowers people to make informed decisions about their coverage that will mean they are always in control of both their health and their finances.

Even if you decide not to join AARP, you can still enjoy the benefits of an AARP Medical Insurance package, as membership is not a requirement.

Let’s explore what joining the millions of AARP Medical Plan subscribers will do for you.

The Top 7 Benefits of AARP Medical Plans

  1. Trusted expertise

The reality is, AARP has been in the game of medical insurance for seniors since its inception. They know the ins and outs of the specific needs of their focus demographic. What’s more, at the heart of their motives is your well being. The organization was founded on principles that value the autonomy of the older sector of the population and appreciate what they have to offer.

  1. Peer Referrals

According to research conducted by AARP’s Medicare Supplement Plan division, 9 out of 10 plan holders were happy with their plans and willing to recommend them to family members. What a thumbs up!

  1. Diversity of Plans

As we will explore further in a moment, there is a range of AARP Medicare Supplement Insurance plans that suit a variety of needs. Whether you are looking for a plan with low monthly premiums and lower coverage, or are willing to pay high premiums for more comprehensive benefits, there is a plan that will match your needs set.

  1. Fewer Health Questions

When you first sign up for Medicare, you have six months to sign up for a supplement plan in what is called an open enrollment period. If you do not sign up for Medigap in this phase, you will more than likely be asked a range of health questions before an insurance company takes you on as a client. AARP Medicare Supplement plans are less subject to health questioning compared to other policies.

  1. No claim-forms to complete

If you have an aversion to bureaucracy, this may just be one of the biggest perks of a AARP Medicare supplement plan. Provided you stick to Medicare-approved healthcare providers, you will not have to spend your days filling out claim-forms that seem to go on for eternity in the hope that you will be compensated.

  1. Available across the country

AARP is represented in 50 states. If you want to find out more about the organization, or speak to a representative about Medicare options, you will not have to travel very far. Medicare supplement providers are also located across the nation, so you can easily find someone to deal with in person.

  1. Become Part of a Community of Shared Values

If you believe that seniors should be treated with respect and dignity, you will be among good company in the AARP community. This is not only about signing up for supplemental health coverage. It’s also about connecting to a network of people who believe in each other’s rights.

If you’re ready to dive into AARP Medigap insurance, we can almost bet what your next question is going to be — how much is this all going to cost?

AARP Insurance Rates

The best way to find out the exact rates for your specific situation is to contact SecureCare65 and one of our licensed agents. We offer a free quotation service that will consider all the factors that affect your life, from location, to medical conditions, to age, to how often you are looking to travel abroad.

Until you have that quote in hand, however, let’s take you through what each of the AARP supplement plans entails. That way, you can start to wrap your head around which option will be best for you.

What does an AARP Medicare Insurance Plan Cover?

Before we tell you what they do cover, it’s important to note that the following are NOT covered by any Medicare Supplement Plan:

  • Prescription drugs
  • Private nursing
  • Vision
  • Hearing
  • Dental
  • Long-term Care

If you are looking for coverage that includes these items, we would be happy to talk you through your various options.

There are seven AARP Medicare Supplement Insurance Plans that offer varying degrees of coverage. As you will see, Plans K and L include an annual out-of-pocket spending limit, which the other plans do not.

Plan APlan BPlan CPlan FPlan KPlan LPlan N
Part A   (includes co-insurance + 365 hospital days after Medicare benefits end) 100%100%100%100%100%100%100%
Part B   (co-insurance / co-payment) 100%100%100%100%50%75%Co-pay
Blood   (first 3 pints each year) 100%100%100%100%50%75%100%
Hospice Care   (co-insurance / co-payment) 100%100%100%100%50%75%100%
Skilled Nursing Facility Care   (co-insurance / co-payment) 100%100%50%75%100%
Part A Deductible100%100%100%50%75%100%
Part B Deductible100%100%
Part B Excess Charges100%
Foreign Travel   Emergency Care 80%80%80%
Annual Out-Of-Pocket   Spending Limit $4940$2470

The various plans are loosely grouped in four categories based on how comprehensive the coverage is. Of course, the more widespread the coverage, the higher the premiums will be.

Let’s take a glance at what the most appropriate coverage might be for you based on your personal needs.

Plans A and B

If you are looking for lower monthly premiums, Plans A and B might be your best bet. Be warned, though — with lower premiums come lower benefits and the potential for higher out-of-pocket expenses. Even if you are fit and healthy now, you may want to consider coverage that accounts for the unknown future. It’s hard to imagine yourself in hospital if you have been healthy all your life, but the reality is it can happen to anyone. The last thing you want is to add financial stress to a health scare.

Plans C and F

Opting for Plans C and F means choosing near-full coverage. The trade-off is higher premiums for lower out-of-pocket costs. If you foresee that you will require hospitalization and other medical services, we would advise that it is worth paying the additional premium. This way, you can easily budget your medical expenses and stave off surprise costs.

Plans G

AARP Medicare supplement Plan G is almost the identical twin to AARP Medicare supplement Plan F except that it requires you to pay the Medicare Part B deductible of $183 (2018) annually. AARP Medicare Plan G is typically a much better value than Plan F as the premium savings over Plan F is usually much greater than the $183 Part B deductible which it requires you to pay.

Plans K and L

Like A and B, Plans K and L mean a lower monthly premium. Of course, with that comes less coverage of out-of-pocket costs, with many of the services being 50% or 75% covered for Plan K and L, respectively. Only consider these options if you are confident that you will not require a high degree of treatment in the future.

Plan N

Lastly, there’s Plan N. Plan N sits in the middle of the various options, offering mid-range premiums and mid-range benefits. The co-payment option for Plan B is worth noting, as it gives you the opportunity to pay lower premiums in exchange for co-payment on some office visits and on emergency visits that don’t result in admission.

Is an AARP Medicare Supplement a Good Choice for You?

The only way for us to answer this question for you is to have a conversation about your unique healthcare needs. You can either call us directly or fill in the form on our website for a free quotation.

Everyone’s needs are different. We want to ensure that yours are taken care of in a manner that takes into account the details of your situation. While Medicare Supplement plans are standardized, your unique requirements are not. That is why we would believe in talking directly to you so that together we can come up with a solution tailor-made to you.

Get in touch! We look forward to talking to you soon.

How & When Do I Enroll in Medicare Parts A & B?

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There are a number of times when you can sign up for Medicare Parts A & B and each of these come with a set of guidelines and limitations. For some who are lucky, they get automatically signed up for one or both programs. For others, the government offers a window of seven months wherein you can enroll in Medicare without being pressured by any medical underwriting. In some instances, the application process will have to be manually done.

The ideal time to enroll into Medicare Parts A & B is when you’re about to turn 65 years old. You will be provided an initial enrollment window for applying to Parts C and D, as well. It is important to know what this period covers especially if it is your first time.

WHEN to Apply for Medicare Part A and Part B

Initial Enrollment Period (IEP)

  • The seven months allowed for the IEP cover the following:
  • 3 months before you turn 65 years’ old
  • The month of your 65th birthday
  • 3 months after your 65th birthday

For example: If your birthday is in August, your IEP begins May 1 and ends November 31.

Note: If you are not able to enroll during this 7-month period, you have another chance during the next General Enrollment Period. You will also find yourself without health insurance for the entire duration of waiting, which can be risky. Medicare allows for late enrollment, however, but you will have to be prepared to shoulder the late fees and penalties.

General Enrollment Period

The GEP happens between January 1 and March 31 of every year. During this time, you can sign up for Medicare Part A and/or Part B if you were not able to sign up during the IEP and if you are not covered by the Special Enrollment Period although you might be required to pay a higher premium. If you decide to go with this option, your coverage will begin July 1 of the same year.

Special Enrollment Period for Medicare

SEPs may be availed if you were able to delay your enrollment to Medicare services. These will only apply for very specific terms, such as when you still have insurance coverage from your office (employer), eight months after this coverage closes for Part A and Part B, and 63 days after this coverage ends for Part C and Part D.

SEP can also apply if you are still covered by benefits from a union group health plan from your current employment or your spouse’s. If you have a disability and are working, or are receiving benefits from a family member who is employed, the SEP can also be considered if the company where you or your family is working has 100 employees or more.

Special Enrollment is also open to individuals who are volunteers and are serving in another country.

Open Enrollment

If you WERE able to avail of Medicare programs during the given period but would like to change your plan, you can do so during the Open Enrollment Period. Also Annual Coordinated Enrollment Period or Annual Election Period, this happens from October 15 to December 7 every year.

If you avail of this option, your revised coverage will begin January 1 of the following year. Open enrollment was created for several reasons, not just for those who missed the Initial Enrollment Period. To be clear, it is open to the following:

  • Those who have Medicare Part A and Part B who want to shift to a Part C
  • Those with Medicare Part C who want to return to Part A and Part B
  • Those with Medicare Part C who want to change to new Part C program
  • Those who are just signing up for Medicare Part A and Part B (who will be given the option to join, cancel, or switch to a Part D plan for prescription medication)

When to Apply for Medigap Plans

You can only avail of any of the 10 Medigap plans when you are already enrolled in Medicare Part A and Part B.

HOW to Apply for Medicare Part A and Part B

Some people will get enrolled into Medicare automatically, while some have to apply for it.

If you are already receiving disability benefits or Social Security retirement benefits the moment you turn 65 years old, you will be automatically enrolled in Part A and Part B. If this is so, you can expect to receive a welcome packet and Medicare ID card in the mail about three months before your birthday.

If not, there are three ways to apply: By Phone, Online, or in Person.

  • By Phone: Call the Social Security customer hotline 1-800-772-1213
  • In Person: Visit the Social Security office in your area
  • Online: Visit the Social Security official website

Things to Remember

  • You do not need to enroll for Medicare every year. However, you will be given a chance during the Open Enrollment period to review your program and make a switch as you wish.
  • Medicare is under the management of the Centers for Medicare & Medicaid Services (CMS). Social Security operates closely with the CMS by ensuring that citizens are enrolled into the program.
  • The Medicare ID is red, blue, and white. It will contain important information such as your Medicare Claim Number, what parts of Medicare (A or B) you have, when your coverage begins, and how to contact Medicare.
  • The Medicare number is typically the same as your Social Security number for practical reasons. Be sure to keep this safe and not share it with just anybody, save for your doctors and healthcare providers.

Is Original Medicare Enough for You?

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Original Medicare includes a wide range of medical services and treatments, but they do not cover everything that a person over 65-years of age may eventually require. Because the federal government is the one that provides it, it easy for recipients to assume that it offers comprehensive benefits. However, closer inspection of the actual needs of a senior will reveal that it only shoulders a portion of the potential medical expense one could be faced with.

This doesn’t mean that Medicare is a Band-Aid solution and is only meant to create a semblance of protection. For many people who are perfectly healthy, it is, indeed, sufficient but only until the unexpected may occur. The issue is that many people at age 65 are in need of ongoing medical care and this is why Medicare Supplement plans are offered by private insurers as add-ons.

What Original Medicare Includes

Before deciding if Original Medicare is enough for you, we have to first lay out what it does cover. There are four parts to the Original plan, with each responsible for a specific set of medical services.

Part A
Part B
Part C*
Part D
Inpatient and hospital coverage
Outpatient and medical coverage
Also called Medicare Advantage, it is an alternative way of obtaining Medicare benefits and consists of different health plans regulated by Medicare itself but operated by private insurance companies (such as PPOs and HMOs)
Coverage for prescription drugs

*Part C may only be obtained only if you already have Medicare Part A and Part B

HMO = Health Maintenance Organization; PPO = Preferred Provider Organization

More About Medicare Advantage

Medicare Advantage or Medicare Part C offers the same benefits as Part A and Part B, and most also cover Part D drug coverage in their packages. It is up to the insurance provider to decide how extensive its package will be and those who subscribe may or may not be asked to pay a monthly premium.

These plans are not available in all geographical areas and HMO’s typically require its members to visit only the hospitals and doctors that are listed in their networks to obtain full benefits, except when it is an emergency. Some PPOs allow members to seek services outside of the network but will charge higher copays. This is why Medicare advisors do not recommend this plan to people who do a lot of traveling.

What Original Medicare Does Not Include That U.S. Seniors Need?

Original Medicare does not cover most types of hearing, vision, or dental care. While Medicare Part A pays for specific dental services that happen in a hospital setting, and Part B covers care caused by an injury, that’s all there is to it. It does not include tooth extractions, dental plates, cleanings, fillings, dentures, and related services. Hearing aids, getting prescription eyeglasses, routine eye exams, and contact lenses are also not part of the plan.

Even Medicare Supplements (Medigap) do not cover these types of medical care. If they do (Enhanced Plans), you will have to pay a higher premium. If these are important to you and you do not want to pay upfront fees per procedure, you can enroll in a Medicare Advantage plan or purchase a supplemental insurance policy that covers specifically these services. Some private insurers offer special policies for vision, dental, and hearing only.

Another thing that Original Medicare does not cover is Long-term Care Coverage. This includes services received in a skilled nursing facility, a day care center for older adults, and an assisted living community. Given that these services can be very expensive, it’s not really a surprise why the government will not cover these costs. For that reason, you might want to enroll in a stand-alone long-term care insurance policy.

Why a Medicare Supplement Plan Is Important

The gaps in the Original Medicare are the reasons why Medigap (Medicare Supplement) is necessary. Because many 65-year-olds need ongoing care – and even if they don’t currently, the consequence of age could eventually reveal new illnesses, Medigap plans offered by private insurers are a necessity.

There are 10 different types of Medigap policies that priced differently depending on the extent of the coverage and benefits that are offered. Medigap may only be acquired if you have Medicare Part A and Part B and can only be purchased through private insurance companies. The coverage of the Medigap plans are standard across the U.S. but the fees will differ by company.

It is, thus, crucial that you shop around and compare rates first before deciding on which Medigap plan to sign up for. Just take note that you only have a limited period before and after your 65th birthday to choose a policy without being required to undergo medical underwriting. During this Open Enrollment Period, insurance providers are required to sign you up regardless of your pre-existing medical condition or health status.

What is the Medicare Annual Election Period

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Before you sign up for Medicare, you have to consider what type of services you need before committing to a plan. The choice often boils down to choosing Part A and Part B or Part C (also called Medicare Advantage) and Part D (Medicare prescription drugs). However, this does not mean that you are bound to the policy that you chose forever.

There are circumstances that will make you want to change your Medicare coverage. Fortunately, the federal government offers a yearly window of opportunity for those who want to make the switch to do so easily. This is called the Medicare Annual Election Period (AEP). During this time, you can dis-enroll from, change, or sign up for a plan.

The Medicare Annual Election Period happens only from October 15 to December 7 each year.

*Take note that AEP is different from the Open Enrollment Period, which applies only to Medicare Supplement Plans (Medigap).

What Can You Do During the AEP?

You cannot just make changes to your Medicare coverage anytime you want. This is why it is important that you know the right schedules when you are able to do so. Here’s what you can do during the AEP.

– Switch from Original Medicare Parts A and B to Medicare Advantage

– Switch from Medicare Advantage to Original Medicare Part A and B

– Switch from one Medicare Advantage policy to another (regardless whether they offer drug coverage)

– Sign up for a stand-alone Medicare Part D prescription drug plan

– Switch from one stand-alone Medicare Part D prescription drug plan to another one, and

– Dis-enroll from Medicare prescription drug coverage completely

When you avail of these changes during the October 15 to December 7 AEP, expect the changes to take effect beginning January 1 of the next year.

What to Do During AEP: A Checklist

Because the conditions of Medicare are ever-changing, it is advised that you consider the benefits on a per-year basis. After all, the AEP happens yearly. While you certainly wouldn’t want to keep switching every year, because that would be troublesome and stressful, getting advice from your doctor or qualified Medicare advisors will help you make an informed decision so that you don’t have any issues when the AEP approaches. Here’s a checklist that can help.

  1. Discuss your current Medicare plan with your doctor.

If you have Original Medigap with a Medigap add-on policy, ask your physician if he or she will continue to take Original Medicare next year. If the answer is yes, then you may continue your current plan, unless you have a major reason to switch.

If you are currently signed up in Medicare Advantage, where the fees can change yearly, there are several things you should consider. Is your doctor still part of the Medicare network and is he or she happy with the service? Is there a possibility of your doctor leaving the network in the next year?

  1. Pay attention to the Annual Notice of Change, which is sent out yearly.

If you are enrolled in Medicare Advantage or the Part D drug plan, you will receive an Annual Notice of Change in the mail before September 30 of each year. This packet contains information about changes that will be happening to your policy in the coming year. This package will be big, and people often neglect looking at its contents or put it off, until they do and they realize it’s too late to make any changes.

When you receive this envelope, just skim through what’s inside, take note of what is changing and decide if these are minor enough to stay with your current plan, or major enough to want to make a change. If it is the latter, it’s best to contact your Medicare agent right away to discuss your options.

  1. Know if the AEP dates are still valid.

The October 15 to December 7 AEP window changes from time to time. It certainly was not the same a few years ago, so be sure to always be updated yearly so you don’t miss any schedules. This window is short so be sure to verify if the same is happening this year and mark it on your calendar.

  1. Review you Prescription Drugs annually.

Have your prescription drugs changed in the past year? If so, you might want to re-evaluate your Part D prescription drug plan and see if it is still the best and most cost-efficient option for you. List them all down along with the frequency and dosage and have them ready for your agent to look over before October.

  1. Talk to your Medicare agent.

While it’s protocol for your Medicare agent to touch base with you at least once a year, it’s best to make a call in September to make sure that you have everything prepared and all choices are laid out before AEP arrives. Even if it’s just the start of the year, just drop in or make a friendly call. Better yet, remind him or her that you would like to set an appointment when the Annual Notice of Change arrives in September. Just make sure your agent is reminded of you so that you stay in his or her radar.

Finding the Best Package for Your Needs

When you consider making changes during AEP, the most important thing to do is get a thorough assessment of your current and projected healthcare expenses. Although you might already be satisfied with your current plan, it wouldn’t hurt to check out the prices offered by other providers to see if you’re getting the most bang out of your buck. Take note that Medicare Advantage plan fees vary depending on the provider.

If you’re still unsure if you should be concerned that AEP is approaching and what you should be doing to prepare, it’s best to consult with a qualified agent so everything is laid out clearly and no stone is left unturned. After all, it’s your health we are talking about here and that reason alone should be good enough for you to be extra mindful and vigilant about Medicare.

Medicare and Dental Coverage for Seniors

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Does a Medicare supplement plan include dental care? It does not. While Original Medicare Part A and Part B do shoulder some dental procedures that are necessary when you are in the hospital as an in-patient, it does not cover any procedure or consultation outside of a hospital stay. Seniors who would like to expand their insurance coverage to include dental care will have to purchase private dental insurance.

The types of procedures that Medicare will cover when you are in the hospital are those that are necessary to protect your overall health, or are prerequisites to another procedure that Medicare actually shoulders. Here are some instances where Medicare does provide dental coverage.

When Medicare DOES Cover Dental

There are specific instances when you will need to undergo a dental procedure so the doctors can proceed to another treatment that is covered by Medicare. For example, it may shoulder:

– Dental services necessary for certain jaw-related ailments prior to radiation treatment, such as oral cancer

– Oral exams prior to a kidney transplant

– Surgical procedures to rectify fractures on the face or the jaw

– Oral exams in a Federally Qualified Health Center or rural clinic before a heart valve replacement surgery

– Dental wirings and splints necessary post jaw surgery

– Surgeries that involve ridge reconstruction during a facial tumor removal procedure

– Dental-related hospitalizations where you require observation due to a health-threatening situation

In the case of hospitalizations that are dental-related, Medicare may cover the likes of x-rays, anesthesia, and even room and board, depending on the condition. However, it will not shoulder the expenses related to dentist fees and the charges for other attending physicians, such as anesthesiologists and radiologists.

Options for Senior Citizens to Acquire Dental Coverage

If you need a dental care plan in your senior years, you will need to be prepared to have it as an out-of-pocket expense because it will not be covered by Medicare. While there are specific inclusions, mostly related to hospitalization, it’s better to count it as an additional coverage that you must pay for.

So how can a senior citizen obtain a dental plan? There are several options.

  1. Enrol in a Medicare Advantage (Part C) plan

Medicare Advantage plans are another way to access Medicare benefits and may include dental care. While Medicare is administered by the U.S. government, Medicare Advantage is offered via private insurance agencies that are working under the rules set by the CMS (Centers for Medicare and Medicaid Services). Medicare Advantage are required to offer the minimum benefits under Original Medicare Part A and Part B, they have greater leeway when it comes to what more they can offer because they are private agencies. Typically, the extra benefits included are vision and dental care, as well as hearing care.

Generally, Medicare Advantage plans that offer dental benefits will cover preventive and diagnostic procedures such as x-rays, cleanings, and annual exams. Many Medicare Advantage providers can also include fillings, extractions, root canals, crowns, dentures, bridges, and treatment of gum diseases. Take note, however, that these plans might require to seek dental care only from a pre-selected list of dental clinics. You can also expect to pay a certain set amount for these services regardless of how much they really cost, while some might put a cap on the dental benefits that you can avail in a year.

  1. Check if your spouse has an existing dental plan and if you can enroll in it

If your spouse is currently employed and is enjoying a group plan that includes dental coverage, you might also qualify for this coverage. Ask your partner to inquire with his company on extended coverage for family members.

  1. Join a club that offers discounts on routine dental procedures

There are organizations where you pay a fee to become a member and then be entitled to a range of services on discount. Look for those clubs that offer special rates for dental procedures or are partnered with clinics that offer cheaper rates, in addition to other healthcare and lifestyle perks.

  1. Sign up for a stand-alone dental insurance policy

Most private insurance agencies offer dental coverage as an independent plan and you can certainly subscribe to a dental only policy. You will be asked to pay a monthly or quarterly premium, but the cost will generally be offset by lower out-of-pocket expenses. Many of the dental plans will require that you work only within a pre-listed network of clinics and healthcare professionals—and this list will vary depending on the private insurer you sign up with. Some plans will allow you to go outside of their network, although be prepared to pay a little more for their consultation fees and services.

What We Offer

At SecureCare65, we offer four types of dental care plans with features that range from routine checkups to the more advanced orthodontic care procedures. The maximum benefit of each also varies depending on the type of plan you sign up for and every package will have varying degrees of coverage for Preventive, Basic, Major, and Orthodontia procedures.

Plans   (For Year 1 only*)
Preventive
Basic
Major
Orthodontia
Spirit Choice 3500
100%
65%
25%
10%
Spirit Choice 1200/2500/5000
100%
50%
10%
10%
Spirit Choice 1200
100%
50%
25%
10%
Spirit Choice 750/1000/1250
100%
50%
10%
none

*The percentage of coverage increases as your subscription extends from year 1 to year 2 and to year 3.

For Spirit Choice 1200/2500/5000 and Spirit Choice 750/1000/1250, here is the distribution of benefits.

Spirit Choice 1200/2500/5000
Preventive
Basic
Major
Orthodontia
Year 1 (max. benefit $1,200)
100%
50%
10%
10%
Year 2 (max. benefit $2,500)
100%
60%
30%
25%
Year 3 (max. benefit $5,000)
100%
80%
50%
50%
Spirit Choice 750/1000/1250
Preventive
Basic
Major
Orthodontia
Year 1 (max. benefit $750)
100%
50%
10%
n/a
Year 2 (max. benefit $1,000)
100%
60%
30%
n/a
Year 3 (max. benefit $1,250)
100%
80%
50%
n/a

Preventive: 3 cleanings and 2 exams per calendar year

Basic: Sealants for 16 years old and below, 1 topical fluoride annually for 16 years old and below, basic fillings, 1 series of bitewing x-rays annually, and space maintainers

Major: Includes implants, simple extractions, oral surgery and restoration services, endodontic and periodontics’ treatments, 1 diagnostic x-ray in panoramic or full in any 3-year period, and prosthetic services such as dentures and bridges

Orthodontia: orthodontic care of proper teeth alignment for dependents under the age of 19 years; has a $1,200 lifetime maximum per child

Note: These rates are guaranteed for your first 12 months and may change in the succeeding years.

Some Reminders About Senior Dental Care

Dental coverage acquired as a stand-alone policy gives you the freedom to avail of any service you want at a price that it lower than the usual market rates. While you are paying a premium for these services, you will find that the healthcare providers included in the private company’s network will be more affordable, if not free. Should you want to obtain services of a dentists who is not part of the network, you will have to be ready to pay larger out-of-pocket fees.

To further illustrate the difference, let’s say you are having a crown installed. This is considered a Major procedure. Here is a sample of your possible fees.

Network
Usual Dentist’s Fee
Reduced Network Fee
Your Plan’s 50% coverage
Your out-of-pocket expense
Within the network
$985
$685
$342.50
$342.50
Outside the network
$985
$750
$375
$610

Before deciding on any dental care policy, talk to your preferred insurance agency about their inclusions and exclusions. For example, you might think that you can get veneers for aesthetic purposes and be able to get it for free because you have a dental plan, and then find out later that your policy does not cover it.

Be upfront with your queries and plans when it comes your oral healthcare, whether it’s for practical healthcare or aesthetic reasons. Better yet, talk to our team of healthcare plan experts so we can help you find the best and most cost effective policy that matches your and your family’s needs and budget.

Let us help you get an accurate quote before enrolling in any dental insurance plan by visiting us at https://securecare65.com/. You can also give us a call at 1-800-354-1078 so our customer service team can assist you immediately and answer any questions you might have

Medical Marijuana and Medicare

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The legalization of marijuana for medical and treatment purposes across several U.S. states has increased the discussion on its viability and safety. The issue remains controversial up to this day, especially as cannabis is listed by the Drug Enforcement Agency as a Schedule 1 drug, which means that it has a high potential for abuse and is seen to have no presently acceptable medical purpose for healing.

Studies on the effectiveness of consuming or inhaling cannabis are few and proof of their sustained positive effects are limited. Still, a growing number of senior citizens are turning to this alternative form of medicine to address a wide number of ageing related conditions and illnesses.

Medical Marijuana and Senior Citizens

According to the National Council for Aging Care, the number of senior citizens using medical marijuana has increased by a whopping 250 percent from 2006 to 2013. In a 2018 study conducted by physicians from the geriatric and palliative medicine at Northwell Health in New York, it was also revealed nine out of 10 seniors like using this product for addressing chronic pain and said they will recommend that their friends and loved ones take it as well.

Those who have used medical cannabis for treatment purposes present reasonable proof that it works, although because it is an herbal product, doctors caution that its effects may differ from person to person. Still, it has not stopped advocates of this treatment to promote it as reliable in terms of treating a wide number of child, adult, and senior health problems such as general pain, Alzheimer’s disease, mental health disorders and anxiety, eating disorders, sleep problems, neurological deficits, glaucoma, and more.

The Legalities of Medical Cannabis

Before moving forward to whether medical marijuana is qualified under Medicare coverage, we have to first understand the legal and state implications related to its use. First, it is classified as a Schedule 1 Drug, which means it is not generally accepted as safe for use. It is also not approved by the U.S. Food and Drug Administration, which is a primary prerequisite for qualifying for Medicare assistance. Although in some states, medical marijuana is considered acceptable and fully legal, it will first need the approval of the FDA for it to be classified as a true medical program.

Do note that for a drug or a treatment to obtain an FDA seal of approval, it will have to undergo clinical trials involving thousands of human subjects to determine the measurable benefits and true risks from its use. To date, there are no large-scale studies that will show the effectiveness of medical cannabis and prove that its benefits outweigh its risks and potential addictive issues.

Medical Marijuana and Medicare Assistance

So, does Medicare cover medical marijuana and its components? For now, it’s a big NO. If your doctor prescribes medical marijuana as part of your treatment program, even if you are in a state that declares it as legal, Medicare reserves the right to refuse shouldering its related expenses. Take note that you will first need a Medicare Part D policy to be able to seek subsidy or full coverage for prescription drugs, otherwise you will have to sign up for a Medicare Supplement (Medigap) to obtain assistance for medications.

Despite this snag, seniors who are supporters of medical marijuana shouldn’t lose hope just yet. This is because there are certain prescription drugs that may mimic the effects of cannabis, which then may be acceptable in Medicare or Medigap’s list of medications for coverage. It’s best that you speak with your healthcare provider to find the best options for care that will still be covered by your policy. Otherwise, be prepared to shoulder the out-of-pocket costs of incorporating medical cannabis to your maintenance or treatment program. If you have questions about the role of Medicare in the use of medical marijuana, talk to a qualified advisor who can help lay out all your choices before you make a decision. Medical cannabis is increasingly being accepted as a solid form of treatment for various types of illnesses. As its proponents launch more campaigns and conduct more research and studies about its effectiveness, it’s not really entirely impossible that Medicare and Medigap would also take it under their wings in the future.