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Medicare Supplement Plan: Hidden Risk and Benefits


The main objective of this post is to help you understand Medicare Supplement Plan and their role in your health care and also to help you select the right plan and right insurance company. 

Nowadays, there are a lot of insurance companies coming in on the market. They are opening one after another, all offering Medicare Health Services. There is no difference in benefits from one medicare supplement plan offered by one insurance company from the other, the only difference is the company itself. Some new insurance companies are only after the money made through medicare. 

We must look over those companies and determine if they outsource manpower outside their company. Usually, they don't last long and tend to sell their business to other companies as well. With this, you should know how unstable they are and if they suddenly stop selling new plans. 


Hidden Risks:
  • Prices increase very rapidly
  • look at the health questions/application to check if it has the potential to have higher expenses or high price increases. If you're new to Medicare, you don't have to answer health questions
  • Underwritings are different from one company to another, others have fewer questions and others are very good that they usually start from low then prices suddenly increase year after year

How will I filter them out?
  • Do not consider companies that have not been in the Medicare business for at least 5 years
  • If they don't have an A rating

Go after companies that have a history of price stability and have a solid foundation in Medicare.


Choosing a Medicare Supplement Plan

If you've chosen a Medicare Supplement Plan or have chosen to get a Medicare Supplement Plan that means you also have chosen to keep the Original Medicare Plan as your primary insurance. 

Why is this? Because basically, you get health care services from Original Medicare plan while Medicare Supplement Plan helps pay some of the health care costs that Original Medicare doesn't cover like coinsurance, copayments, and deductibles.

Medicare covers what is medically necessary.

Note: Definition of Terms
  • Coinsurance - An amount you may be required to pay as your share of the cost for services after you pay any deductibles. It is usually a percentage, for example, 20%.
  • Copayment - An amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor's visit, hospital outpatient visit, or prescription drug. It is usually a set amount, rather than a percentage. For example, you might pay $10 for a doctor's visit.
  • Deductible - The amount you pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay.

Before diving into any Medicare Supplement Plan, you need to know if your State has any specific rules that overwrite Medicare in the consumer's favor and can impact your decision. You should also consider the future cost that will impact your budget. 

Things you should always consider:
  • geography
  • the plan itself
  • the company
For detailed information that will help you choose the best plan, you can download the Medicare Supplement Benefit Table.

Benefit
Medicare Supplement's role is to reduce financial risk. Thus, you need to have it as soon as your eligible because you cannot change your Medicare Supplement plan once you are critically ill. 

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NCOV -19 and MEDICARE 2020

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Cardiovascular Disease Risk Reduction

Cardiovascular disease generally refers to conditions that can lead to a heart attack or stroke. Cardiovascular disease risk reduction visits can help detect and prevent this disease. How to know if I am Eligible? Medicare   Part B  covers an annual cardiovascular disease risk reduction visit with your primary care  provider . You do not need to show any signs or symptoms of cardiovascular disease to qualify for screening, but you must be considered competent and alert when counseling is provided.  During the screening, your provider may; Encourage aspirin use if the benefits outweigh the risks You are a man  of age 45-79 Or a woman of age 55-79 Screen for high blood pressure if you are age 18+ Provide behavioral counseling and tips to encourage a healthy diet Note: Men under 45 and women under 55 are not encouraged to use aspirin as a tool to reduce cardiovascular disease. How much will it cost? If you are eligible,  Original Medicare  will cover your cardiovascular disease risk red

Lifetime Reserve Days

There are  90 days of  inpatient  hospital care coverage on Original Medicare for each  benefit period , In addition, you also have an additional 60 days of coverag e , called LIFETIME RESERVE DAYS .   These Lifetime Reserved Days  can be used only ONCE, and you will pay a  coinsurance  for each of it. To have a better understanding of it, let’s imagine an individual who had a 120-day  Medicare -covered inpatient stay, this means that they used 30 lifetime reserve days. After they have been out of the hospital for 60 days in a row, they will be eligible for another 90 days of hospital coverage because they will be in a new  benefit period . However, if they need  inpatient care  beyond the benefit period maximum, they will only have 30 of their 60 lifetime reserve days remaining. The above example illustrates that lifetime reserve days do not have to be applied to the same hospital stay. If you need to stay in the hospital twice for 120 days each time during different benefit