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Medicare Advantage Plans Have A $0 Premium For Most

When it is time to consider Medicare, usually around the time you turn 65 years old, it would be wise to take a look at different Medicare Advantage plans. Medicare Advantage plans, also known as Medicare Part C, usually offer more benefits than Original Medicare for a lower cost. About one-third of Medicare beneficiaries have chosen to go with a Medicare Advantage plan, and it is projected to be almost 34% more in the upcoming years. The reason for this estimated rise and popularity is due to how many benefits you get at such a low cost, in fact, many plans have a $0 premium.

prescription drug bottles — *Medicare Advantage Plans will cover things that Original Medicare does not, such as prescription drug coverage.*

How Medicare Advantage Works

Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. MA plans include both Medicare Part A and Part B. When you enroll, you continue to pay your Part B premiums, and you have a separate monthly premium for having the Medicare Advantage plan (Part C plan). The Part C plan offers the same benefits offered by Original Medicare along with medically necessary procedures, prescription drug coverage and other benefits like vision and dental.

You must have Medicare Parts A and B to join an MA plan. You must also live in the plan’s service area, and you must not have End-Stage Renal Disease (ESRD).

Different Medicare Advantage plans:

Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Private Fee-for-Service (PFFS)
Special Needs Plans (SNPs)
HMO Point-Of-Service (HMOPOS)
Medical Savings Account (MSA)

How Cheap Medicare Advantage Costs

hundred dollar bills inside a glass jar. — *Medicare Advantage Plans will help you save money, especially since most plans have a $0 premium.*

If you worked for at least 10 years and paid Medicare taxes, then your Part A premiums are free, if not you will pay a monthly premium. The standard Part B monthly premiums for 2018 is $134, but may be higher depending on your income. For a Medicare Advantage plan (Part C), you pay very little. Around 81% of Medicare enrollees have the option of a $0 premium plan. If you do end up paying $0, you may be responsible for paying higher cost sharing such as copays, coinsurance, or deductibles (which is determinant on the plan you choose).

The average Medicare Advantage plan premium in 2018 will be around $30, and can range anywhere from $0 to $200 a month. An example of how affordable these plans are, are the estimated monthly premiums of different Advantage plans in 2017. HMO monthly rate was around $28, the Regional PPO plan was $41, and the Local PPO was around $55.

All Medicare Advantage plans include a yearly Maximum Out-of-Pocket amount. This amount is the maximum you will pay out of pocket for covered services within a year. When this limit is met, your plan will cover 100% of the costs for the rest of the year.

Need Help?

Medicare’s Open Enrollment is October 15-December 7 every year, which is when you can enroll into a Medicare Advantage plan. EZ.Insure will answer any questions you might have regarding the different plans, and guide you through the process. Start saving on Medicare costs with a low costing, or $0 premium Medicare Advantage plan! Our agents are trained and knowledgeable on the plans in your area. To start saving, contact an agent by entering your zip code in the bar above, email [email protected], and call 855-220-1144. What’s even better, is you get all this help from our agents free of charge. Our goal is to help you save and provide you with the best customer service possible.

Updated Medicare Advantage Guidelines

There are specific times of the year when you can enroll, disenroll, or switch from a Medicare Advantage Plan, also called Part C or MA Plans. These plans are sold by private insurance companies that are approved by Medicare. If you miss these enrollment periods, it may be hard to make changes to your coverage, or enroll in a new plan.

Initial Coverage Election Period (ICEP)

The Initial Coverage Election Period is when you are first eligible to enroll in a Medicare Advantage Plan. For most people eligibility begins when they turn 65. You are allowed to enroll anytime over a 7 month period. This 7 month period starts 3 months before you turn 65 and ends 3 months after your birthday month. This means if your 65th birthday is in May you have the ability to sign up from February through August.

The initial enrollment period is when you are eligible for Part A and Part B. If you delay enrolling in Part B, then your ICEP for Medicare Advantage will not take place until you enroll.

To be eligible you must:

Have Medicare Part A and Part B
Permanently reside in the service area of the Medicare Advantage plan
Not have End-Stage Renal Disease (ESRD)

If you missed or did not utilize the ICEP, you can still join a Medicare Advantage plan during two other periods:

Annual Enrollment Period (AEP)

The Annual Enrollment Period occurs every year from October 15 through December 7, with coverage beginning January 1. This period is also referred to as the Fall Open Enrollment. During this period, people who are eligible can enroll in a Medicare Advantage plan. You can also switch plans and add, drop or change prescription drug coverage during the AEP.

Special Enrollment Period (SEP)

A Special Enrollment Period is a period when beneficiaries can enroll, or make changes to their Medicare Advantage plan outside of regular enrollment periods. If you qualify and get granted an SEP, your coverage will start the first of the month after you sign up. Certain situations are required to be eligible for a SEP, such as:

Moving out of your plan’s service area
Having full Medicaid coverage and Medicare
Qualifying for a low-income subsidy program
Tricked or misled into joining a plan
Living in a nursing home, rehab hospital, or skilled nursing facility
Enrolled in a State Pharmaceutical Assistance Program, or lose SPAP eligibility
Joining a Medicare Advantage plan during your initial enrollment period when you turned 65. The first year is considered a trial period, so you can change to Original Medicare at any time within the 12 months.
Receiving Extra Help to pay for your prescription drugs

In order to enroll in a Special Enrollment Period, you must apply and provide the necessary proof regarding the qualifying situation.

5-Star SEP

During the 5-star special election period, you can switch to a 5-star Medicare Advantage Plan from December 8 through November 30. The plan will go into effect beginning December 1. It is important to know that you can only use this SEP once per calendar year. After receiving your application, you will begin coverage the first day of the following month. To be eligible, you have to have Medicare Part A and B, and live in the service area.

What you can do during this period is:

Drop Original Medicare and enroll in a 5-star Medicare Advantage plan.
Switch from any Medicare Advantage plan to a 5-star Medicare Advantage plan.
Switch from a 5-star Medicare Advantage plan to a different 5-star Medicare Advantage plan.

Medicare star ratings are updated every fall on Medicare.gov.

Medicare Advantage Disenrollment Period (MADP)

Another different kind of enrollment period is the Medicare Advantage Disenrollment Period. This period occurs from January 1, to February 14 every year. This is when you can drop your current Medicare Advantage plan and switch to Original Medicare with or without adding a stand-alone Medicare drug plan (Part D). You cannot enroll in a Medicare Advantage plan, or switch to another Medicare Advantage Plan during this period, only drop a MA plan.

Shopping around will help you save money while finding a plan that best suits your needs. Research has shown that people with Medicare Advantage Plans could lower their costs just by shopping plans every year. EZ.Insure can help you shop around and compare different Medicare Advantage plans in your area. You can speak to one of our agent’s one on one without any hassle or obligation. To get started, just call 855-220-1144, email at [email protected], or simply put your zip code in the bar below to get quotes. The process of choosing a plan or signing up should not be difficult, make easy for you.

Trump Takes Action on Lowering Medicare Drug Prices

Medicare drug prices continue to increase making it harder for seniors to afford, President Trump decided to take action. Trump proposed a plan to bring down the prices of Medicare drugs by giving back to customers and focusing on raising foreign drug prices.

The federal government is not allowed to negotiate Medicare drug prices, so Trump said his plan will work without needing Congress’ approval. Insurers get discounts for the expensive name brand drugs, which are negotiated by pharmacy managers. Trump wants these rebates and discount distributed to the customers, which would help lower the prices. President Trump’s plan is to give at least one-third of the rebates to beneficiaries.

Seema Verma, the administrator of the Centers for Medicare & Medicaid Services, stated that the rebates are a “convoluted system,” because they allow manufacturers to raise list prices. This, in turn, increases the amount of money that insurers and pharmacy benefit managers collect in rebates, giving them no incentive to keep prices down.

“When prices go up, patient cost-sharing also goes up,” she said in a speech before the American Hospital Association earlier this week. “We’ve all noticed the increase in the amount we have to pay at the pharmacy counter. For seniors who are sometimes on fixed incomes, the pain is real. This is not acceptable.”

The Trump administration wants to raise the prices of foreign drugs in order to reduce the drug prices at home. The reasoning for this is because foreign places keep their prices low while Americans continue to pay highly for their drugs. The foreign countries benefit from America paying high prices for these drugs and essentially their development. “The United States both conducts and finances much of the biopharmaceutical innovation that the world depends on, allowing foreign governments to enjoy bargain prices for such innovations,” the council’s report said. “Simply put, other nations are free-riding, or taking unfair advantage of the United States’ progress in this area.”

The Food & Drug Administration is focusing on trying to introduce more generic drugs that are identical to name brand drugs. This way customers can opt to buy the generic brand and save some money. The agency is hoping that by producing more generic drugs will increase competition and eventually bring down the pricing of brand-name drugs.

Seniors have been struggling to obtain the medications they need due to how expensive they are. Some have to make drastic changes in order to get these medications because they can die without them. There are still talks amongst the Trump administration about reducing Medicare drug prices and they are hoping to make some positive changes in 2019.

Republican Tax Bill Cuts 25 Billion From Medicare

The GOP tax bill that the Republicans have been working on, can lead to major cuts in Medicare funding and spending in 2018. The bill is estimated to cut $25 billion from Medicare starting 2018, and resulting in $400 billion over the next ten years.

The Congressional Office has estimated a $1.5 trillion deficit to over the next 10 years due to the tax bill.

In 2010, Washington passed a “pay as you go” rule which requires any new laws to be deficit neutral. Basically if there is not enough economic growth to balance the money lost, then the Office of Management and Budget has to cut spending. Unfortunately, it is likely that one of the spending cuts will be to Medicare.

The tax bill is expected to pass, and while it does not exactly say that it will cut spending on Medicare, it will be an unintended result. Some Republicans stated that the cuts would affect doctors, health providers, and hospitals, not Medicare beneficiaries. They have also had talks to try and change the Medicare eligibility age from 65 to 67.

House Speaker Paul Ryan seems to threaten cuts to Medicare saying “we’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit. I think the President is understanding choice and competition works everywhere, especially in Medicare.”

A major issue with the possible cuts is that Medicare beneficiaries could end up being kicked off of their current Medicare plan, or receive fewer benefits.

Juliette Cubanski, associate director of the Program on Medicare Policy at the Kaiser Family Foundation says,“these cuts could be one bad side effect of this tax legislation. Many providers may be able to absorb the payment reductions if they have a very diverse patient base. But others who rely primarily on Medicare may find this cut really difficult to deal with.”

Roughly 54 million Americans currently receive Medicare benefits. Many fear the cuts will leave many Americans without coverage or unattainable expense to have coverage. However, McCarthy claims lawmakers will find a way to avoid the Medicare tax cuts. The tax bill is expected to be voted on in early January, when we will begin to see the effects of the bill.

Five Ways To Get Better Health Plans At Lower Costs

Health insurance premiums and deductibles can become costly, and continuously go u p every year depending on the plan. There are ways to help ease the burden of a high premium/deductible plan that is cost-effective while receiving the medical services you need.

Compare Plans

More than 90% of people end up not looking into their plan for the following year and renew last year’s plan by default. Not researching this can cost you greatly into the following year because your monthly premiums can increase, and/or what is covered can be changed.

Shopping around is probably the most important way you can save money. Prices can vary from not only plan to plan but from provider to provider. This is why it is important to not only shop around for price, but for the quality of services, and coverage also.

Plans with low premiums will have higher out-of-pocket expenses like deductibles and copays. These plans are more sensible for people who did not come close to meeting their deductible. Then there are plans with a higher premium and lower deductible that would be more sensible if you meet your deductible quickly.

Comparing plans with one company makes it easier. Every agency will give you the same plans, so EZ.Insure shows you all of your options in one place!

Shopping around and comparing different insurers and plans can become time-consuming, unappealing, and strenuous. EZ.Insure does all the work for you with our highly trained agents that specialize in your region. Your advisor will do the work for you and even sign you up for a plan that matches your criteria for coverage and price, all at no cost to you.

Use What’s Free

Free preventative care services are offered at no charge as long as you are within your insurance network. There are a lot of no-cost routine services to keep you healthy and catch problems early on before it becomes serious. Colonoscopies, mammograms, vaccinations, depression screenings are all free in insurance plans. Many people are unaware of these free services and thus avoided preventative tests. Make sure to go to the doctor and use these free services to stay healthy and prevent serious health issues and expenses later.

Choose Your Doctor

Make sure you choose a doctor that works with your plan. Some offices cost more than others, and some only accept a certain percentage of benefits!

A primary doctor can help you save money, which is why it is wise to do some homework an choose the right one. When you use a primary doctor who charges less then you can also find cheaper prices for outpatient services, specialist, and lab services. Talking to your doctor can lead to reliable information when it comes to quality care at a reasonable price. Your doctor can offer ideas on how to save money and help you find/refer you to less expensive prescription drugs, or diagnostic tests.

Avoid Unnecessary Bills

When talking to your doctor, there are questions to be sure to ask about medical tests and treatments that are overused. Many of them might waste your money. Some people choose to go to the hospital for an MRI or lab work which ends up costing you. Try to utilize Lab Corp or Quest Diagnostic independent labs to avoid high costs. Hospitals will charge you double the cost of an independent provider.

Leverage Tax Breaks

Putting money into a health savings account (HSA) will help with high out-of-pocket medical costs. The account will let you put aside tax-free money to cover your medical costs. HSA allows you to put up to $3,400 for individuals and $6,750 for families within a year. You can use the money to pay for your deductible and other qualified medical expenses, and whatever you do not use will roll over into the following year tax-free.

Changes To Medicare Advantage in 2018

Medicare Advantage Plans have become very popular over the years, and like other insurance plans, changes occur every year. The most common changes are the list of drugs that are covered, how much your insurance company charges for them, premiums, and the percentage the plan pays towards your medical expenses. Changes can leave customers confused and with fewer options so it is important to look out for changes in the year ahead in order to get the proper care you need.

Changes in existing plan

Insurance companies will notify customers of changes in their existing Medicare Advantage plan occurring the following year. It is important to look over the changes of your current plan, and determine if these changes will cover your needs next year.

Loss of State Health Insurance Assistance Programs

State Health Insurance Assistance Programs, also known as SHIPS, aim to assist people with their Medicare options and compare Medicare Advantage plans. They provide counseling in every state, which is useful when trying to pick a Medicare plan for the year. These programs are funded by the federal government, but due to the Trump Administration’s budget cuts, it can be discontinued. The budget will eliminate funding of these state assistance programs by 94%, possibly eliminating them. However, EZ.Insure will continue to assist people with their Medicare and Medicare Advantage options even after these programs are gone. EZ.Insure always provides constant counseling, and help seeking the most ideal plan.

Network coverage

Insurance companies are constantly looking for doctors, hospitals, and other healthcare providers with cheaper rates to save money. The insurers negotiate with these providers to find the lowest cost each year, which is why plans change their network coverage every year. In the past couple of years, the network of providers has gotten smaller, with fewer specialists. It is important to make sure that your physician or specialists are included in your network year to year.

Loss of insurers

Reports from the Kaiser Family Foundation found that as of 2017, 147 counties across 14 states do not have Medicare Advantage plans. Some rural counties have been left with either only one or no insurers to choose from. If a Medicare Advantage plan is not an option, some people should consider a Medicare Supplement plan.

With all the changes occurring in the upcoming year, and loss of network coverage, it can be difficult to find a plan. At EZ Insure, we are dedicated to helping you compare and find a plan in your region. Contact us through email, [email protected], or enter your zip code in the link above to receive a quote. We make it that easy.

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