medicare insurance Archives - Page 24 of 38

Beware Of Medicare Scams During Open Enrollment

Medicare Open Enrollment is the perfect opportunity for you to change plans and find ways to get more coverage and save money. Medicare Open Enrollment is also the perfect opportunity for scammers to try and steal your information. They know that you will be looking for the best coverage at this time, so they’ll jump on the chance to confuse, bait, or scare you. In order to protect yourself, you have to be aware of the most common scams and scamming tactics.

The Different Types of Scams

The most important thing you need to know is that, unless you request information from them, Medicare will not call you. You should treat any unsolicited calls from someone claiming to be with Medicare as suspicious; in fact, the majority of Medicare scams are phone calls. Here are scams to look out for:

A call or recorded message from someone who claims to be helping you navigate your Medicare options. This person might claim that they are an advocate working on your behalf, and that they can enroll you in a better, cheaper Medicare plan if you give them some personal information. If you did not sign up for help, then this is a scammer trying to get your information.
A call from someone claiming to be with Medicare who offers you promotional gifts.
A call from someone claiming to be with Medicare who threatens to discontinue your insurance if you don’t re-enroll now.
If you suspect a scammer has contacted you, call 1-800-Medicare to report it.

What To Do

No one representing Medicare will ever contact you by phone, email, or in person unless you have already made contact with them. The best way to avoid any scam is to never give your Medicare ID number, Social Security number, health plan information, bank information, or any other personal information to someone that you don’t know.

If you do receive a call that is suspicious, then hang up and call 1-800-Medicare to report it. Then contact your Medicare agent, or Medicare, to make sure that there is nothing wrong with your current plan, and that there are no actions that you need to take.

Getting Trusted Help

Medicare Open Enrollment can be a very busy and overwhelming time. You are in the midst of figuring out if your current plan is right for you, and researching other plans in your area to try to save money and get the most coverage. On top of that, you have to worry about people trying to steal your information. You can protect yourself from the many scammers out there by knowing their scare tactics and the ways that they will pretend to help you. In addition, you can make sure that you are fully protected from identity theft or worse by contacting an EZ agent!

EZ.Insure uses state-of-the-art technology to protect your information when you fill out our online form. To further protect your information, we will only share it with one agent. Whether you want to know more about your Medicare options, sign up for a Medicare Supplement Plan, or simply compare plans, EZ’s got you covered. With us, you will never have to worry about outside parties getting their hands on your information. To start comparing quotes for free, enter your zip code in the bar above, or to speak directly to an agent, call 888-753-7207.

B.E. F.A.S.T When You Spot A Stroke

Strokes are more common than you might think: they are one of the leading causes of death and disability in the US. According to the CDC, each year almost 800,000 people suffer a stroke. Nearly three-quarters of all strokes occur in people over the age of 65, and the risk of having a stroke more than doubles each decade after the age of 55. Strokes can have devastating and long-lasting impacts, but spotting a stroke quickly could mean reducing the damage done. The earlier you can get help, the better, so it is vital to know what to watch out for.

older caucasian man with one side of his face drooping — *Facial weakness or uneven smile is one of the symptoms of a stroke.*

Spotting The Signs Of A Stroke

Strokes happen suddenly when blood flow to the brain is disrupted or cut off. Once this happens, brain cells start dying; the more brain cells that die, the higher the risk of becoming paralyzed or dying. The classic warning signs of a stroke to look out for are simple – use the acronym B.E. F.A.S.T. to remember them:

B – Balance. Sudden dizziness, loss of balance or coordination.
E- Eyes. Sudden trouble seeing out of one or both eyes
F- Face. Facial weakness or uneven smile
A– Arm. Weakness or inability to raise both arms evenly
S– Speech. Impaired, slurred speech, and/or difficulty repeating back simple phrases
T– Time. Every second counts, so call 911 immediately

Additional Symptoms Of A Stroke

Strokes can also cause:

Sudden confusion, trouble speaking, or understanding others when they speak
Chest pain is also a sign of a stroke.
Hiccups
Sudden severe headache with no known cause
Chest pain
Feeling weak all over
Rapid heartbeat
Shortness of breath

What To Do If You Suspect a Stroke

A stroke victim needs treatment right away. If any of the common warning signs are present, use the F.A.S.T test to help determine whether someone is having a stroke:

F (Face) – Ask the person to smile, and if one side of their face droops or the smile is uneven, that’s a sign of weakness or numbness in the face, which could indicate a stroke.
A (Arms) – Ask the person to raise both arms, and if one arm drifts downwards, that’s a sign of weakness on one side of their body.
S (Speech) – Ask the person to repeat a simple phrase. Slurring, sounding strange, or being unable to repeat the phrase are tell-tale signs of a stroke.
T (Time) – If the person shows any of these symptoms, get help immediately by calling 911. Let the operator know what time the test was given so they can estimate when the stroke occurred.

Even if symptoms go away, that doesn’t mean that the person is in the clear; a mini-stroke can last up to 24 hours. Any sign of a stroke could mean lasting damage, because these symptoms indicate that brain cells have begun to die. It is better to be on the safe side, so even if symptoms seem to pass, go to the emergency room or call 911. A health professional can administer tests, and can help to get the condition under control in order to reduce the risk of a stroke in the future. Every minute counts!

Does Medicare Cover Allergy Testing?

Allergies. Anyone can suffer from them, no matter their age. They can be seasonal, they can be food-related, they can be triggered by pets…but no matter the cause, they’re always annoying, and sometimes dangerous. Over 50 million people in the United States live with allergies, making them the sixth leading cause of chronic illness. Allergies can develop at any stage in your life, so what happens when you suspect that you’ve developed an allergy to something when you’re 65 or older? Will Medicare cover the necessary testing?

Eligibility

back of a woman with her hair in a ponytail in a lab testing something — *The laboratory where the allergy testing is done must be Medicare approved.*

Medicare coverage eligibility is always determined by how necessary and reasonable the treatment is considered to be. Allergy tests are considered “clinical diagnostic laboratory services,” which means they will be covered under Part B as long as you meet certain criteria:

Your doctor must prescribe an allergy test
The doctor prescribing the allergy testing must be enrolled in Medicare and accept Medicare assignment.
The allergy testing must be done in laboratories that are Medicare-approved.
No previous kinds of therapy have been able to help manage your allergies
Your doctor can prove that the testing is the first step in a complete, Medicare-approved treatment program.

Not all allergy testing procedures are covered by Medicare, so it’s important to know which tests are covered. In order to find out which ones are, you need to contact your physician before testing to make sure that Medicare will pay for your specific procedure.

The Different Allergy Tests Covered By Medicare

purple glove holding a tube full of blood — *Allergy testing can be done by testing the blood for allergens.*

Medicare will begin covering any allergy testing after you meet your annual Part B deductible. Medicare will then pay for 80% of the cost of your diagnostic testing. The following types of allergy tests are usually covered:

Skin Procedures– this type of test looks for allergies related to substances such as food, pollen, certain drugs, and more. The skin is pricked or scratched, the suspected allergens are applied to the area, and then the reaction is recorded.
Blood Testing- this type of test looks for allergies by analyzing the antibodies in your blood after your body comes in contact with allergens.
Food Challenge- in this test, which is used to confirm or rule out allergic reactions to foods, you are required to eat increasing amounts of the suspected food allergen until you have a reaction, or until your doctor can rule it out as the cause of your symptoms.

Before undergoing any testing, make sure you notify your doctor of all the current medications you are taking, as some medications can interfere with the results of your tests.

When To Get Help

Some symptoms of an allergic reaction will happen immediately after being exposed to the allergen. Symptoms of the more serious reactions include swelling of the throat, which can lead to death if not dealt with immediately. If you experience any of the following symptoms, you should make an appointment with your doctor as soon as possible:

caucasian woman's chest with pink hives all over it — *One of the many signs of allergies are breaking out in hives that are red and itchy.*

Sneezing and itchy, runny nose
Blocked nasal passages
Itchy eyes that are red and watery
Hives that are red and itchy
Swollen lips, tongue, face, or eyes
Coughing
Skin that is dry, cracked, and irritated
Wheezing and shortness of breath
Swelling of the mouth or throat

Millions of Americans experience allergies – if you’re one of them, know that it is possible to manage your symptoms, as long as you are aware of the allergy, and take the necessary medications. If you experience any of the symptoms listed above, talk to your doctor about getting an allergy test. Make sure that the doctor is Medicare-approved and that any tests being performed are approved by Medicare, as well. Some allergies can be life-threatening, so if you suspect you have an allergy, get tested, because it might just save your life.

Preparing For Medicare Open Enrollment: Medicare’s 2021 Part B Premium Capped By Congress

Amid uncertainties about Medicare prices for 2021, Congress has taken action to provide some relief next year for the 64 million Medicare beneficiaries in the United States. On Wednesday, September 30th, a short-term government funding bill was passed by the Senate and signed by President Trump that will cap Medicare Part B premiums for 2021. There has been no official announcement indicating how much premiums will be next year, but thanks to the bill, any increase will be capped at 25% of what it otherwise would have been.

picture of congress building — *A short-term government funding bill was passed by the Senate will cap Medicare Part B premiums for 2021.*

No Real Numbers Yet

Medicare Part B premiums rose nearly 7% in 2020, which had Medicare trustees predicting back in April of this year that the standard 2021 Part B premium would be $153.20, a 6% increase. However, due to the pandemic, there has been uncertainty surrounding Medicare prices for next year. The impacts of COVID-19 might be a major factor in determining how much premiums will increase.

“One thing that’s really hard about this year is that there’s been increased costs from treating Covid, but decreased cost from people delaying care or avoiding being in hospitals or doctors offices,” said Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center.

Social Security COLA Role

social security card under some money bills and coins — *Social Security COLA is expected to be 1.3%, but this might not be enough.*

It is also unclear whether Social Security’s associated annual cost of living adjustment, or COLA, will be enough to cover next year’s increase in Medicare premiums. The COLA, which is provided to seniors to help with the costs of necessities like Medicare premiums, is estimated to increase 1.3% next year, meaning the average monthly benefits will increase from $1,053 to a little over $1,522.

A discrepancy between the increase in Part B premiums and the increase in the COLA wouldn’t necessarily be a major problem for Social Security recipients. If Part B premiums increase is more than the COLA, then Medicare beneficiaries who are collecting Social Security are “held harmless.” This means that they can see a premium increase but it can’t be larger than their COLA dollar-amount increase. Unfortunately, Medicare beneficiaries who are not collecting Social Security benefits absorb the extra costs, which means they could see a sharp rise in premiums.

“What seems to be motivating Congress is the fear that there will be an unexpected spike in premiums, or one that’s out of step with normal premium increases across the board, or specifically for those not held harmless,” Schwarz said.

The Cap

sign of a red hand in a red triangles — *Congress put a cap on Part B premiums so that it is guaranteed to not exceed a 25% rise.*

While we would normally have a good idea by now of how much premiums are going to be for the following year, the pandemic is putting everything on hold. Only 25% of Part B is funded through premiums; the other 75% is funded through money from the federal government’s general revenue – this year, the government took a “loss” by providing millions of Americans, hospitals and businesses with financial relief, and so that loss may be passed on to Medicare beneficiaries.

Even if Congress has capped the premiums and will not allow them to increase by more than 25% of what they would have increased by, that percentage could still mean a large jump in premium prices. Many Medicare beneficiaries could still end up struggling to keep up with costs. Premium prices are expected to be revealed in early November.

If you need help planning for next year, consider getting help from an EZ.Insure agent. Our licensed agents will help you prepare financially for next year, and review all Medicare options in your area. To get free advice and quotes on plans, enter your zip code in the bar above, or to speak directly to one of our agents, call 888-753-7207.

Medicare Advantage Vs. Medicare

You’re probably already familiar with Original Medicare, especially if you’re nearing the age of 65 and getting ready to enroll. You may not be aware, though, that there are some gaps in Original Medicare’s coverage, which lead many people to either add a Medicare Supplement Plan or choose a Medicare Advantage Plan. Medicare Advantage Plans, also known as Medicare Part C, are very similar to Original Medicare. However, there is a slight difference between the two, mainly that Medicare Advantage Plans offer more coverage than Original Medicare.

caucasian hand over an older caucasian hand bringing it towards blocks — *Medicare Part B covers physical therapy, doctor visits, and more.*

Original Medicare Overview

Medicare is a government health insurance program consisting of:

Part A– Hospital insurance that covers hospital stays, skilled nursing care facilities, hospice care, and limited home healthcare services.
Part B– Medical insurance that covers preventive services, doctors’ office visits, flu shots, physical therapy, durable medical equipment, diabetes screening and supplies, and mental health care.

In most cases, you will not pay a monthly premium for Medicare Part A; the Medicare taxes that you paid while you were working are what pay for Part A. However, Part A does have a deductible, coinsurance, and co-payments.

Part B, on the other hand, does have a monthly premium: the Medicare Part B premium for 2020 is $144.60, but could be higher depending on your income. Like Part A, Part B also has a deductible, coinsurance, and co-payments for most services. Medicare Part B covers 80% of your costs, meaning you will need to pay the remaining 20% of any bills.

Medicare Advantage Overview

Medicare Advantage is an “all-in-one” alternative to Original Medicare. Private insurance companies approved by Medicare can offer Medicare Advantage Plans. Unlike Original Medicare, most Medicare Advantage Plans include prescription drug coverage, and some plans offer more benefits, like routine dental or hearing care. In order to be eligible for Medicare Advantage, you have to be enrolled in Medicare Part A and Part B. You must also live in the plan’s service area, and you cannot have end-stage renal disease.Medicare Advantage Plan premiums differ from plan to plan. Many Medicare Advantage Plans have low-cost, or even $0, premiums. The average Medicare Advantage premium is only $30 a month. Remember, you will still have to pay your monthly Medicare Part B premiums in addition to any Medicare Advantage premium.

The Similarities

All Medicare Advantage Plans have to offer at least the same benefits as Medicare Parts A and B do. This means that if Original Medicare covers hospital care at a certain level, then so will a Medicare Advantage Plan.

The Differences

The benefit of Medicare Advantage Plans is that they offer more coverage than Original Medicare. The following chart breaks down the differences between the two:

Medicare Spent $1.4B on Discarded Medicare Drugs

According to a recent study, Medicare spent $1.4 billion on drugs in 2017 and 2018 that ended up being discarded. More specifically, Medicare spent $695 million on discarded Part B drugs in 2017, and $725 million in 2018. Most of these wasted tax dollars went towards chemotherapy and cancer-treating drugs that were not used. Medicare now has plans for utilizing that $1.4 billion rather than wasting it.

Wasted Resources

hundred dollar bills and other bills crumbled in a trash can — *$1.4 billion of wasted money was on drugs that were discarded, that could’ve been used for other things.*

Most of the drugs that were discarded in this two-year period were unused units of chemotherapy drugs. They ended up being disposed of because many units were single-dose vials that contained a higher dose than was needed to treat the average patient. This $1.4 billion of essentially wasted money accounts for 16% of Medicare spending, and 2% of Part B drug spending.

According to a report put forward by MedicareAdvantage.com, this amount of spending could:

Cover a year’s worth of insulin for more than 3.3 million Part D beneficiaries
Buy 87,000 hospital ventilators, which the country is in desperate need of due to the coronavirus pandemic
Buy more than 1 billion N95 masks
Cover the cost of 31.6 million flu shots
Go towards necessary women’s health treatments

Why Is So Much Money Wasted?

The report also suggests that Medicare’s “buy and bill” drug supply model is likely to blame for the waste. In the “buy and bill” model, healthcare providers and hospitals purchase, store and administer drugs to patients, and then bill insurers or patients for the drug. All drugs purchased by providers must either be administered or thrown away after opening, which often happens because many vials contain higher doses than is appropriate for patients.

“Because of this model, drug manufacturers are incentivized to produce medication amounts that are more likely to end up discarded when single-dose vials or containers include higher doses than are necessary,” says the report on MedicareAdvantage.com. “Profits are increased by billing for the whole vial even if only a portion of it is needed and used. Doctors and hospitals also enjoy bloated profit margins under this system.”

The Government’s Considerations

The information in this study has prompted CMS to consider enacting two possible solutions:

Require drugmakers, hospitals, and doctors to refund CMS for discarded drugs
Require pharmaceutical companies to right-size drug containers so that no medication gets wasted/discarded
Do both of the above

Tag: medicare insurance