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Monday, February 28 2011

Medicare Insurance Coverage Pie Chart

So, you are turning 65 or new to Medicare and you’re not sure which route to take when covering the gaps left by just having Medicare alone. When becoming eligible for Medicare and having to find your own health insurance, due to not having group or retirement coverage, you really only have two options to choose from. Here in Texas you can choose a Medigap Insurance Plan or a Medicare Advantage Plan. Well, with only two options, which one is the best?
I wish that question was as easy to answer as it is to ask. The answer to this question is completely up to you. Knowing the differences between the two insurance options is the first place to start; complete knowledge of the risks and rewards of each will help protect you in the long run from cost you were not expecting. Now, if you were to ask me that question, as an insurance professional, I would have to ask you a question right back; “How much of a gambler are you?” The reason for that statement is insurance is a gamble no matter how you look at it. You can pay for coverage month after month for twenty years and never use it or you can go without because of how healthy you think you are and the next thing you know you are looking at a $250,000 hospital bill.
The cushion to the gamble of insurance when you are Medicare eligible is Original Medicare. Medicare Part A covers most of your hospital services and you pay for that with the taxes you pay in over the years that you work. Medicare Part B, even though you have to pay for it, helps pick up 80% of Medicare’s approved charges for medical services. The problem is most seniors are on a fixed income, and the out of pockets risks left by just having Medicare alone could really hurt that income coming in. This is why there are options to help protect that income.
In my professional opinion, I would suggest to anyone that they choose a Texas Medicare supplement insurance plans over a Medicare Advantage plan, if it fit their budget. The reason for this is these plans are designed to fill in the gaps left by just having Medicare alone, hence the name Medigap. You are also not restricted to seeing certain doctors or hospitals, as long as you do not choose a Medicare Select Plan. More importantly you know exactly what your risk or gamble is, depending on which plan you pick.
On the flip side, there are numerous options of Medicare Advantage Plans to choose from, but make sure you fully understand the rules of the plan before signing up for one. Even though I think that there always should be the option of both plans to choose from, I just would not recommend a plan that restricts you doctor and hospital choices, offers lower premiums (sometimes $0) but leaves you with the chance to be out of pocket more if you have to use them, but the number one reason why I would suggest a Medigap Insurance Plan in Texas over a Medicare Advantage Plan is the uncertainty of their future. The point being is this, we all know that the government passed the Health Care Reform Law, well in this bill there is over $500 Billion dollars in cuts to Medicare. Out of the $500 Billion, $130 Billion are aimed directly at Medicare Advantage Plans. Even though these cuts do not kick in until 2012, here in Texas I saw 4 PFFS Plans pull out of the state and sent letters to their customers stating they would not have benefits come January 1, 2011.
I do not mind a little gambling, but if I only had two choices to pick from and one was uncertain with more out of pocket risk while the other was designed to cover specific areas that were not and offered freedom of choice, I believe my choice would be easy. Now, that is just my opinion and it is mainly pointed to the 65 year and older crowd. Here in Texas if you are on Medicare Disability, your options for Medicare Supplement Insurance Plans go from 10 Plan choices to 1. This is why I enjoy my job; I help people understand this gamble in life. As for the decision they make, I will always be unbiased in passing on my knowledge and hope that I will give them informed information to make an informed one. If I can answer any questions or concerns you may have feel free to contact me directly.  
Posted by: Cameron Kirchoff AT 04:44 pm   |  Permalink   |  0 Comments  |  Email
Friday, February 18 2011

Medicare Supplement Rates in Texas

When searching for the best insurance coverage to meet your specific needs, it all depends on the type of insurance that you are shopping for to see where comparisons will differ. What I mean is that when shopping for a Major Medical Plan in Texas through companies like Blue Cross Blue Shield, Humama, or United Healthcare, there is more to look at than just price. These companies will offer an array of deductibles, plans with or without co-pays, even different co-insurance options. So, doing your homework can payoff when finding the right coverage for your needs, but when it comes to other types of insurance you may only have to look at price and company stability to find the best coverage available with the best rates.
A good example would be Term Life insurance coverage. If you know how long you want the term to be and what face amount you, than there is really no difference in coverage from one insurance company to another. What you will find is different monthly rates, different financial ratings of insurance companies, and maybe some type of benefit rider that you can added to your policy that other companies do not offer. Point is, a $100,000 20yr Term, is life insurance coverage that will cover you for 20 years in the amount of $100,000.
The same is true about Medicare supplement insurance plans in Texas. All Plans are standardized, and you can choose from Plans A – N. What this means is that if you choose a Medicare supplement Plan F as your coverage, you are not going to find any difference in basic benefits from one insurance company to another. So, like the example of the Term Life coverage, you are back to looking at the Medicare supplements rates or premiums from different insurance companies, and I strongly suggest looking at the financial stability as well.
Even though it sounds like taking the lower premium for a Texas Medigap insurance coverage is the way to go, you will also want to keep in mind a few more factors that can come in to play the longer you have your coverage:
  • How does that company rate their premiums? Do they use attained age, issue  age, or a community rating?

  • Making sure you know if the plan being quoted is a standard Medicare supplement insurance plan or have you been quoted a Select plan price.

  • Knowing if there are or how many complaints against the insurance company.
All of this information can be overwhelming to obtain, this is why we are here to help. Feel free to contact an agent today to have any questions or concerns you may have answered, as well as a free Medicare insurance review in which we will provide side-by-side Texas Medicare supplement quotes from top rated insurance companies throughout the state.  
Posted by: Cameron Kirchoff AT 02:10 pm   |  Permalink   |  0 Comments  |  Email
Monday, February 14 2011

Rep. Paul Ryan on Medicare

How much longer will Medicare be around? Can it sustain the influx of Baby Boomers that are becoming Medicare eligible at a rapid daily rate? What options will be available for me? I could go on for about two more pages of the questions that arise when talking about Medicare and its future. The truth is something is going to have to happen to keep Medicare alive; the problem is no one has the right answer. Or do they?
With only having two options to cover the gaps left with Original Medicare, if you are not covered by a group retirement plan, cost of the options continue to go up and with one option benefits continue to go down. The main problem, I believe, is that both Republican and Democrats cannot agree on what option is the best for individuals. So, depending on which party controls the vote, the other insurance option seems to fade away.
Here in Texas I can help explain your options and even suggest to you which coverage would be the best fit for your needs. Texas Medigap insurance plans are designed to cover most, if not all of the gaps left by Medicare. The monthly cost of the insurance could be more than the other option, but depending on what plan you choose; overall medical costs could be quite lower. The other option an individual can look at is a Medicare Advantage plans in Texas. With this coverage it is possible to have a lower monthly cost for your insurance, but you take more of a financial risk with most plans if you have to use your insurance.
The Republicans favor the options of both Medicare supplements and Medicare Advantage plans, but with the recent health care reform signed into law Democrats seem to believe that Medicare Advantage is overall to costly. Who’s right? I wish I could give you the answer, but I am an insurance professional not a politician. As it is my job, I try to keep as up to date as possible with everything going on and found an article that really intrigued me. Could this be where Medicare is going? I do not know, but I felt like I should share it with everyone so that you could gage your own options.
Posted by: Cameron Kirchoff AT 04:06 pm   |  Permalink   |  0 Comments  |  Email
Friday, February 04 2011

Medicare Part B Excess Charges

If you have done any homework or research in to how Medicare Part A and B will cover you once you turn 65 or age in to Medicare, you more than likely have come across what is know as the Medicare Part B Excess Charge. In my years of helping Texans understand their options with filling in the gaps left by only having Original Medicare, this is the one question that seems to always come up.
When looking at the benefits of Medicare Part B, you will notice that Medicare will pay for 80% of their approved charges for covered services. Without having any supplement, you will automatically pay the other 20% of approved charges. These approved charges are called Medicare assignment, and the good news is as of now most hospitals and doctors accept Medicare pay schedule. What most people do not understand is that any hospital or doctor has the option and the right to charge up to 15% more than Medicare’s approved charges. If you do not have a supplemental insurance plan that covers these excess charges than you may be responsible for up to 15%.
For example, let us take a doctor visit that cost $100. If $100 is the approved Medicare amount for that doctor visit, than a doctor can charge 15% more than $100, which would be an extra $15. Medicare would pay 80% of the $100, which would be $80, leaving a balance of $20 owed for the Medicare approved amounts. If you are covered by a Medicare supplement plan, most will pick up the $20 charge that is left over from this doctor visit, but what if the doctor charges the extra $15?
This is where choosing the right Medicare Supplement in Texas can protect you from any and all unexpected out of pocket expenses. Since June 1, 2010, when the Modernized Medicare Supplements were released, Medicare Supplement Plan F and Plan G are the only two plans that cover the excess charges. Now, understand there is a Part B deductible that has to be met with a Plan G, but other than that both Plans will cover not only the Medicare approved amounts, but the excess charges as well.
The problem with excess charges, or just Medicare Part B alone, is the fact that there is not a cap on how much the charges could be. So, if all you look at is a $100 doctor visit that you could be responsible for an extra $15, it does not seem to be that much of a worry. Now, if you consider that Medicare Part B deal with all outpatient medical services, paying an extra $15,000 on $100,000 worth of charges brings a little more importance to having the excess charges covered.
Contact an agent today for your free side by side comparison of Texas Medigap Insurance Plans, and see the rates of a Texas Medicare Supplement Plan F and a Texas Medicare Supplement Plan G from top rated Texas Medicare insurance companies.
Posted by: Cameron Kirchoff AT 04:38 pm   |  Permalink   |  0 Comments  |  Email
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