Understanding and Comparing Medicare Part D

On December 8th 2003, as part of Congressional legislation called the Medicare Modernization Act of 2003 or (MMA), Medicare Part D came into being. For the first time in American history seniors could count on Medicare to assist them with their prescription drug costs. Though the MMA has been around for the past five years many of my new clients continue to ask me to explain how their prescription drug benefits work, which I always gladly do.

All the insurance companies offering these plans must adhere to a minimum standard of policy design. From this base plan they all enrich their plans and premiums differently. It is this base policy that I will discuss, so it is important to check your actual policy for the details that apply to you.

There are four phases of coverage:

• Annual Deductible
• Initial coverage
• The Gap
• Catastrophic Coverage

As of 2008, all insurance companies are required to offer a base plan that has a maximum deductible of $275 in addition to their other plans. It is important to remember that deductibles will change over time. When looking at plans it is important to weigh premium cost against benefit. As of right now there are many generous and affordable plans available that do not have any deductible at all. For those on a MAPD: Most Arizona Medicare Advantage plans do not have any deductible at all.

Initially the plan coverage your drug purchases up to $2510. During this period all you are required to do is pay the co-pays as described in your outline of benefits. Though you are only paying co-pays your insurance company is calculating their true cost for each of your medicines. The true cost being calculated is the insurance carriers pre-negotiated discounted retail price. When you have purchased drugs totaling $2510.00 (true cost) your insurance company will notify you that you have reached the Gap.

During the “Gap” your insurance company will continue to extend to you their pre-negotiated discounted price (the true cost) but you will pay that cost with your own funds, no co-pays. Some insurance companies will cover generics in the gap but many do not.

Once you have spent $4050 you have entered into the catastrophic phase. During this period or until the end of the calendar year all you will pay is $2.25 for generics and $5.60 for all other drugs.

These plans are annual renewable contracts. Stand alone plans can be purchased or replaced for 11/15 through 12/31 each year for a start date of January 1 of the New Year. For those on a MAPD you can switch again from 01/01 through 03/31 of each year as well.

Because these are annual renewable contracts the best way to decide which one is the right one for you, is to actually Compare Medicare Part D Plans side by side you could save hundreds by making an informed decision!
Click to compare & save

Understanding Arizona Medicare Supplemental Insurance

Medicare is a federal health insurance program for people 65 years of age or older. It pays for much of a participant’s health care, but not all of it. Some costs not covered are, prescription drugs, deductibles, and the 20% coinsurance. Medicare Supplements and Medicare Advantage plans are health insurance policies sold by private heath insurance companies that are designed to fill in the gaps in Medicare coverage. The key to understanding Arizona Medicare supplement insurance coverage is to realize that there are only two basic choices, select either a Medicare Supplement policy or a Medicare Advantage plan. Both accomplish filling in the gabs differently.

There was a time not too many years ago, when Medicare supplements were the only choice for Medicare recipients. A good Medicare supplement gives a policy holder the most access to health care nationwide. With a Medicare supplement you can go to any doctor or health care facility in the nation that is willing to accept Medicare billing. This is very helpful to snowbirds and those who travel extensively for months at a time. These insurance policies are guaranteed renewable for life. During a Medicare participant’s open enrollment period they can elect to participate in any Medicare Supplement policy with any insurance carrier without having to provide proof of insurability. The open enrollment period is the three months before and the three months after their Medicare Part B start date. After this time period switching carriers often requires proof of insurability. If a Medicare participant elects to go with a Medicare supplement policy they will be required to buy a Medicare Part D policy to cover their prescription drug cost. There are fourteen different standardized Medicare Supplement plans to choose from. Each provider’s plans are identical so unlike the MA plans shopping for these are much easier. Medicare supplement policies all come with a monthly premium. Costs will vary from company to company. However, each company’s plans are all exactly the same. With all that parody in these insurance plans what should a Medicare recipient be looking for?

Seniors should be looking for companies with:

• A track record of verifiable financial stability
• Excellent customer and bill paying services
• A history of consistent premium costs free of huge increases

This important information is not readily available to consumers.

Of the 14 standardized Medicare supplement plans only two should be considered by most Medicare recipients – plan F and plan G. Plan is F is the most popular because it guaranties to cover a person up to the maximum allowed by Medicare for any Medicare approved service. This leaves little to chance and a policy holder will know that they should never receive a bill unless they have had a non-Medicare approved service or procedure. An example would be a face lift. Plan G is a little different in that it will not pay for any excess charges allowed by Medicare. A person with plan G must be vigilant that their providers will accept Medicare assignment. That is why consulting with an independent agent is a good starting point in finding the best Arizona Medicare supplement policy.

Over the past few years Medicare Advantage (also called MA) plans have become very popular in Arizona because the premiums are very low or nothing at all. There are three distinct types of MA plans; HMO, PPO and PFFS. Arizona Medicare Advantage Plans are annually renewable contracts between you and the insurance company. Unlike Medicare Supplements, your enrollment can never be turned down for coverage due to any preexisting health conditions. Many companies that offer these MA plans even have special need plans for those with chronic conditions, to further help them with their medical costs. Another nice feature of the MA plan is that they are available with a prescription drug plan at no additional cost. These types of plans are often referred to as MAPD plans.

Medicare Advantage plans are heavily advertised by the insurance companies during the two open enrollment periods AEP and OEP. AEP is the annual enrolment period currently starting from November 15th and runs through December 31st each year. During this time period Medicare recipients can freely switch from one MA and or PD plan to another with a policy start date of January 1st. OEP is the open enrollment period and runs from January 1st through March 31st of each year. During this time period Medicare recipients can once again change plans and providers with one limitation they can not add a drug plan if they do not already have one.

HMO's are health maintenance organizations. Like many health plans in Arizona you are limited to the contracted health care providers and facilities the company has in their directory. These plans provide for limited or no coverage outside of the company directory unless you have an emergency that requires immediate hospitalization. These types of plans require that you designate a primary care physician or (PCP) who is contracted with the company. They are your single source for health care with a few exceptions, such as urgent care and emergency care. If you need a specialist or surgery they will be the ones to refer you to other providers within the organization. One of the reasons many people who choose this type of plan enjoy it (besides the good service they receive) is the cost. Currently, the monthly premium for an MAPD in Maricopa County Arizona is zero.

PPO's are preferred provider organizations. They are similar to the HMO style plan except that you have the freedom to choose any health care provider, service or facility within the directory without a referral from a PCP. Many insurance companies offer both HMO and PPO style plans to their Medicare Advantage members. Though the freedom of a PPO comes with the extra expense of a monthly premium, it is an excellent choice for those who want the freedom to pick and choose without having to be referred by a PCP. These plans will also save you on your monthly premium compared to a traditional Medicare Supplement. Like the HMO plan Part D is included for no additional expense. The PPO plan is a very good fit for Arizonans who live in multiple covered counties at different times of the year.

PFF's are Private Fee for Service Plans. This type of MA plan has only one major limitation. The provider you use for services must be willing to accept the insurance companies’ payment for services performed. If your provider is willing to accept the terms and conditions of the PFFS insurance carrier you are only responsible to pay the co- pays as described in the plan’s summary of benefits.

In 2005 Medicare Part D was introduced to help Medicare recipients with the cost of their prescription drugs. Like the MA plans Part D is an annually renewable contract and all plans are not created equal. So it is important to have your plan tailored to your prescription needs so that you get the maximum saving on an annual basis.
Medicare is constantly changing from year to year and keeping up with those changes is often a daunting task. I highly recommend the use of an experienced insurance agent when looking to buy or change plans.

As an independent agent I represent my clients so I offer many different Medicare plan options from many different providers. With thorough explanations of your choices, rights and options I allow my clients to choose the one that will best help them meet their individual needs and budget. To contact me you can call me at (602) 502-3113 or go to (AzHealthNow)and fill out a confidential quote form.

Finding Affordable Dental Insurance

Oral hygiene and care are the foundation of good health. Families with dental insurance are far more likely to seek routine oral hygiene services from a dentist than families without dental insurance. I have never met anyone who enjoyed going to the dentist, yet nearly everyone wants affordable dental insurance. Let’s examine the three most common types of dental plans and where to get a quote. The three most common types of dental plans are Discount Dental Plans, PPO Dental Insurance Policies and the oldest type of coverage, Indemnity Dental Insurance Policies.

Dental discount plans are just as the names suggests. For every service provided by the dentist you get the corresponding discount and then must pay the remaining balance. These plans always have a preferred provider directory you must use to receive covered services. Discount dental plans are an excellent choice because they offer verifiable discounted prices and allow the policy owner to know the cost associated with the various types of treatments. The discounts will vary with each dental insurance company, so it is important to compare multiple dental insurance carriers when considering these plans. To compare up to thirty different dental discount plans in your area
click here and type in your zip code and hit enter. This tool will allow you to see the benefits, costs and compare all the dental discount plans available in your area. Here you can even check to see witch plan your dentist is on, then apply for coverage. To increase savings you can combine your dental discount plan with an indemnity dental insurance policy.

PPO dental insurance policies are the Cadillac of dental insurance plans. They are similar to health insurance policies in that they have annual deductibles and then pay a percentage (up to 50%) of covered services up to an annual maximum. These plans always require the use of their preferred provider organization. PPO dental plans are one of the most sought after employer benefits by the majority of job seekers. They are hard to find as personal insurance policies. I have found a place that offers some very generous plans nationwide. Click here to find affordable dental plans.
Fill out the form for a no obligation instant quote and compare plans in your area.

Indemnity dental insurance policies allow the insured to receive treatment with any licensed dental provider. These policies pay a specific dollar amount (up to a pre- determined annual maximum) for each covered service and reimburse the funds directly to the insured or at the insured direction can be sent directly to the provider. Depending on the dentist used, the holder of one of these policies usually pays the dentist office directly and gets a reimbursement from the insurance company. If the dentist allows for balance billing they will send a bill after they have received funds from the insurance company. When pared up with a discount plan these policies can be the most cost effective.
Click here to get a quote for a dental indemnity plan .

Regardless of your income you will be able to find an affordable dental insurance plan for yourself and your family with one of these generous dental insurance plans.

In Remembrance of our Countries Founders

IN CONGRESS, JULY 4, 1776

The unanimous Declaration of the thirteen united States of America

When in the Course of human events it becomes necessary for one people to dissolve the political bands which have connected them with another and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature's God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, — That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn that mankind are more disposed to suffer, while evils are sufferable than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security. — Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.

He has refused his Assent to Laws, the most wholesome and necessary for the public good.

He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them.

He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only.

He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository of their Public Records, for the sole purpose of fatiguing them into compliance with his measures.

He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people.

He has refused for a long time, after such dissolutions, to cause others to be elected, whereby the Legislative Powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within.

He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations hither, and raising the conditions of new Appropriations of Lands.

He has obstructed the Administration of Justice by refusing his Assent to Laws for establishing Judiciary Powers.

He has made Judges dependent on his Will alone for the tenure of their offices, and the amount and payment of their salaries.

He has erected a multitude of New Offices, and sent hither swarms of Officers to harass our people and eat out their substance.

He has kept among us, in times of peace, Standing Armies without the Consent of our legislatures.

He has affected to render the Military independent of and superior to the Civil Power.

He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation:

For quartering large bodies of armed troops among us:

For protecting them, by a mock Trial from punishment for any Murders which they should commit on the Inhabitants of these States:

For cutting off our Trade with all parts of the world:

For imposing Taxes on us without our Consent:

For depriving us in many cases, of the benefit of Trial by Jury:

For transporting us beyond Seas to be tried for pretended offences:

For abolishing the free System of English Laws in a neighbouring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies

For taking away our Charters, abolishing our most valuable Laws and altering fundamentally the Forms of our Governments:

For suspending our own Legislatures, and declaring themselves invested with power to legislate for us in all cases whatsoever.

He has abdicated Government here, by declaring us out of his Protection and waging War against us.

He has plundered our seas, ravaged our coasts, burnt our towns, and destroyed the lives of our people.

He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation, and tyranny, already begun with circumstances of Cruelty & Perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation.

He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands.

He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.

In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince, whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people.

Nor have We been wanting in attentions to our British brethren. We have warned them from time to time of attempts by their legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the circumstances of our emigration and settlement here. We have appealed to their native justice and magnanimity, and we have conjured them by the ties of our common kindred to disavow these usurpations, which would inevitably interrupt our connections and correspondence. They too have been deaf to the voice of justice and of consanguinity. We must, therefore, acquiesce in the necessity, which denounces our Separation, and hold them, as we hold the rest of mankind, Enemies in War, in Peace Friends.

We, therefore, the Representatives of the united States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these united Colonies are, and of Right ought to be Free and Independent States, that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. — And for the support of this Declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our Lives, our Fortunes, and our sacred Honor.

— John Hancock

New Hampshire:
Josiah Bartlett, William Whipple, Matthew Thornton

Massachusetts:
John Hancock, Samuel Adams, John Adams, Robert Treat Paine, Elbridge Gerry

Rhode Island:
Stephen Hopkins, William Ellery

Connecticut:
Roger Sherman, Samuel Huntington, William Williams, Oliver Wolcott

New York:
William Floyd, Philip Livingston, Francis Lewis, Lewis Morris

New Jersey:
Richard Stockton, John Witherspoon, Francis Hopkinson, John Hart, Abraham Clark

Pennsylvania:
Robert Morris, Benjamin Rush, Benjamin Franklin, John Morton, George Clymer, James Smith, George Taylor, James Wilson, George Ross

Delaware:
Caesar Rodney, George Read, Thomas McKean

Maryland:
Samuel Chase, William Paca, Thomas Stone, Charles Carroll of Carrollton

Virginia:
George Wythe, Richard Henry Lee, Thomas Jefferson, Benjamin Harrison, Thomas Nelson, Jr., Francis Lightfoot Lee, Carter Braxton

North Carolina:
William Hooper, Joseph Hewes, John Penn

South Carolina:
Edward Rutledge, Thomas Heyward, Jr., Thomas Lynch, Jr., Arthur Middleton

Georgia:
Button Gwinnett, Lyman Hall, George Walton

Ideas on Affordable Arizona Group Health Insurance

Arizona Small businesses have some unique challenge when considering how to best solve their employee benefits problem. Shockingly the size of the group and what percentage of employees willing to participate are factors that can wreak havoc on a small group health insurance plan. All insurance companies require that you maintain a minimum percentage of eligible employees on your health plan. A common percentage is 50 percent. If your small group should loose one employee and the percentage of employees drops below the minimum number requirement, all your employees will loose their coverage because the group will be disbanded. Why put yourself and your employees in this horrible situation, when you can institute these three ideas. Below are some great suggestions from past articles.

Individual Medical or (IM) are a type of voluntary health benefit that creates a total paradigm shift in the human resource equation. A total voluntary benefits package lifts the financial and management burden from the employer. All the owner is required to do is to payroll deduct the insurance premium of the employee each month and remit one consolidated payment to the insurance company. The employee still enjoys the benefits of the coverage and the advantage of payroll deduction. The insurance agent becomes the benefits coordinator and assists both the employees and the employer with their respective health benefits needs. It is a solution for those small businesses that can not offer benefits to their employees because the costs are prohibitive.
(Read the whole article)

HRA’s are an employer funded plan designed to reimburse employees for certain medical expenses (For a list of eligible expenses). Though an HRA is not health insurance, it is a supplemental health insurance plan that will pay for a wide range of health expenses, including an employee’s privately owned health policy premium. HRA’s are notional arrangements, meaning no funds are expensed until reimbursements are made. Those reimbursements are tax deductible to the employer and tax free to the employee. HRA’s are made available due to IRS code section 213d and IRS publication 502.
(Read the whole article)

Voluntary health insurance is a group of supplemental insurance indemnity policies that are designed to protect your employees from a variety of illnesses and calamities. National statistics show that, because these plans pay cash directly to the policy holder, employees love them. That is why there is not a single Fortune 500 company that does not offer a voluntary health plan as a part of their benefit package
(Read the whole article)

Each of these cost effective ideas can be implemented individually or all together to create a comprehensive benefits package. For additional information feel free to call me at (602) 502-3113 or fill out a confidential quote form at AzHealthNow.com

Arizona Child Only Health Insurance

A 2005 study by (SHADAC) and the US Census Bureau ranked Arizona in the bottom of all the United States for providing healthcare to children. The three worst states were Arizona, Louisiana and Mississippi. The state does have some very generous programs for low income families to obtain health insurance. KidsCare is the states version of the federally mandated SCHIP program and complements our states long standing Arizona Health Care Cost Containment System Care (AHCCCS) or Medicaid. Although we rank poorly in this survey, our elected officials have provided a generous healthcare plan for children 18 and under that are at risk due to economic factors. However, the state is at fault for not getting the word out so every child who qualifies gets the health insurance they deserve.

Most KidsCare members must pay an inexpensive monthly premium. The amount a family must pay is based on family income and the number of children who get KidsCare. Premiums will cost no more than $25 a month for one child or no more than $35 a month no matter how many children are in the household. For more information or to apply for KidsCare click here

What can a family do, if they don’t qualify for these great Arizona health insurance programs? There are only two choices: enroll at work for group coverage or get a child only health insurance policy. Depending on the age of the child these policies are generous and extremely affordable. Undoubtedly Blue Cross and Blue Shield of Arizona has the most generous and affordable child only policies in the state. As of June 2008 a ten year old boy or girl could have a “BluePreferred Basic” health insurance policy for $50.00 a month. For such a low premium many families should be considering taking their child/children off their work plan and enrolling them in a child/children only plan to save money. To get a quote on a BCBSAZ child only plan click here.

Due to the internet, shopping for health insurance has become as easy as going to an instant quote search engine like AzHealthNow.com. Here you can compare no obligation instant health insurance quotes from six top Arizona carriers. All parents want to protect their children.

Starting the Long Term Care Discussion

According to AARP “About 60 percent of people over age 65 will require at least some type of long term care during their lifetime”. With statistics like these it is more important than ever to start the long term care discussion with your family.

Long term care or (chronic care) is custodial care. This type of care is for people who are chronicle ill, have been injured or become so frail due to advancing age they need assistance with activities of daily living. Unless a person dies in their sleep there is a high probability of needing this type of care at some point in their lifetime. The unanswerable questions are when, what and for how long will the chronic condition be for. When the need for care arises it is important that everyone in the family understand the wishes of the ill or injured party. This can be a very emotionally trying time for any family. Having a plan in place that everyone understands will reassure family members so they can act accordingly.

The financial cost of receiving long term care services can be expensive. Understanding these costs is important. Low income individuals have certain rights but they vary from state to state. In Arizona we have state aid for low income individuals and a program for others to spend down all their assets to become eligible for state aid. Every family should understand their options and devise a plan based upon their economic realities. A common misconception about who will pay for long term care or chronic care is that Medicare will cover the costs. Medicare will not pay any costs for custodial care which is what long term care is all about. The state will pay, but only after an individual or couple has liquidated the bulk of their assets.

What should a person wishing to create a plan do first? Luckily due to the internet there is a wealth of information. The U.S. Department of Health and Human Services has created a department called the National Clearinghouse for Long-Term Care Information. They also have created a website http://www.longtermcare.gov where these topics are discussed in detail. They even have a long term care planning guide that can be ordered free of charge to assist concerned citizens on how to start their long term care plan. They recommend that each plan first and foremost consider their finances. By coming to a conclusion on how to pay for a long term care event families will be led to what must be done next.

My clients are often shocked when they find out how affordable long term care insurance can be. However, there is more than one way to pay the cost associated with chronic care. For more information on these important financial health care issues click here, fill in the confidential quote request form, and I will be glad to contact you and discuss your options.