When turning 65, individuals become eligible for Medicare, a federal health insurance program in the United States. Medicare provides coverage for hospital stays, doctor visits, prescription drugs, and more. Enrollment typically begins three months before turning 65 and extends for seven months thereafter, ensuring timely access to healthcare benefits.
Today is the first day to share with you the new 2024 Medicare Plans. The Annual Enrollment period is October 15th- December 7th for a January 1, 2024 effective date. Feel free to give me a quick call at 619.886.5665. If you happen to be losing your doctors I can share a few options for you to remain with your doctors and hospitals.
The choice between a Medicare Supplement (Medigap) plan and a Medicare Advantage plan depends on your individual circumstances and priorities. Medigap plans provide comprehensive coverage for out-of-pocket costs, offering greater predictability in healthcare expenses. They allow you to see any doctor or specialist who accepts Medicare, giving you flexibility in healthcare provider choice. However, they typically come with higher monthly premiums.
On the other hand, Medicare Advantage plans often have lower monthly premiums but involve cost-sharing through copayments and coinsurance when you receive medical services. They may include additional benefits like prescription drug coverage and extras like dental and vision care, providing a more all-inclusive healthcare package. However, they often have network restrictions, requiring you to use specific doctors and hospitals.
The better choice depends on your healthcare needs, budget, and provider preferences. If you prioritize flexibility and can afford higher premiums, Medigap may be the better option. If you’re looking for cost savings and don’t mind some restrictions on providers, a Medicare Advantage plan could be more suitable. It’s essential to carefully compare plan details and assess your specific situation before making a decision.
Leaving group health insurance to sign up for Medicare is a pivotal decision for many seniors. Medicare, a federal health insurance program in the United States, becomes available at age 65. It offers comprehensive coverage, including Part A (hospital insurance) and Part B (medical insurance), with options for additional coverage like Part D (prescription drugs) and Medigap plans.
Transitioning to Medicare often means more flexibility in healthcare choices, as you can see any doctor who accepts Medicare. Additionally, Medicare typically costs less than private group insurance, making it an attractive option for those on a fixed income. However, timing is crucial, as missing enrollment deadlines can result in penalties. Consult with Medicare expert Kevin Leinum at 619.886.5665 to ensure a smooth transition.
Two physician groups affiliated with Scripps Health in San Diego County have reportedly filed termination notices with Medicare Advantage plans, which could potentially affect thousands of patients. Here’s a breakdown of the key points:
Termination Notices: Scripps Clinic and Scripps Coastal, both affiliated with Scripps Health, have apparently terminated their senior Medicare Advantage HMO plans, effective from January 1, 2024.
Impacts on Patients: The termination of these Medicare Advantage plans may lead to potential changes for patients. They may have to change doctors or could face increased monthly premiums if they remain with their current plans.
Response from Mercy Physicians Medical Group: The director of Mercy Physicians Medical Group issued an undated memo to its member physicians, informing them of the termination of the Scripps Clinic and Scripps Coastal plans. This memo also indicates that various health plans have approached Mercy Physicians Medical Group with offers to assist in accepting a significant portion of the affected membership.
Physician Response: Physicians within the Mercy Physicians Medical Group were encouraged to express their willingness to accept additional patients by July 31. This suggests that they are considering the possibility of accommodating patients who may need to change doctors due to the termination of their Medicare Advantage plans with Scripps Clinic and Scripps Coastal.
Ongoing Negotiations: Scripps Health has stated that it remains in negotiations with the affected plans. The information indicates that no final decisions have been made, implying that there may still be room for resolution or changes in the situation.
Overall, the situation appears to be fluid, with negotiations ongoing between the involved parties. Patients and physicians in the affected groups may need to monitor the situation closely for updates and potential changes to their healthcare options.
Medicare is a federal health insurance program primarily available to U.S. citizens and legal permanent residents who meet certain eligibility criteria. To qualify for Medicare, individuals typically must be:
Age 65 or older: Most individuals become eligible for Medicare when they turn 65, provided they or their spouse have paid into the Social Security system.
Disabled: People under 65 with certain disabilities may also qualify for Medicare, provided they have received Social Security Disability Insurance (SSDI) benefits for at least 24 months.
End-Stage Renal Disease (ESRD): Those with ESRD, such as kidney failure, may be eligible for Medicare, regardless of age, under specific circumstances.
ALS (Amyotrophic Lateral Sclerosis): Individuals diagnosed with ALS are automatically eligible for Medicare, regardless of age.
Medicare consists of different parts (A, B, C, and D), each covering specific healthcare services, and individuals may choose to enroll in different parts based on their needs and circumstances. It’s important to verify current eligibility and enrollment information with the Centers for Medicare & Medicaid Services (CMS), as program criteria may evolve over time.
A person can sign up for Medicare during several enrollment periods. The Initial Enrollment Period (IEP) begins three months before turning 65 and lasts for a total of seven months. The General Enrollment Period runs from January 1 to March 31 each year, with coverage starting in July. The Medicare Advantage Open Enrollment Period takes place from January 1 to March 31, allowing those with Medicare Advantage plans to switch or drop coverage. Additionally, there’s the Special Enrollment Period (SEP) triggered by certain life events like retirement or loss of employer coverage. Each period offers opportunities for individuals to access Medicare benefits.
The Medicare Annual Enrollment Period is a crucial time each year, typically from October 15 to December 7, when individuals can review and make changes to their Medicare coverage. Beneficiaries can switch plans, add prescription drug coverage, or modify their existing plan to better suit their healthcare needs.
Because of the close relationship between Medicare and Social Security, people often confuse these two programs. Although there are connections between Medicare and Social Security, they are two separate government programs. Medicare – Individuals over 65, people with chronic illnesses, and those with end-stage renal disease are covered by Medicare. Social Security – a government pension available to people older than 62 who have chronic disabilities. Social Security benefits are also available to Medicare recipients and vice versa. Besides eligibility, Medicare and Social Security overlap in a few other ways. Enrollment: Both programs require initial enrollment through the Social Security Administration. The Social Security Administration is the place to go to enroll in a Medicare plan or defer your Medicare coverage (for example, to return to an employer plan). Premiums: Medicare premium increases are based on Social Security pension amounts. Part B premiums are typically deducted automatically from Social Security pensions. Eligibility: People who receive Social Security Disability (SSD) benefits are automatically enrolled in Medicare. Similarly, if a person is collecting Social Security when they turn 65, they are automatically enrolled in Medicare (although they can defer Medicare if they have other coverage). Call Kevin Leinum your local Medicare expert for more information.
According to the US Government Centers for Medicare & Medicaid Services (CMS), the average monthly premium for standard Medicare Part D coverage is currently projected to be $31.50 in 2023 which is a decrease of 1.8% from $32.08 in 2022. Before Medicare Open Enrollment, when beneficiaries can select plans for the upcoming benefit year, CMS releases the projected average monthly Part D premium, calculated based on plan bids submitted to CMS. To help Part D plan sponsors prepare for Medicare Open Enrollment, CMS also provides additional information, such as the Part D national average monthly bid amount. Medicare Open Enrollment for coverage beginning January 1, 2023, will run from October 15 to December 7, 2022. CMS anticipates releasing the 2023 Medicare Advantage and Part D premium and cost-sharing information in September 2022. Call Kevin Leinum your local Medicare expert for more information. Kevin Leinum makes Medicare Easy!
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We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 75 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This is a proprietary website and is not associated, endorsed, or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program, please visit the Official U.S. Government Site for People with Medicare located at http://www.medicare.gov.