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When planning ahead for your healthcare expenses and how they align with your Medicare coverage, it’s very important to stay informed on the changes to Medicare each year. Several aspects of Medicare - particularly related to out-of-pocket costs - can change on an annual basis. Beyond costs or plan changes, Congress also occasionally proposes and passes legislation that often impacts Medicare benefits. In this article, we’ll review the recent changes, including the 2023 Medicare costs and an overall look at the state of Medicare in 2023. 2023 Medicare Costs: An Overview The Medicare costs that change each year are: Part A deductiblePart A daily coinsurancePart B deductible Medicare Part A CostsThe changes to Part A costs include:Part A deductible - $1,600, an increase of $44 from 2022Part A daily coinsurance for hospital stays over 60 days - $400 per day, an increase of $19 per dayPart A daily coinsurance for hospital stays over 90 days - $800 per day, an increase of $22 per dayPart A daily coinsurance for skilled nursing facility stays longer than 20 days - up to 100 days $200, an increase of $5.50 per month Keep in mind that it is possible to pay the Part A deductible more than once in a year. This would only happen when you have multiple hospital stays in one year, and your stays are separated by more than 60 days. In this situation, you’d pay the Part A deductible each time.When you pay the Part A deductible, that gets you 60 days in the hospital and 20 days in a skilled nursing facility. If your stay goes beyond those times, you’ll have to pay the updated daily co-insurance amounts indicated above. Medicare Part B CostsThe Part B deductible for 2023 decreased to $226. It was $233 for 2022. You have to pay the Part B deductible each year before Medicare starts paying its portion of your outpatient care. Unlike the Part A deductible, you’ll only be required to pay the Part B deductible once per year.After you’ve met the Part B deductible, Medicare will pay the first 80% of the cost for your care; you’ll be responsible for the remaining 20%. Besides standard Part B coinsurance, you might encounter Part B excess charges, which can be as much as 15% of the Medicare-approved cost for your care.There were no changes to these coinsurance costs for 2023. How Much Will Medicare Premiums Increase in 2023? The standard Part B premium for 2023 is $164.90, which is a decrease of $5.20 per month. This decrease takes some of the sting out of last year’s increase, which was one of the largest in history. You may pay a higher premium for Medicare if you have incomes exceeding $97,000 (single filers) or $194,000 (married filing jointly).In addition to the costs for using your coverage, you’ll also have to consider the cost for getting your coverage. Most people don't have to pay a premium for Part A coverage (because it’s been pre-funded through payroll tax deductions), but you do have to pay a premium for Part B coverage. Medicare Part D Changes Another major component of your Medicare coverage is Medicare Part D, also known as Prescription Drug Plans (PDPs). Part D is offered by private insurance carriers with a Medicare contract - not offered by the federal Medicare program. There have been major changes to Part D in the past year as a result of the Inflation Reduction Act. Some of these changes won’t take effect until 2024 or later, but a few of them will be effective in 2023. The changes that will be applicable for 2023 include:Caps on the cost of certain insulinTaxes on excessive increases in the cost for prescription drugsLowering the cost of many vaccinations covered under Part DEach of these changes will have an impact on both standalone Part D Prescription Drug Plans (PDP) and Medicare Advantage Prescription Drug Plans (MAPD). New Caps On Insulin PricesThe Inflation Reduction Act has brought us the Insulin Savings Program, which was a temporary “test program” that began in 2020. The program is now permanent and mandatory. But previously, it was optional: Part D plans could choose to participate on a voluntary basis.The Inflation Reduction Act limits monthly cost sharing for covered insulin products to no more than $35 for Medicare beneficiaries, as long as the insulin is on the plans formulary. No deductible will apply to these insulin prescriptions. For 2023 and beyond, insulin prescriptions are capped at $35 for a one month supply. This price level stays the same throughout the year, even if you enter the coverage gap or “donut hole.” Excise Tax On Excessive Cost Increases Cost increases on prescription drugs, which are set by the manufacturers, will be subject to a new tax beginning in 2023. Medicare will use 2022 drug prices as a baseline and will investigate the prices for 2023 prescription drugs. If the increases from 2022 to 2023 are larger than the official rate of inflation, the manufacturer will pay a tax equal to 100% of the amount that the increase exceeded inflation for the year. Drug prices will be tracked each year in this way. The hope is that manufacturers will be less likely to increase prices aggressively since they won’t be able to keep any of the extra revenue that large cost increases used to bring them.While this new policy doesn’t directly reduce or limit the prices you pay through your drug plan, over time, it may allow for smaller copayments and coinsurance for your prescriptions. Reduced Vaccine Costs Under Part D The Inflation Reduction Act is also impacting how much you’ll pay for vaccinations under Part D. Prior to 2023, most non-essential vaccines were subject to cost-sharing, which meant that you had to pay a copayment or coinsurance for them. For example, the shingles vaccine was famously expensive. For 2023 and beyond, many Part D covered vaccines will be available at no cost. This brings the Part D vaccinations into alignment with the rules and cost structure for Part B vaccines (like the COVID-19 and flu shots). This includes the shingles shot, so protecting against this painful illness will be cheaper starting in 2023. There are still vaccines that you’ll have to pay for under Medicare, even after these recent changes. Vaccines that are needed to treat injuries or exposure to certain diseases may still require cost-sharing. General Enrollment Period (GEP) ChangesThe last major change to Medicare in 2023 relates to entering Medicare when you’ve missed your original enrollment window. Most people get to enter Medicare when they turn 65-years-old. In that case, you have a seven-month enrollment period known as your Initial Election Period (IEP) during which you can enroll. If you miss this chance, you have to enroll during the General Enrollment Period (GEP). GEP runs from January 1st to March 31st each year. Previously, if you enrolled during the GEP, your Medicare coverage wasn’t effective until July 1, which left you with a significant gap in your medical coverage.For 2023 and beyond, your coverage will be effective on the first day of the month after you sign up during the General Enrollment Period, eliminating the lengthy waiting period. Learn MoreIf you still have questions about 2023 Medicare costs and how they impact you, call 800-620-4519 to speak to one of our licensed insurance agents. You can also view our Medicare resources online:Compare Medicare plans: Visit our Medicare plan comparison tool.Learn about Medicare: View our Medicare Learning Center.Note: These 2023 Medicare costs and updates are courtesy of the Centers for Medicare & Medicaid Services (CMS). For more information, visit the CMS newsroom.
Researching your Medicare plan and understanding how to use your benefits wisely is key to maximizing your Medicare plan. But if you don't take the time to learn all that your current plan has to offer, or if you avoid comparing Medicare plans when it may be time to make a change, you could end up paying more money for your healthcare. To help you make an informed choice, we’ve put together this guide about 10 costly mistakes to avoid when picking a Medicare plan. Mistake #1: Using Doctors And Medications That Are Not Covered By Your Plan Medicare Advantage plans have formal networks of providers and lists of medications that are covered (called a formulary). If you see doctors who aren’t in-network, you’ll be paying more for your care than if you use in-network providers. While some PPO plans will allow you to see non-network providers, you’ll save the most money when you use in-network providers. In the same way, plans only provide coverage for medications that are on the formulary. If you use non-covered medications, you’ll end up paying full price for them. So if your current plan doesn’t work with your doctors and medications, you may want to consider making a change to your coverage a qualifying enrollment period. Our online guided Medicare enrollment tool also allows you to check and see if your doctor and drugs are covered in a Medicare Advantage plan. Mistake #2: Not Taking Advantage of Additional BenefitsOne of the reasons Medicare Advantage plans are increasingly popular is because they usually provide benefits that are not covered by Original Medicare. These kinds of benefits can include dental, vision, hearing, or prescription drug coverage.These benefits also may be included in your plan at no additional cost. If you don’t use them, you might be paying more than you need to for these services. In addition to the potential cost savings, these additional benefits are designed to help you live a healthier life. Mistake #3: Paying Cash For Your MedicationsIt can be tempting to pay cash for some of your less expensive medications. This is especially true when you look into any of the various prescription discount card programs that are currently available. However, it's wise to avoid paying for your medications if you're expected to reach the third coverage stage of the Medicare Part D drug program (often called the donut hole). Your drug plan tracks your spending, so if you pay cash for a prescription, it doesn’t count towards your official spending. This means that you might not be able to move out of the donut hole if you pay cash for some of your medications. Instead, consider using your plan even if you’ll pay more, if it means that you’ll move out of the donut hole faster. Mistake #4: Not Understanding Your Plan’s CostsWhile Medicare Advantage plans generally help to limit your healthcare costs, it’s important to remember that there are costs you’ll be expected to pay for your care. These costs are usually referred to as cost-sharing. Cost-sharing can include deductibles, copayments, and coinsurance. Besides these amounts, you’ll want to double check your plan’s Out-of-Pocket Maximum (OOPM), which is the most you could possibly spend in one year. Mistake #5: Choosing A Plan Based On Premiums AloneIt can be tempting to focus on the monthly premium you pay for your coverage, and not dig deeper into the costs you’ll pay to use your benefits. Pay particular attention to any deductible that you have to meet, as well as co-payments for services you’re likely to use. Besides these, consider your total costs in light of any costs for prescription drugs you take, too. Mistake #6: Not Checking To See If You Qualify For Financial AssistanceThere are a number of federal and state programs that are designed to help you pay for the cost of your health care. These can include Medicaid, Extra Help, Low Income Subsidy, and state pharmaceutical assistance programs. While there are income and asset limits for participation in some of these, you should apply for them if you think there is any chance that you could be eligible. Many times the limits are dependent on household size so you may qualify even if your income appears to exceed the limits. The upside is huge and there’s no downside to applying, so don’t miss out any potential for savings with these programs. Mistake #7: Not Considering Late Enrollment PenaltiesIt’s very important to consider the impact of late enrollment penalties, especially when you’re first entering Medicare. You can potentially be subject to enrollment penalties for both Part B and Part D. These penalties are assessed in the form of an additional monthly premium. Importantly, these penalties are generally permanent; once you’re subject to them, you’ll pay them for the rest of your life.If you’re already in Medicare, and you have avoided late enrollment penalties so far, just make sure that you continue to have Part D drug coverage, either from a Medicare Advantage Plan or a standalone Prescription Drug Plan.Mistake #8: Not Reviewing Changes In Your CircumstancesIt's important to review any changes in your circumstances on an annual basis. If you’ve been referred to a new specialist, prescribed a new medication, or diagnosed with a new medical condition, you might be better served by a different plan for the new year. So be sure to consider the impact these kinds of circumstances may have on your Medicare coverage. Mistake #9: Automatically Renewing Your Plan Each YearEach year, your plan will mail your Annual Notice of Change (ANOC) before the fall Annual Enrollment Period (AEP). The ANOC outlines changes in your plan benefits or costs for the upcoming year. Use this document, along with your plan’s overall Evidence of Coverage (EOC) to know how to use your benefits for this year.If you don’t make a change during AEP, you’ll automatically stay in your current plan. But plan benefits change from year to year, as do Medicare Advantage plan networks. So it's essential to review your coverage each year. Mistake #10: Not Working With A Licensed Insurance AgentAs you research the plans available in your area, consider working with a licensed insurance agent like one of our TogetherHealth agents. We work with a network of the nation’s major insurance carriers and can provide you with a variety of plan options to fit your healthcare needs, remain in-network with your doctors, and give you strategies to save money on prescription drugs. Get Help With MedicareIf you need more guidance, call 1-800-620-4519 (TTY 711) to speak to one of our licensed agents and get advice on how to avoid these 10 costly Medicare mistakes.
The Medicare Annual Enrollment Period (AEP), sometimes called Medicare Open Enrollment or the Medicare Annual Election Period, runs from October 15 to December 7 each year. This is the time period in which Medicare-eligible consumers can make certain changes to their Medicare plans. These plan changes would then become effective on January 1. View Our Medicare Annual Enrollment Period Guide Medicare plan costs and benefits can change annually, so it's wise to review your Medicare coverage each year. Use our Guide to the Medicare Annual Enrollment Period as a resource to review your current Medicare plan on an annual basis, then call our licensed insurance agents to compare Medicare plans during AEP. Medicare Guide to Annual Enrollment Medicare Guide Understand your Medicare plan options and learn what actions to take and when. Download your guide Call to compare Medicare plans: 1-888-605-1433 (TTY 711). Our licensed insurance agents are available to help 7 days a week. Weekdays: 8am – 11pm ET Saturday: 10am – 7pm ET Sunday: 11am – 6pm ET Overview of Medicare Enrollment PeriodsIt's important to know that the Medicare Annual Enrollment Period is different from other Medicare enrollment periods. Here’s a quick overview of the differences:Initial Enrollment Period (IEP): The 7-month initial enrollment period when you can first sign up for Medicare Parts A, B, C or D. This period spans:3 months before your 65th birthdayThe month of your 65th birthday3 months after your 65th birthdayAnnual Enrollment Period (AEP): An election period that allows you to make changes to your Medicare coverage each year. Open Enrollment Period (OEP): Applies only to those with Medicare Advantage, who can change Medicare Advantage plans or drop them and return to Original MedicareGeneral Enrollment Period (GEP): Open enrollment period to join Medicare Part A and B.Special Enrollment Period (SEP): Occurs if you have eligible life changes that mean you need to change your plan before the next annual enrollment period.Be sure to visit our guide to different enrollment periods to learn more.What’s the Difference Between Medicare AEP and the Medicare General Enrollment Period?The Medicare Annual Enrollment Period is sometimes confused with the Medicare General Enrollment period, which is January 1 to March 31 each year. It’s important to understand the differences between the two enrollment periods.The Medicare General Enrollment Period is for Medicare beneficiaries who didn’t sign up for Medicare Part A) or Part B when they first became eligible and aren’t eligible for a Medicare Part B special enrollment period. The AEP, however, is for beneficiaries who are already enrolled in Medicare and want to change their Medicare coverage.What Changes Can I Make During the Medicare Annual Enrollment Period?The first thing to know is that you cannot use the Medicare Annual Election Period to enroll in Medicare Part A or Part B for the first time.If you’re enrolled in Medicare Part A and Part B and you’d like to change your Medicare coverage, here are some things you can do during the Medicare AEP:Change Medicare Advantage plans.Change Prescription Drug (Part D) plans. Enroll in a Prescription Drug Plan.Cancel your Prescription Drug Plan.Switch from Original Medicare to a Medicare Advantage plan.Switch from a Medicare Advantage plan back to Original Medicare (and add a Part D plan or Medicare Supplement plan if needed). 5 Tips to Prepare for the Medicare Annual Enrollment PeriodThere are many Medicare insurance carriers and plan options, but there are several steps you can take to be a savvy shopper and choose the right plan for your unique needs.1. Mark Your CalendarThis may seem like an obvious tip, but it’s worth mentioning: Mark your calendar for October 15 through December 7 if you’d like to make a change to your Medicare plan.You might even set aside a few hours to research and compare Medicare Advantage plans and Prescription Drug plans ahead of October 15. These plans announce their benefits for the next year starting on October 1.Writing down these Medicare AEP dates and to-dos will help you to commit to these priorities.2. Review Your Medicare Annual Notice of ChangeYou’ll receive lots of information over the next month or so prior to and during AEP, so if you’re currently enrolled in a Medicare Advantage or Prescription Drug Plan, the Annual Notice of Change (ANOC) is one piece of mail you’ll want to read.Your Medicare plan will mail your Annual Notice of Change letter to you by September 30. The ANOC letter will inform you of most changes to your Medicare health plan, including coverage and benefits that will take effect on January 1 each year.Each year, your Medicare health plan sets the amounts it will charge you for premiums, deductibles and other services. Medicare doesn’t set these rates - but your insurance company does. With this in mind, the amounts you pay could change each year.While evaluating your current Medicare plan, you may want to ask yourself questions like:Did the plan cover the services I needed?Did I use out-of-network providers?Did I spend more out of pocket than I originally anticipated?Has something changed with my health (new diagnosis, new prescriptions, etc.)?The ANOC will also provide a side-by-side comparison of your current plan and next year’s plan benefits, costs and other changes (if any).Moral of the story: Don’t toss this piece of mail aside. Always review your ANOC to ensure your plan continues to meet your needs on an annual basis. And if you don’t receive your ANOC by September 30, contact your Medicare insurance company.3. Make a List of What’s Important to Your HealthKeeping a list of what’s important to your health is an invaluable way to prepare for the Medicare Annual Enrollment Period.Start by writing down all of your doctors, preferred health care facilities and hospitals, and prescription drugs, if you take any.We also recommend making a list of value-added benefits that may fit your health, lifestyle and budget.For example, you may be someone who likes to keep active and have social interaction. So a fitness program like SilverSneakers, which gives you access to a network of gyms and other programs, might be a good fit for you. A Medicare Advantage plan may provide these types of fitness or wellness programs.Another thing to consider is whether or not you have an elective surgery planned for 2023. If so, you’ll want to check your hospital-specific benefits under your current Medicare Advantage plan.4. Check Your Plan’s Drug FormularyYour Medicare plan’s drug formulary will not be included in your Annual Notice of Change, so be sure you call your insurance carrier to see if your prescription drugs will be covered for the 2023 plan year.If your prescription drugs aren’t covered, it’s wise to use the Medicare Annual Enrollment Period to find a plan that does cover them.5. Talk To Your DoctorAnother “Medicare must-do” is to make sure all of your doctors and healthcare facilities will remain in network with your current Medicare plan. If they aren’t, you may want to take advantage of the Medicare Annual Enrollment Period.So be sure to ask your doctor if he or she plans on changing health plan affiliations over the next year.What Changes Can I Make During the Medicare Annual Enrollment Period?The first thing to know is that you cannot use the Medicare Annual Election Period to enroll in Medicare Part A or Part B for the first time.But if you’re enrolled in Medicare Part A and Part B and you’d like to change your Medicare coverage, here are some things you can do during the Medicare Annual Election Period:Change from Original Medicare to a Medicare Advantage plan.Change from one Medicare Advantage plan to another.Disenroll from your Medicare Advantage plan and go back to Original Medicare.Change from one prescription drug plan (Medicare Part D) to another.Enroll in a prescription drug plan.Cancel your prescription drug coverage.What Are The Benefits of a Medicare Advantage Plan?Understanding your Medicare plan options - starting with a Medicare Advantage plan - is a smart first step to take because you can switch, enroll into or disenroll from Medicare Advantage plans during AEP.Medicare Advantage plans, otherwise known as “Medicare Part C” or “MA Plans,” bundle Original Medicare (Parts A and B) services into one plan. These plans are offered by private insurance companies. And while Original Medicare offers you a number of benefits, it may not cover health and medical services you might need.Medicare Advantage plans are appealing to many people because they’re considered “all-in-one” plans that give you an annual cap on your spending as well as access to extra benefits, which may include: Dental and vision coveragePrescription drug coverageAccess to fitness programsHealth incentive programsRides to medical appointmentsTelemedicine servicesNote: If you have limited income, you might also qualify for extra savings on Medicare costs through these programs.Medicare Savings Programs. These programs help pay for some of your Medicare Part A and Part B out-of-pocket costs, such as copays, deductibles and premiums. Most programs are for Medicare beneficiaries who also qualify for Medicaid. And as mentioned, Medicaid covers the majority of your costs when you join a Medicare Advantage Special Needs Plan. You can check if you qualify through your local Medicaid office.Medicare Extra Help. Extra Help reduces your Medicare prescription drug plan costs. You should contact Social Security to check your eligibility for Extra Help if you have an existing Medicare drug plan or you join one during AEP. Find A Medicare Advantage Plan During AEPTo enroll in an eligible plan during the Medicare Annual Enrollment Period, you can use our comparison tool as a guide to assess your needs and help you choose a Medicare plan. Or, you can give us a call.Our licensed insurance agents are available to help 7 days a week. Call us toll-free at 1-888-605-1433 (TTY 711). Weekdays: 8am – 11pm ET Saturday: 10am – 7pm ET Sunday: 11am – 6pm ET Tip: Be sure to have these 3 items handy before you call us or enroll in a Medicare plan online during AEP:Your Medicare number, which is found on your red, white and blue ID card.Your list of prescription drugs and preferred pharmacy.Your list of preferred doctors and hospitals.We’re here to help you compare your options and find you a Medicare plan that meets your individual needs.
For many seniors, having a walk-in tub can be very helpful. When you have limited mobility, getting in or out of a traditional tub can be very difficult. If you have Medicare for your health insurance coverage, you might wonder, “Can a walk-in tub be covered by Medicare?” This guide will help you understand if this type of tub is considered durable medical equipment and eligible for coverage. Let’s get started! Does Medicare cover walk-in tubs? Does Medicare cover the cost of a walk-in tub? Original Medicare covers specific types of durable medical equipment (DME) as long as you get the equipment from a DME provider that accepts assignment from Medicare. Durable Medical Equipment must meet the following requirements: Can be used repeatedlyIs used only for a medical reasonIs used in the patient’s homeIs expected to last 3 years or longerIs not useful to people who are not sick or injuredUnfortunately, a walk-in tub is not considered DME by Original Medicare. However, if you have a Medicare Advantage plan, you may be able to get coverage for a walk-in tub using that plan if your doctor prescribes it.How much are walk-in tubs for the elderly?Walk-in tubs can be quite expensive. For a basic model, you could pay between $2,000 and $3,000. Wheelchair-accessible tubs are more than twice as expensive, with prices between $5,000 and $10,000. There’s also the cost of installation to consider, which can vary significantly based on where you live, your bathroom layout, and what types of plumbing, tile work, and other changes need to be made.Getting a walk-in tub is a significant investment, which is why so many seniors would like to have help from Medicare in paying for it.How to get Medicare to pay for a walk-in tubWhile you won’t be able to get Original Medicare to pay for a walk-in tub, you might have better luck with a Medicare Advantage plan. These plans can offer additional benefits above and beyond what Original Medicare provides.Before you choose a Medicare Advantage plan, make sure it fits your needs. For example, they often have specific medical provider networks, and you’ll want to ensure that your preferred doctors and specialists are included. You also want to compare monthly premiums, deductibles, and copayments when you are deciding between plans.A walk-in tub can help you significantly if you have mobility issues, but there are other options that are less expensive. For example, you might look to installing grab bars in your bathroom to help you balance. These can cost as little as $75, up to $200 or so.Keep in mind that Original Medicare doesn’t cover these items, but a Medicare Advantage plan might. This could provide savings to you not just in terms of the walk-in shower, if covered by the plan, but with your overall Medicare costs. Contact us to learn more about Medicare and walk-in tubsIf you have questions about other aspects of your Medicare coverage, we’re here to help. When you’re comparing Medicare plans and trying to choose the right option for your needs, talking to a licensed agent can help put your mind at ease.Contact us today to compare plans or ask questions about your Medicare coverage!
You might remember when the price tag of the EpiPen made headlines in 2016. The cost of this life-saving medication, used to treat severe allergic reactions, went from $93.88 to $608.61 in a seven-year timeframe - a 500% price increase by drug manufacturer Mylan Pharmaceuticals. While the EpiPen story was an extreme case, it's not uncommon for prescription drugs to increase in price and become unaffordable. That's why you want to make sure you're paying the best price for your prescriptions. Here are 6 tips to save money on prescription drugs & be a savvy shopper. #1. Buy Generic Brands This may be a no-brainer for some, but it's a cost-saving tip worth remembering. Generic drugs can be significantly cheaper than brand-name versions. While everyone benefits from generic drug prices, people over age 65, especially, saved $75 billion in 2016 by choosing generic drugs. It's important to know that you're not compromising the quality of the drug if you choose a generic brand: The FDA says that generic drugs have the same active ingredients and effectiveness of brand-name drugs - a part of the FDA's approval process. So if your doctor prescribes a brand-name drug, ask if there's a generic equivalent. The savings are worth the effort. #2. Join Rewards ProgramsCertain stores or pharmacies may offer coupons or rewards programs. Every rewards program is different, but in general: You can join a store's program (sometimes for free or for a small monthly payment) and earn points based on purchases. You can then use those points towards in-store purchases.You might also receive other perks like free 1 – 2 day shipping for prescriptions, 24/7 pharmacy consultations, or points for reporting wellness activities like walking or running. There are many reward programs to choose from - CVS ExtraCare Pharmacy & Health Rewards, Meijer mPerks, and Rite Aid wellness+ rewards are just three examples.#3. See If Your Drugs Qualify for Home DeliveryYou might save money if you get your prescription drugs shipped directly to your home. In some cases, you can order a 60- to 90-day supply for a better price than buying the drug in person at your local pharmacy. Prescription home delivery also makes sense if you're unable to drive or want the convenience of not having to travel to the pharmacy to pick up medications. Just be sure to check with both your doctor and your insurance company to make sure the home delivery option is available for your specific prescription drug.#4. Get A Prescription Savings CardPrescription savings cards provide discounts or coupons for medications at thousands of retailers nationwide. Many companies such as GoodRx and WellRx now offer them. Some even allow you to use them for pet prescriptions. Prescription savings cards typically show you where a drug is available and what the prices are at certain pharmacies.Simvastatin is a popular drug used to lower cholesterol and reduce the risk of stroke or heart attack. The average retail price of Simvastatin is around $66.39, but it can be as low as $4.00 prescription savings card. Prescription savings cards are suitable for almost everyone. However, it's important to check out the fine print to see what's covered.#5. Apply For Extra HelpYou may qualify to get help paying for your Medicare Prescription Drug Plan monthly premiums, annual deductibles and copayments through the Extra Help program.#6. Know Your Coverage OptionsIf you're enrolled in Original Medicare (Part A & B) and need prescription drug coverage, you have to sign up for a Medicare Prescription Drug Plan (Part D) or a Medicare Advantage (Part C) plan, but you can't have both. Call us today to compare plans and see if you qualify: 1-800-620-4519. This article is for general education purposes and does not replace the advice of a medical professional. Always seek the guidance of your physician or a medical professional for medical advice, diagnosis, and treatment. Outside of the Medicare Annual Enrollment Period, you can only enroll in a Medicare Advantage or Medicare Part D plan if you meet certain criteria.
As we grow older, we often need help getting around. This might mean getting a cane, a walker, or another walking aid. One of the concerns seniors have is how they can afford these devices. If you use Medicare as your primary insurance coverage, you might have questions like “Does Medicare cover walkers?” or “Does Medicare pay for walking aids?” This guide is designed to answer the most common questions about Medicare and walking aids. Does Medicare Pay for Upright Walkers? Does Medicare pay for walkers for seniors? It’s a common question, and it depends on which Medicare plan you have. Original Medicare will cover walkers that are medically necessary and prescribed by your doctor. This is covered under Medicare Part B as durable medical equipment. In order to receive coverage, your medical equipment provider must accept Medicare as payment. They also need to have a Medicare supplier number. You will be responsible for your Part B deductible if it hasn’t already been paid, and then you’ll pay 20% of the Medicare-approved amount for the walker. Medicare will cover the rest. If you have a Medicare Advantage plan, you will also receive coverage for a medically-necessary walker. All Advantage plans must cover at least as much as Original Medicare. You will probably need to choose a medical equipment provider within the insurer’s network. Check your plan for details. Does Medicare Pay for a Walking Boot?Crutches and walking boots are also covered by Medicare when they are medically necessary. The good news is that you can often rent these devices instead of buying them, which saves you money. With Original Medicare, you can expect to pay 20% of the Medicare-approved cost after your deductible is covered. Medicare will pay the other 80%. When you rent an item, the provider is responsible for maintaining it, so contact them if you have any problems. Learn more about Medicare costs, deductibles, and premiums in 2022.A Medicare Advantage plan will also cover a medically necessary boot or crutches. You may have a different copayment amount, however, so be sure you contact your plan for details.Does Medicare Pay for Walking Canes?Walking canes that are prescribed by a doctor for a mobility impairment are covered by Medicare. If you buy a cane and then it needs to be repaired, you can generally get the repairs covered by Medicare as well.Keep in mind that the normal durable medical equipment (DME) rules apply: the cane needs to be medically necessary, prescribed by a doctor, and provided by a medical equipment supplier that accepts Medicare and has a Medicare supplier number.One notable exception is that Original Medicare does not cover white canes for the blind. They define these canes as a self-help device rather than one that treats an illness or injury. If you have a Medicare Advantage plan, you may have additional coverage options for canes. You’ll need to choose an equipment provider that’s in the insurance network. Be sure to contact your insurer to get the details you need. Learn More About Medicare and WalkersStill have questions about Medicare coverage for walkers or other devices? It can be helpful to talk to a licensed agent about your insurance coverage, and we’re here to help. Contact us today to learn more about your Medicare coverage and compare available options!
Some Medicare beneficiaries have concerns about their out-of-pocket expenses. In particular, it can be intimidating to face 20% coinsurance after your deductible is met. That can get expensive. Both Medicare Advantage and Medicare Supplements can address these concerns, in different ways. Understanding the difference between Medicare Advantage vs Medicare Supplements can help you choose the right plan for your needs. This article will help you understand the differences between Original Medicare, Medicare Advantage, and Medigap Did you know Medicare has the highest rate of satisfaction among Medicare beneficiaries? In fact, they ranked both Original Medicare and Medicare Advantage highly according to a 2019 survey. Still, it can be a difficult task to pick the best Medicare plan for your needs. Let's simplify the process by looking at Original Medicare, then discussing how Medicare Part C (Medicare Advantage) plans and Medicare Supplement (Medigap plans) work and take a closer look at the difference between Medigap and Medicare Advantage. What Is Medicare? Medicare is health insurance with different parts for: People who are 65 and over.People under 65 years old who are disabled and have been receiving Social Security Disability benefits for at least 24 months.People suffering from End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis, also known as ALS or Lou Gehrig’s disease.Medicare Part A CostsOriginal Medicare is broken into two parts: Part A (for hospitalization) and Part B (for medical services). In most cases, there is no cost for Medicare Part A.But you would have to pay a $471 monthly premium for Medicare Part A if you only paid Medicare taxes for 29 quarters or less (about 7.25 years). And if you paid Medicare taxes between 30-39 quarters (7.5 years to 9.75 years), the standard Part A premium is $259.Medicare Part B CostsMedicare Part B premiums are determined by your modified adjusted gross income.If your income for 2021 was less than or equal to $87,000 for a single or $174,000 for a married couple filing jointly, you will pay the standard Medicare Part B rate, which is $148.50 a month in 2021. Part B premiums rise to a maximum of $504.90 a month if your income exceeds $500,000 for an individual or $750,000 for a couple filing jointly.Many people are automatically enrolled in Medicare Part A and Part B when they turn 65 and begin to receive Social Security retirement benefits.But you might be in a situation where you have other health insurance besides Medicare, like a plan through your employer. In this case, you can delay your enrollment in Part B without being penalized and save paying the monthly premium. However, you would have to pay a $458 monthly premium for Medicare Part A if you only paid Medicare taxes for 29 quarters or less (about 7.25 years). And if you paid Medicare taxes between 30-39 quarters (7.5 years to 9.75 years), the standard Part A premium is $252.How to Enroll in Original MedicareIf you don’t receive Social Security benefits at age 65, you need to sign up on your own. There are three ways to enroll:Go online to www.SocialSecurity.gov.Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).Visit your local Social Security office in person.The seven-month Initial Enrollment Period (IEP) for Medicare begins three months before you turn 65, continues during your birthday month, and runs for three months after you turn 65. If you don’t enroll in Medicare during this timeframe, you could face penalties for not complying with Medicare rules.There’s also a Medicare annual enrollment period each year after your initial enrollment, which allows you to make changes to your coverage for the following year.What are the Different Types of Original Medicare Plans?Medicare Part A is hospital insurance. It helps cover inpatient care, skilled nursing facility care, hospice care, and home healthcare. In most cases, there is no cost for care, but there is a deductible of $1,484 in 2021.Medicare Part B is medical insurance. This plan helps cover doctor visits, outpatient care, home healthcare, durable medical equipment, and many preventive care services. Monthly premiums vary based on your income, and there is a deductible of $203 in 2021.Medicare Part C is Medicare Advantage. Medicare Advantage plans combine Medicare Part A and Part B into a health plan. Many Medicare Advantage plans may include prescription drug coverage and extra benefits. (More on this below).Medicare Part D is prescription drug coverage. Medicare Part D helps cover the cost of prescription drugs. The standard maximum deductible is $445 in 2021.Medicare plans A-N is Medicare Supplement coverage. Medicare Supplement, also known as Medigap, have several different plans, which help cover benefits that Original Medicare may not cover. Medigap prices vary by plan benefits, not income. Note that Plans C, E, F, H, I, and J are no longer sold to new enrollees.So, the big question is: Should you consider Medicare Advantage, or enroll in Original Medicare and get a Medicare Supplement instead? And the short answer is: It depends.You have to evaluate your healthcare needs and how much you can afford to pay out-of-pocket for health insurance.What is Medicare Advantage (Medicare Part C)?Medicare Advantage provides all of your Part A (hospital) and Part B (medical) coverage. A majority of Medicare Advantage plans offer extra coverage, such as vision (78%), hearing, dental care (67%) or wellness programs (72%). Most include Part D prescriptions drug coverage (90%).As a Medicare beneficiary, you have a choice between selecting Original Medicare or choosing a Medicare Advantage plan (also known as Part C), which is provided by private health insurance companies.How Much Does Medicare Advantage Cost?Medicare Part C premiums vary by the plan (many plans have $0 premiums). And each Medicare Advantage plan can charge different out-of-pocket costs and have different rules for how you get medical services.For example, most insurance companies require Medicare Advantage plan participants to get pre-approved before they can have a procedure done, but another insurance company might not have that requirement.Do Medicare Advantage Plans Cover Pre-existing Conditions?Yes, your acceptance is guaranteed and you're not required to complete any medical history forms. This includes coverage for people with End State Renal Disease (ESRD), which is a 2021 change to Medicare.What is a Medicare Supplement (Medigap) Plan?Medicare supplement plans (Medigap) plans provide extra coverage to help pay for some of the healthcare costs and services that Medicare doesn’t pay. These plans can offer protection from large out-of-pocket medical costs that result from numerous doctor or hospital visits.It’s important to note that you can’t have more than one Medicare supplement plan. And though Medicare supplement plans may have higher monthly premiums than Medicare Advantage plans, you may want to consider buying a Medicare supplement insurance plan if:You’re likely to have numerous hospital stays during a year.You have regular doctor visits and/or medical services.You live in different places during the year and cannot be confined to a local network.You frequently travel outside the U.S. and want insurance coverage for emergency medical care overseas, which Medicare Part A and Medicare Part B may not provide. Note: Some Medicare supplement plans provide international travel coverage.A Medicare supplement plan may also be a good fit if you want to visit a specific top-tier medical facility like the Mayo Clinic. You wouldn’t qualify for an in-network check-up with a Medicare Advantage plan, but you’d have the ability to see a Mayo Clinic doctor with a Medicare supplement plan, with coverage for a large chunk of your services.How Much Do Medigap Plans Cost?Pricing for Medicare Supplement plans are based on the plan you select (high/low benefits), your age at time of enrollment, your state of residence, and the health insurance company you select. That’s why it is important to compare when you shop from plan to plan or even between the same company’s plan differences before choosing a Medicare supplement plan.What's the Difference Between Medicare Advantage vs Medicare Supplements?Medicare Advantage offers more choice and covers more medical services than Medicare, while still following all of Medicare’s rules. One of the biggest differences between the two is the difference in cost. Medigap plans generally have a higher premiums than Medicare Advantage plans, but in some cases, Medicare Advantage can cover less expenses than Medigap. This means that despite a lower initial cost, you may end up paying more in out-of-pocket expenses with Medicare Advantage than with a medicare supplement. Remember: Medicare Advantage acts as an alternative to original Medicare, while Medicare Supplement plans are additions to Original Medicare coverage.Do I Need a Original Medicare with a Supplement or Medicare Advantage?Choosing between a Medicare Advantage plan or adding a Medicare Supplement plan on to your Original Medicare coverage depends on your situation.To start, ask yourself these types of questions:Do I travel outside of the United States regularly? Do I live in a different state for a portion of the year? Do I want to see any doctor and not be limited to a network? Is my budget more important than my health benefits? Are extra benefits like dental and vision coverage important to me?Answering these questions will help you determine if Medigap or Medicare Advantage is a better fit for you.Can You Switch From Medicare Advantage to Medigap?Switching from Medicare Advantage to Medigap means you need to go back to Original Medicare. Instead of having coverage under Medicare Part C (Medicare Advantage), you’ll have coverage under Medicare Part A and Part B, with Medigap added on.This can only be done during open enrollment periods. The Annual Election Period is between October 15th and December 7th of each year. The Medicare Advantage Open Enrollment Period is between January 1st and March 31st each year.Keep in mind that usually if you switch from Medicare Advantage to Original Medicare with Medigap, you may pay a higher price for your Medigap plan because you won’t have guaranteed issue rights. Guaranteed issue rights give you the ability to buy any Medigap plan without paying more due to your health status.To switch from Medicare Advantage to Medigap with guaranteed issue, you need to:Have purchased your Medicare Advantage plan when you were first eligible, but decided within the first year to switch.Lose your Medicare Advantage plan because you moved out of the service area or the plan stopped operating in your area.These temporary guaranteed issue opportunities may not include all Medigap plans — it will depend on the rules in your state.Compare Medigap and Medicare AdvantageThe chart below offers a side-by-side comparison of costs and coverage to help you understand the difference between Medigap and Medicare Advantage. Medicare AdvantageMedicare SupplementCoverageIn most cases, copayments (a fixed amount of money you pay) are required.In most cases, it can cover deductibles, copayments, and coinsurance that isn’t covered by Part A and Part B.CostMany times $0 or a low monthly cost.Higher monthly cost based on state, gender, and age.TravelMany plans may cover emergency care when you’re out of the country, but there’s typically a maximum amount the plan will pay.Many plans may cover emergency care when you’re out of the country, but there’s typically a maximum amount the plan will pay.Prescription DrugsTypically included with coverage.Not covered. You must enroll in a Part D plan for drug coverage.Routine dental, vision, hearing coverageMay be covered depending on the plan selected.Not covered.Copayments and coinsuranceUsually have copayments and/or coinsurance.Typically pays for copayments and coinsurance.NetworkMedicare Advantage plans have different networks: HMO, PFFS, and PPO. It’s important to understand the rules about going out of network for your healthcare.No network. See almost any doctor or medical facility that accepts Medicare.Medicare Advantage and Medigap plans may provide benefits for the following services (but check your plan details for specific benefits):Hospitalization: Medicare limits the number of days you can spend in the hospital. If you pass the maximum number of days, supplemental insurance pays the copayment that Medicare does not cover.Skilled Nursing Facility: Depending on the plan you select, Medicare supplement covers skilled nursing services that Medicare does not cover.Blood: If you need blood, Medigap coverage could pick up the tab on a few pints.Hospice care: Medicare pays for everything but copayment and coinsurance. Medicare supplement could pay the copayment and coinsurance.Inpatient or outpatient hospital medical expenses: Medicare generally pays 80% of all expenses, and a Medigap plan generally pays the remaining 20%.Note: Medicare supplement plan benefits are subject to state rules and regulations. Benefits described here encompass common Medigap plans available in the marketplace. Other services may be covered based on the supplemental plan you pick. Please check your insurance policy documents or talk to a customer service representative for more information.Find & Compare Medicare Advantage and Medigap PlansBut you don’t have to go it alone: We can answer your questions about Medicare and help you find the best Medicare quotes for your needs. Just try our Medicare Advantage plan comparison tool to get Medicare quotes online, or call 800-620-4519 to get help from a licensed insurance agent.