Medicare is confusing to too many people.  There is basic Medicare coverage.  Then there are various supplements that cover various things.  On top of all that, there is Medicare Advantage.  If you’re not confused enough by now, consider this: Medicare Supplements, also called Medigap, are sold by numerous insurance companies, and these companies come up with their own premiums.  This means that you can get the same supplement that has the same exact coverage from two different companies but it can cost different amounts – vastly different amounts – from those different companies.

It is important to determine what your needs are and what coverage is available.  When you are considering these things, it is critical to list your health conditions and the medications that you take for each, along with the cost for each of your prescriptions and how often each prescription you have gets filled.  Also write down how often you go to the doctor and how much each visit costs. 

Those are your basic medical expenses, and they will help you to determine how much coverage you need for each category – medication and doctor visits – then the total.  In addition, you will need to look at the potential costs of any tests you might have to have done both on a regular basis and possible emergency tests, hospital stays or surgery.  There is no way to be accurate about this, but you can discuss the immediate future with your doctor to get an idea.  It’s not a real fun bit of research; however, it is something that could save you thousands of dollars over time.  

Once you have done this research, it is time to look at the available Medicare and Medicare Supplement coverage available.  There are some legitimate places to get accurate information.  The Center for Medicare Services (CMS) and Medicare itself both have web sites that can give you the information you need regarding plans, rates and coverage.  You can also call 1-800-MEDICARE, however, the websites are better from the standpoint that you are able to spend as much time as you need looking through the information.  In addition, when calling the 1-800 number, the information you receive often depends upon how busy the call center is, how new the person is that you speak to, as well as how well you take notes.

Regardless of how you choose to research, once you have determined the basics that we have discussed above, it couldn’t hurt to call a couple of insurance companies to see what they suggest you need, based on your medical information that you have gathered and the information you have received from Medicare.  That way, you will know that the rates they quote are not inflated.

To do your research on the official Medicare sites, go to www.medicare.gov or www.cms.gov.   No matter which you choose – or if you choose, wisely, to explore both sites – it will help you in the long run to do your research well.

Medigap policies are another name for Medicare Supplemental Insurance policies.  These policies pick up where your basic Medicare leaves off and they pay for things that basic Medicare does not, such as deductibles and co pays.

There are nine Medigap policies and they all are named by a letter of the alphabet.  Plans A through G gradually increase in price and plans H,I, and J are no longer available.  Plans L and K have high deductibles which means that your premiums are lower but you pay for more expenses out of your own pocket.  Each policy is just a little different than the next, covering different things that would be appropriate to a person’s particular situation.

It is important to study each one to find out which fits your particular situation the best so that you are not paying for coverage that you don’t need and so that the coverage you are paying for actually covers what you need.  Plan F is the plan that sells most, likely because of its balance of benefits and

The nine Medicare Supplements are standardized, meaning that no matter who you get them through they are the same.  Each of the nine is unique unto itself, however if you purchase plan A through G from any company, the coverage is the same.  The only difference can be the premiums, which can vary greatly from company to company.  For instance, AARP might charge one price, Mutual of Omaha another price and  United American a third price, yet the coverage is exactly the same.

This is why it is important that you thoroughly review each of the lettered supplements thoroughly before you decide upon what to purchase.  If you are unsure which is best for you, call 1-800-MEDICARE and get further information.
Make sure you do your research because a little time and some reasonable premiums can save you hundreds, and possibly thousands, of dollars.

From the time we are kids, most of us are taught that we should budget our money.  If we get an allowance, we are able to figure out how much we can spend for that week and how much to put away.  A bit later on when we get a job, we can budget how much money goes toward our bills and how much toward savings, plus how much we have left that we can spend for whatever we want.

As we go through life we usually have some sort of budget based on our income vs. our expenses.  We may not have a hard and fast budget, but most of us have a good idea of what amount is coming in and what amount needs to be paid out.

When we are getting ready to retire, it is essential that we continue to budget our money, and it is extremely essential that we deal with savings, retirement plans, health insurance and Medicare in the same way.  This requires some research but it will be well worth it.

First of all, it is a good idea to begin researching your options regarding Medicare at least 6 months before you retire or six months before your 65th birthday, whichever comes first.  Part of the reason for this is that you are eligible for Medicare when you are age 65, and there is a six month open enrollment window during which you can enroll in Medicare and get any health problems covered – even serious ones such as cancer or heart problems.

This is important because it could save you literally thousands of dollars in medical bills.  It is estimated that seniors will spend over $225,000 in medical bills during their retirement.  Enrolling in Medicare could eliminate much of that amount.

Enrollment in the appropriate Medicare Supplement or Medicare Advantage is also critical because these plans will cover expenses that basic Medicare does not cover.  The best way to determine which supplemental plan is best for you is to check the internet by typing in the words Medicare Supplement, Medicare Advantage or Medicare on Google and there will literally be hundreds of sites including the government site which will help you look at all the coverage available along with the premiums.

Don’t be left out and don’t wait too long to examine your options.  Be ready when you are 65.  You have been paying into the plan for years, as the money has been coming out of your paychecks.  Retirement is the time for relaxation, not stress.

Individuals who have retired and are depending upon Medicare to offset the costs of their medical expenses often have to dip into their savings and retirement funds to pay for products and services that are not covered, such as co-pays.  Sometimes this is not a very high amount and has very little effect on a person’s finances.  At other times, the amount can be quite high, and often, the costs are ongoing and can end up overwhelming.  This is when individuals who are not aware of Medicare supplements are at risk of depleting their retirement funds.

There are Medicare Supplemental Insurance plans available that can help offset the costs that are not covered by basic Medicare coverage.  The cost of these supplemental policies can save a person money many times the price of the premiums, especially if there are ongoing medical concerns that require doctor’s visits and/or prescriptions and other services with out-of-pocket costs.

It is important that as individuals begin to approach retirement they factor in all the expenses they will need to cover – especially medical expenses.  Areas including costs for co-pays, treatment that is not covered, prescriptions, and premiums for supplemental insurance and/or long term care coverage.

It is not always easy to look ahead to these areas; however, it will be even harder if there is no planning and no coverage.  It could be financially devastating.  

There is an abundance of information available regarding Medicare supplemental insurance.  You can start by checking with the Centers for Medicare and Medicaid Services (CMS) and go to their website to get basic information and facts.  For instance, the site will advise you that supplemental insurance coverage is the same no matter what company you purchase it from, however premiums can differ tremendously depending on the company you buy from.  For instance, Part J is Part J and covers the same things regardless of who you buy it from.  The issue is that you might pay $50 more per month with one company than the other.  To protect your savings and your retirement funds, it is essential that you research the coverage that is available.

As you move closer to retirement, begin to research the supplemental insurance that is available and determine what is right for you.  If you do this research in advance, you will be able to use your retirement funds for what they were intended to do: finance the retirement you envisioned.

Seniors have long been a target of pressure and scams over the years for everything from purchasing cars, TVs, phone service, insurance and more.  One of the biggest areas that seniors can be defrauded is in the area of Medicare Supplemental Insurance, also called Medigap insurance.

Medigap covers what Medicare does not.  This could be prescriptions, co-pays and other products and services.  The problem is that there are a lot of companies that sell this type of insurance and it is easy to get confused.  In addition, if you have a sales person who is smooth enough or pushy enough – or both – you could be talked into coverage that is too expensive or coverage that is not right for you.

The good news is that each supplement – no matter which company is selling it – is the same and has the same coverage.  Only the premiums are different, depending upon the company you purchase the supplement from. 

For instance, if you are looking at Medicare Part J with three different companies, the coverage for Part J is determined by Medicare and is the same no matter which company you decide to buy from.  The difference is that company A might charge $20 more per month than company B, and company B and C might charge $40 more per month than everybody else.

It is important to check prices and check to see how good the insurance company is that you are buying from.  You can check with the insurance commissioner in your state to find out how well the company pays claims, how long they have been in business and other important facts about them, including whether there are complaints or lawsuits against them.

So, if you are looking for Medigap or Supplemental Insurance, be sure that you have the facts about the company, the amount they are charging, and don’t let anyone push you into buying anything you don’t feel right about.  If that happens, call someone else for a second opinion.

With all the goings back and forth regarding Medicare and Medicare Supplements in the Bush Administration and Congress, people are getting quite confused.  Add to the situation the fact that there are a lot of changes that the administration has proposed and tried to veto, and there are changes that Congress has over-ridden, with all sides trying to tell us that they are trying to fix the Medicare system before it goes from bad to worse.

Things are extremely confusing, but there are some straight answers to some of the questions out there.  One such issue is the phasing out of Medicare Advantage.  There has been quite a rumor going around stating that this phasing out is going to happen.  In actuality, Medicare Advantage is not going to be phased out.  Instead, the subsidies that the government pays to the insurers that sell the plan will possibly be in the future, but nothing has happened to date.

In light of the rumors, however, people have questions about what they should do with their old prescription drug coverage, such as Medicare Part J.  Many people want to know if it is prudent to keep what they have or change to Medicare Advantage.

Most advisers suggest that people switch out of their medigap/prescription drug plan (such as plan H, I, or J), since companies are phasing these plans out and are not selling these plans to new clients any more.  They are allowing people who already have them to keep their policies, but the premiums are higher than those of the Medicare Advantage and higher than Medicare Part D (for prescriptions), which is government subsidized. 

Medicare Advantage is sold by individual insurance companies.  You can switch to this plan and get your coverage for prescriptions that way, or you can get your coverage through Part D.  It is best to determine what is right for you.  The most important thing to do is to research the correct information and then get the coverage that is best for your circumstances.

Don’t let the confusion draw you in.  Find out what you need and make sure to get it so that your prescriptions are taken care of.  

A few years ago Medicare was pretty simple and straightforward.  OK, the billing and the claims have long been confusing, but at least the coverage was somewhat understandable.  Things are different now.

With the addition of numerous Medicare Supplement plans things have gotten a lot more confusing – and that’s just for deciding which supplement is the best for your situation.

There are over 50 Medicare Supplements available to cover services and supplies that basic Medicare does not cover.  Some cover co pays for long term care facilities, others cover various treatments, and still others cover prescription medication.  Quite a few cover medication, and they are all different, so it is necessary for individuals to determine which supplement will cover the types of prescription medications that they use.  With over 50 supplemental plans just to cover prescriptions, and with all of them charging different premiums and covering different medications, there is an overwhelming amount of information and confusion trying to sort it all out.

To make matters more difficult, supplements are offered by private insurance companies, each of whom has different premiums.  In addition, these insurers are often downright pushy when trying to sell supplemental policies to seniors.
One thing for seniors to know is that each Medicare Supplement covers specific things.  For instance,  if you decide that part J is the best prescription coverage for you, the coverage is exactly the same no matter what company you purchase it from.  Part J is Part J, and will cover you for certain specific things whether you buy from Insurance Company A or Insurance Company Z.  The confusion occurs because the insurance companies set their own premiums and rates, so you could get Part J from one company for $50 per month, while another company is selling the exact same coverage for $100 per month, twice the other company’s amount.

To help with these issues it would be best to discuss the plans that are available with your family, your financial advisor and/or your insurance agent and check with Medicare.gov or call 1-800-MEDICARE.  They will give you straight answers about coverage and premium.  In addition, check with your local senior center.  Most senior centers have seminars and workshops provided by Medicare and Social Security offices to help people eliminate as much confusion as possible.

Get the information you need to eliminate confusion and make sure you are covered for the things you need.  There is help available so that you can navigate Medicare Supplements successfully.

There are numerous Medicare recipients who have been in the hospital for an illness or injury and then been released to go home without incident, simply feeling fine, recovering the rest of the way at home and moving forward from there.

Unfortunately, this is not always the case.  Many times an individual returns home only to encounter complications that need further care.  Sometimes this care can come in the form of home health nurses and practitioners, follow up visits to the doctor, help from friends and family or a combination of all of these.  Again, this combination can work well and result in a successful recovery.

What happens if the person’s recovery is not going as well?  What can be done if all of these measures in the examples above have been taken and the person needs more care or more intensive and inclusive care and the are on Medicare?\

If the doctor determines that the individual does not have to be in the hospital but does need to be in a skilled nursing care facility for rehabilitation, there is coverage available through Medicare and Medicare Supplemental Coverage. 

If the doctor has the individual admitted to a skilled nursing facility, Medicare will cover this as long as the doctor shows that the person is being treated for the same issue that they were being treated for previously in the hospital and at home, prior to being admitted into the skilled nursing facility.  To link these things together, the doctor must show that the person was in the hospital for at least three consecutive days before eventually being admitted to the skilled nursing facility, whether they came home in between or not. 

Medicare will cover the first twenty days in the skilled nursing facility in full.  Then, from day 21 to 100 the individual is responsible for a copy of $128 per day.  If the individual has a Medicare Supplement, the copy for days 21 through 100 might be covered.

It is important to explore the Medicare Supplements available and determine which ones are right for you and which ones have premiums that will fit into your budget.  Do this research while you are still healthy if possible so that you can put it into place ahead of time.  If you have your coverage sorted out before you experience a serious illness or injury, you will be able to concentrate on your recovery rather than your coverage when you are trying to get well.

What do you do in a situation when your parent is having surgery and needs some recovery time?  How do you deal with the situation where your parent wants to recover at home – which creates a cost savings, no matter what sort of coverage they do or do not have – but Medicare Advantage wants them to go into an expensive nursing home?  You hope that the politicians who are trying to mess with Medicare figure things out soon.

So, in Medicare’s bureaucratic wisdom, it makes more sense for them to send a person to a nursing home that costs from the high hundreds to thousands rather than allowing them o stay home and have a nurse visit when necessary at a much lower cost.

This is some of the issue that creates the lack of confidence in Medicare.  It is also part of the reason that Medicare is having so many financial issues and so many people are predicting the downfall of the program within the next twenty years.

On the other hand, what could happen if the people running Medicare made financially intelligent and fiscally sound decisions – such as letting people stay at home rather than in nursing homes or hospitals wherever possible – the savings for those and other intelligent decisions would most likely be enough to save Medicare, if not extend it for years.  Add to that an efficient, effective and accessible system so that Medicare recipients could get good services that save the system money while helping the people that need help, and Medicare might just work indefinitely.

Certainly some of these ideas have been thought of, but why have they not been implemented?  This is a question for the ages.  Hopefully there will be some good answers – and solutions – sooner, rather than later.   

  It has been discovered that private Medicare providers underestimated the profits that they will receive or have received, which will inflate the government reimbursement rate.

The Government Accountability Office (GAO) states that the private Medicare Advantage plans on average reported spending 85.7% of incoming revenue on medical expenses in 2005 but in actuality, they had projected that they were going to spend 90.2%.  That may not seem like a lot of extra profit, but it amounts to quite a lot, considering that millions of Medicare recipients have opted for coverage through Medicare Advantage.  Therefore, at the end of the year, their profits would be higher than projected because their expenses were lower.

What does this mean in actuality?  It means that when all was said and done, profits for private Medicare Advantage providers totaled about $1.4 billion more than they had projected.  This is not a small chunk of change, and nobody has said exactly what will happen to that extra profit.

Medicare expanded by law in 2003, and added prescription drug coverage that created better incentives for private plans to sell insurance to provide that coverage. Though 44 million elderly or disabled people are enrolled in Medicare, about 10 million are enrolled in the additional private plans sold by several companies.

The way the law works, if the private companies report revenue, and as a result, profits, lower than a set rate, they are supposed to compensate for this by providing extra benefits or reducing costs to the individuals in the program.  According to critics of the plans, it has been estimated that these Medicare Advantage plans are paid from 13% to 17% more than the government spends treating Medicare patients not enrolled in a private plan.

Time will tell how this situation will be addressed and how these expenses and savings can be used or applied to go toward fixing the Medicare financial issues that have been the subject of such heated debate during the past few years, as well as these past months leading up to the presidential election.

If you have ever suffered from shingles, you know how painful it can be.  Shingles is extremely debilitating, especially to the elderly.  It usually starts with extreme pain on one side of the body.  This pain can include severe itching, tingling, burning, constant aching, or deep shooting pain.  Usually between 1 – 3 days after the pain starts, a rash with raised red bumps and blisters breaks out in the same area that the pain has been in.  The bumps fill with pus and turn to scabs in about 0 to 12 days.

If this reminds you of the chicken pox, it is because it is from a relative of the same virus, which is a form of herpes virus. If you have had the chicken pox as a child, the virus becomes dormant and remains in the body.  They don’t always erupt later, however, sometimes they do.  There is no specific issue or reason that creates the eruptions, however, if a person has had an organ transplant, HIV or cancer, these compromise and weaken the immune system and could make a person more susceptible to any virus.  These are not necessarily the cause of shingles, and most people with shingles are otherwise quite healthy.

It is suggested that most people over 60 years of age receive the vaccine against shingles every year.  The good news is that Medicare Part D covers the cost of this vaccine.  The vaccine enhances the immune system’s ability to fight off the virus that causes shingles, and decreases the incidence of the disease.  Booster shots are being looked into so that individuals don’t have to take the vaccine shot every year. 

It is strongly suggested that – especially if you are over 60 – you talk to your doctor about the shingles vaccine.  Since Medicare Part D will cover the expense of the vaccine, all it will cost you is a little time, and it can save you a lot of pain. 

With the economy as it is including gas prices rising upward every day, the last thing seniors need is to not be able to afford their medical care, however, we know that this is a huge issue in this country and a huge election issue as well.

Studies are showing that seniors, who need medical care and coverage the most, are filing for bankruptcy at an alarming rate, and that at the core of these filings is the problem of astronomical health care costs.

A big part of the problem is that seniors – even with Medicare Supplements – have had to use their credit cards to pay for medication and other medical services that are not covered by their Medicare coverage or supplements.  Often, these individuals don’t have a huge nest egg, retirement income or Social Security income, and as a result, are trying to survive without giving up essential medications and treatment.  Many of these seniors only take half their dose of medication to make it stretch further, but even so, the cost is astounding, and too much for them to bear.

Once their credit cards are maxxed out, there is often no way for them to escape the overwhelming financial burdens which also include higher costs of even the basics such as food and gasoline.  Most of these seniors are unable to find jobs for many reasons.  Even though they are able to work and have the needed credentials and experience, they are not hired because of age discrimination and other factors.  Thus, bankruptcy becomes the last, desperate act in trying to stay above water, and this is particularly difficult for seniors because they have few job options, thus no way to pay their way out.

Health care is at the center of seniors struggles to stay economically stable.  It is important that answers and solutions be found that will help the most vulnerable of our citizens maintain at least a decent standard of living.

It hardly seems that there should be too many problems with Medicare and Medicare Supplement charges by doctors and hospitals.  After all, you basically put in a code, the doctor and treatment information or hospital information and turn the claim in within the three month period that is allowed.  Right?  WRONG.

One thing that has been going wrong with these bills is that a lot of doctors and hospitals are not turning in their paperwork on time.  As a result, seniors on supplemental plans may have changed companies or coverage by the time the bills are received by Medicare.  Simple fix, right?  WRONG, again. 

What happens then is that the new company on record often gets the billing from Medicare, but has no idea what to do because they were not covering the person at the time of the claim.  Meanwhile, the doctor is frustrated, the individual covered by Medicare or a Medicare Supplement is receiving bills that need to be paid, and everyone is in the dark.

There are some ways to overcome this.  If you are on Medicare or a Medicare Supplement, it is important for you to keep track and keep copies of everything.  If you begin to get any bills that don’t make sense after you  have been to the doctor or the hospital, call the doctor, the hospital or Medicare immediately to have the situation researched.  If you have changed supplemental plans after the bill was generated, be sure to let the doctor, the hospital and Medicare know your old information about your prior company so that they can re-bill correctly.

Just these simple steps can save everybody involved – especially you – a lot of confusion, frustration and aggravation.  If you are seeking information or need to call Medicare because you are in a similar situation, contact them at 1-800-MEDICARE, or find them online at www.Medicare.gov or www.cms.gov.

So you are supposed to get your prescriptions covered by Medicare Part D.  You’re not sure what it covers or how much it costs and the information isn’t easy to understand.  Here’s a simple rundown about how it works.

Medicare Part D covers prescriptions because they are not covered through the original basic Medicare plan.  There is, however, a premium for this coverage.  It is important for you to check premiums through Medicare and other companies to see who has the best premiums for this coverage that will fit your situation.  Often, companies charge a lot more for the same coverage.  You might pay one amount for coverage with one company and for the exact coverage through another company, you might be stuck paying double or even triple!

Therefore, it is very important to research and ask questions, especially about limits of coverage.  Medicare Part D and the new Medicare Advantage Plan both have limits to them, and depending on how much coverage you purchase vs. how much you need,  you could end up paying $2,500 or more out of your pocket for prescriptions in addition to the premiums for the prescription coverage.  Of course, the plans will cover quite a lot before you get to that point, but it is very important to see how much money they will pay out (total) per year for your prescriptions before you have to start paying out of pocket.

What can happen is that a plan may pay up to $3,000 for your prescriptions for the year (you will choose an amount depending on the plan you choose).  After you reach that amount, you have to start paying for your own prescriptions until the plan picks up again.  If your prescriptions don’t cost that much, you don’t have to worry, but if they do, it is important that you determine how much you will have to pay out including premiums.

To get information, contact Medicare at www.Medicare.gov , or for some good calculator information, AARP has a program online that will help you figure the finances out.  You can also call 1-800-MEDICARE for assistance so you get the coverage you need.

Long term care has long been an important issue that needs to be addressed and has been debated many times.  With Medicare and Medicaid systems under so much financial strain and with proposals in the works for revisions and provisions, it seems that Congress on both sides of the aisles is grappling with the issue of Long Term Care funding.

This is a serious issue, as it affects millions of individuals and their families and over 10 million individuals who are living at home and receiving services in there homes and in the community.  These people need assistance and services and are normally on a very limited income, being cared for by family and friends.  They are often in situations where they are trying to stay at home and in the community in which they live, receiving their supports there, rather than ending up in an assisted living or long term care facility.

It has been shown that when a person can stay in the community and in familiar surroundings receiving long-term supports that is the best situation for them if their situation and condition permits.  Congress – and other organizations – is looking further into the cost savings and health effects of helping people stay in the community vs. a healthcare facility.  There are various studies that have taken place and are taking place – especially in the recent past and currently – trying to determine to continue to fund the essential service of long term care. 

With Congress presently looking at ways to buy time so that Bush Medicare cuts – which affect Medicaid drastically – won’t take place immediately, there is a good chance to work on long term care issues at the same time.

In the meantime, if you are dealing with long term care issues, be sure to keep current with what is happening.  For current information you can log into www.CMS.gov.