What Is Medicare?

bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com

Medicare is a Health Insurance Program for:

• People age 65 or older.
• People under age 65 with certain disabilities.
• People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).

Medicare has Two Parts:

• Part A (Hospital Insurance)Most people don’t have to pay for Part A.
• Part B (Medical Insurance)Most people pay monthly for Part B.

You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in Original Medicare. You may want to consider a Medicare Prescription Drug Plan to add drug coverage. Or, you may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D coverage. You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall.

As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have Original Medicare, or you belong to a Medicare Advantage Plan (like an HMO or PPO). For more information see the Your Medicare Coverage database.

Part A (Hospital Insurance)

Helps Pay For:

Care in hospitals as an inpatient, critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas), skilled nursing facilities (not custodial or long-term care), hospice care, and some home health care. Information about your coverage under Medicare Part A can be found in the Your Medicare Coverage database.

If you aren’t sure if you have Part A, look on your red, white, and blue Medicare card. If you have Part A, “HOSPITAL (PART A)” is printed on your card.

Cost:

Most people get Part A automatically when they turn age 65. They don’t have to pay a monthly payment called a premium for Part A because they or a spouse paid Medicare taxes while they were working.

If you don’t automatically get premium-free Part A, you may be able to buy it if

• You (or your spouse) aren’t entitled to Social Security because you didn’t work or didn’t pay enough Medicare taxes while you worked and you are age 65 or older, or
• You are disabled but no longer get premium-free Part A because you returned to work.

If you have limited income and resources, your state may help you pay for Part A and/or Part B. For more information, visit www.socialsecurity.gov on the web or call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-877-772-5772.

 

Part B (Medical Insurance)

Helps Pay For:

Doctors’ services, outpatient hospital care, and some other medical services that Part A doesn’t cover, such as the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Information about your coverage under Medicare Part B can be found in the Your Medicare Coverage database.

Cost:

Most people pay the Medicare Part B premium of $96.40* per month in 2009. This amount may change January 1, 2010. In some cases this amount may be higher if you didn’t choose Part B when you first became eligible at age 65. The cost of Part B may go up 10% for each 12-month period that you could have had Part B but did not sign up for it, except in special cases. You will have to pay this extra 10% as long as you have Medicare Part B.

bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com

Learn More About Medicare Coverage Options

bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com

Choose a plan that meets your needs:

Original Medicare

This fee-for-service plan covers many health care services. You can go to any doctor or supplier that is enrolled and accepts Medicare and is accepting new Medicare patients, or to any hospital or other facility.

Original Medicare is a fee-for-service plan managed by the Federal Government. In general, with Original Medicare:

• You use your red, white, and blue Medicare card when you get health care.
• You can go to any doctor or supplier that accepts Medicare and is accepting new Medicare patients, or to any hospital or other facility.
• You pay a set amount for your health care (a deductible) before Medicare pays its part. Then, Medicare pays its share, and you pay your share (your coinsurance or copayment) for covered services and supplies (unless you have a Medigap policy or other supplemental insurance that may pay for these costs.)
• You may have a Medigap policy or other supplemental coverage that may pay deductibles, coinsurance, or other costs that aren’t covered by Original Medicare. 

bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com

Over burdened primary care doctors and healthcare reform

bringing you the  www.insurnacedfw.com

What happens to an already volatile situation with far to few primary are doctors when millions of new patients join a healthcare system that is unprepared and unequipped to handle the load.

In the USA there currently exists a  shortage of between 5,000 and 13,000 primary care doctors, according to the Robert Graham Center. Add millions of previously uninsured people and the shortfall will balloon to as many as 50,000 doctors.

Positioned as the patients’ first healthcare contact, the primary care doctor, how will it be possible to  extend preventive care to millions with the a lack of this medical physical support. 

Solving this problem will take time and money more necessary then the allowed August deadline. 

bringing you the www.insurnacedfw.com

Continuum of care

5 ways to go with health insurance if you’re laid off
By Dana Dratch, Bankrate.com

If you’ve been laid off, the first things you think about are keeping food on the table and bill collectors away from the door. But there is one intangible you really do need: health insurance.

Once you leave your job — because you were laid off, quit or were fired — you basically have five choices on health insurance: continue on your current group plan and pay the premiums yourself, enroll in your spouse’s plan, buy individual insurance, use a state-sponsored plan or — the worst of all worlds — go without.

Get the facts
Problem: Insurance laws vary from state to state, the language is confusing and even experts don’t have all the answers. You need a quick overview of your situation.

Solution: Call your state insurance commissioner’s office, ask for a consumer representative and have that person walk you through your options.

“It’s a free call, it’s a free service and an objective third party who knows the market can help you sift through the options,” says Kathleen Sebelius, the Kansas insurance commissioner and president of the National Association of Insurance Commissioners.
It’s also less stressful than playing phone tag with your former employer and easier than trying to decode reams of insurance paperwork on your own.

Don’t be afraid to ask questions. The most important one: Find out what deadlines you have to meet to keep your options open on insurance and what coverage options are available in your state.

Option 1: COBRA
The Consolidated Omnibus Budget Reconciliation Act of 1986 — popularly known as COBRA — allows you to keep your current insurance coverage for at least 18 months after you leave your job. The downside: you have to pay all the premiums yourself — and that can get expensive. Even a healthy 20- to 30-something can count on a monthly bill of $200 to $300.
Patricia Yoon, 25, used COBRA for a couple of months when she was laid off two years ago.
“I did think it was expensive — $200-$250,” a month, says Yoon, who was laid off again in June. “It’s tough, especially when you’re young and saving is not a priority — when you’re living hand to mouth.”
But don’t let the cost scare you off.
“It’s one of a handful of options, but it might be the best one out there, especially for a person with a pre-existing condition,” says Paul Fronstin, a senior research associate with the Employee Benefit Research Institute, a nonprofit organization that studies benefits and related issues.
Since you’re continuing your current coverage, you can’t be dropped or face exclusions. And because it’s a group plan, the carrier can’t single you out for a rate increase if your care gets expensive.

COBRA is “one of a handful of options, but it might be the best one out there, especially for a person with a pre-existing condition.”

— Paul Fronstin, Employee Benefit Research Institute
Federal law guarantees that if you maintain group coverage without a 63-day gap, you and your dependents won’t face any exclusions when you find work and enroll in another group plan.
Your employer can require a waiting period, as long as it applies equally to everyone, but cannot exclude you because of a pre-existing condition.

COBRA is available only if you worked for a company with 20 or more employees, had health insurance through your employer and your former employer is still in business. The idea of COBRA is that you piggyback on another group plan. If that plan doesn’t exist because the company went under, there is no COBRA.
If your company offers COBRA, sign up — whether you can afford the payments or not. Why? Between the deadline to apply and the date the first payment is due, you have more than three months to get another position, find a better insurance deal on your own or get a part-time job to make the COBRA payments. But if you do have a calamity, chances are that COBRA premium will be a lot cheaper than the hospital bill.
“It’s tough medicine because when you’re laid off it’s really a challenge to pay those COBRA bills,” says Gail Shearer, director of health policy analysis for the Washington, D.C., office of Consumers Union, the group that publishes Consumer Reports magazine.

Option 2: Your spouse’s plan
Obviously, this is not an option for everyone. Compare the cost and the coverage to what you would have with your own COBRA plan. One big plus: If you’re moving from one group plan directly to your spouse’s plan, you can’t be excluded for any pre-existing health condition, such as a pregnancy. 

Continuum of care
Before you sign on the dotted line, ask yourself two questions: How stable is your spouse’s job and how strong is your relationship.
If your spouse gets sacked, both of you will be stuck with the COBRA version of your spouse’s plan. Ditto if you divorce.

Option 3: Individual insurance
Shopping for an individual insurance policy is a lot like buying a car — only more confusing.
Best advice: Start shopping for health insurance as soon as you lose your job. Whether you’re going to build your own business, temp or look for a new position, make securing health insurance a priority.
Again, your state insurance commissioner’s office is a great resource — and one of the few that doesn’t have a financial stake in your decision. They can tell you about complaints against a company, the firm’s reputation and its financial stability. Be realistic — virtually all insurance firms will have had some complaints.
Make a list of insurance companies or HMOs you want to investigate. Don’t know where to start shopping? Call the company that your former employer used, if you liked the coverage. Ask friends and family members what companies they use — and if they are satisfied. Check with your doctors to learn what plans they honor. That should give you a good start.
Next, make a list of coverage options that are important to you. Do you want access to specific doctors or facilities? Do you need low-cost prescription refills? How much do you want to pay for a doctor visit? Are you just looking for a high-deductible policy to cover catastrophic situations? Do you want access to alternative therapies?
Now contact the companies on your first list and see how their coverage matches up with your wish list. Look at four things: how much are premiums, what will the policy cover, what will it exclude and how much is a doctor visit.
Before you sign up, research the stability and service reputation of your picks.
Several companies study the financial strength of insurance companies, HMOs or both. A few of the top ratings firms are Standard and Poor’s, A.M. Best, Moody’s Investor Service and Weiss Ratings.
If you want to know how a prospective company stacks up on the customer service end, check out its ranking with the four major accreditation agencies: the National Committee for Quality Assurance, the Accreditation Association for Ambulatory Health Care, the Joint Commission on Accreditation of Health Care Organizations and URAC, the American Accreditation HealthCare Commission.
The rule with individual insurance: you pay more, you get less. Conversely, group policies “tend to get more bang for the buck and avoid the problems of the individual market,” says Shearer.
And be aware: There is no guarantee you’ll be able to purchase an individual policy.
But if you can’t afford COBRA and don’t have a spouse, an individual policy may be your best choice. Read the fine print, shop smart and know your state regulations.

Option 4: State-sponsored plans
What if your former company is too small to qualify under COBRA or the company’s gone under? You may be eligible for a state insurance pool.
Under federal law, every state must provide this choice, sometimes called a high-risk pool. In theory, you pay the premium and, in turn, reap the reward of group coverage. You can also use a state pool if you exhaust your COBRA coverage — usually after 18 months — and still don’t have another job. But the jury is still out on whether the plans are a hit or a miss.
“High-risk pools have not been a tremendous success story from our point of view,” says Shearer, citing high premiums for limited coverage, waiting lists and only an estimated 100,000 people in the pools nationwide. “The picture’s not pretty.”
Every state also has a low-cost health insurance plan for children. You don’t necessarily have to have a low income to qualify. If you have children under 18, ask about the plan when you talk to the state insurance commissioner’s office.
A national toll-free number, (877) KIDSNOW, will connect you with the children’s insurance program in your state. Children are eligible up to age 19.

Option 5: No insurance
Joining the ranks of this country’s 42 million uninsured is not a good option. Going without insurance puts both your physical and financial health in peril, as medical bills are the fourth-biggest reason people go into serious debt, according to statistics from the National Foundation for Credit Counseling.
If you can’t afford anything else, at least pick up a catastrophic insurance policy. While it won’t cover every doctor visit — or be as cheap as you might expect — at least you won’t be wiped out if you or a family member become seriously ill.

Contact us to see what we can do for you… www.insurancedfw.com.

Hello world!

Welcome to WordPress.com and www.insurancedfw.com !