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Date: 4/26/2019 8:47 AM EDT

About half of all veterans 65 or older have Medicare coverage in addition to their VA benefits. Eligibility for VA benefits is dependent on status, service-connected disability status, income and more. It is also dependent on funding by Congress and location of facilities.

TRICARE for Life provides medical coverage for qualified military retirees that are on TRICARE and have Medicare Parts A & B. TRICARE for Life pays providers (secondary) after Medicare pays first. It generally pays the remainder if it is a TRICARE benefit.

Recipients with TRICARE for Life may also enroll into a Medicare Advantage Plan with or without prescription drug coverage for additional benefits and enhanced provider coverage opportunities. An important benefit of having both Medicare Advantage and VA benefits is that it allows the beneficiary to receive care at VA facilities and at Medicare assigned facilities. That means care where you need it conveniently and at lower cost.

VA prescription drug coverage only covers drugs at VA facilities. Medicare Part D plans only cover prescription drugs in the plans network. So, if a prescription is written by an Advantage plan provider then it will need to be reviewed and rewritten by a VA doctor to receive the prescription at a VA facility. If the beneficiary is in a nursing home, then prescriptions may need to be filled by the nursing home pharmacy which would likely require Part D prescription coverage.

Veterans may want to enroll in a Medicare Supplement Plan if they do not live neat a VA facility, would like to use other providers and hospitals or are in a lower priority group where the benefits may be lost depending on Congress and VA funding.

Joining a Medicare Advantage Plan (Just so you know, zero cost plans are available.), can add additional benefits beyond TRICARE for Life benefits. You do not lose the TRICARE benefits. You will gain the additional provider options including the Advantage Provider network in addition to Military Treatment Facilities.

Medicare Advantage Plans provide more health and wellness benefits including preventive screenings and may provide lower copayments and lower overall costs in times of catastrophic illness.

Here’s some examples of potential additional benefits with Advantage Plans in addition to TRICARE for Life potentially at zero additional cost:

  • Hospital and medical charges limited to Out of Pocket Maximum
  • Worldwide Emergency Care
  • Free Annual Physical
  • Free Bone Mass Measurement
  • Diabetic Monitoring Supplies at no charge
  • Vision Coverage and corrective lenses
  • Hearing Coverage and Hearing Aid Allowance
  • Dental Coverage in many plans
  • No charge Health Club Memberships
Free Agents NH, LLC specializes in helping our clients navigate the Medicare options when they first become eligible and then remains by their side as needs and opportunities change. We are independent and able to represent all the options available in NH so that our clients get unbiased advice and the very best value, at no cost to you. The prices are the same with or without an agent. 

Give us a call at 603-527-8117 or visit our website www.FreeAgentsNH.com and let us help.

We have offices in Windham and Laconia New Hampshire.

We serve all of New Hampshire including Salem, Derry, Londonderry, Hudson, Nashua, Atkinson, Pelham, Plaistow, Hampstead, Exeter, Dover, Durham, Manchester, Concord and other communities.

 

Posted by freeagentsnh | Post a Comment

Date: 7/2/2018 10:37 AM EDT

Medicare has now begun mailing new Medicare cards. These new cards will no longer include your Social Security number to help protect your identity and personal identifiable information. The New Medicare Card Project (NMCP) began providing new cards April 1, 2018 and will complete the process by the beginning of April 2019. The Railroad Retirement Board (RRB) will issue new Medicare cards to their beneficiaries.

This is great news that finally your Social Security number will no longer be so readily available helping to keep your personal information personal. If you don't get your new card by April 2019 then you should call 1-800-MEDICARE.

Don't be concerned if your friend or neighbor receives their card before you do. This process is a one-year project and the old card number will work until you have been issued a new card. Once you receive your new card then destroy your old card.

The new cards will automatically be sent to beneficiaries. If your mailing address is up to date, then you should receive your new card. If you need to update your mailing address you should contact Social Security at ssa.gov/myaccount or call 1-800-772-1213.

Be sure to protect your card and only give it to your providers or people that you trust to work with Medicare on your behalf. You should carry the card with you to provide to health care providers when you need care. Your providers may also be able to look up your Medicare number online.

Your new card will be a paper card for lower cost. You can also print a replacement card if you need one.

If you have a Medicare Advantage Plan you should keep that card as well as carry your new Medicare card because you may need to provide both to a provider.

Free Agents NH, LLC specializes in helping our clients navigate the Medicare options when they first become eligible and then remains by their side as needs and opportunities change. We are independent and able to represent dozens of options so that our clients get unbiased advice and the very best value.  

Give us a call at 603-527-8117 or visit our website www.FreeAgentsNH.com and let us help.

We have offices in Windham and Laconia New Hampshire.

We serve all of New Hampshire including Salem, Derry, Londonderry, Hudson, Nashua, Atkinson, Pelham, Plaistow, Hampstead, Exeter, Dover, Durham, Manchester, Concord and other communities.

Posted by freeagentsnh | Post a Comment

Date: 5/21/2018 5:03 PM EDT

Deciding when to enroll in Medicare is an important decision as you approach Medicare eligibility at age 65. Many people continue to work past 65, because Social Security benefits now begin at 66 or older. Larger employers with 20 or more employees typically continue to offer health insurance coverage, if you continue to work past age 65. Your spouse may be able to continue health insurance benefits as well on your employer plan. This is the time to have a conversation with the Human Resource Department in your company to be sure of your options, as well as, consequences of your decisions. Once you have the facts from HR, it would be wise to review this with an independent agent like Free Agents NH, LLC; who understands Medicare Part A and Medicare Part B and who works with Medicare Supplements and Medicare Advantage Plans, to help you determine what is best for you.     

Here are some important questions to ask the HR Department:  

If I dropped employer health insurance, would I need to find other coverage for my spouse or would the coverage remain in place? 

Do I receive other employee benefits like dental and vision coverage? Can these benefits be continued with COBRA if I did not keep my health insurance benefit? If so, is it 18 months? Employer dental is much less costly than individual dental, because of the group buying power.  

Let's do the math? What do you pay currently for your share of the health insurance costs through your employer? What are your deductibles, co-pays and prescription costs? How about your provider network? These are all things that we review with our clients before they make the decision to take Medicare and a Medicare Supplement or Advantage Plan. If you drop the employer plan, then you may not be able to get it back, so we need to make sure that we make a wise choice.   

You can decide when to enroll in Medicare Part B if you are able to continue your employer health insurance coverage. Enrolling before you need it could cause some problems on top of an unnecessary expense of $134/month. When you enroll in Medicare Part B you begin a 6-month period called Open Enrollment, where there is no medical underwriting.  

You do not want to enroll in Medicare Part B until you are ready to leave your employer plan so that you can pick your Supplement plan without limiting your choices because of medical underwriting. You can even drop Part B and your Supplement in the future, if you take another job that includes health insurance benefits and pick it up again when you stop working and the benefits end.  

You may be offered retiree benefits that include health insurance. Let us review this with you. Typically, the retiree plans have less generous benefits than most people think. In many cases we have found individual Medicare Supplement Plans or Advantage Plans offer better value!  

Let Free Agents NH, LLC help you answer your questions. We can compare the options and costs. We will guide you with honest advice. We can make this simple and leave you with the satisfaction of a good choice. We can meet at our offices or we will be happy to meet at your home both days and evenings.   

Give us a call at 603-527-8117 or visit our website www.FreeAgentsNH.com and get to know us. 

We have offices in Windham and Laconia, NH. 

We serve all of New Hampshire including Salem, Derry, Londonderry, Hudson, Nashua, Manchester, Hampstead, Plaistow, Pelham, Exeter, and Concord as well as surrounding areas. 

Posted by freeagentsnh | Post a Comment

Date: 5/15/2018 7:53 AM EDT

As independent agents who work with Medicare Supplements for our clients, in our experience it is very rare that we hear about claim issues where the Supplement insurance company did not pay a specific claim. In fact; every time that we have heard this after our further investigation, generally the reason was always something else. The purpose of this BLOG is to share some of our experiences.

At Free Agents NH, LLC we continue to support our clients long after the enrollment is complete. I guess that you could say, “we are with you for life”. We encourage our clients to call us whenever things don't seem right with the Explanation of Benefits. If claims have not been paid, this is an important time to call us. If your current agent does not offer this level of service, then maybe you should think about a new agent.

You will receive statements from your Medicare Supplement insurance company explaining your claims and what has been paid. You will also receive statements from Medicare. These are the easiest way to check to see what your responsibility is to the provider. If these don't agree with your expectations, then it is time to review.

One reason that we find unpaid claims is annual deductibles that must be met before the Medicare Supplement Plan picks up the cost. If you have a Medicare Supplement Plan G with a $183 annual calendar year deductible, then the first $183 of Medicare Part B medical costs/claims are the consumer’s responsibility. That's ok; because the consumer saved between $350 and $550 per year in premiums, to accept a deductible each year of $183. Remember it is calendar year, so on January 1 of the following year the deductible resets again. But the monthly premium savings also continue each year for the Medicare Supplement Plan G over Plan F if you had taken it.

Another instance where claims are unpaid relates to provider coding. Medicare reimburses providers an amount based on codes for a specific service. The Medicare Supplement insurance companies then reimburse their responsibility for their share. If the claim is unpaid it is most likely improperly coded by the provider; or it could be care that is not considered medically necessary; or not a covered service by Medicare. A great resource to find Medicare Covered Services that is updated each year is Medicare and You. We like to download it each year. Using CONTROL F on our computer we can easily find the information that we are looking for in this vast resource. You can order the book or download it at:

https://www.medicare.gov/Publications/

Free Agents NH, LLC is an independent insurance agency specializing in Medicare Supplement Insurance and Medicare Advantage Plans. Since we are independent and not captive agents we can help you sort through all those options (we represent all of them) and continue to help after you are enrolled. That includes help reviewing claims and selecting Medicare Part D Prescription Plans (with a review annually if your needs change). You need agents that are not just there for your initial enrollment, but agents that are available year after year.

Please visit our website www.FreeAgentsNH.com. You can reach us at 603-527-8117.

We are happy to meet by phone or in person, at your home or our offices.

We have offices in Windham and Laconia NH.

We serve all of New Hampshire including but not limited to; Salem, Hampstead, Plaistow, Pelham, Londonderry, Derry, Exeter, Durham, Dover, Manchester, Nashua, Manchester and Concord areas.

Posted by freeagentsnh | Post a Comment

Date: 4/30/2018 12:46 PM EDT

Are you tired of getting all those annoying brochures/letters about aging into Medicare? Don’t worry this is not one of them. In fact; we hope you will let us help you, so you can “toss the pile of annoying advertisements” away!

Without our help, consumers typically wade through tons of advertising flyers trying to make their decisions based on what they read, which in most cases may not be the best choice for them. Free Agents NH, LLC can explain the features and limitations of each plan. Many people are not aware that having Medicare Part A and Part B is not enough. When Medicare pays the claim, you are still left with costly medical expenses. Therefore, a Medicare Supplement or Medicare Advantage Plan is important.

Selecting the right Medicare Supplement or Medicare Advantage Plan and a Prescription Drug plan is far more difficult and important than you can probably imagine. Selecting a well-informed health insurance agent is your first step to making your best decision that fits your needs and that you will be happy with for the rest of your life. Our experienced and unbiased help is FREE; because your cost is the same with or without our help, and the insurance companies pay us. At Free Agents NH, LLC, we specialize in helping clients make the right Medicare Supplement or Advantage choice every day and have been for over 15 years.

It is important to know that with Medicare Supplement insurance, you usually only get one chance to get it right. Why? Because when you turn 65 or when you decide to take your Part B Medicare coverage, you are eligible for a 6-month Open Enrollment period to choose a Medicare Supplement with no medical underwriting. You are welcome to change Medicare Supplement plans after this 6-month period, BUT you must be able to pass medical underwriting when you apply for new coverage. Unfortunately, most people cannot pass the 2-page list of medical questions, so they are stuck with their first choice.

Because we are independent agents and able to represent dozens of available options, it is all about educating you, the clients. We invest the time to earn your business; meeting with you at your home at your convenience, at our offices or by phone, to explain the Medicare Supplement and Medicare Advantage Plans’ benefits and limitations. We will explain terms such as medical underwriting, guaranteed issue and many more. And if applicable, we can also help you compare employer retiree options and their costs versus individual Supplement Plans.

Do you want to learn what you may be missing? Give us a call; after all you don’t do this every day, but we do. We don't expect to enroll you in a plan when we first meet. This is “way too important” to make a quick decision! Our goal is to spend the time to educate you so that you understand all your options. Then, we leave you to think about things and only meet again when you are ready to enroll.

Visit our website at www.FreeAgentsNH.com and check out our BLOG Section where there are several articles on Medicare Supplement Insurance or Advantage plans that will be very informative and helpful. Please put us to the test and thanks for the opportunity! 

Give Free Agents NH, LLC a call for unbiased guidance and ongoing support at 603-527-8117.

We have offices in Windham, NH and Laconia, NH; or we can also come to see you.

Also serving Salem, Londonderry, Derry, Pelham, Plaistow, Hampstead, Exeter, Dover, Durham, Manchester, Nashua, Concord and surrounding areas!

 

Posted by freeagentsnh | Post a Comment

Date: 4/21/2018 5:00 PM EDT

When purchasing health insurance; whether it be individual under 65, Medicare for over 65 or group coverage, there are cost sharing expenses that are important to understand. Selecting the right plan for your unique needs, requires an understanding of all the costs that you may be responsible for.

What is most difficult is the task of comparing plans from several insurance companies, that may have different amounts of consumer cost sharing or risk. It's no longer comparing apples and apples. It is important to have an independent health insurance agent rather than a captive agent. Independent agents can represent multiple companies and will compare your financial responsibilities or risks. Captive agents are employed by a single insurance company and can only represent the plans offered by that single company. Getting a clear and unbiased education on your options from an experienced health insurance agent, is the only way to start your search for your best health insurance plan.

In most cases, the cost of insurance is the same with or without the help of a good agent. At Free Agents NH, LLC we are independent agents and represent all the available health insurance plans in New Hampshire. We are paid by the insurance companies, so our advice is FREE. The cost of your insurance is the same with or without our help. Sadly, not everybody knows this and assumes that it costs more to have unbiased and experienced help. The real risk is trying to select a health insurance plan without the necessary facts and experience. We do this every day; don’t try it alone, let us help!

When selecting a health insurance plan, the choices are complicated by things like deductibles, coinsurance, copays and out of pocket maximums. These are the additional risks that you assume after you pay your monthly premiums. Sometimes this risk sharing is beneficial if the expected need for care is low. By accepting more risk, with higher consumer cost sharing items, you can reduce your monthly premium of health insurance. Of course, none of us have a crystal ball to predict our future. If your need for care is historically low, then you can assume more risk, with the understanding that this years’ health costs could be different.

The most obvious additional cost is deductible; where you are required to pay for the full cost of covered health care expenses until your deductible is met, before the insurance company is required to pay anything except in most cases preventive care. There are both individual and family deductibles. These are met depending on how the health insurance policy is constructed.

  • Individual example: a $2,000 deductible would require the insured to pay the first $2,000 of covered health care expenses (except preventive care in most plans) and then the health insurance plan would begin to assist with covering the costs.
  • Family example: the maximum family deductible could be two or three times the individual deductible for the entire family. If the individual deductible is imbedded, then an individual will not exceed the individual deductible. Non-embedded individual deductibles mean that the family needs to reach the family deductible, which is higher, before the insurance company begins to pay.
Copays are a fixed amount of cost sharing expressed as a number. A doctor visit or prescription drug may have a copay. For example: $20 or $30 for a Primary care provider or a prescription.

Coinsurance is more difficult to understand. Coinsurance is your cost sharing after you have reached the deductible. Many plans may have a coinsurance cost (risk) of 20% or 30%. This means that after paying your deductible you are responsible to pay 20% or 30% of the covered health care services and the insurance company will cover the balance.

Out of Pocket Maximum is your protection from unlimited exposure. Most health insurance plans will limit your maximum exposure, but this can be substantial. Out of pocket maximums include paid deductible, copays, coinsurance in the individual under 65 Marketplace plans. It’s important to recognize whether the coinsurance and out of pocket maximums are for an individual or a much higher family out of pocket maximum cost. The out of pocket maximums in Marketplace plans are $7,350 for individuals and $14,700 for families in 2018. This could be different in a Medicare over 65 and/or group plans; Free Agents NH, LLC can help review your plan details. Once you reach out of pocket maximum then the insurance company pays 100% of covered health care services.

Our suggestion is to work with experienced health insurance agents to understand the risks and costs, like Free Agents NH, LLC, who will consider your needs and help you understand your options.

Give Free Agents NH, LLC a call for unbiased guidance and ongoing support at 603-527-8117.

We have offices in Windham, NH and Laconia, NH.

Serving Central and Southern New Hampshire:  Derry, Londonderry, Salem, Pelham, Plaistow, Hampstead, Manchester, Nashua, Concord, Portsmouth, Exeter, Dover, Durham, Plymouth and more

Posted by freeagentsnh | Post a Comment

Date: 4/17/2018 10:16 AM EDT

The Small Business Health Options Program (SHOP) Marketplace is for small employers who want to provide health and dental coverage to their employees – affordably, flexibly, and conveniently. SHOP can be a great way to cover your eligible employees with health insurance and get Tax Credits to help with the cost! Tax credits are available for up to two consecutive years. If SHOP fits for you it could be a terrific option and Free Agents NH, LLC can help you with the process.

One of the most popular aspects of SHOP is the ability to receive TAX CREDITS for helping your employees obtain health and/or dental insurance coverage. The eligibility form (link below) will help you to determine if your small business or non-profit is eligible.

Some of the eligibility rules are:

  • Must have between 1-50 Full Time Equivalent Employees
  • Must offer SHOP coverage to all full-time employees. (over 30 hours)
  • At least one employee enrolls that is not the owner, a partner or the spouse of an owner or partner
SHOP ELIGIBILITY FORM

https://forms.cms.gov/shop-eligibility-determination-form/?utm_campaign=hcgov_shopab&utm_content=enroll2018&utm_medium=email&utm_source=govdelivery

The TAX CREDITS available to an employer can make a big difference; and these are CREDITS NOT JUST a DEDUCTION – you could qualify for up to a 50% TAX CREDIT based on your premiums paid.

  • If you pay 50% or greater of the employees cost of insurance (35% for non-profits)
  • If you have less than 25 Full Time Equivalent employees
  • And if the average of employee's income is less than $50,000
The amount of your credit is determined by the number of employees, average wages and amount paid towards premiums cost. The smaller employers with lower wages receive the largest tax credits as a percentage.

SHOP TAX CREDIT ESTIMATOR

https://www.healthcare.gov/shop-calculators-taxcredit/   

A Minimum Participation of 70% of eligible full-time employees is necessary in New Hampshire. Employees waiving coverage because they are covered by a spouse or parent, employees with Marketplace coverage, COBRA, Veteran's, Medicare, or Medicaid are not counted as eligible where you need to be concerned if they do not participate. The Participation formula includes the eligible employees without this previously mentioned coverage and looks at the eligible employees without coverage declining coverage. During Open Enrollment for SHOP, November 15-December 15, there is no participation minimum requirement.

SHOP MINIMUM PARTICIPATION RATE CALCULATOR

https://www.healthcare.gov/small-businesses/shop-calculators-mpr/

SHOP Marketplace offers beneficial flexibility built into the plans. You can offer one plan or multiple plans and when available you can offer multiple insurance companies. Currently there is only one insurance company in New Hampshire offering SHOP plans. Health, dental, health and dental or just dental plans can be offered to your employees and if you chose you can offer coverage for dependents but are not required to. The employer decides how much to contribute; however, it must be over 50% of the employee only cost of a plan to be eligible for tax credit. The eligibility waiting time for new employees is determined by the employer.

Other important Links:

The IRS Employer Tax Credit Link - https://www.irs.gov/affordable-care-act/employers

TO CLAIM TAX CREDIT USE FORM 8941 -

https://www.irs.gov/forms-pubs/form-8941-credit-for-small-employer-health-insurance-premiums

As independent insurance agents, Free Agents NH, LLC with offices in Laconia & Windham NH can help you determine if SHOP is right for you.

We can also help you with other health insurance options including employer group, individual health for under 65 and Medicare Supplements or Advantage Plans for those 65 and over. Give Free Agents NH, LLC a call for unbiased guidance and ongoing support at 603-527-8117.

 

 

Posted by freeagentsnh | Post a Comment

Date: 4/7/2018 8:22 AM EDT

Earlier this year I was introduced to a program that could save my wife and I about $5,000 every year in our taxes just by the way that we handled paying for our health insurance premiums and out of pocket costs. It did not require us to change plans or do any other crazy stuff- just change the way we paid the premiums and out of pocket expenses.

As self-employed, we deduct our health insurance premium, but we have been missing a big part of the deduction. We have been missing 15.3% FICA contributions, because we are taking the deduction on the front page of the 1040 tax return rather than on the business part of the return. In addition, we were not able to deduct health insurance expenses like dental, vision, co-pays, coinsurance, deductibles and prescriptions unless they exceed 7.5% of our income! For most people, that means no deduction for out of pocket costs. These missing deductions have been available for years and have been expanded to help the small employer; for Sole Proprietors, a LLC and C corporations.

My first question was why my accountant had not told us about this? I guess the short answer to that is for many, setting up a compliant Healthcare/ Medical Expense Reimbursement (Section 105 HRA) is somewhat complicated and uncertain for those that don't do it every day. We now have a compliant Health Reimbursement Account (HRA) with plan documents and a report that we can give to our accountant at tax time. So, it is no additional work for them and the plan documents are updated to keep me compliant. The HRA also has an audit guarantee from a well-established company with a 40-year track-record. They can supply all the information on the tax law to your accountant to satisfy any concern. Also, they will set you up with the HRA so there is no extra burden on your accountant.

This is much better for the small employer than an HSA! It offers more financial benefits and much more flexibility. With an HSA, you get to write off the contributions to your HSA savings account, up to the contribution limits set yearly by the IRS, and your money is tied up in that account. This limit may not even cover your deductible on your health insurance plan. With an HSA, there are lots of fees and little to no interest earned. With the HSA, you do not save the 15.3% FICA on health insurance premiums paid or on your HSA contributions. That's several thousand dollars of tax liability that could have been avoided with deductions that the government allows through Section 105 HRAs.

With an HRA, you can determine the amount of reimbursement of health care expenses from the business and you are not tying up money in an account with fees and no interest. With an HRA, you are not required to put the funds in a special account that you use to pay unreimbursed healthcare expenses. You get a debit card and replace funds only as they are used.

An HSA requires that the underlying health insurance plan be a qualified HSA plan. That means that the plan can only pay for preventive care before reaching the deductible. Many people do not select an HSA with tax benefits because doctor visits and prescriptions can't be covered until the deductible is reached. With an HRA, the choice of insurance plans does not matter. You are simply reimbursing the employee (spouse) for medical expenses including premium and out of pocket expenses. And, the out of pocket expenses do not have to exceed 7.5% of income before you deduct them. This means that you not only save the 15.3% of payroll tax on the cost of out of pocket expenses, but you get to deduct them which may amount to an additional 30% in taxes saved on that deduction.

If you are self-employed, you may be able to save as well. Free Agents NH, LLC will be happy to put you in touch with the experts. That's not us; we are just telling our clients how they can save if they are eligible. Free Agents NH, LLC has offices in Windam and Laconia NH. Give us a call at 603-527-8117 or email me at Steve@freeagentsnh.com

Posted by freeagentsnh | Post a Comment

Date: 3/31/2018 8:00 AM EDT

If you are aging into Medicare, there are some very important things that you need to know to decide which direction that you would like to go. When you become eligible for Medicare you are no longer eligible to be covered by individual health insurance. Eligibility for Medicare begins the first of the month of your 65th birthday. For example, a June 2, 1953 date of birth is a June 1, 2018 Medicare eligible date. You should sign up for Medicare Parts A & B three (3) months prior to becoming eligible for Medicare. Social Security Administration does not automatically enroll you in Medicare health coverage unless you are already receiving Social Security.

This is the beginning of health care coverage for 65+; but Medicare Part A and Part B alone is not sufficient medical coverage, because it only covers a part of medical coverage and leaves some very important and expensive gaps in coverage and no prescription coverage. Medicare coverage alone could bankrupt most individuals if in the future any expensive medical care is needed. See our other blogs on Medicare Part A and Part B: https://w.mawebcenters.com/FreeAgentsllc/nhinsuranceblog.html

Signing up for Medicare coverage is usually easy. You should sign up for both Medicare Parts A & B. The exception to this is if you are still working and have other health insurance coverage, you can postpone signing up for Part B. To apply online at Social Security for Medicare Part A & B just click this link: https://secure.ssa.gov/iClaim/rib  

Because of the gaps in coverage with only having Medicare Part A and Medicare Part B, it is important to limit your exposure to these high costs with a Medicare Advantage Plan or Medicare Supplement. These are two very different plans. Since we are independent Medicare Agents, Free Agents NH, LLC can represent all the insurance company options. We can show you the differences in the plans and help you arrive at the most suitable plan for your specific needs. Below is a brief outline of the differences.

Medicare Advantage Plans are typically lower cost (as low as $0) but come with some important sacrifices. You must stay in a network (HMO or PPO) and only get care from providers in that network. If you need specialists or care outside the immediate area it could be more difficult, except for an emergency while out of network. With Advantage Plans you have copays at your expense for services and hospital admissions.

Medicare Supplement Plans work differently. With Medicare and Supplements in NH there is no provider network, so you can get care from any provider that accepts Medicare nationwide. As a rule, there are no copays depending on the plan that you select. Medicare Supplements are better coverage because of this; however, you will find Medicare Supplements are also more expensive. It’s important to know what you get for the extra cost.

The most important thing that you need to know when first becoming eligible for Medicare is about OPEN ENROLLMENT AND UNDERWRITING. When you are first eligible (when getting Part B) you have a 6-month OPEN ENROLLMENT period to enroll in a Medicare Supplement plan with no medical underwriting. Most people think that with the new Affordable Care Act that Pre-Existing Conditions no longer apply. Unfortunately, that is not true with over 65 Medicare coverage. The reason we spend so much time in the first visit with clients, is to educate them on the key issues and then leave them to consider their options. Changing plans in the future requires you to go through medical underwriting and most people because of pre-existing conditions, cannot be accepted in a new plan forcing them to remain in the plan that they first selected. It is our goal to be sure that the first choice is a choice that you can be happy with for a lifetime.

Give Free Agents NH, LLC a call for unbiased guidance and ongoing support from a Medicare agent at 603-527-8117. We have offices in Windham, NH and Laconia, NH; or we can also come to see you.

Posted by freeagentsnh | Post a Comment

Date: 3/24/2018 9:14 AM EDT

Medicare health insurance coverage includes four parts. In this discussion, we will outline Medicare Part B coverage and the need for Medicare Supplement insurance. Typically; Medicare Part B covers 80% of Approved Services and Amounts, leaving 20% to be covered by the patient or by an insurance company that you might have a Medicare Supplement with. See more on Medicare Supplement Plans below.

Medicare Part B covers Medical expenses BOTH in and out of the Hospital like physician services, both inpatient and outpatient medical and surgical services, diagnostic tests, durable medical equipment, physical & speech therapy, and Home Health Care.

We also want to stress the importance to understand the Medicare Part B deductible, Part B Excess Charges and Foreign Travel Emergency. 

Medicare Part B Deductible: Each year the government announces a new deductible for Part B, which is currently $183/ year. This year it remained the same. There are some Supplement Plans that may cover this deductible; however, you should verify with a Medicare Agent which plans do.

Medicare Part B Excess Charges: Of greater concern to us is the Part B Excess charges. This could be an unforeseen expense that you need to understand. Providers are paid by Medicare, based on a code fee schedule. The Part B Excess coverage is to protect you if the provider decides to charge more than the Medicare Fee Schedule. Did you know providers are allowed to charge up to 15% more than Medicare approved rates and if your coverage does not cover that Excess then you are responsible for the 15% extra? And even if your provider does not charge that now, they can charge it later. That is why you need a Medicare Agent that understands these differences and does it every day; like Free Agents NH, LLC. You will see that we are not sales people; but more like educators helping you to make your most suitable choice, right from the start. 

Foreign Travel Emergency: In general, health care you get while traveling outside the U.S. is NOT covered. In some cases, Medicare may cover medically necessary health care services you get on board a ship within the territorial waters. Medicare supplement insurance (Medigap) policies may cover you when you travel outside the U.S. Our Medicare agents at Free Agents NH, LLC can help you determine those that do.

We mentioned that Medicare Part B generally covers 80% of Medicare Approved Services. The supplements generally cover the remaining 20% of approved charges not covered by Medicare. Medicare Supplements are the alternative to Part C or Advantage Plans and just as the name suggests, they supplement Medicare coverage because coverage by Medicare is not complete. In fact, a big health issue could bankrupt most people if the Advantage Plan or Supplement was not there to cover the Medicare shortfall.

You can read more about Medicare Part A, Part C and Part D health insurance coverage by clicking link, https://w.mawebcenters.com/FreeAgentsllc/nhinsuranceblog.html

Medicare Part A (Hospital services which include Hospitalization, Skilled Nursing Facility Care, blood and most Hospice Care)

Part C Plans are Medicare Advantage Plans (not covered by Medicare) In the case of Advantage Plans, the insurance company becomes the primary payor of claims rather than Medicare as primary payor. Advantage plans may be lower cost than Medicare Supplements because in many cases the insured has greater cost sharing responsibilities (RISK) and often must get care inside an insurance company's HMO or PPO provider networks.

Part D is drug coverage supported and subsidized by Medicare and the plans are managed by insurance companies.

Just as our name implies our services are free and the cost for insurance is the same with or without our help. Give Free Agents NH, LLC a call for unbiased guidance and ongoing support from a Medicare Agent at 603-527-8117. We have offices in Windham, NH and Laconia, NH; or we can also come to see you.

 

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