As Part of the Medicare Modernization Act of 2003 beneficiaries now face choices every year in a period of time called the Annual Election Period. Medicare now allows beneficiaries to change their Medicare plan and their Part D drug plan beginning November 15th of each year. Changes would go into effect on January 1st of the next year.

TWO TYPES OF MEDICARE
The choices for Medicare doctor and hospital coverage depend on which Medicare plan the beneficiary chooses:

Traditional Medicare: Medicare is the primary insurance and a secondary plan called a Medicare supplement or a group plan covers the rest. Individual traditional plans will carry premiums from $100 to $300 per month depending on the age of the enrollee. These plans will generally have no co-pays and very little out of pocket exposure for the insured.

Medicare Advantage: As part of the Medicare Modernization Act of 2003 Medicare Advantage plans offer a pay as you go approach to health insurance. Members pay very little if any monthly premiums in exchange for copays when benefits are used. These plans can also incorporate Part D drug benefits as part of their protection. Medicare Advantage plans use a single payer approach to health billing with members showing only one card instead of showing their Medicare card and a secondary insurance card.

With recent changes in Medicare coverage comes a lot of confusion among beneficiaries as to which type of Medicare is best for them. When doing seminars on this topic we answer a lot of their questions. FHK Corporation conducts weekly seminars on Medicare choices during the Annual Election Period to inform seniors of their options. Many seniors have attended these events and listed below are frequently asked questions at those events.

FREQUENTLY ASKED QUESTIONS:

I am getting mail on Medicare plans that cost zero premium, is this too good to be true?
No. Remember, most of the money on a low premium Medicare Advantage Plan comes from Medicare paying a private insurance company to basically do its job. Medicare will pay a private insurance company approximately $650 a month to provide the member with Medicare benefits. With most of the money coming from the government a private insurance company on a Medicare Advantage Plan will often allow members huge savings over traditional Medicare supplement plans in return for some co-pays.

I have a lot of health problems, who will accept me and will the insurance plan cover all my health conditions?
Yes. Medicare Advantage Plans do not ask medical questions for acceptance. Only people on End Stage Renal disease can be excluded from enrollment in these plans due to health. Advantage Plans also cannot use waiting periods for pre-existing health conditions.

Can a plan leave the Medicare Advantage system?
Yes. Private insurance companies are able to leave the Advantage system at the end of a calendar year. However, members of that plan will then be given 63 days to get into any Medicare plan being offered in their state regardless of their health. This is called Guarantee Issue and assures members of acceptance to another plan if their plan opts out.

Is it better to pay premiums or co-pays?
Since many of the traditional Medicare supplements have raised premiums substantially over the past few years many beneficiaries face a bigger burden on their heath care costs. Medicare Advantage plans offer a pay-as-you-go approach to heath care. Members in an Advantage Plans in a good health year can save thousands of dollars on their insurance this way. A good Advantage Plan can even save premiums in a bad health year.

Can I keep my current Doctor and Hospital?
With a Private Fee for Service (PFFS) Medicare Advantage plan you can keep you current doctor and hospital as long as they accept Medicare and the plan.

How do I compare Medicare Advantage Plans in my area?
The best Medicare Advantage Plans have the lowest co-pays. Most of the plans will have low premiums but it is important for the member to examine how much exposure members will have with co-pays especially for hospital stays and out-patient surgery. The lowest premium plans may not always be the best.

The decision between Traditional Medicare and Medicare Advantage should not be taken lightly. Depend on advice from Health insurance professionals that know the facts and can help you to understand your options.

FHK Corporation invites you to discuss your options with one of its independent agents or, if you prefer, attend one of our many informational seminars. Seminar dates and locations can be found here on our website.

Trust FHK, the Senior Citizens Trusted Source.