Saturday, June 16, 2012

Which companies sell Medicare Supplement insurance in Indiana?


Companies must be approved by IDOI in order to sell Medicare Supplement policies. All of the companies listed below have been approved by the state.

To make it easier for you to compare one Medicare Supplement policy to another, Indiana allows twelve standard plans to be sold. The plans are labeled with a letter, A through J. Not all companies sell all ten plans. Following each company name and phone number, we have listed the Medicare Supplement plans sold by that company based on the following categories:

    Medicare Supplements for Persons 65 and Older
    Medicare Supplements for Persons Under 65 and Disabled
    Medicare SELECT Insurance Companies

Friday, June 15, 2012

What if I am under 65 and disabled?


If I am under 65 and receive Medicare due to disability, does the supplement company have to sell a policy to me? No. At this time, there is no "Open Enrollment" period for disabled Medicare beneficiaries until they are 65. However, new laws are being proposed that would give disabled Medicare beneficiaries an Open Enrollment period.

If I am still working and have Medicare due to disability, can my employer group health plan turn me down?

That depends on the size of your employer.

If your company employs 100 or more employees and:

You work full time and your employer group health plan offers coverage to other full-time employees, they cannot turn you down, or charge you premiums which are higher than other employee premiums.
You work part time and your employer group health plan offers coverage to other part-time employees, they cannot turn you down or charge you premiums which are higher than other employee premiums.
If your company employs fewer than 100 employees, Medicare would be your primary insurance.

Can my working spouse's employer group plan turn me down?

That depends on the size of the employer.

Your working spouse's employer group health plan can only turn you down if the company has fewer than 100 employees. They have to cover you the same as any other spouse. They cannot give you less coverage or charge you a higher premium.
If your working spouse's employer has less than 100 employees, Medicare would be your primary insurance.

What are my other options?

Medicare Managed Health Maintenance Organizations (HMOs) cannot turn you down if you are on Medicare due to a disability.
View Medicare Advantage plans available where I live?
Some companies accept applications for a Medicare supplement policy application from those under 65 and disabled. However, there is no guarantee that they will sell a policy to you.
View companies approved to sell Medicare Supplement insurance.
ICHIA, the Indiana Comprehensive Health Insurance Association, can provide major medical coverage. The premiums and deductibles are usually very high. Call SHIP at (800) 452-4800 for more information.

If you are under 65 and receiving Medicare due to a disability, you trigger an "Open Enrollment" period when you turn 65. At this time, your Medicare is due to age and no longer due to disability.

Under 65 dissable brocchure

Thursday, June 14, 2012

Does the company have to sell a Medicare Supplement policy to me?

There is a time period when a company must sell a Medicare Supplement policy to you. This six-month period is called "Open Enrollment." Open Enrollment begins when you are 65 or older and enroll in Medicare Part B.

During Open Enrollment, a company:

Cannot refuse to sell you a Medicare supplement policy, regardless of your health.
Can ask you health related questions on the application.
Cannot charge you a higher premium because of your health history.

If you are 65 years old or older:

If you enroll in Medicare Part B when you turn 65, your Medigap Open Enrollment begins the day your Medicare Part B becomes effective.
 
If you continue to work past age 65 (to any age) and delay enrolling in Medicare Part B, you "trigger" your Open Enrollment period by enrolling in Medicare Part B. It begins the day your Medicare Part B becomes effective.
 
If you are 65 or older and delayed enrolling in Medicare Part B because you were covered by your working spouse's employer group health plan, you "trigger" your Open Enrollment period by enrolling in Medicare Part B. It begins the day your Medicare Part B becomes effective.

If you are under 65 and receive Medicare due to disability:

Currently, there is no Open Enrollment period for disabled Medicare beneficiaries until they are 65. However, some new laws are being proposed that would give disabled Medicare beneficiaries an open enrollment period.

There are other options for those who are under 65 and disabled:

Medicare Advantage Plans cannot turn you down if you are on Medicare due to a disability
Some companies accept applications for a Medicare Supplement policy application from those under 65 and disabled. However, there is no guarantee that they will sell a policy to you.

If you are under 65 and receive Medicare due to a disability, you trigger an Open Enrollment period when you turn 65. When you turn 65, your Medicare is due to age and no longer due to disability. A company must then sell you any plan it offers.

Tuesday, June 12, 2012

What does Medicare Supplement insurance cover?

Medicare Supplement insurance is sold in 12 standard plans. As of January 1, 2006, Plans H, I, J are no longer sold with drug coverage.

View all plans and the benefits they include.

Every company must sell Plan A, which is the basic plan, or the "core benefit" plan. The standard plans are labeled A through L.

Remember, the plans are standardized. So, Plan F from one company will be the same as Plan F from another company.

Select the supplement policy which fits your needs, and then purchase that plan from the company which offers the lowest premiums and best customer service. Core Benefits:

Included in all plans.
Pays Part A Hospital copayment ($289 per day for 61-90 days and $578 per day for 91-150 days in 2012)
Pays for an additional 365 days of hospitalization after Medicare benefits end.
Pays Part B copayment (usually 20% of the Medicare approved amount)
Pays for the first three pints of blood per year.

You will have to pay part of the cost-sharing of some covered services until you meet the annual out-of-pocket limit. Plan K has a $4,660 out-of-pocket limit. Plan L has a $2,330 out-of-pocket limit. Once you meet the annual limit, the plan pays 100% of the Medicare copayments, coinsurance, and deductibles for the rest of the calendar year. These amounts can change each year.
Part A Deductible

The initial amount Medicare does not pay for an inpatient hospital stay per benefit period ($1,156 in 2012).
Skilled Nursing Copayment

The amount Medicare does not pay for days 21-100 in a skilled nursing facility ($144.50/day in 2012).
Part B Deductible

The initial amount Medicare will not pay for covered physical or other outpatient services each calendar year ($140 in 2012).
Foreign Travel Emergency

(Medicare does not pay for care received in a foreign country.) This benefit covers, after a $250 deductible per year, 80% of health expenses for emergency care received in the first 60 days of a trip to a foreign country, up to a lifetime maximum of $50,000.
At Home Recovery

(Medicare only pays for skilled nursing home health care.) This benefit covers home health visits for assistance with activities of daily living, when either Medicare home health coverage is currently being received or within eight weeks from the last Medicare home health visit, up to $1,600 per year.
Preventive Care

Part B also covers preventive services at $0 copay and $0 deductible. These include welcome to Medicare physical exam, abdominal aortic aneurysm screening, annual wellness exam, bone mass measurement, cardiovascular disease screening, colorectal cancer screening, diabetes screening, mammogram screening, pap test/pelvic exam/clinical breast exam, vaccines, flu H1N1 flu, hepatitis B, pneumonia. Copay and deductible apply to glaucoma tests, HIV screening, Medicare nutrition therapy services, prostate cancer screening, smoking cessation counseling.
Part B Excess

(Medicare does not pay excess charges above its approved amount.) This benefit covers the difference between the Medicare approved amount and the limiting charge (which is no more than 15% above the Medicare approved amount). This benefit pays either 80% or 100% of the Part B excess charges.

Saturday, June 9, 2012

What is Medicare Supplement insurance?

Medicare does not pay for everything. Medicare beneficiaries also pay a portion of their medical expenses, which includes deductibles, copayments, services not covered by Medicare, and excess charges when doctors do not accept assignment.
Medicare Supplement Insurance (Medigap)

Medicare Supplement insurance is also called Medigap insurance because it covers the "gaps" in Medicare benefits, such as deductibles and copayments.

Medicare Supplement insurance is a private health insurance policy purchased by a Medicare beneficiary. Federal and state law regulates Medicare Supplement policies.

Only a Medicare Supplement policy, or a Medigap policy, will help fill gaps in Medicare benefits. Other kinds of insurance may help you pay out-of-pocket health care costs, but they do not qualify as true Medicare Supplement insurance.

For example, an employer retirement health plan may pay for prescriptions, vision and dental services, but it may not pay for Medicare deductibles and copayments.

Therefore, it is not a true Medicare Supplement policy because it does not coordinate benefits with Medicare.
Do I Need a Medicare Supplement Policy?

The answer to this question depends on one factor. Do you know you will always have adequate income and assets to cover all medical costs NOT covered by Medicare, such as deductibles, copayments, or non-covered services?

If you are not sure the answer is yes, or if you do not want to risk it, you should explore your options for supplementing Medicare.
Standard Medicare Supplement Coverage

To make it easier for you to compare one Medicare Supplement policy to another, Indiana allows twelve standard plans to be sold.

The plans are labeled with a letter, A through J. Plan A is the basic benefit package and Plan J is the most comprehensive.

These ten plans are standardized, which means that benefits will be the same no matter which company sells the policy to you. Plan D from one company is the same as Plan D from another company. Since Medicare Supplement policies are standardized, you are free to shop for the company with the best price and customer service.

Generally, Medicare Supplement policies pay most, if not all, Medicare copayment amounts, and policies may pay Medicare deductible amounts. Also, some of the ten standard plans pay for services not covered by Medicare, such as prescriptions.

Although the benefits are the same for each standard plan, the premiums may vary greatly. Before purchasing a supplement policy, determine how the company calculates its premiums.

An insurance company can calculate premiums one of three ways.

    Issue Age: If you were 65 when you bought the policy, you will pay the same premium the company charges people who are 65 regardless of your age.
    Attained Age: The premium is based on your current age and will increase as you grow older.
    No Age Rating: Everyone pays the same premium regardless of age.

The Indiana Department of Insurance must approve premium rates for all Medicare Supplement policies.
Medicare SELECT Insurance Policies

Medicare SELECT policies are a type of Medicare Supplement insurance sold by a few private insurance companies. A Medicare SELECT policy is one of the ten standardized supplement policies.

It differs from Medicare Supplement insurance because you are expected to use a network of hospitals associated with the insurance company.

In return, you will usually pay lower premiums. Also, in order to enroll in a Medicare SELECT plan, you must live within the service area of a network facility.

Thursday, June 7, 2012

Am I eligible for Medicare?

To receive Medicare, you must be eligible for Social Security benefits. 

Part A Eligibility

Most people age 65 or older are eligible for Medicare Part A (Hospital Insurance) based on their own employment, or their spouse's employment.  Most people have enough Social Security credits to get Part A for free.  Others must purchase it. 

You are eligible for Medicare Part A if you meet one of the following criteria: 
•    You are eligible for Social Security or Railroad Retirement benefits, even if you do not receive those benefits.
•    You are entitled to Social Security benefits based on a spouse's, or divorced spouse's work record, and that spouse is at least 62 years old.
•    You have worked long enough in a federal, state, or local government job to be eligible for Medicare.
If you are under 65, you are eligible for Medicare Part A if you meet one of the following criteria: 
•    You have received Social Security disability benefits for 24 months.
•    You have received Social Security benefits as a disabled widow(er), divorced disabled widow(er), or a disabled child for 24 months.
•    You have worked long enough in a federal, state, or local government job and meet the requirements of the Social Security disability program.
•    You have permanent kidney failure that requires maintenance dialysis or a kidney transplant.
•    You are diagnosed with ALS or Lou Gehrig's disease.

Part B Eligibility

If you are eligible for Part A, you can enroll in Medicare Part B (Medical Insurance) which has a monthly premium.

What Does a Medicare Supplement Cover?

What Does a Medicare Supplement Cover?

By Alicia Ramirez

Medic Insurance - Medicalcare image
 A Medicare Supplement, also referred to as a Medigap Policy, is basically an insurance plan that is secondary to original Medicare. You must be enrolled in Parts A and B in order to be eligible to enroll in a Medicare Supplement Plan.

Original Medicare has four parts. Part A is hospital insurance with a deductible of $1156.00 for 2012. Part B is medical insurance with a deductible of $140.00 for 2012. Part C is known as a Medicare Advantage Plan. Medicare Advantage Plans replace your original Medicare insurance. They include hospital insurance, medical insurance, and some plans include prescription drug coverage. Part D is prescription drug coverage. If your Part C plan does not include prescription drug coverage, you can enroll in Part D.

Wednesday, June 6, 2012

Teaching Chair Yoga for Heart Health

By Faye Martins


When my teacher first started talking about using a chair in yoga classes I really wasn't interested. Then he invited me to see classes in progress at the local senior and rehabilitation centers. The students are friendly, dedicated, and really see the benefits of steadily practicing yoga. To see therapeutic vinyasa flows in a chair wasn't what I expected - at all. In fact, I had a preconceived notion that they would practice a few asanas, relaxation, pranayama and some relaxation. Instead, it was a full-blown class with an opening, centering, and some challenges. They laugh when doing Lion Face! I was hooked and took a chair yoga teacher training course.

Heart Health Fitness Options

Jogging, running or power walking usually come to mind when people think of exercising for heart health, but such pulse-pounding exercises are not always appropriate for those who need it the most. Yoga in chairs provides seniors of all health and fitness levels with an opportunity to give their heart the exercise it needs to be in good, strong shape. The heart still needs exercise, regardless of the health of the individual.

Stress vs. Relaxation

One of the most common contributing factors for heart disease is a high level of stress. Few people can make their way through life without encountering stress in one form or another, but individual responses to stress are diverse and varied. It's never too late to learn a better and more appropriate way to handle negative emotions, and chair yoga is a gentle way for seniors to become more present, grounded and relaxed. This positive attitude promotes a lower blood pressure level, which is extremely beneficial for those with heart disease.

In addition, participating in a chair yoga class gives seniors a sense of control over the health and wellness of their heart. This easily leads to making better choices outside of the classroom, such as eating more fresh veggies and lowering intake of harmful fats and sugars. These seemingly simple lifestyle choices add up over time, leading to a higher quality of life overall.

How it Works

Yoga in a chair also increases the circulation in the arms, legs and feet, and this is excellent for the well being of the heart. The heart of a sedentary individual is typically overworked by trying to pump blood to these harder to reach extremities, and seniors typically fit into the sedentary category more than any other age group.

Practicing yoga in a chair is incredibly gentle, but the practice still yields all the positive benefits of a traditional hatha practice, including increased flexibility. Studies have shown that greater levels of muscular flexibility have been linked to higher levels of arterial health. When the muscles are elastic and stretchable, the major arteries tend to be the same way. This goes a long way toward keeping the heart in top shape.

Chair yoga is a healthy addition to a senior lifestyle, and definitely provides ample benefits for heart health. If you want to become a yoga instructor or are seeking continuing education, it worth considering the benefits you can bring to dedicated students.