Monthly Archives: February 2016

What Are Medicare HMO Plans?

Medicare itself is not an HMO or PPO or any other type of network. Original Medicare which is now how Medicare is typically referred to is either accepted or not by a doctor. By accepting Medicare the doctor is agreeing to accept what Medicare pays for a certain procedure/visit. The doctor also can agree to accept Medicare Assignment or not which is a whole different topic.

What Are Medicare HMO Plans?

Medicare HMO plans are going to be Medicare Advantage Plans or Medicare Part C plans. These plans are completely different than Original Medicare. When you join a Medicare HMO plan you do have to be aware of the network of physicians and facilities that the HMO plan is contracted with. If you see a provider outside of the HMO network, the HMO insurance will not pay the bill. With Medicare HMO plans you must remain in the network at all times with the exception of emergency and urgent care when traveling. Medicare HMO plans also require a referral in most cases to see a specialist. There are a few exceptions to this rule, but not many. Finally, these plans also usually require authorizations for most procedures and expensive name brand drugs. On the positive side, you will find that you will typically save money on premium and co-pays when you are in a Medicare HMO plan which is why many Medicare beneficiaries find them so attractive.

Is a Medicare HMO Plan Right For You

Everyone has different needs and wants when it comes to health coverage. The first thing you must look at is how attached you are to your doctor. If you have a primary care doctor that you will absolutely not leave then you have to make sure that doctor is in the HMO’s network. If you see several specialist the same thing applies. Also, consider how willing you are to deal with the HMO requiring the referral and the authorizations. Take into consideration that most specialist are going to require the referral even if the insurance does not.

And finally, consider the cost. Many times the HMO is going to be considerably cheaper for the more expensive procedures. Hospital stays, MRI’s, and outpatient surgery are some typical areas where you can save substantially with an HMO. Also, know that not all HMO’s are created equally. Some HMO’s offer better networks than others as well as making faster payments to the doctors. Some examples of companies offering HMO’s are Humana, United Healthcare, Wellcare, and Healthspring.

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Medicare Supplemental Plans – Some Reasons Why You Need It

Most seniors that are just becoming recipients of Original Medicare do not realize the importance of supplemental Medicare plans for 2012. Even for those in perfect health, you never know the need for extensive surgery, or the need for a visit to the emergency room plus some lab work might leave you in tons of debt. As can be predicted, for those with an exiting medical problem like arthritis, cancer, diabetes, or high blood levels, not having a medicare supplement plan will end up costing your way more then any premium that you would have paid.

Medigap Insurance and Your Health Risks

Irrespective of how you choose to perceive things, a long life will cost your body. This consists of developing a much higher risk of tumors, cancer, stroke, and a ton of other major medical problems. Medicare only handles about 80 percent of a seniors total health care bill and for some even more, covering those costs can be impossible if one doesn’t have the ideal amount of supplemental coverage. In fact, for those seniors that are already suffering from a pre-existing condition, or have some sort of medical problem that runs in the family, getting a Medicare plan is the right choice if if you may not need it right away as it will give you financial security.

Protecting Your Financial Assets with a Medicare Supplement Plan

Most senior citizens know the benefits that come along with becoming a recipient of Original Medicare, but so many just do not bother with shopping for medicare supplemental plans. For a minute think about a scenario in which you have just retired, and have now got Medicare opposed to the insurance coverage that was provided by your employer. You must remember a time having surgery and only having to pay off your yearly deductible. However, with just Medicare insurance, you will have to shell out much more. For just a couple of x-rays and some minor surgery after a fall, you can end up paying over $3,000 for the entire bill.

Should you have not satisfied your annual Part B deductible, you will have to pay about $907.00 for a visit to the hospital. As you can imagine, for those who get diagnosed with a major medical problem like cancer or diabetes, chances are that you are going to accumulate thousands of dollars in medicals bills over a couple of weeks. Your life savings can disappear over night if you don’t have much in savings, you can purchase medicare supplemental insurance to avoid such catastrophes.

Nowadays, seniors still look forward to getting Original Medicare as it is still an okay safety net for those rough times. Although it does cover the health care needs for many seniors, that 20 percent which the recipient is expected to cover does add up fast and can get real hard to cover. If those deductibles and co-pays worry you, then you you have an obligation to yourself to get a Medigap insurance plan in order to preserve your finances and future along with being able to choose which doctors you want to see and having control of the quality of your coverage.

Shopping for insurance to medicare supplemental plans can be difficult as their are so many different companies and medicare plans to choose from. With the expert advice and online quote engine at mostmedicare.com you can easily know and understand all your options. It is essential to do research on everything and compare insurers in your area to see which one offers the most competitive rates on the Medigap insurance that you want.

Asset Protection – What You Need to Know Now

The first question you will be asked by a Financial Advisor is about what coverage you have on your personal insurance program? Having proper coverage is integral to protecting your assets. Insurance contracts vary. Consider these points when determining if you have proper protection:

– Excess Liability vs Umbrella. Just like “Kleenex” has become the generic label for facial tissue, “Umbrella” has become the generic label used for liability policies with high limits. These days, “true” umbrellas are harder to find. Most of these policies are actually “excess liability” policies which means you must have an underlying primary policy covered loss (such as an auto or home policy) for the excess liability policy to provide any coverage. That’s great if your loss is covered by your auto or home policy but what if you rent a boat or motor home on your next vacation? “True” umbrellas may cover additional exposures and provide more protection.

– Board of Directors, anyone? Nonprofits and associations commonly have a managing board of directors. If you gave up a few evenings a month to serve on one, you certainly want to make sure they are providing “Directors and Officers” insurance for you especially if it is a paid position otherwise any act by the board that results in bodily injury, property damage or personal injury to others, could hold you personally responsible.

– Personal Injury coverage- to have or not to have? This was just mentioned in the previous point and also applies to you personally – especially if you own rental dwelling properties. Personal Injury covers things like libel, slander, false imprisonment, malicious prosecution, invasion of privacy, defamation of character and wrongful eviction.

– Maintain liability limits required by your umbrella. Did you call the “lizard” that you saw on a television commercial to make sure you were not paying too much for your auto insurance? Do you have an umbrella policy? Umbrella policies require that certain underlying liability limits be maintained for the higher limits to respond. If you have $15,000/$30,000 limits on your auto policy and the umbrella or excess liability requires you maintain $250,000/$500,000 limits- you have a significant “gap” in coverage. That’s an expensive mistake!

– How much coverage do you need? Add together the equity in your home and any other “real” property you own, personal belongings, investments outside of a retirement account (Retirement accounts such as 401k’s are usually “judgment proof.”) Also include savings, checking accounts and future wages. (Most people forget about future wages.) The total is the amount of total liability coverage you should have.

Contrary to popular belief, you are not paying “extra” to have an independent insurance agent guiding you on the coverage you need for your particular situation. Contact your agent today if you have any questions on your personal insurance program to be sure you’re getting the protection you think you have.

Deciding If You Need Supplemental Insurance

Now that we have covered some of the more time-consuming aspects of pasta, like making pasta from scratch, let’s move on to more familiar territory. Have you ever noticed how big the pasta aisle at the super market is? It’s because pasta is a quick meal that can be tailored to fit any tastes, no matter how sophisticated or how picky. Dry pasta can be used to make hot or cold meals. It stores well and doesn’t lose its flavor. There are even some excellent jarred sauces that make preparation even quicker. The following dishes use dry pasta and some prepackaged ingredients for the sake of expediency.

Baked pasta dishes are great for a crowd or for leftovers the next day. Dinner that can also feed everyone lunch the next day? Perfect! This version of baked ziti uses store-bought pesto, but this can easily be made fresh if you prefer.

Baked Ziti

1 package Hot Italian Sausages, casings removed

4 cloves Garlic, diced

1 large White Onion, diced

1/2 of a package Pesto, the kind found in the refrigerated section works well here

1 28 ounce can Tomatoes, diced and peeled

1 package Frozen Chopped Spinach, thawed and drained

8 ounces Mozzarella cheese diced into cubes

1 cup Parmesan Cheese, Grated

3 cups cooked Ziti or Penne Pasta

Method:

Pre-heat oven to 350 degrees. Grease a 9 by 13 inch Pyrex pan.

Sauté sausage, garlic and onions until slightly browned. Add Pesto and diced tomatoes. Allow this mixture to simmer on low for 30 to 40 minutes.

In a bowl combine, spinach, mozzarella and Parmesan cheeses. Add the Ziti to the spinach mixture. Combine Ziti and tomato mixture. Mix thoroughly and pour into greased pan. Cover with foil and bake Ziti mixture for 30-40 minutes or until the cheese is melted and the top is slightly browned.

The spinach and sausage in this dish make it extremely tasty, and the cheese gives it a satisfying creaminess.

An Easier Pasta Dish

For an even easier dish cook the Ziti or Penne and let it cool slightly. To this add your choice of chopped olives, chopped pepperoni, cubed mozzarella and chopped roasted red peppers (these can be found jarred in the pickle section of your supermarket). Dress this with Italian dressing. Allow to sit 30 minutes before serving. This is a great dish to serve on hot days or as a side dish. It can be modified a million different ways by adding fresh produce or different kinds of cheese.

A good place to find easy pasta dishes is on the box of dry pasta itself. Depending on the type of noodle you will find hundreds of recipes this way.

If you have major medical expenses, and not all of your treatments are covered by your carrier, you might need to consider some type of supplemental insurance. This could be a wise investment before all of your savings are gone.

One thing to keep in mind, this type of policy is never meant to replace your regular coverage, only to add to it. Certain expenses are not covered by your regular policy, they would be paid out of pocket by you, but there are companies whose sole purpose is to cover these types of expenses.

With your primary policy, you might be required to pay a deductible, or perhaps meet a copayment. With a supplemental policy, some of these expenses could be paid, or they might provide a lump sum that would allow you to use the money in a manner that you see fit.

Instead of the money given at one time, some agencies will give you the reimbursement over a period of time. This will vary from carrier to carrier, so do some research before you sign any paperwork. In this way, you will know in advance how the payments work.

There are quite a few very good companies to choose from, and like a regular agencies, they have regulations to meet. Some take a certain type of client only. Some companies will only cover people who are on Medicare already, others do not want people to be on this program yet.

If you are critically ill, and you are having trouble with your primary provider, having an additional plan that will cover special doctors, or travel, or experimental treatments, could be very advantageous for you.

But in addition to this, that secondary coverage could also help with your day to day living costs, or either help with the household or your children. All of this will help ease the stress your family is already going through due to the illness.

If you are required to stay in the hospital for an extended period you could also receive help with this. With this you could receive either a cash payment up front, or probably more convenient financially, a weekly amount to help with expenses.

Another type of supplement is the accidental death policy. This would pay in the event that a person dies or suffers a loss of limb, eyesight, or is paralyzed in an accident of some sort.

But is this coverage necessary for most of us, or just another way for the insurance companies to make money. If there is a history of certain illnesses in your family, or if you travel a lot by trains or planes, this could be a very good plan for you and your family.

Choose wisely before deciding if you need supplemental insurance. If you think it is necessary, find a reputable company that handles what you need, and pays in a way that is acceptable to you. Be sure that it covers all of the out of pocket expenses that you think you might be incurring.

Vision Insurance for the Elderly

How important is vision insurance?

Unfortunately, most people do not think of it as critical. It is bought separately from general health insurance policies and often thrown in with other types of insurance, most commonly dental insurance. Additionally people are not always aware of how to care for their vision. As we age, our vision, like the rest of the body, degrades.

However, to show how critical vision is, compare the following facts.

Even with the medical advances, restoration of full vision is nearly impossible; so once lost, very little can done to restore vision to its previous strength. This is not true of most body parts including teeth
It is relatively cheap to insure vision, vs. dental or health insurance
Policies are relatively simple to understand, unlike health insurance policies with their myriad exclusions

Before we get into insurance, let us talk about common vision ailments and what you, as an elderly person, can do to prevent vision problems.

STRUCTURE OF THE EYE

Let me break down your eye structure. Key functions of the eye are to receive light, focus on objects and transmit data to the brain. Here are the key parts of your eye.

Pupil, transmits light to the back of the eye
Lens, retina and macula work together to transmit not only light and contours but interpret it and communicate data to the brain
Vitreous gel, which is 90+ percent water, keeps the shape of the eye and provides moisture
Cornea helps to keep the eye from getting infected and also regulates light entering into the eye
Iris acts a light meter or filter

COMMON EYE CONDITIONS

Common vision and sight-impairement conditions are as follows:

1. Cataract

2. Diabetes related dieseases

3. Macular degeneration

4. Glaucoma

5. Dry eye

6. Vision impairment

PREVENTIVE TIPS

While age related degradation of the eye is common and unfortunately cannot be eliminated, its advance can be slowed down through discipline and some smart practices. They are;

1. Testing: make sure you see your eye doctor at least once a year (usually every six months after the age of 60 or if you have genetic issues with the eye) is recommended. Make sure you undergo a “comprehensive dilated eye exam”

2. Hereditory history: certain eye problems are genetic; know your family’s exposure to eye diseases.

3. Diet: a healthy diet rich in fruits and vegetables, particularly leafy vegetables is good for the health of your eye

4. Rest: like the rest of our body, your eyes need to rest. Constant focusing, particularly in back-lit devices, can strain eye muscles.

5. Over-exposure: wear sunglasses–not just to look cool, but avoid hits of sun’s ultraviolet rays.

VISION INSURANCE:

Most vision insurance policies cover basic preventive routines such as eye exams etc. Most come with an annual maximum. But aside from the money, your vision insurance provider should offer the following broad categories of protection and support.

1. Products, Services: these include eye exams, surgery, age-related procedures and discounts on frames and lenses

2. Acceptance. Make sure your provider’s policy is accepted across a wide network of opthomologists and eye surgeons near where you live or work. Particularly if you are retired, you may not be very mobile. To have to drive or be driven far to see your eye doctor is not acceptable. It is worth paying a little bit extra for a provider who is accepted widely.

3. Resources. Your provider should have a website member support center that can answer technical questions

4. Customer service. Your provider should have knowledgeable customer service reps who understand what is and is not covered under the policy, how much a particularly procedure can cost in your area and recommend good doctors.

In summary, there is a lot you as a senior can do for your eyes–and be smart about the policy you buy as vision insurance.