Podcast
Medicare Nation
Hosted by Diane Daniels · EN
How much would you pay out-of-pocket for a five day hospital stay on Medicare? The majority of people have no idea!
The problem with Medicare is there is too much information. An overwhelming amount of information and not enough resources. Medicare Nation solves that problem by educating you about all the things you want to know about Medicare, but are afraid to ask. This podcast will educate you about the components of Medicare, the different categories of Medicare Plans and Medicare benefits. On other episodes I'll interview expert guests in the health and wellness field, about diseases, Medicare issues and current changes to the Medicare program.
Medicare Nation is dedicated to answering all your questions about Medicare.
Expert information and insights regarding Medicare and you!
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CMS Hands Out Civil Money Penalties To 3 More Medicare Plans
Jun 12, 202000:26:29Tap to summarizeHey Medicare Nation! www.TheMedicareNation.com Today, I'm finishing up my series on the Medicare Plan Sponsors that CMS has issued Sanctions and/or Civil Money Penalties for in 2020! THREE more plan sponsors to discuss! CMS sent notice to Ms. Aparna Abburi, President of Health Care Service Corporation (HCSC), on February 28, 2020, that CMS was imposing a Civil Money Penalty in the amount of $381,272.00! HUGE Penalty people! According to CMS Summary of Non-Compliance, HCSC disclosed to CMS that it "discovered" a backlog of unprocessed Part C (Medical) Appeals. The Majority of these appeals were from claims from providers (doctors and/or facilities) or ..... reimbursement requests from enrollees. HCSC has the right to Appeal CMS Decision. NEXT Up..... is Triple-S Management Corporation! CMS sent a Notice to Ms. Madeline Hernandez-Urquiza, President of Triple-S Management Corporation, on February 28, 2020. CMS notified Triple-S that they had made a determination to impose a civil money penalty in the amount of $329,872.00! CMS reported that Triple-S failed to comply with Medicare requirements related to Part D Formulary and benefit administration. Triple-S has the right to Appeal CMS decision. Last up..... is Tufts Health Plan, Inc. CMS sent notice to Mr. Thomas Crosswell, President and CEO of Tufts Health Plan, Inc., to advise them of CMS' determination to impose a Civil Money Penalty in the amount of $28,302.00. CMS Auditors reported that Tufts failed to comply with Medicare requirements related to Part D Formulary and benefit administration and coverage determinations, appeals, and grievances in violations of Medicare regulations. Tufts has the right to Appeal CMS' decision. If YOU are unhappy with any of the three Medicare Advantage Plan Sponsors, give Medicare a call. You can request a "Special Election Period," based on your experience with any of these companies. Call Medicare at 800 - 633 - 4227 24hrs a day, 7 days a week. www.TheMedicareNation.com Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!
Transcribe →CMS SLAPS Humana With Hefty Civil Money Penalty
May 29, 202000:26:47Tap to summarizeHey Medicare Nation! Medicare Nation CMS Imposes a Civil Money Penalty against HUMANA! CMS conducted an "Audit" of Humana's Medicare Operations from June 3, 2019 through June 21, 2019. Humana failed to comply with Medicare requirements related to Part D formulary and benefit administration and coverage derterminations, appeals, and grievances in violation of 42 C.F.R. Part 423, Subparts C and M. Humana's failures in these areas were systemic and adversely affected, or had the substantial likelihood of adversely affecting, enrollees. CMS provided notice to Humana's CEO, Mr. Bruce Broussard, on February 28, 2020, that CMS imposed a Civil Money Penalty in the amount of ........ $257, 262! Humana failed to properly administer the CMS "transition" policy. This means if you are enrolling in a new plan, and you take a prescription that is NOT on the new plan's formulary (drug list), the plan MUST allow you to "transition" by allowing you a 31 day supply of your prescription drug. This allows you time to speak with your doctor to see if there is an alternative prescription drug on the new plan ...... or...... you can request a "Formulary Exception." This means your doctor is requiring you to take this medication, because it is the one that is stablizing or correcting your condition, and that you need to continue to take it. If the drug is NOT on the new plan's formulary and they Approve the formulary exception, you WILL be charged a higher amount for taking a drug that is not on their formulary. Humana has the right to appeal the decision by requesting a hearing. The notice is signed by John Scott, Acting Director of the Medicare Parts C and D Oversight and Enforcement Group. Medicare Nation NEXT CMS Penalty is given notice to......... SOLIS Health Plans out of Miami, Florida On December 4, 2019, CMS gave notice to Mr. Daniel Hernandez - CEO of Solis Health Plans. CMS imposed a CIVIL MONEY PENALTY of $41,552.00! CMS stated in their summary that Agents employed by SOLIS engaged in an aggressive marketing campaign that was conducted by a contractor provider clinic. Solis Agents conducted a marketing presentation in a secluded area and enroll patients upon conclusion of the presentation. CMS determined that Solis violated the communication and marketing requirements, which had the substantial likelihood of adversely affecting its enrollees. Solis Failed to oversee and manage the marketing process to ensure its agents and brokers did not engage in inappropriate marketing practices including "misleading" beneficiaries. Solis may request a hearing to appeal CMS's determination. Both notices are signed by John Scott, acting director of the Medicare parts C and D Oversight and Enforcement Group. Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels
Transcribe →CMS Imposes BIG Sanctions on Delaware Life Ins. Company
May 15, 202000:18:55Tap to summarizeHey Medicare Nation! Medicare Nation Today, I'm informing you about The Centers For Medicare & Medicaid Services Notice, given to Mr. Art Carlos, CEO of Delaware Life Insurance Company. In a notice dated January 31, 2020, CMS notified Mr. Carlos that they were immediately imposing Intermediate "Sanctions" against Delaware Life Insurance Company. CMS determined that Delaware Life Insurance Company is "in substantial violation of Medicare Advantage and Prescription Drug Plan requirements." SIX specific violations were listed in the notice to Carlos. LISTEN to the episode to learn about the violations and what you can do if YOU are a beneficiary under one of Delaware Life Insurance Company's Medicare Advantage Plan or Prescription Drug Plan. www.TheMedicareNation.com Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels Medicare Consultant
Transcribe →How Much Does it Cost For COVID19 Services Under Medicare?
Apr 10, 202000:22:26Tap to summarizeHey Medicare Nation! www.TheMedicareNation.com Medicare has taken many steps to assist you during the COVID-19 crisis. Coronavirus tests Medicare Part B (Medical Insurance) covers a test to see if you have coronavirus (officially called COVID-19). This test is covered when your doctor or other health care provider orders the test. I spoke about testing for COVID-19 in the previous episode, dated April 1, 2020. Listen to episode 101 to learn more about COVID-19 Testing. Your costs in Original Medicare for COVID-19 Testing. You pay nothing for this test. NADA! This includes the newly available COVID-19 "Antibody" test, which determines if you have antibodies in your blood, that were created to recognize the COVID-19 Virus in your body. Hospitalization Medicare covers All medically necessary hospitalizations. This includes if you're diagnosed with COVID-19 and might have been discharged from the hospital after an inpatient stay, but……. instead you need to stay in the hospital under quarantine. Your costs in Original Medicare ZERO! 3 VACCINE FOR COVID-19 At this time, there's no vaccine for COVID-19. However, If and when one becomes available, it will be covered by all MEDICARE Prescription Drug plans - Which is Part D of Medicare. TELEHEALTH SERVICES During the National Emergency for COVID-19, you will be able to receive a specific set of services through telehealth These services include: Evaluation and management visits (common office visits), mental health counseling and preventive health screenings without a copayment if you have Original Medicare. Your costs in Original Medicare $0 Co-Pay if you have Original Medicare. You can use your smart phone or computer to access Telehealth services. 5. Virtual check-ins virtual check-ins (also called "brief communication technology-based services") with your doctors and certain other practitioners. What is it ? Virtual check-ins allow you to talk to your doctor or certain other practitioners, like nurse practitioners or physician assistants, using a device like your phone, integrated audio/video system on your laptop or computer, or captured video image without going to the doctor's office. Your doctor or other practitioner can respond to you using: Phone Audio/visit Secure text messages Email Use of a patient portal Virtual Check-Ins can be used for treatment for the Coronavirus from ANYWHERE……including places of residences….HOMES. Nursing Homes, AND Assisted Living Facilities. Things to know You must talk to your doctor or other practitioner to start these types of visits. The communication must not be related to a medical visit within the past 7 days and must not lead to the medical visit within the next 24 hours (or the soonest appointment available). You must verbally consent to the virtual check-in, and your consent must be documented in your medical record. Since January 1, 2020 your doctor may obtain a single consent for a year's worth of these services. Your costs in Original Medicare Normally, you would pay for "Virtual Visits" under Part B of Medicare. During the National Emergency, your co-insurance and deductible will be waived, and you will have "No Co-insurance, or deductible" for Virtual Visits for COVID-19 services. Certain Skilled Nursing Facility Care requirements have been waived during the National Emergency for COVID-19. During the COVID-19 Pandemic, some people may be able to get renewed SNF coverage without first having to start a new benefit period. Original Medicare covers up to "100 consecutive days" in a Skilled Nursing Facility." For each benefit stay. During the National Emergency for COVID-19, your Doctor may request an extension of days for your benefit period. If you're not able to be in your home during the COVID-19 pandemic or are otherwise affected by the pandemic, you can get SNF care without a qualifying hospital stay. if you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Many plans offer additional telehealth benefits beyond the ones described above and many plans have waived Hospital co-pays during the pandemic. Check with your plan about your coverage and costs for ALL services covered for COVID-19. Review your Summary of Benefit Booklet for 2020 from your Medicare Advantage Plan Carrier. Don't have one……… Go to the plan's website to download a digital copy. OR…… Call the Customer Service number on the back of your Identification card and ask them to mail you a "Formulary" for your Specific plan. Preparing for healthcare needs Be sure you have over-the-counter medicines and medical supplies like tissues….cough drops…. Tylenol…etc. to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home. Have enough household items and groceries on hand…..Soup, Macaroni and Cheese, Bread for Toast…. Whatever it is you will eat & drink when you're sick….so that you'll be prepared to stay at home for a period of time. Check out the following websites for updates on COVID-19 Centers for Disease and Control - CDC.gov ….. has the latest public health and safety information from the CDC and for the medical and health provider community on COVID-19. USA.gov - has the latest information about what the U.S. Government is doing in response to COVID-19. CoronaVirus.gov - is the source for the latest information about COVID-19 prevention, symptoms, and answers to frequent questions. Visit your State Department of Health for local COVID-19 Information about YOUR State. You can search on Google for your State's Health Dept. by typing in ……… NY State Health Depart……… CA State Health Dept……..Florida State Health Depart…… Visit my website for a LIST of EVERY State Health Department's Phone Number…… By going to www.TheMedicareNation.com/COVID19 Many of you are turning 65 and have no idea what to do to enroll in Medicare or what Plan to enroll in. I invite you to contact me….. so that I can assist you with all this. Send me your question to Support@TheMedicareNation.com I answer ALL emails myself! No Assistants, NO Virtual Assistants….. I do! I will answer your question in one paragraph. If I cannot, I will let you know how to contact me if you wish to reach out to me for a consultation. Until next time……. Practice Social Distancing…..Do things to Make you Happy……. AND Stay Healthy!! Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would lik...
Transcribe →COVID19 Update: Testing, Phone Numbers & 50 State Status
Apr 1, 202000:28:23Tap to summarizeHey Medicare Nation! www.TheMedicareNation.com It's April 1st and over One Million People have been diagnosed with the COVID-19 Virus Worldwide! On this week's episode….. I provide a time-line of the events of the Pandemic as well as updates on COVID-19 testing and Important phone numbers should you have symptoms or questions about COVID-19. I also have a "list" of phone numbers, for EACH Health Department in All 50 States! You can email me at Support@TheMedicareNation.com for the list or check the show notes for an attachment. Here is an important phone number for the CDC HOTLINE on COVID-19 800 -232- 4636 - CDC Hotline Advent Health 24hr Hotline - 877 – 847 – 8747 You can also download the Advent Health App on iTunes or Google Play in order to have a "Virtual" visit with an Advent Health Doctor. Bay Care Virtual Doctor Hotline - 800 – 229 – 2273 You can also go to this website for a "virtual" visit with a Bay Care Doctor – www.BayCareAnywhere.org The Florida Department of Health Hotline is 866 – 779 – 6121 State Health Department List of Phone Numbers Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Contact Me! Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening!
Transcribe →Where Do I Go To Get Tested For The Corona Virus?
Mar 13, 202000:31:05Tap to summarizeHey Medicare Nation! We're smack in the middle of a Corona Virus Pandemic! The Medicare Nation I wanted to give you an episode that is full of USEFULL information. I know you've been hammered by the news, internet and newspapers about the Corona Virus. Let's start with a very important fact: Human coronaviruses were first identified in the mid-1960s. The 1960's people! the coronavirus gets its name from a distinctive corona or in a scientists world…a "Crown of Sugary Proteins," that projects from the surface of the virus. There are four main types of Human Corona Viruses Alphacoronavirus, Betacoronavirus, Gammacoronavirus, and Deltacoronavirus. The first two only infect mammals, including bats, pigs, cats, and humans. Gammacoronavirus mostly infects birds such as poultry (chickens) and Deltacoronavirus can infect both birds and mammals. Do you recognize the Virus named SARS? Severe acute respiratory syndrome abbreviated as …. (SARS-CoV) SARS-CoV (the beta coronavirus. Guess what it causes? It causes severe… acute…..respiratory syndrome, SARS was first recognized as a distinct strain of coronavirus in 2002. The source of the virus has never been clear, though the first human infections can be traced back to the Chinese province of Guangdong in November of 2002. The virus then became a pandemic, causing more than 8,000 infections of an influenza-like disease in 26 countries with close to 800 deaths. In the United States, only eight persons were laboratory-confirmed as SARS cases. There were NO SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring. By July of 2003….. the World Health Organization declared the outbreak over. On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China. The new name of this disease is….SARS-COV-2 aka coronavirus disease 2019, abbreviated as COVID-19. 'CO' stands for 'corona,' 'VI' for 'virus,' and 'D' for disease. The Medicare Nation COVID-19 is a new disease, caused by a novel (or new) "coronavirus" or strain of "Corona Virus" that has not previously been seen in humans. What are the Symptoms of COVID-19? The CDC (Centers of Disease Control) have listed these as the most common symptoms of COVID-19: Fever Cough Shortness of breath Symptoms may appear 2-14 days after exposure. Reported illnesses have ranged from mild symptoms….like a dry cough…. to severe illness, with high fever and shortness of breath, requiring hospitalization and there have been deaths reported for confirmed coronavirus disease 2019 (COVID-19) cases. Currently……according to the WHO… as of March 13th….there are over 132, 758 reported cases of COVID-19 …. Worldwide. Of those cases….. there are 4,955 Deaths worldwide. Over 80% of the reported cases are recovering. In the U.S…… there are currently 1,629 reported cases…… in 47 of the 50 States. No reported cases yet….in Idaho, Alabama and West Virginia. There have been 41 Deaths reported in the U.S. ….. with 37 Deaths coming from the State of Washington. The deaths mainly being reported from a nursing facility, with those being elderly and having underlying medical conditions prior to contracting the CoronaVirus. What do we mean by Underlying medical conditions???? If you have a blood disorder.... like sickle cell disease... or ... you have chronic kidney disease.... you're currently receiving chemotherapy or radiation. You may have congestive heart failure or coronary artery disease. You may have chronic asthma or chronic obstructive pulmonary disease or you may need oxygen at home. All of these conditions..... as well as many more..... may raise your risk of contracting COVID-19. You may NOT contract the virus. Just be more cognizant of your surroundings and who you are in contact with. What do you do if you believe you have symptoms of the COVID-19? NUMBER 1…. Call your Primary Doctor. Speak with the Nurse or Physician's Assistant. Tell them your symptoms and they will advise you of what to do. IF You CANT get Through to your Doctor……. If you have a Medicare Advantage Plan…… the Plan most likely has a 24 hr. Nurse's Line. CALL THEM!! Tell the nurse your symptoms. They will advise you. Call your STATE Health Department for Advise. Each State has an information line dedicated to the COVID-19 Crisis and will be able to assist you with answering question. If you have any severe symptoms….. as in Difficulty Breathing, fluid in your lungs, High fever of over 104 degrees…. CALL 911! If you do have symptoms, and your doctor wants you to have the test to confirm COVID-19…. Where do you go?? According to the FDA….. here is the current list of laboratories across the U.S. that will be offering testing for the COVID-19 very soon Advent Health Laboratories Lab Corp Quest Laboratories As well as many other public health, university and private labs will be available on the FDA list of laboratories to test for the COVID-19. Medicare IS Covering the Test for COVID-19 as a Preventative Diagnostic Test….and therefore ….. you will have NO COPAY when you take the test. There are currently TWO Testing Codes for the COVID-19 Test Is for having the Test at a Public Health Lab ( your local community Health Department) which is U0001 The 2nd is for having the test at a commercial or private lab (like Lab Corp) which is U0002. If you are diagnosed with COVID-19, self-quarantine yourself in your home, away from your family members and pets, until you have tested negative. We ALL need to SELF-Police ourselves and HELP STOP the Spread of COVID-19….. so we can curtail the spread and help stop the pandemic. Remember to Drink lots of fluids….. eat plenty of chicken soup and crackers ….. and get lots of REST!! The Medicare Nation You can go to the Center for Disease Control website for daily updates on the Corona Virus 19 situation ….. go to….. www.CDC.gov You can also go to the World Health Organization website…. Go to …. www.who.int AND…. PLEASE go to your STATE"S Health Department website for local information by "Googling" your State. That's all for today Nation. Call your Parents….. Make sure they're ok and help them subscribe to Medicare Nation…. So they can hear this episode as well as over 100 other episodes about Medicare and it's Resources. Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks aga...
Transcribe →Medicare NOW Covers Acupuncture
Jan 24, 202000:16:38Tap to summarizeHey Medicare Nation! www.TheMedicareNation.com It's still January...but February is right around the corner. Spring WILL come. I promise! Let me give you some good news! Medicare is now covering Acupuncture! As of January 21, 2020, The Center for Medicare & Medicaid Services (CMS), will cover acupuncture for "Chronic Low Back Pain." Let's look at the coverage in the Medicare National Coverage Determination Manual. Section 1862(a)(1)(A) of the Social Security Act Up to "12" visits in 90 days are covered for Medicare Beneficiaries under the following circumstances: a. Chronic Low Back Pain which lasts "12 weeks or longer," b. the Chronic Low Back Pain is "non-specific," in that it has NO identifiable systemic cause (NOT associated with metastatic, inflammatory, infectious, disease). c. the Chronic Low Back Pain is NOT associated with surgery d. the Chronic Low Back Pain is NOT associated with pregnancy. An ADDITIONAL "Eight" (8) sessions WILL be covered for those patients demonstrating an improvement. No more than "20" acupuncture treatments may be administered annually. Treatment MUST be discontinued if the patient is NOT improving or is regressing. The Acupuncture must be Administered under the supervision of a doctor of medicine or osteopathy. Need more information? Check out our website www.TheMedicareNation.com What plans cover Acupuncture? Acupuncture for Chronic Low Back Pain, will be covered under ORIGINAL Medicare. If you present your Medicare ID Card to providers as your Health Insurance..... You may start utilizing this treatment now. If you present your Medicare ID Card, as well as a Medi-Gap (Medicare Supplement) Plan..... You may start utilizing this treatment now. If you have a Medicare Advantage Plan, you need to check your Summary of Benefits Book under your plan, to see if they cover Acupuncture. If you can't find it.... call the customer service number on the back of your ID Card and ask the representative. Acupuncture is NOT covered under Medicare Part D. Part D is ONLY for Prescription Drug Coverage. If you have any questions.... send them to Support@TheMedicareNation.com Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels Medicare Consultant Support@TheMedicareNation.com
Transcribe →Unhappy With Your Medicare Advantage Plan? Change it Now!
Jan 3, 202000:13:34Tap to summarizeHey Medicare Nation! www.TheMedicareNation.com It's 2020! Love the sound of that! Right now...... the Medicare Advantage Open Enrollment Period is in full swing. If you are on a "Medicare Advantage Plan," you have the opportunity to make a ONE TIME change, between January 1st through March 31st. You can change from one Medicare Advantage Plan to another Medicare Advantage Plan. You can "disenroll" from the Medicare Advantage Plan you're on and go back onto "Original Medicare." With Original Medicare, you can add a stand-alone-prescription drug plan and ..... you can enroll into a Medicare Supplement Plan (aka Medi-gap) to help defray the costs of Original Medicare. Here are options you can do during the Medicare Advantage Open Enrollment Period: Change from a Medicare Advantage Plan back to Original Medicare. Switch from one Medicare Advantage Plan to another Medicare Advantage Plan. Switch from a Medicare Advantage Plan that doesn't offer drug coverage to a Medicare Advantage Plan that offers drug coverage. Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn't offer drug coverage. Join a Medicare Prescription Drug Plan. Switch from one Medicare drug plan to another Medicare drug plan. Drop your Medicare prescription drug coverage completely I'm adding the EXACT language from the Medicare Managed Manual, regarding the Medicare Advantage Open Enrollment Period. 30.5 – Medicare Advantage Open Enrollment Period (MA OEP) 42 CFR 422.62(a)(3) (Rev. 1, Issued: July 31, 2018; Effective/Implementation: 01-01-2019) During the MA OEP, MA plan enrollees may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during the MA OEP. This chart outlines who can use the MA OEP and when: Who can use the MA OEP: MA OEP occurs: Individuals enrolled in MA plans as of January 1 – March 31 New Medicare beneficiaries who are enrolled in an MA plan during their ICEP The month of entitlement to Part A and Part B – the last day of the 3rd month of entitlement Individuals may add or drop Part D coverage during the MA OEP. Individuals enrolled in either MAPD or MA-only plans can switch to: • MA-PD • MA-only • Original Medicare (with or without a stand-alone Part D plan) The effective date for an MA OEP election is the first of the month following receipt of the enrollment request. NOTE: The MA OEP does not provide an opportunity for an individual enrolled in Original Medicare to join a MA plan. It also does not allow for Part D changes for individuals enrolled in Original Medicare, including those enrolled in stand-alone Part D plans. The MA OEP is not available for those enrolled in Medicare Savings Accounts or other Medicare health plan types (such as cost plans or PACE). You may also go onto Medicare.gov to view information on the Medicare Advantage Open Enrollment Period. If you decide to make a change during the MA OEP, you will be "locked-in" to the new plan, until the next enrollment period.... which is....the Annual Enrollment Period, from October 15th through December 7th. You may also make a change to your plan if you have a "special circumstance." These are listed under the "Special Election Periods" for Medicare on Medicare.gov You can also LISTEN to my previous show on Special Election Periods..... Episode 051, which was published on July 29, 2016. The episode is titled..... "Special Election Period Q & A" I go into detail about the Special Elections available. www.TheMedicareNation.com Remember Medicare Nation listeners........ an "Insurance Agent," is NOT allowed to "solicit" you during the Medicare Advantage Open Enrollment Period. There are strict Medicare regulations regarding this. YOU must make the first move in contacting or telling your "Agent" or Medicare Specialist, that you are unhappy with your current plan. No one should be calling you, texting you, emailing you ..... or worse...... knocking on your door, telling you about the Open Enrollment Period. If someone does...... tell them to "Take a Hike!" You don't need a dishonest person like that helping you with your Medicare needs! If you need help finding a new plan during the OEP, contact you're Medicare Advisor. If you are all set with your Medicare Advantage Plan for 2020, You don't need to do anything! Just enjoy your family, friends and activities! Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Contact me on my website - www.TheMedicareNation.com Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels Medicare Consultant Medicare Nation LLC.
Transcribe →2020 Medicare Changes Announced!
Nov 9, 201900:21:44Tap to summarizeHey Medicare Nation! CMS just announced the 2020 Medicare Part B Premium increase! CMS also announced 2020 Part A Deductible and co-pays, as well as the Part B annual deductible. Here's a look at what's changing in 2020: Medicare premiums, deductibles, and co-payment amounts are adjusted each year in accordance with the Soc Sec Act. SOCIAL SECURITY Increase: 1.6% (Avg $24 more a month) Average Monthly SS Check $1,503.00 2020 - PART A DEDUCTIBLE AND COINSURANCE Inpatient Hospital Deductible: $1408.00 Daily Coinsurance Days 61-90: $ 352.00 Daily Coinsurance-Lifetime Reserve: $ 704.00 Skilled Nursing Facility-Days 21-100: $ 176.00 2020 - PART B PREMIUM AND ANNUAL DEDUCTIBLE Standard Monthly Premium: $ 144.60 ($9.00 More) Annual Deductible: $ 198.00 It's a great time to review your plan for 2020. Is it the right plan to fit your unique needs? If so........ keep it! If not....... change it! I am available to assist you with your Medicare Plan choices for 2020. If I can answer your email in one paragraph or less, I WILL answer your question for you! If the answer to your question requires any research or my response is longer than one paragraph..... I will let you know that you will need to hire me to answer that question. If you live outside of Florida, you can hire me as your consultant at a rate of $200.00 an hour ( The hourly rate is going up to $250.00 an hour, starting January 1 2020). If you are a Florida resident, I can assist you in enrolling into the plan that fit's your unique needs at no additional charge. I will receive a commission from the insurance carrier once you are enrolled. The commission is regulated by Medicare. The Annual Enrollment Period ends December 7th, so make sure you do your "due dilligence" and find the plan that works for you! Until next time..... Have a Happy, peaceful & prosperous week! Diane Daniels Medicare Consultant 855-855-7266
Transcribe →Part D Prescription Drug Plan Info For 2020
Oct 4, 201900:34:05Tap to summarizeHey Medicare Nation! www.TheMedicareNation.com It's October! That means it's Medicare Time! The Annual Enrollment Period is just around the corner. Did you receive your "Annual Notice of Changes (ANOC)" for your Medicare Advantage Plan or Prescription Drug Plan? If not....contact your plan and request the ANOC. Today......I want to talk with you about Part D Prescription Drug Coverage for 2020! Medicare has set the maximum Part D Deductible for 2020 at $435.00. Medicare Advantage Plans and Stand-Alone Prescription Drug Plans have the option to charge the maximum deductible amount of $435.00...... or....... They can eliminate the Deductible altogether.... or...... They can charge an amount in between. You MUST do your "Due Dilligence" in determining which Prescription Drug Plan will fit your unique needs for 2020. Contact your Medicare Specialist and request their assistance in finding a Prescription Drug Plan for 2020. If you have a question about Medicare or your Prescription Drug Plan.... You can send me an email to Support@TheMedicareNation.com If I can answer your question in ONE Paragraph, I will answer your question! If I cannot ...... I will request you hire me as your consultant. I currently charge $199.00 an hour for my consultation services. I always do my best to answer your questions in ONE paragraph. The "initial coverage period (ICP)" for Part D, has a threshold of $4,020.00 When you hand in a prescription, the total amount of the prescription is applied towards the ICP. If you have a Deductible, that is applied towards the ICP too. When the total amount of your prescriptions reaches $4,020.00..... you will now enter a new phase called the "coverage gap." In this stage.... you will now pay 25% of generic drugs.... and you will pay 25% of brand name drugs. If you reach $5,018.75 you will enter the next stage, which is called.... The "Catastrophic Stage." In the Catastrophic Stage, you will now pay a 5% co-insurance or $3.60 for Generic Drugs..... or.... $8.95 for Brand or non-preferred Drugs.... which ever is a greater amount. You will remain in the Catastrophic Stage until your out-of-pocket spending reaches $6,350 or..... when the ball drops on New Year's Eve! I know prescription drugs can be very expensive! There are programs available for those of you with lower incomes. The program is called "Extra Help," or "Low Income Subsidy." To apply for Extra Help, go to the social security website - www.socialsecurity.gov/extrahelp If your individual income is less than $1,562 a month, you would qualify for the LIS program. If your income is more than $1,562 a month, but is less than $1,900 a month....APPLY! You have nothing to lose! All they can say is No! You can also appy for the "Medicare Savings Program" If you qualify, CMS will pay for your Medicare Part B Premium. Depending on your qualifications, CMS may pay your premium, deductible and co-insurance. Apply for the Medicare Savings Program here: https://www.medicare.gov/Contacts/#resources/msps Thank you for listening to Medicare Nation! If you are part of my "Sandwich Generation," Share this show with your parents and/or grandparents. They have many questions about Medicare and this show will answer them! Buy them a "Smart Phone," and introduce them to Medicare Nation! If you are a Baby Boomer, share Medicare Nation with other "Baby Boomers." I want to educate as many of you as I can about Medicare! I certainly can use your help in putting the word out! If you have any questions, send them to Support@TheMedicareNation.com If I can answer it in one email - I will personally answer you! If your question requires research or additional contact with you, I do offer consulting if you would like me to assist you in that manner. Want to hear a topic on Medicare Nation? A special guest? Let me know and I'll do my best to get them on the show! Thanks again for listening! Diane Daniels
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