Crystal Manning Medicare Advisor

A new prescription drug law that went into effect January 1, 2023 will help save money for people with Medicare. This law improves access to affordable treatments and strengthens the Medicare program.In addition, several changes to improve the way Medicare beneficiaries can access behavioral health care will take effect in 2023. Changes could also be coming to telehealth.Beginning in 2023, under a provision in the Inflation Reduction Act, Part D enrollees will pay no more than $35 per month for covered insulin products in all Part D plans, and will pay no cost sharing for adult vaccines covered under Part D.Under the provision, copays for a 30-day supply of any insulin that a Medicare drug plan covers will be capped at $35. Enrollees wont have to pay more than $35 even if they have not yet met their annual Part D deductible. Note that not every plan covers every type of insulin.Also under the new law, vaccines recommended for adults which are covered under Part B are already free to Medicare enrollees. Others are covered by Part D prescription drug plans and require beneficiaries to pay some of the cost. These include shots for the flu, pneumonia, COVID-19 (initial shots and boosters) and hepatitis B for some enrollees are free under Part B and that coverage will continue in 2023. Part B also covers vaccines needed to treat certain injuries or exposure to a disease. Those include hepatitis A, rabies, and tetanus.Other vaccines, most notably the two-dose Shingrix which guards against shingles, are covered under Part D prescription drug plans but may require cost sharing depending on the plan. Shingrix, for example, can run as much as $200 a dose.Another provision of the new law that will be fully effective in 2023 requires pharmaceutical manufacturers to pay a rebate to Medicare if they raise prices of their drugs more than the rate of general inflation.I am an independent Medicare Advisor who works for you, not an insurance company. Editors Note:  This article was written by Crystal Manning, Licensed Medicare Advisor.  If you would like my consult at no cost to you, please contact me by phone at 412-716-4942 or by email at crystalmanning33@gmail.com

If you are already 65 or approaching that age and remain employed and eligible for your employers health insurance coverage, you should not ignore the potential opportunities of Medicare coverage. The following are four potentially serious mistakes thatmany boomers should be cautious of when they become Medicare eligible.Missed Opportunity. You have a seven-month window to sign up- three months before your 65th birthday, the month of your birthday and three months after - so it is critical to get the timing right. Signing up in hopes of getting coverage early does not work and signing up late - even though you are still working - may result in financial penalties, which do not disappear.Electing COBRA coverage. Another mistake is taking COBRA (Consolidated Omnibus Budget Reconciliation Act) and not signing up for Medicare Part B. If you are 65 or older when you leave your employer and your employer offers you the opportunity to keep your health insurance through COBRA, chances are you should say no thanks. This applies even if your employer offers to pay your health coverage once you retire.Choosing Medicare Advantage because it seems easier. Medicare Advantage plans offer all-in-one options that are very similar to the health care coverage many people maintained while employed. However, traditional Medicare coverage with a Medigap supplemental plan and Medicare Part D prescription drug insurance while seemingly more complex, is likely the better choice for someone with a chronic medical condition or a serious illness.Failure to shop for coverage. For most people, their first Medigapchoice is their lasting choice because their options diminish once the initial selection is made. Aside from the initial Medicare eligibility age of 65, every year thereafter during the Medicare open enrollment period beginning October 15th through December 7th, you will have the opportunity to change Medicare Advantage plans. Its the enrollees decision and you may decide to make that an annual exercise. Before you enroll in any Medicare plan, carefully review your options.Whether you are approaching age 65 or have already arrived, seek advice from a licensed advisor that desires to help you with what options work best for you today and in the future.Editors Note: This article was written by Crystal A. Manning, Medicare Advisor. For more information on avoiding the above mistakes contact her directly at (412) 716-4942 or email crystalmanning33@gmail.com. 

Deciding whether to enroll in Medicare is an important decision, so you will want to make sure you are as knowledgeable about this health coverage program before you make it.  You also need to be aware of enrollment requirements and timeframes. If you miss your initial enrollment period, which begins three months before you turn 65 and runs until three months after, then you will need to wait until a general enrollment period opens, unless you qualify for special enrollment. Also, keep in mind that if you fail to sign up for Part B or prescription drug plan (part D) when you first become eligible and do not have an approved exception, you face penalty premiums for each year you do not register.What is Medicare?  Medicare is a federal health insurance program, primarily for people who are 65 years and older. It has four parts, each of which has a distinct intent: Medicare Part A: Covers hospital stays, care in a skilled nursing facility, hospice care and some home health. Deductibles & copays are the patient responsibility. Medicare Part B: Covers certain doctors services, outpatient care, medical supplies, and preventive services. Medicare pays 20% of all covered expenses except for the annual deductible. Medigap: Supplemental coverage for Parts A and B provided by private insurers that in most cases eliminates all copayments, coinsurance, and deductibles. Medicare Part C (also known as Medicare Advantage): Supplemental coverage provided by private insurers that often reduces copayments and coinsurance and may include dental, vision and prescription coverage.- Medicare Part D: Supplemental plans that cover prescription drugs costs for Parts A and B supplemental plans. Prescription coverage is mandated by Medicare. You will incur a penalty if you do not have creditable prescription coverage which remains in effect for as long as you have coverage.Medicare C or Medigap: what are the differences? Now you have Medicare A & B how can you avoid the high copays & deductibles from Medicare? You cannot purchase both Medicare Part C and Medigap. You will need to choose the option that best fits your needs. Here is how they compare:Medicare C (Medicare Advantage) --- (Follow Rules) Lower premiums Higher out-of-pocket costs that vary by plan; each plan has an out-of-pocket maximum. HMO or PPO option: possible limited in-network doctor selection or out-of-network rules. Referral to see specialist often required. Usually only local or regional coverage. Usually includes Medicare Part D as part of the premium. Some include extra coverage for vision, dental and hearing aids and exercise programs.Many Medicare Advantage plans offer zero to various premiums. With more Medicare Advantage plan options being sold by more providers, the increased competition between insurance companies helps keep costs low for consumers. And with more benefits being approved for use, plan providers may gain even greater flexibility with their pricing and coverage offerings.The Affordable Care Act (also known as Obamacare) put an incentive system in place for Medicare Advantage plans. Beginning in 2012, plans that provide high-quality care will receive a bonus or rebate. By law, the bonus money must be reinvested in additional plan benefits. Going forward, Medicare Advantage plan providers will no doubt continue to adapt and improve the quality of the plans they offer to meet these bonus requirements.  In addition to the bonus program, Medicare issues star ratings for all Medicare Advantage plans each year, and these Medicare Star Ratings can be a large point of emphasis for shoppers.  In 2018, Centers for Medicare and Medicaid (CMS) expanded its definition of the primary health-related benefits that insurance companies can include in Medicare Advantage plans.  As a result, new benefits were available to be added to some Medicare Advantage plans.These new benefits may include services such as: Home-delivered meals Air conditioners for people with asthma Transportation to doctors offices Grab bars in home bathrooms If you sign up for Medicare Advantage, review your coverage annually. Coverage, benefits, and costs of Medicare Advantage plans change each year. Reviewing your plan could save you money, help you find a better  coverage fit or both.Medigap (Medicare Supplement Insurance) --- (Peace of Mind) Higher premiums. Usually, Medicare annual deductible, which is $203 in 2021, depending on the plan you choose. Accepted everywhere that Medicare is accepted. Usually, referrals are not required to see a specialist. Generally accepted in every state or U.S. territory and some plans may be accepted internationally when traveling. Medicare Part D must be purchased separately. Coverage for extras must be added through additional plans. Note -- Those who need frequent medical care, or like to budget with fixed costs, often choose Medigap to keep their total medical costs flat.Choosing the right insurance plan is the most important decision you will make for your future health. You need to make some of the most consequential decisions about Medicare at a time when you know the least about Medicare. As a licensed Medicare Advisor, Crystal Manning can assist with many options that are best for you. Contact her at 412-716-4942 or crystalmanning33@gmail.com.

What is Medicares Open Enrollment Period?From Oct. 15 to Dec. 7 each year, its when Medicare beneficiaries can make changes to their Medicare Advantage or Medicare Part D Prescription Drug coverage for the coming year.Why is open enrollment and reviewing my plan so important?Medicare Advantage and Medicare Part D Prescription Drug plans can change each year, meaning the amounts you pay in premiums and deductibles could increase. Insurance carriers also can change their drug formularies, meaning a drug that costs you a few dollars each month could double or triple in price next year if dropped from your carriers formulary. Reviewing your plans is one of the best ways to manage your long-term retirement plan because you can identify any changes that could add up expenses over time, or that could quickly lead to financial hardship. Plus, you could even find a plan with better coverage.Can I change my Medicare Supplement during open enrollment?Yes, if you have a Medicare Supplement plan instead of Medicare Advantage, it can be a good idea to review your plan because Medicare Supplement premiums and plans also can change. However, be advised that switching Medicare Supplement policies could require you to submit to a medical underwriting process that could result in a higher rate or denial based on its findings.Why is an annual review of my Medicare Part D Prescription Drug coverage especially important each year? If you have new medications, have switched medications or your insurance carrier changes its drug formulary, your costs could skyrocket if you dont carefully review your current plan. And switching to a plan because you can save on the monthly premium could be costly, too. The plans with the lowest premiums are not always the better financial choice. The cost of one months worth of one drug thats not on your plans formulary could exceed an entire years worth of your monthly premiums. Many plans now have diabetes prescriptions for $35 even through the coverage gap.I can help simplify your Medicare plan choices and evaluate the right plan for YOU.Editors Note: Crystal A. Manning Licensed Medicare Advisor 412-716-4942 or crystalmanning33@gmail.com

As we approach retirement, one of the greatest concerns is determining the cost of health care, which will likely be your biggest expense during the golden years. Obviously, these costs are a tough number to nail down and one that will vary by person. Since 1966, the governments Medicare program, also known as Medicare Part A and Part B, has helped millions of Americans obtain health care. It includes coverage at the hospital (known as Medicare Part A) and at the doctors office (known as Medicare Part B).Most people dont pay a premium for Medicare Part A, which covers hospital visits. But you will pay monthly premiums for Part B (doctor services and outpatient care), Part D (prescription drugs), and supplemental coverage which may cover the cost for deductibles, co-pays and medications. Some of these premiums may be deducted from your Social Security checks.The premium for Part B is tied to inflation. You may have to pay more if you do not receive Social Security because you receive a government pension, or if your annual income is more than $85,000. The premiums for Part D and supplemental insurance are set by your provider and vary by plan and by where you live. You can expect these to take up a big chunk of your expenses and are big drivers of rising health care costs. Youll still have to pay for some expenses out of pocket. Medicare doesnt cover things like long-term care, or dental and vision insurance. Studies show that Medicare patients satisfaction with their coverage depends on whether they were enrolled in traditional Medicare supplemental plans or in Medicare Advantage plans that are offered by private insurance companies. People with Medicare Advantage plans also were more likely to have trouble affording their medical care than those with traditional Medicare. Health care costs are a major concern in retirement and should be an integral part of your retirement planning.  The role of a Licensed Medicare Advisor is to advise those approaching retirement to understand Medicare coverage and the affordability of comprehensive coverage.   Editors Note:  This article was written by Crystal Manning, Licensed Medicare Advisor.  If you would like my consult at no cost to you, please contact me by phone at 412-716-4942.

Finding affordable medical insurance is a critical part of your retirement planning. Once you're eligible for Medicare at age 65, insurance becomes more affordable, and you cannot be denied coverage for pre-existing conditions. You'll need to plan carefully to make every dollar count.  In some cases, though, you may save money by delaying your enrollment in Medicare Part B. For example, if you currently have employer-sponsored group coverage - either through your or your spouses employment, you would qualify for a special enrollment period (SEP) when you stop working or that health coverage ends (whichever happens first).  If you're becoming eligible for Medicare but you already have insurance, learn whether/how your current plan coordinates with Medicare and whether/how you can delay Medicare enrollment. There are several different kinds of health insurance:Job-based insurance: Insurance offered by an employer or union for current employees. Retiree insurance: Insurance plans that employers may provide to former employees who have retired. Retiree insurance always pays secondary to Medicare.Federal Employee Health Benefits (FEHB): Insurance for current and former government employees and their family members.TRICARE: Insurance provided by the federal government to active duty and retired military personnel and their family members.Veterans Affairs (VA) benefits: Insurance provided by the federal government to veterans.Otherwise, a Medigap plan with a separate prescription plan or a Medicare Advantage plan with Hospital, Medical and prescription coverage are available options. These plans may include additional options such as discount dental and vision, and may also include gym memberships and other benefits, not provided by Medicare.Finally, if you decide to delay enrolling in Medicare, make sure to stop contributing to your HSA at least six months before you do plan to enroll in Medicare to avoid a tax penalty. If you enroll in Medicare Part A and/or B, you can no longer contribute pre-tax dollars to your HSA. This is because to contribute pre-tax dollars to an HSA you cannot have any health insurance other than a High Deductible Health Plan (HDHP).Sometimes it's easiest to talk with an expert. As an independent Licensed Medicare Advisor, I work to help you and not an insurance company.Editors Note: This article was written by Crystal Manning, Licensed Medicare Advisor at 412-716-4942 or email crystalmanning33@gmail.com.