One of the things that sets me apart from other local Independent Insurance Brokers is that I am also a Licensed Nursing Home Administrator or ‘HFA’ in the state of Indiana.  I was responsible for the entirety of the Nursing Home operations in multiple facilities over my 15 years in the industry.  This included overseeing the insurance contracts and ensuring residents on short term rehab stays got the therapy and nursing care needed while also billing all the different Medicare benefit carriers.  This gives me a unique and justified perspective on managing a Rehab stay for Medicare Beneficiaries who have Advantage Plans.  I promise you; it is doable!  I hope that the following points help debunk any myths or negative things you may have heard about Advantage Plans and Nursing Home Rehab! 

Medicare Open Enrollment occurs every year from October 15th through December 7th.  It is an opportunity for all existing Medicare Beneficiaries to make a plan change for the next year.  It is important because drug formularies change, premiums change, and many insurance companies bring new plans to the market with better features and benefits to take advantage of.  However, this is not the only time in the year a change can be made.  It happens to be the most publicized and marketed, but we agents are busy all year long assisting Medicare Beneficiaries with enrollments.  

Each year as we head toward the last quarter of the year, the Center for Medicare/Medicaid Services or ‘CMS’ begins to announce changes to Medicare for the coming year. Sometimes the changes are new regulations put in place by CMS, and sometimes there are changes written and signed into law by the acting government. So, what is coming up for 2023? Here is a sneak peek at the exciting and maybe not-so-exciting changes.

With the market getting very competitive in the Medicare space, there seem to be more cards showing up in the mail once you have selected and enrolled in your plan or plans. The good news is that this is because plans are adding more and more benefits, such as flex spending cards, over-the-counter cards, etc. However, be cautioned about what card or cards you show a provider or front office person. No offense to any administrative staff, but they often do not understand the difference in those cards any more than you do as a beneficiary. If they bill or charge incorrectly, getting everything corrected can be a nightmare. The following tidbits are going to hopefully make your experience smooth!

We all know that Medicare isn’t free…. don’t we? Well, there are two parts to Original Medicare – Part A and Part B. Part A covers Hospital Room and Board, Home Health and Hospice and generally has no premium. HOWEVER, Part B covers medical visits, procedures, and tests, but is not free. Unless you qualify for full Medicaid [State Income Assistance], you will owe a monthly premium for Part B. It is paid directly back to the Social Security Administration. But how much will you pay and why is the amount different for different people? And why are there so many premium changes? Let’s take a deeper dive into this Part B premium!

First of all, let’s back it up! Do you even need to sign up for Medicare? Many folks turning 65 have reached out to me in somewhat of panic, saying they were told they HAD to sign up for Medicare within 3 months of their 65th birthday. They are worried and aren’t sure how to sign up, where to go, and do they need just Part A or will they need Part B and pay a premium. Never fear, CDI is here to clear this up from the beginning of your Medicare benefit window!

When meeting with clients, many questions come up about using Good Rx and how it works with their Medicare Part D prescription drug coverage. While it can be tricky to navigate and understand the difference, using a pharmaceutical assistance program like Good Rx can be very helpful in saving money especially for Seniors on a fixed income! Let’s clarify some of the details to help you make the best use of these products and programs.

When we look at Medicare Creditable Coverage, we are really looking at how to avoid more penalties as it relates to Medicare. Unfortunately, the system allows for so many minor missteps and pitfalls that most folks are not aware of, nor does Medicare adequately inform or educate people on. The consequence of not having Creditable Coverage for a period of time is a lifetime of financial penalties for Medicare. This again is where your good local Independent Agent comes in. Our job is to constantly research and understand all the potential hazards related to creditable coverage and educate you on how to avoid them. Insert here your local rockstar agent……