Medicare Blog2024-08-22T16:51:10-05:00

Medicare Blog

Medicare Information in Nebraska

Dept of Health & Human Services Final Rule on Medicare Prior Authorization: A Tool

Prior authorization has arisen as an issue for Medicare Advantage Organizations (MAO)—insurance companies—and Medicaid--states. According to consumer claims, consumers are denied needed coverage unnecessarily.  You can imagine the pain and hardship this causes.  What if there was a Medicare prior authorization tool providers, insurance companies, and patients could use to communicate with one another?   Congress recently conducted hearings on [...]

Does Traditional Medicare Require Prior Authorization?

People ask, what is the difference between Traditional Medicare (only Part A & Part B) and Medicare Advantage (or Part C)?  Traditional Medicare does not require prior authorization. Prior Authorization Contains Cost Medicare Advantage is managed healthcare, similar to your health insurance policies under an employer health plan. A tool that managed healthcare uses is prior authorization to contain costs. [...]

Categories: Medicare|

Does Medicare Advantage Require Prior Authorization?

Are you considering enrolling in a Medicare Advantage plan?  Before making a decision, it’s crucial to understand the coverage options and potential limitations.  One common concern is whether Medicare Advantage plans can deny coverage because they require prior authorization. Medicare Advantage plans, or Medicare Part C, are offered by private insurance companies approved by Medicare.  These plans provide all the [...]

Medicare Payment for 2024: How to set it up

Over the years, the process I use to introduce clients to Medicare and Medicare insurance has evolved. This evolution has been based on my personal and professional growth. The process has evolved chiefly because Medicare and insurance companies have evolved. Clients and their needs change and evolve as well. Paying for Medicare is one of those changes. So, how do [...]

How Medicare Covers Ozempic for Weight Loss

Finding effective solutions to manage weight loss can sometimes feel like searching for a needle in a haystack. But what if there was a medication that could help you on your journey? Enter Ozempic, a breakthrough drug making waves in the weight loss community. Does Medicare cover Ozempic for weight loss? In this article, we will explore how Medicare may [...]

Categories: Medicare Part D, Prescription Drugs|

Medicare Advantage Prior Authorization: Everything You Need to Know

Are you feeling lost and confused about Medicare Advantage prior authorization? You're not alone. Navigating the healthcare system can be overwhelming, especially regarding insurance processes. But fear not—we are here to demystify it all for you.This comprehensive guide will delve into everything you need to know about Medicare Advantage prior authorization. From understanding what it is, why it's necessary to [...]

IRS Exceptions for Medicare IRMAA: Reduce Medicare Costs Now!

Are you in the lucky top 4% of earners? You will pay more for your Medicare benefits.  The more is IRMAA (Income-Related Monthly Adjustment Amount).  The amount you pay for your Medicare health and prescription drug coverage depends on your level of income.  There is a ladder. Would you like to avoid paying that tax or possibly pay a smaller [...]

Medicare Cancer Drug Coverage: Navigating the Implications for Affordability and Access

With the rising prevalence of cancer diagnoses, obtaining affordable and accessible cancer drug coverage with Medicare is critical for patients.  Medicare, the government health insurance program primarily for individuals age 65 and older, is vital in ensuring that cancer treatments are financially attainable.  Many of my clients will call me when they receive a diagnosis of cancer.  As you can [...]

Categories: Cancer Treatment, Medicare|

Find A Trustworthy Medicare Advantage Insurance Agents Near Me

Are you searching for a trustworthy Medicare Advantage plan insurance agent near you? Look no further! In this article, we will provide you with key tips and insights to help you find the right agent to meet your healthcare needs. Medicare Advantage plans offer additional benefits beyond the basic coverage of Original Medicare.  Choosing the right plan can be overwhelming. [...]

Exploring Medicare Advantage in My Area: Uncover the Benefits

Are you ready to unlock the potential benefits of Medicare Advantage in your area? Look no further. This informative article will explore the advantages of Medicare Advantage plans and how they can enhance your healthcare coverage. Medicare Advantage, also known as Medicare Part C, goes beyond what Original Medicare provides. With a Medicare Advantage plan, you can enjoy additional benefits [...]

Categories: Medicare Advantage Plans, Omaha|

Get the Most out of Medicare: Unleashing the Power of a Medicare Supplement Quoting Tool

Are you trying to navigate the complex world of Medicare but overwhelmed by the sheer number of options available? Enter the Medicare supplement quoting tool – your secret weapon to unlocking the power of Medicare. This article will explore how this innovative tool can help you get the most out of your Medicare coverage. A Medicare supplement quoting tool effortlessly [...]

Unlocking the Secrets of Medicare Supplement Underwriting: A Comprehensive Cheat Sheet

Are you struggling to understand the intricacies of Medicare supplement underwriting? You're not alone. Navigating the insurance world can be daunting, but fear not - we've got you covered. In this medicare supplement underwriting cheat sheet, we'll unlock the secrets of insurance underwriting for Medigap policies. We'll make it easier for you to understand and find the coverage that meets [...]

Categories: Medicare Supplement Underwriting|

Maximizing Your Healthcare Coverage: Medicare Advantage Part C Benefits Explained

Are you looking to maximize your healthcare coverage? In this article, we will explain the benefits of Medicare Advantage Part C, helping you make informed decisions about your healthcare options. Medicare Advantage Part C offers an alternative to traditional Medicare coverage, providing additional benefits and services to enhance your overall healthcare experience.  With Medicare Advantage Part C, you can enjoy [...]

Categories: Medicare Advantage Plans|

The Ultimate Medicare Plan Comparisons Chart: Choosing the Best Plan for Your Needs

Is it overwhelming to choose the best Medicare plan for your needs? With so many options available, it’s understandable. But worry not because we have your ultimate solution – the Medicare Plan Comparisons Chart.   The best way to compare is side-by-side.  We can see each relevant benefit or cost in chart form and compare apples to apples. There is still a [...]

Categories: Medicare Advantage Plans|

Demystifying Medicare Part D Health Plans: Everything You Need to Know

Are you confused about Medicare Part D health plans? Don’t worry, you’re not alone. Understanding your options can be overwhelming with all the jargon and complex rules. That’s why we’re here to demystify everything for you.  Whether you’re new to Medicare or have been enrolled for years, this article is designed to help you understand the key aspects of Part [...]

Categories: Medicare Part D, Prescription Drugs|

Unlocking the Benefits: Does Medicare Part D Cover Xarelto?

Are you wondering if your Medicare Part D plan covers Xarelto? Well, you’re in the right place! This article will unlock the benefits and examine whether Medicare Part D pays for Xarelto. Xarelto is a widely prescribed anticoagulant medication used to prevent blood clots. It is commonly prescribed for conditions such as atrial fibrillation, deep vein thrombosis, and pulmonary embolism. [...]

Categories: Medicare Part D, Prescription Drugs|

How Long Will Medicare Pay for Nursing Home Care?

 As people age, the value of good health becomes more important than ever. When you had a bad fall in your 40s, it would take a few weeks to recover. Now, a bad fall may result in a hip injury that takes months of recovery, doctor visits, physical therapy, or even surgery. Some must go to skilled nursing facilities to [...]

How Much Does Medicare Cover for Hospice Care?

Is Hospice Care Covered by Medicare? When a loved one receives a terminal diagnosis, they’re typically given an average of six months to live. The next step is to find a place that can meet those special needs.  While this is devastating news, the next logical step is to seek out options regarding hospice care to ensure a comfortable transition [...]

Categories: Hospice, Skilled Nursing Facilities|

What is the Medicare IRMAA 2024 Schedule?

 Many years ago, I was still new to the Medicare insurance business. I had a few hundred clients but no high-income earners. I knew what Medicare IRMAA was, but I had never met someone subject to the IRMAA tax before Doug. He was an improbable candidate. After many years and thousands of clients later, I am very familiar with IRMAA, [...]

Medicare Enrollment for 2024: the Essential Medicare Enrollment Guide

Is Medicare health insurance an option for you?  Medicare is not a one-and-done choice.  Medicare is a journey that is quick and short for some.  For others, it takes place over years on a road with many twists and turns.  What will your Medicare enrollment path look like for 2024? The Essential Medicare Enrollment Guide is something to read and [...]

Categories: Medicare Enrollment|

Everything You Need to Know About Medicare Coverage for Ozempic

Are you looking for comprehensive information on Medicare coverage for Ozempic?  Look no further!  In this article, we’ll provide everything you need to know about this medication and how Medicare covers it. Ozempic is a popular prescription medication used to treat type 2 diabetes.  It belongs to a class of drugs called GLP-1 receptor agonists, which help lower blood sugar [...]

Categories: Medicare Part D, Prescription Drugs|

What Does Medicare Drug Price Negotiations Mean For Me?

The Power of Negotiation Enables Medicare to Lower Drug Prices   In today’s healthcare landscape, the soaring cost of prescription drugs has become a critical concern for millions of Americans.  As Medicare beneficiaries struggle with skyrocketing medication prices, the power to negotiate Medicare drug prices emerges as a potential solution. With over 65 million enrollees, Medicare has significant purchasing power.  However, [...]

Categories: Medicare Part D, Prescription Drugs|

Navigating Medicare Approved Chiropractors: Your Guide to Local Specialists

Finding a Medicare approved chiropractor can be a daunting task, especially if you're dealing with chronic pain or a specific condition requiring specialized care. Knowing where to turn for effective treatment is crucial. That's where our comprehensive guide comes in, dedicated to helping you navigate the world of Medicare approved chiropractors near you with ease. In this article, we'll walk [...]

Medicare Plan N vs Plan G: Understanding the Differences

Are you ready to dive into the intricate world of Medicare Supplements? If you're exploring your options, you've probably come across Medicare Supplement Plan N and Plan G. While both plans offer comprehensive coverage, what are the differences between Medicare Plan N vs Plan G? In this essential guide, we'll take a closer look at Medigap Plan N and Plan [...]

Categories: Medigap, Plan G, Plan N|

Nursing Home Coverage in Medicare Advantage Plans Explored

How Does Medicare Advantage Work In Nursing Homes? Taking care of our loved ones is always a top priority, especially regarding their health and well-being. For many seniors, nursing home care is necessary as they require specialized medical attention, like intense physical & occupational therapy and speech-language pathology. In such situations, it's crucial to understand the nursing home coverage options [...]

Newest Medicare Eligibility Rules

You don’t get Medicare because you want it. You must be eligible for Medicare. Medicare eligibility doesn't mean you can enroll in Medicare whenever you wish. You can only enroll in Medicare during specific periods under particular circumstances.  These special times are called election periods, each governed by criteria and circumstances. You must meet specific criteria to be eligible for [...]

Categories: Medicare Regulations|

2023 Medicare Changes for Insulin

Medicare is superb health insurance.  The coverage is the most comprehensive of any health plan.  The cost is incredibly low for the consumer.  The medication portion, unfortunately, which has been relatively new since 2006, is not as good as most employer-provided drug coverage, at least for the Medicare demographic.  Consequently, Medicare continually evolves, so the 2023 Medicare changes for drugs [...]

Why Are Medicare Advantage Plans So Bad?

Why do so many people bash Medicare Advantage? Yet, in every Part of the country, Medicare plans are expanding, and more people are joining. Why are Medicare Advantage plans considered so bad when they attract so many people and keep them as loyal customers? What Makes Medicare Advantage Plans Bad? The main reason is location, location, location.  Medicare Advantage plans [...]

What Is Medicare Supplement Free Look Period?

Medicare has lots of rules and regulations. The insurance companies and the State Insurance Commissioners have even more laws. The Medicare supplement 30-day free look period is one of those rules. Medicare Supplements are called Medigap policies because filling in the gaps is precisely what they do. They fill in the gaps in Original Medicare. Supplements fill in the Part [...]

Which is Better, Medicare Advantage vs. Medicare Supplement?

When people compare Medicare with Medicare Advantage, they usually mean Medicare (Original Medicare) with a Medicare Supplement and a Medicare Part D prescription drug plan versus Medicare Advantage (Part C) with prescription drugs included. The comparison is difficult because they are drastically different, so I believe a fair side-by-side comparison is impossible. That, however, does not stop people from asking [...]

Is Medicare Prior Authorization Required?

Medicare has had an exciting history with prior authorization. Medicare prior authorization has become controversial over the years because of Medicare Advantage. Have You Always Been Subject to Prior Authorization? Health plans started using prior authorization in the 1960s. Hospital admittance grew after the creation of Medicare and Medicaid. At the same time, more employers began offering employees health insurance [...]

Inflation Reduction Act of 2022 Medicare Changes

When I meet with prospective clients, I begin with a brief explanation of Medicare. Then move on to the hundreds of plans. Drugs are next. This is hard. Clients must lay down their cards; some hold a straight flush of costly medications. The Inflation Reduction Act of 2022 is a long-awaited solution to improve Medicare drug plans and make Part [...]

HSA With Medicare

A Health Savings Account (HSA) is a powerful tax-advantaged devise. An HSA, however, can have devastating effect if you do not understand how an HSA works with Medicare. What Is An HSA? A Health Savings Account (HSA) is a type of personal savings account introduced in 2003. It is designed to work with employer health plans, especially high deductible plans. [...]

Categories: Medicare|

What Is The Medicare Donut Hole?

Many people have heard of the Medicare Donut Hole, but even those on Medicare are not familiar with what the donut hole really means unless they fall into it. When you are in the Medicare Donut Hole, you know it and quickly learn what it means.  Clients call me monthly asking, “What’s going on? My medication jumped from $45 to [...]

Categories: Medicare Part D, Prescription Drugs|

What Is The 2023 Medicare Part A Deductible?

The amount of the Medicare Part A Hospital deductible for 2023 is vital because other numbers are based upon it. The Part Hospital A deductible in 2023 is more than just a dollar amount. The Part A deductible for Medicare drives the other copays, coinsurance, and deductibles. Part A not only covers inpatient hospital stays. Medicare Part A and the [...]

Categories: Medicare, Original Medicare|

What Is The Medicare Drug Deductible for 2023?

January begins a new calendar year for Medicare. What does that mean for your Medicare drug deductibles in 2023? For most Medicare members with a Medicare Part D prescription drug plan, you have a deductible. The Medicare drug deductible for 2023 is currently $505. The Part D drug deductible for 2022 was $480, which means a 5% increase. The deductible [...]

My Medicare Login

I changed how I do my meetings with new clients. I set up their My Medicare login before they leave my office because . . . . Client Problem A client called me because he had an unpaid bill. He claimed the insurance company with his Medicare Supplement policy would not pay his hospital bills. I tend not to react [...]

How to Apply For Medicare In Nebraska For 2022

If you have paid payroll taxes (FICA) for 40 quarters (or 10 years), you are eligible to apply for Medicare in Nebraska for 2022. You are eligible for Medicare Part A at zero premium and may purchase Part B at the current cost if your income is below the IRMAA (Income Related Monthly Adjustment Amounts) amounts. The Easy Way To [...]

Medicare Or Employer Provided Health Insurance?

Which Is A Better Deal for You? Medicare Or Employer Health Insurance Congress created a problem in the 1980s when it increased the age for full Social Security benefits. Eligibility was age 65 for both Social Security AND Medicare. Medicare eligibility is still age 65, but full Social Security benefit now is 66 and six months or 67 for those [...]

Categories: Medicare, What is Medicare?|

How Does Medicaid Work?

What is Medicaid? 'Medicare For All' is a slogan that we have heard repeatedly in political campaigns and on the news.  Medicare, and Medicaid to a lesser extent, are successful social programs that a majority of Americans embrace. How does Medicaid work? The biggest bones of contention have to do with the funding of Medicaid.  The reality is--through the Medicaid [...]

Categories: Medicaid|

Medicare And Hospice

Does Medicare Cover Hospice? Many people are still not very familiar with Medicare and hospice.  It is actually a fairly new idea.  The "end of life movement" began in the '70s.  (The "end of life movement" is separate and distinct from the Euthanasia movement and organizations, like the Hemlock Society.)  Medicare did not cover Hospice when Medicare started in 1965.  [...]

What Is Medicaid? Know the Story

Since 2013 I have worked exclusively in Medicare insurance.  Many people will ask me, however, 'What is Medicaid?'  Some of my clients are on both Medicare and Medicaid.  Those situations are more complex because you are dealing with two government agencies and a different setup in terms of insurance. To help clients, I call Nebraska Medicaid or Access Nebraska frequently.  [...]

Categories: Medicaid|

Does Medicare Pay For Hospice?

What Is Medicare Hospice? Does Medicare Pay For Hospice Care? Medicare pays for hospice, but what is hospice exactly? Medicare defines hospice as a program of care and support for people who are terminally ill.  Terminal illness, as Medicare definites it, is a life expectancy of six months or less.  The primary goal of hospice in Medicare is to help [...]

Medicare Insurance Brokers Near Me

What Does A Medicare Insurance Agent Do? When you sign up for a Medicare plan or Medicare supplement, you use a licensed insurance agent.  An agent is a person who acts on behalf of someone.  That someone may be the client or he may be the insurance company.  He is licensed which means that the state certifies he has passed [...]

Incredible Changes to Medicare 2022

Needed Changes to the Medicare Enrollment Process 2022 I have been a licensed insurance agent since 2003.  I’ve seen a lot of changes to Medicare over that time.  One of the problems that always baffled me was how difficult it was to enroll in Medicare.  Let me put you in the front seat of the upcoming changes to Medicare for [...]

Why Nebraska Medicare Advantage Plans Do It Better

What Are Medicare Advantage Plans First of All? Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Original Medicare. Original Medicare is just Part A and Part B.  It is Original Medicare because that is how "originally" Medicare started. Private insurance companies approved by Medicare create and offer Medicare Advantage plans.  The [...]

Categories: Medicare Advantage Plans|

Who Pays For Medicare?

What is Medicare? Medicare is under the Social Security Administration (SSA).  SSA is the bookkeeper for Medicare collecting premiums from Medicare beneficiaries and distributing funds to Medicare and insurance companies with Medicare contracts.  The Centers for Medicare & Medicaid Services (CMS) is the federal agency that manages the Medicare Program. CMS is under the Department of Health and Human Services [...]

Nebraska Medicaid Changes

Initiative 427 The Nebraska Medicaid program currently provides coverage to approximately 240,000 Nebraskans, with expenditures totaling $2,117,730.000 in 2018. Nebraska voters passed Initiative 427 in the November 2018 election that expanded Medicaid coverage to eligible able-bodied adults ages 19-64 who earn up to 138 percent of the federal poverty level. That is about $17,000 per year for a single adult. Governor Pete Ricketts's administration is tasked [...]

How To File A Medicare Claim

Beneficiary Assignment For Medicare Claims The provider or institution will file a Medicare claim most of the time. They must file the claim within twelve months of service, but there may be some instances when it doesn't happen. Your healthcare provider cannot file the claim, or they won't. Some providers and suppliers do not take assignment for Medicare or are [...]

Why You Should Use a Licensed Medicare Insurance Agent?

Why Do You Need a Medicare Agent? Many who turn 65 realize why they need a licensed Medicare insurance agent specializing in Medicare planning. Insurance companies and insurance agents inundated you with letters, postcards, brochures, booklets, and phone calls. You need to contact the FBI for witness protection to avoid the bombardment you get from all the phone calls. Anyone [...]

How Do You Get Medicare Dental Coverage?

Medicare Dental Coverage For Seniors Medicare dental coverage is confusing because the Medicare language is confusing.  The word Medicare is used to describe "Original Medicare," which is Medicare Part A for the hospital and Medicare Part B for doctor visits and outpatient procedures.  Medicare is also used to describe Medicare Part C (or Medicare Advantage plans).  Yes, the language is [...]

What Is Medicare Advantage Plans

What Is the Medicare Advantage Controversy About? Medicare Advantage plans (MA plans) or Medicare Part C is Medicare.  Confused people get it wrong.  Some will call MA plans a "Medicare replacement plan."  Others will claim Medicare Part C is not Medicare.  Let me let you in on a little secret.  Medicare is in the name--"Medicare Part C," like Medicare Part [...]

Categories: Medicare Advantage Plans|

The Secret to Keeping Your Medicare With Your Doctor

Do All Doctors Accept Medicare Advantage Plans? Keeping your doctor when on Medicare is very important for many Medicare beneficiaries.  The Secret to keeping your doctor when on Medicare is easy. Dr. Paul Martin, MD The doctor who delivered me also delivered my two younger brothers, my father and his brother and sister.  My Grandpa Grimmond was friends with Dr. [...]

Medicare Enrollment Dates to Remember

As much information as there is about Medicare, I'm surprised people still do not remember important Medicare dates.  The surplus of commercials, mailers, emails, and advertisements probably do more to obscure and confuse people about Medicare enrollment dates.  The first Medicare enrollment date to remember is the most important one. Medicare Initial Enrollment Period You are first eligible for Medicare [...]

Medicare Open Enrollment Is the Time to Pay Attention to Your Plan

Medicare Open Enrollment Is Also Known As Medicare Annual Election Period  Medicare Open Enrollment is when people may make changes to their Medicare plan.  Medicare Open Enrollment is also called Annual Election Period or AEP. That is the new official name Medicare Open Enrollment.  Annual Election Period (AEP) is when you can change your Medicare Part D prescription drug plan or your Medicare [...]

New Medicare Card

The red, white, and blue Medicare card has changed.  It is the new and improved Medicare card. The one complaint that I have heard over the years repeatedly is that the Medicare card has 'my social security number on it.'  The Medicare claim number, as it is called, is your social security number with an A on end, or it [...]

Categories: Medicare|

The Beginner’s Guide to Understanding Your Medicare Coverage Choices

I remember when the hospital staff explained my mother's Medicare coverage to me. I kept asking, "What does Part A cover? How is Part B different?"  I couldn't remember anything. I'm sure the stress of my mother dying had a lot to do with it, but it seemed like I was a child going back to school trying to learn my [...]

Medicare Health Screenings You Should Consider Yearly

Medicare Wants You To Live A Healthy Life Medicare will be a different health insurance experience than when you were on your employer's health plan. Many employer health plans try to reduce how often you use the program to keep down costs. In contrast, Medicare understands that more health issues arise in the Medicare age population. A big driver for [...]

Categories: Medicare|

How to Choose A Medicare Plan: 7 Things to Consider

When you speak of "Medicare plans," that is the terminology for a Medicare Advantage plan.  Medicare Supplements or Medigap policies are private insurance that works with Medicare, but Part C/Medicare Advantage (MA) plans are "Medicare plans."  So, let us consider important factors when reviewing Medicare plans.  How do I choose a Medicare Plan? How do you figure out which Medicare [...]

Honest Pros and Cons of Buying Medicare Insurance

You are eligible for Medicare insurance at age 65 when you have worked at least 40 quarters and paid the FICA (Federal Insurance Contributions Act - U.S payroll tax deducted to fund the Social Security and Medicare programs). Medicare tax is included in the FICA or payroll tax that comes out of your paycheck each pay period. Many people, however, will [...]

Reasons to Pay Attention to Medicare Open Enrollment

Medicare is a federal government program.  Like anything government program, there are lots of rules and regulations.  Medicare Open Enrollment has rules.  Inattentiveness to those rules may result in unwanted penalties and painful costs. What is Medicare Open Enrollment? Open Enrollment Period, now called Annual Election Period (AEP), is from October 15th--December 7th.  You can change your Medicare Part D [...]

Categories: Medicare|

Medicare Fraud Is Real

What is Medicare Fraud? The Medicare Fraud definition is knowingly collecting money from the Medicare program when you are not entitled to the reimbursement.  Fraud occurs when someone knowingly deceives Medicare to receive payment when they should not, or they receive a higher payment than they should. The three keys to a definition of Medicare fraud are the person and/or [...]

Categories: Medicare Fraud|

Ways Medicare Is There for Your Mental Health

Mental Health Among 60+ Older people on Medicare face unique physical and mental health care challenges which need to be recognized.  Over 20% of adults aged 60 and over suffer from a mental or neurological disorder (excluding headache disorders). Mental and neurological disorders among all disabled people over 60 years old are 6.6%. These disorders in older people account for [...]

What Is IRMAA? Do You Owe It?

IRMAA Tax Definition Many of you may see the letters IRMAA when learning about Medicare.  The government loves acronyms.  IRMAA stands for Income-Related Monthly Adjustment Amounts.  It is based on a person's modified adjusted gross income (MAGI).  The IRS uses a tiered scale.  Your Medicare Part B and Part D premium will cost more based upon the income thresholds you [...]

How Do You Find the Best Medicare Insurance Agents?

There is no full-proof way to find the best Medicare insurance agent out there. Still, you can separate a lot of wheat from the chaff by asking a few key questions. How Many Medicare Clients Do You Have? I recently had surgery. When I met with the surgeon, I asked how many times she had performed this particular surgery. She [...]

Does Medicare Cover Cataract Surgery?

Cataracts Are Common Among Seniors: Does Medicare Cover Cataract Surgery?  Over 24 Million Americans have cataracts–and worse, the risk of cataracts increases each decade of life, starting around age 40. Statistically, as many as 50 percent of Americans over 75 will be diagnosed with cataracts, and by 80, that number has grown as large as 70 percent. The good news [...]

Medicare Advantage: What If I Move?

Why is Medicare Advantage Different When You Move? Medicare Advantage plans have lots of rules.  When you move your permanent residence, those Medicare plan rules take effect.  As it states on the Medicare.gov website,  Medicare Advantage is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are [...]

Medicare Secret #3 Don’t Let An Opportunity Pass You By

https://www.youtube.com/watch?v=KxjOFDmSDEQ Medicare Open Enrollment is January 1st-March 31st when you can leave your Medicare Advantage plan and return to Original Medicare--Medicare Part A and Part B. You then have the opportunity to purchase a Medicare Part D prescription drug plan and apply for a Medicare Supplement/Medigap policy. It is another opportunity to make sure you have the Medicare plan [...]

Categories: Videos|

Medicare Secret #2 Don’t Loss Out

https://www.youtube.com/watch?v=Ih33XBZOhdA The Medicare & You Official Handbook says "it's important to compare Medigap policies since the costs can vary between insurance companies for exactly the same coverage." Don't overpay for the exact same coverage. Make sure you thoroughly shop the market for the lowest prices from the most trusted sources.

Categories: Videos|

Getting to Know Omaha Insurance Solutions Your Medicare Advisor

Who Are the Medicare Advisors at Omaha Insurance Solutions? My name is Chris, and I’ll be your Medicare Advisor at Omaha Insurance Solutions here to help you navigate Medicare insurance plans in the area. Go Big Red! Some of the first words I learned were, "Go Big Red!"  Sunday at church was important, but Saturday during football season was the real high [...]

Categories: Medicare|

Does Medicare Cover Chiropractic Care?

What Does Medicare Cover For Chiropractic Care? Does your back hurt? If you are on Medicare, you may wonder if Medicare pays for chiropractic care.  My first experience with chiropractic care was at 17. Medicare-covered chiropractic care had not even crossed my mind. I was complaining to my dad that I woke up with pain in my back. He said [...]

Must Ask Questions For Your Medicare Insurance Agent in Omaha

Are You An Independent Medicare Insurance Agent in the Omaha Area? There are different kinds of Medicare advisors in Omaha, NE. Some Medicare agents are captive, meaning they sell Medicare insurance company products exclusively for one insurance company. Some of those companies may have subsidiaries, so it appears the agent offers multiple companies, but in fact, he commits exclusively to [...]

Beginner’s Guide to Medicare Advantage

For as long as I have been educating people about Medicare, prospects are always surprised when I talk about Medicare Advantage insurance plans in Omaha, Nebraska.  Even for those who have heard something about Medicare Advantage, people are astonished when I go into the details of the plans.   So I've found people need a beginner's guide to Medicare Advantage [...]

Categories: Medicare Advantage Plans|

Finding Medicare Advisors in Omaha, NE

Finding a Medicare advisor in Omaha, NE, is not difficult. If you are turning 65, marketing companies sell your contact information, including birthday and phone numbers, to insurance agents. Lead companies are mailing you business reply cards (BRC) in hope that you will fill them out and mail them back in. Direct mail marketing companies are sending you postcards, flyers, [...]

What Is the Medicare Modernization Act?

Medicare Modernization Caused Medicare Confusion After Congress created Medicare and President Lyndon Johnson signed the Medicare program into law, insurance companies began designing and offering health plans to fill in the gaps in Medicare-covered services. Insurance companies started developing many Medigap policies to fill in Medicare Part A and Part B gaps. There were no federal guidelines or laws for [...]

The Cost of Medicare Supplement Plans

Mistake 1--The Cost of Medicare Supplement Plans is Different, but the Plans Are the Same The line I hear repeatedly is 'I'm looking for the best coverage for the least amount of money.'   Here are some common mistakes consumers make when selecting their Medigap plan. The key to understanding the cost of Medicare supplement plans is knowing the law. Since [...]

Categories: Medigap|

Medicare Advantage Insurance Plans in Omaha Nebraska: The Pros & Cons

When people talk about Medicare Part C or Medicare Advantage insurance plans in Omaha, Nebraska, they are usually making a comparison. The comparison is generally to Original Medicare and a Medicare Supplement with Part D. These are the two main ways most people get their Medicare. These two ways are very different, and I don't believe it is really possible [...]

The 3 Questions To Ask Your Medicare Insurance Agent

So, What Questions Should You Ask Your Medicare Insurance Agent? What Is Medicare Advantage? Sometimes there is confusion about Medicare Part C or Medicare Advantage insurance plans in Omaha, Nebraska. I have heard doctors' offices call it "Medicare replacement plans" or "it is not Medicare." So when asking what questions to ask your Medicare insurance agent, the definition of Medicare [...]

3 Questions About Medicare Supplement Underwriting in Omaha

#1. Can You Change Your Medicare Supplement Without Underwriting in Omaha? Outside of your Open Enrollment or Guaranteed Issue (GI) situation, you must go through Medicare Supplement underwriting in Omaha. This means all of Nebraska and Iowa as well. I had an incredible case a couple of years ago. Several financial advisors refer their clients to me for their Medicare [...]

What 3 Important Questions Should a Good Medicare Insurance Agent Ask?

#1. A Good Medicare Insurance Agent Should Ask "What Kind of Prescription Medications You Are Taking?" After almost a decade of being a Medicare insurance agent, I still get nervous when prospective clients push their list of medications across the conference table. When I look at the list, I either tense up or breathe a sigh of relief. Medication Costs [...]

Medicare 2021 Changes to Know About

Every year there are changes to Medicare.  The changes are usually not as drastic as the television commercials would lead you to believe.  The purpose of the advertisements is to stimulate fear, uncertainty, and greed.  They hit it hard to motivate you to call the 800-number.  They will claim to offer a free objective evaluation.  I find their objective evaluation [...]

Categories: Changes to Medicare|

Does Medicare Advantage Pay For Home Health Care?

Medicare Advantage and Home Health Care All Medicare Advantage (MA) plans must provide at least the same level of coverage for home health care as does Original Medicare, so Medicare Advantage pays for home health care.  However, an MA plan may have different rules, costs, and restrictions on services.  For example, depending on a person's MA plan, it may require [...]

Enrolling In Medicare Problems

https://youtu.be/b1-U-fNHbTU More and more people delay enrolling in Medicare Part B and remain on an employer's health plan. When they get off the employer's health plan and go on Medicare completely, problems sometimes arise. Here are some tips to avoid going to Medicare jail.

Categories: Videos|

How Long Does Medicare Pay For Home Health Care?

Navigating the Complexities: What You Need to Know About Medicare and Home Healthcare Coverage Are you confused about Medicare and home health care coverage? If so, you're not alone. Navigating the complexities of these topics can be overwhelming.  It's essential to understand your options and ensure you receive the care you need. Does Medicare pay for home health care services? [...]

Does Medicare Cover Home Health Care?

Medicare covers Home Health Care, but the Medicare beneficiary must meet particular criteria, maintain a status of medical need, and follow Medicare regulations and processes to enjoy the benefits. Eligibility For Medicare Home Health Care Benefits A physician must certify that skilled care is needed and must prescribe the plan of care. A participating Medicare-approved home health care organization must [...]

What Is Home Health Care?

We know what hospitals are. We all have been to a doctor's office. Many have experienced a relative in a nursing home, but what is home health care? Home health care is like it sounds. It is the care that takes place in the home.  It consists of a wide range of services, like physical therapy, occupational therapy, speech therapy, [...]

Medicare Coverage of Skilled Nursing Facility Stays

Jimmo vs. Sebelius On Skilled Nursing Skilled Nursing Care is amazingly complex. Because the Medicare coverage of Skilled Nursing Facility stays is so confusing, patients sued.  The case went all the way to the Federal Courts. Jimmo vs. Sebelius, a class-action lawsuit, challenged the Center For Medicare & Medicaid Services (CMS) interpretation of the “improvement stand” that many used to [...]

Skilled Nursing Facility Medicare Covered

Medicare Coverage For Skilled Nursing Facilities Skilled Nursing Facilities—or better known in the jargon of Medicare as SNF—is the cause of much consternation among people on Medicare.  The reason for the distress and stress is because Medicare beneficiaries are sometimes denied coverage.  This both confuses and angers Medicare beneficiaries because there doesn’t seem to be any rhyme or reason to [...]

How Long Does Medicare Pay For Skilled Nursing Care?

The chances are you or someone in your family will require skilled nursing care because of a serious injury, stroke, or surgery.  Twenty-five percent of skilled nursing stays are less than three months.  Many, however, are longer.  Nursing home care costs vary from state to state and location to location.    The questions my clients ask are: how long does [...]

Does Medicare Pay For Hospice In A Skilled Nursing Facility?

Maximizing Medicare: Understanding Coverage for Hospice in Skilled Nursing Facilities Do you or a loved one need hospice care in a skilled nursing facility? Understanding Medicare coverage for this essential service is crucial for maximizing benefits and ensuring quality end-of-life care. This article will explore some of the ins and outs of hospice coverage I didn't know when my mother [...]

Medicare Covers Skilled Nursing Facilities

What Are Skilled Nursing Facilities? All of us have strong memories of visiting the “old folks’ home.”  Whether grandparents, relatives, or friends, we recall the smells, linoleum, long hallways, and institutional dormitory rooms.  "Old folks’ homes" or nursing homes fall under the category of Skilled Nursing Facilities (SNF).  Medicare covers skilled nursing facilities within limits. Patients go to the SNF [...]

The Medicare Part C Advantage

The Medicare Part C advantage comes in five ways.  The Medicare Part C advantages are in relation, or even opposition, to Original Medicare.  These are the advantages of Medicare Part C, though they will vary from plan and location. The Medicare Part C Advantage is Maximum Out-Of-Pocket The Medicare Part C advantage comes first in a maximum out-of-pocket.  Original Medicare [...]

Categories: Medicare Advantage Plans|

What is Medicare Part C

Medicare Advantage or Medicare Part C is another way to receive Medicare.  "Original Medicare" is a combination of Medicare Part A and Part B.  It is called "Original Medicare" because that was its first plan in the late 60's.  Medicare Part A was hospital insurance and Medicare Part B was added later.  It included doctor visits and outpatient procedures.  Some [...]

Picking Medicare Plan

When people arrive at the doorstep of Medicare at age 65, they are confronted with the daunting task of picking a Medicare plan.  Most people find picking Medicare plan overwhelming and confusing. 100's of Supplements to Pick From Insurance companies offer hundreds of different Medicare supplements, Medicare Advantage plans, and Medicare Part D prescription drug plans.  Picking Medicare plan means [...]

Medicare Travel Tips

We’ve all experienced that less than happy holiday vacation spent ill. What’s worse is getting sick abroad and worrying about Medicare insurance coverage. If you’re planning a winter getaway, check out and share our healthy Medicare travel tips to ensure your vacation goes off without a hitch. Prevention Whether you’re going foreign or domestic, Medicare travel tip #1.  Always research your destination. [...]

Backup Medicare Advantage

Medicare Advantage Growing Medicare Advantage or Medicare Part C is an alternative to traditional or original Medicare.  While the majority of Medicare beneficiaries are still on original Medicare, Medicare Advantage has grown to 31% of all Medicare beneficiaries, which is triple the number from only twelve years ago.  In Nebraska the number of Medicare beneficiaries in a Medicare Advantage plan is 12% [...]

Medicare Eligibility

One of the most common questions we receive is: “Am I eligible for Medicare?” Well, there’s no black and white answer to Medicare eligibility. Your Medicare eligibility may depend on several different situations. Luckily, we make Medicare easy—this post will show you how and when to apply for Medicare based on your unique situation. Medicare Eligibility You become eligible for Medicare when you [...]

Categories: Original Medicare|

Medicare Changes Part D

Medicare usually makes some changes every year.  Medicare changes Part D without exception.  Medicare and the insurance companies make adjustments based upon drug costs and contracts with pharmaceutical companies.  Medicare is also gradually eliminating the dreaded gap in Part D coverage, better known as the "Donut Hole." Medicare Changes Part D Deductible The change that gets the most recognition this [...]

Categories: Medicare Part D, Prescription Drugs|

Medicare Changes Part B Deductible

Medicare Changes Part B Deductible Medicare changes came out in December.  The Medicare changes Part B deductible was an increase.  The Medicare Part B deductible for 2016 was $166.  The 2017 Part B deductible is $183.  While the $17 increase is small in dollar terms, it was a 10% increase.  That's big!  Part B Deductible What is the Medicare Part B [...]

Categories: Original Medicare, Plan F, Plan G|

Medicare Changes Part A Deductible

Medicare Changes Part A Deductible Medicare changes for 2017 came out in December.  One of the changes was for Medicare Part A.  Part A is the hospital side of Medicare.  It does not cost anything because you paid the Medicare Part A premium during your working years.  It was part of your payroll taxes.  The premium is zero if you [...]

Categories: Original Medicare, What is Medicare?|

Medicare Changes

Medicare Part B Medicare changes almost every year.  Medicare changes for 2017 are significant.  The Medicare Part B monthly premium is the change that hits people first.  For Medicare beneficiaries who were on Medicare before 2016, the increase will be from $104.90 to $109 per month.  For those who began Medicare Part B in 2016, the premium will move from $121.80 to $134.  [...]

Categories: Original Medicare, What is Medicare?|

What is Medicare?

What is Medicare?  A basic question.  Or rather, why should anyone care about Medicare?   The reason people should care is that most bankruptcies are medical bankruptcies.  In other words, if you wish to protect your retirement nest egg from bill collectors, Medicare is important to know about.  There are few things that are more disturbing than a pile of medical bills sitting on [...]

Aetna Exits ACA Not Medicare

A number of distressed clients called me because they saw announcements on the news that Aetna and United Healthcare (UHC) were pulling out of individual states and would not be offering health insurance any more.  It is true that Aetna and UHC are pulling out of some healthcare plans, but Aetna exits ACA NOT Medicare. Aetna Exits ACA Not Medicare [...]

Categories: Medicare|

More Than Medicare Supplement Plans

More Than Medicare Supplement Plans I help people sign up for Medicare Part A and Medicare Part B.  We go to Medicare.gov and run their medications.  I check to make sure their doctors and hospitals are in network for the Medicare Advantage plans.  I explain their Medicare eligibility and show All the Medicare supplement plans, Medicare Advantage Plans, and Medicare [...]

Delay Medicare Enrollment

Delay Medicare Enrollment Many people work past 65.  They continue on with them employer group coverage.  They delay Medicare enrollment.  At 66+, they wonder what to do about Medicare. How to Enroll after 65 Here is what to do.  Go to Medicare.gov.  Click on "Forms, Help, Resources" on the top right. Then click on "Medicare Forms" on the left middle.  [...]

Medicare Mental Health

A distressed prospective client told me that Medicare did not cover mental health treatment.  I stammered a bit because the subject had never come up before,  and I was surprised.  I said that it did.  She had read that it only covered a one time welcome visit to Medicare.  I then showed her in the Medicare & You Handbook on pages 40 [...]

Medicare Scare Tactics

The Big Lie The "Big Lie" is a phrase and idea that Adolph Hitler and then Joseph Goebbels promoted in their propaganda war.  They observed that if you told a lie about the opposition, made the lie an outrageous claim, and repeated the claim, people would believe it.  This technique existed before the Nazis and will continue on to the [...]

Medicare Going Bankrupt

The leading cause of bankruptcies in the U.S. are medical bills. Coupled with the headlines "Medicare Going Bankrupt," the question is: whose going bankrupt first?  Health care and Medicare have been in the news and will be even more so as the political season kicks into high gear. Don’t let Medicare’s budget problems became yours. Medicare Going Bankrupt The headlines that state "Medicare Going [...]

Categories: Medicare|

Medigap Guarantee Issue

A gentleman called me who was losing his group health coverage from a former employer. He was a retiree from a Fortune 100 company. You would recognize the name of the company immediately. As part of his retirement package, he had a very generous health plan for himself and his wife. He had been on it for decades, but the [...]

Supplement Health Questions

A prospective client called me about saving money on her Medicare supplement. I asked her the basic supplement health questions and gave a quote.  We set up a time to meet.  At the meeting, I started going through the standard health questions on the application.  When I came to the question about recommended future treatments, she said no, but the way she [...]

Pre-Existing Conditions

For two years, my father was on dialysis.  Those were tough years.  When I got a client on dialysis, I wanted the best for him.  Kidney dialysis is one of the pre-existing conditions that usually excludes you from a supplement.  My client had a one-time opportunity.  I was going to make sure he got it! Obama Care Confuses Pre-Existing Conditions Pre-existing conditions are confusing when it comes to Medicare.  The ACA (Affordable [...]

Keys to Unlocking Medicare

One of the most painful calls I get is from a client who is calling on behalf of a parent.  They want to know if there is anything I can do for a parent who is paying huge monthly premiums for her Medicare supplement.  The agent who signed them up is long gone.  The supplement has increased over the years due to age [...]

Is Medigap the Solution?

People constantly ask me, 'What should I do about Medicare?'  They are overwhelmed with all the brochures from insurance companies.  They look through the 162 pages of the Official Medicare Handbook and are further confused.  Some go to the Medicare.gov website, and are confounded in attempts to navigate through the endless ocean of information.  They simply ask in bewilderment, "What does [...]

Leave My Medicare Supplement Alone!

You may have been caught up in the recent political circus on TV and missed the political power play behind the scenes.  Congress voted to eliminate a Medicare supplement that provides first dollar coverage.  (First dollar coverage means you pay no co-pays, deductibles, or co-insurance.  Medicare and the Medicare supplement pay everything.)  This will change everything about how you approach your Medicare, and [...]

Common Medicare Misconceptions

With all the information out there about Medicare Benefits, it’s easy to be confused, or even misinformed. It’s vital for those who are eligible for Medicare to understand the details about this long-standing, much needed program. The following are a few common Medicare misconceptions and the facts recipients need to set them straight. Myth #1: Medicare Covers Everything It is [...]

Categories: Original Medicare|Tags: , , |

Tranquilizers Approved Under Medicare, but at What Cost?

The year Medicare approved tranquilizer coverage, it spent an estimated $377 million on prescriptions for the drugs. While congress originally outlawed the coverage of these drugs, pressure from patients and medical societies caused the reversal of this law in 2013 under Medicare Part D. Although these drugs were not covered until recently, it is evident that patients were simply finding [...]

Medicare is simple as A, B, & D.

I learned to sing the alphabet before I learned to say it, and from that humble beginning, language opened up to me. You can’t understand language without first understanding its alphabet.  Medicare has a language, and Medicare has an alphabet.  It begins with A, B, & D.  They are the three essential components of Medicare. A is for Medicare Part [...]

Categories: Medicare|Tags: , , , |

Medicare Market Place

Markets are constantly changing. The Wednesday and Sunday additions of the Omaha World Herald are full of ads and fliers. Stores publicize sales, put up posters with markdowns, advertise deals, and promote special events. Prices and products are constantly changing. The market place does not stand still. The insurance and Medicare market is no different. Aetna announced a 37 billion dollar [...]

Categories: Medicare|

Medicare Intelligence

A popular show on AMC is Turn. It is about General Washington’s spies during the Revolutionary War. You find out quickly that intelligence is critical for an army to be successful. It was intelligence that moved Washington to cross the Delaware River Christmas night to catch the Hessians sleeping at Trenton. That victory was one of the turning points in [...]

Categories: Medicare|

Shifting from Your ACA Marketplace to Medicare

The Affordable Care Act (ACA) has brought many questions to business owners and individuals alike. What plan is the best? What kind of healthcare will you qualify for? Will you get to keep your same doctors? For those who are retired or close to retirement, the subject can be even more complicated. When you retire or turn 65, do you [...]

Medicare and Foreign Travel

When I was 23, I fell down a mountain while jobbing in Mexico. It was my 2nd trip. My tumble resulted in some serious scrapes and cuts. The nurse at the school I was studying strongly suggested that I get a tetanus shot since I couldn’t remember the last time I had had one. I found a doctor who under [...]

Plan F is the Best?

Sheep get sheared.  They follow the other sheep into the pen, down the shoot, then in to the hands of the shearer and are fleeced.  The ram is a alert.  He doesn’t go with the flow he leads the way and butts heads when he is force to go where he doesn’t want to go. How do people pick their Medicare [...]

The Best Medicare Supplement

The question that I am constantly asked during the course of a consultation on Medicare is ‘which is the best plan?’  My answer to the question of the best Medicare supplement is always the same.  It all depends.  Each person is different.  Needs are different.  Perception of reality is different.  If you ask my wife, which is better—two piece or [...]

What Are the Most Common Medicare Mistakes People Make?

Medicare can be a confusing topic to navigate, especially for those who have not had any experience with it yet. From wondering what ACA implications have to do with Medicare, if anything, to learning the different components of Medicare coverage, it’s easy to make mistakes. Unfortunately, Medicare mistakes can be very costly and time consuming! Perhaps the worst assumption people [...]

Medicare is a Bargain!

Would you be interested in a service that you must absolutely have? As a matter-of-fact, almost everyone has it. It’s not free. You will have to pay, but let’s say you could get the same thing for 400% less than what most people pay. Would you be interested in a bargain like that? Most people would enthusiastically say ‘YES!’  You [...]

Categories: Medigap Quotes, Omaha, Original Medicare|

Does Medicare Cover Cancer Treatment?

Does Medicare Cover Cancer Treatment After Age 76 My mother had her routine physical in Nov of 2011. There were many tests.  One test came back positive for cancer. We were stunned. She had no symptoms. Everything was fine, we thought.  As the doctors performed more tests, they determined my mother had stage four ovarian cancer.  The next week, she [...]

Medicare Part B, Or Not Part B

I talk to lots of people about Medicare.  One gentleman told me about his $1,258.80 mistake.  He signed up for Social Security and Medicare at sixty-five because he thought he had to.  Started receiving Social Security.  Got his Medicare Part A and Part B card.  Started paying his $104.90 for Part B.  At the end of the year, Jim sat [...]

Categories: Original Medicare|Tags: , , |

How To Buy Medigap Insurance?

Most people show up at the steps of Medicare without any idea about how to buy Medigap insurance.  If they have health insurance company A at their work, they call up health insurance company A and buy their Medigap insurance from company A.  They don't shop, and most pay more without getting more. Amateur Or Professional? A few years ago, [...]

VA Benefits and Medicare

My father was a Korean War veteran.  He served on a tin can-minesweeper along the Korean coast.  The last 3 months of his life he spent in a VA Hospital.  My brothers and I and our family’s kept vigil.  I was sleeping next to his bed the morning he passed.  After we grieved, the nurses prepared his body for transport.  They [...]

What Does Medicare Cover For Diabetes Costs For Medicare Part A & B?

What Does Medicare Cover For Diabetics? Diabetes is one of the fastest-growing medical conditions in America and can be one of the most costly conditions to treat. Diabetes costs for Medicare are important for Medicare beneficiaries to know. According to the Center for Disease Control, there are currently 21.0 million Americans who have been diagnosed with at least one type [...]

How To Enroll For Medicare Easily and Quickly in Omaha, Nebraska

Enroll in Medicare Online Without Breaking a Sweat Don't expect a letter from Medicare. Don't wait for a phone call. No one will show up at your door from Social Security with a red, white, and blue Medicare card in hand. You are on your own enrolling for Medicare.  So, how do you do it? I will walk you step-by-step [...]

What Does Medicare A Cover For Free And Not Cover?

Know What Medicare A Covers I have known veterans who only took Medicare A because it was free, and they opted out of  Medicare Part B for doctor and outpatient services because it cost something.  They thought Medicare A was enough because they could rely on the VA hospital.  The VA, however, changes what it will cover or reimburse, depending [...]

How Much Is Medicare Part A Deductible For 2021?

Like most children, I learned to sing the alphabet before I learned to read it. From that humble beginning, language opened up to me. Why does that matter when we're talking about Medicare? You can't understand language without first understanding the alphabet. Medicare has a language and an alphabet all its own.    Medicare Part A is the first letter [...]

Categories: Original Medicare|Tags: , , , |

How Does the ACA Affect Omaha Medicare Recipients?

The Affordable Care Act (ACA) has left many Americans with questions, especially lately with many of the regulations going into effect for 2015. The ACA provides a Health Insurance Marketplace, designed to assist people who don’t otherwise have health coverage through their employer or otherwise. How does this all affect Omaha Medicare Recipients? The short answer is; nothing changes. If [...]

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