Prescription Drug Coverage combined with Medicare Advantage Plans and Supplemental Medicare Insurance

In case, the person is to touch 65, then it becomes essential to know how Medicare functions and the different Medicare Supplement Plans 2018 that are offered. Some plans are found to be similar, with their differences being blurred, thus confusing the potential beneficiaries. Selecting the right plan is of utmost importance.

About Medicare Advantage Plan

Also called Medicare Part C, it is among the 4 fundamental part of Medicare system, allowing Original Medicare Part A & B to derive coverage from their choice of government approved private providers. Medicare Advantage Plans are known to include plans such as PPO (Preferred Provider Organization plan) and HMO (Health Maintenance Organization plans). A major weakness noticed in original Medicare plan is prescription drugs are not covered by them. If additional coverage is desired, then few options are provided.

Supplement Part D

Those having original Medicare (Part B & A) can avail Medicare Part D plan. It can help to cover prescription drug cost. This coverage is availed from Medicare approved private insurance provider. If Medigap policy is there like that of supplemental Medicare insurance, then drug cost may be covered already. If not, then Prescription Drug Plan can be availed as part of Part D. Drug costs will not be covered by all Medicare Supplement Plans 2018. Hence, the right plan is to be availed to enjoy the benefits. If not, then still drug coverage can be derived through Medicare plan.

Part D plan

If supplemental Medicare insurance or Medicare Part D is not used, then Medicare Part C can be considered as it is Medicare Advantage Plan! They are offered by private insurance providers and cover prescription drugs, but at additional costs. If any of such plans are present, then supplemental Medicare insurance will not be required. Coverage history of past employers is to be checked out as additional coverage choices may be present if current of former employer has provided with prescription coverage.

If Medicare Advantage Plan is present, then supplemental Medicare plan is not required. This is found to be illegal unless Medigap plan is completely dropped and original Medicare is returned to. When dropping supplemental Medicare insurance, caution is to be taken, since it might not be derived in the future. The issue is to be discussed with the insurance provider and the State Health Insurance Assistance Program prior to taking the decision, so as to enjoy long term coverage benefits.

Medicare Fraud and How to Report it

It is unfortunate that many seniors are victims of Medicare fraud each year. Medicare fraud is unacceptable and it hurts more than just the operations of Medicare. It also terribly hurts the seniors. In the same way, some people abuse their Medicare benefits. This is also illegal and can cause considerable annoyance to the beneficiary. There are many ways to protect yourself from Medicare fraud.

What is Medicare Fraud?

Medicare fraud seems to be a large and complicated issue, but it is ultimately broken down into one main definition. It is the deliberate unlawful use of the Medicare information of another for personal gain. Some examples of Medicare fraud are:

  • Make false requests to receive an illegal payout
  • Use of your own Medicare card by another person to avail health services
  • Use of your Medicare status to receive medicines or services for another person

Medicare fraud can occur in any of these ways. These crimes do not have a single culprit. They can range from individuals looking for personal benefits to operations or groups who want to use vulnerable senior citizens. Regardless of who commits the crime, it can often be a costly affair and lead to prison.

What is Medicare abuse?

Medicare abuse is similar to Medicare fraud but a little different. Medicare abuse refers to any practice that ends in disproportionate or unnecessary Medicare costs. This type of abuse often applies to counterfeit payments, eg. improper invoicing processes or excessive costs for services or supplies. Abuse of medication, if not caught in time, can sometimes lead to fraud. Abuse is also illegal and a punishable offense.

How to avoid fraud and abuse of Medicare

To avoid fraud and abuse of Medicare, you should keep track of all your Medicare transactions. This includes any services or goods you receive from Medicare, disbursements and payment notifications you receive from Medicare or an insurance company. Once you have received these documents, you can determine if and when strange occurrences occur in your statements. As soon as you see this, it’s time to report. Get a 2019 advantage plan here

How do I report fraud and abuse of Medicare?

  • If you suspect or notice that a person or group is part of a fraud or abuse program, you must promptly report the crime. There are many ways to report Medicare fraud or abuse. Before you report the crime, you need to get certain information about the crime. This information include:
  • The name of the provider or an ID number
  • All services or objects that are questioned
  • The date of the fraudulent services or objects
  • The date displayed on your MSN
  • Total payment amount approved and paid by Medicare
  • Your Medicare name and number
  • A description of why you believe Medicare did not pay
  • Additional information you may have about the case

After receiving all this information, you will need to report the fraud or abuse next. To do this, you may:

Call Medicare: 1-800-MEDICARE (1-800-633-4227).

Report the fraud or abuse on the internet

Call the Inspector General Tip Line: 1-800-HHS-TIPS (1-800-447-8477).

Medicare Advantage Plan Review

An alternative to traditional Medicare is Medicare advantage plan. Private health insurance is paid by the federal government to provide insurance services that are at least as good as the payment models offered under the traditional Medicare offering.

The “benefits” for these plans include value added services which are not part of the traditional Medicare offering.

Medicare Advantage plan is a managed care plan that has low monthly premiums in return for relatively tight local area networks, prior approval / recommendations, and back payments that come out of your pocket every time you use a medical service and you will still have to pay your monthly Medicare part B premium. Many of these plans include the coverage of prescription drugs.

What’s the better deal – Medicare Advantage or supplement?

When deciding on your health insurance, a cheap premium should not be the only factor to consider. Whether Medicare Advantage is a better offer than the original Medicare or Medicare Supplemental plan depends on a variety of individual factors, for example, your comfort as regards managed care and your willingness to trade lower premiums while you are healthy may increase your out-of-pocket expenses if you become seriously ill.

The best protection that can be offered to Medicare Advantage customers is enlightenment. The biggest problems faced with these plans have to do with qualified nursing homes/nursing facilities.

Medicare Advantage plans are designed to help reduce unnecessary medical expenses and also fraud through review and more extensive oversight than original Medicare. Unfortunately, this creates a system of paperwork, checks, and balances that many administrators of hospitals and nursing homes do not like.

Here are some current scenarios in which our clients and local care facilities have been included:

  1. First authorizations for admission to a nursing home are sometimes rejected. Normally the rejection can be resolved by a call from the attending physician. If you receive a refusal, ensure the referring hospital/physician is doing the footwork necessary to fix the problem for you.
  2. The Nursing Home advises that Medicare Advantage 2019 member to drop their plan to use traditional Medicare and buy a supplement. For many reasons this is not good advice! While the paperwork for the nursing home is simpler under traditional Medicare; clients typically find that spending on Medicare alone is much higher.

Do not forget that Medicare supplements have medical underwriting. If you too sick and need skilled nursing care, probably you are too ill to qualify for Medigap plan. This lack of nurse knowledge has cost thousands of dollars for clients.

  1. Networks also hold water for skilled nursing centers, and often the nursing home that is closest to your home may not be the one with your plan on the network. The extra mileage causes additional stress for caretakers, who drive several times a day to visit their loved ones. If you desire to choose a nursing home freely, there are available nursing home plans of short term nature that you can purchase to make sure you could travel wherever you want.

Medicare Easy Pay 101: How do I register?

We are in the digital age. Over time you will write fewer checks or make phone calls to make payments. In this technological development, you might be wondering if there are more efficient ways to pay your Medicare bill. Fortunately there is. You can enroll for Medicare Easy Pay to pay your Medicare bills quickly and electronically.

What is Medicare Easy Pay?

If you have a savings account or checking account, you can enroll for Medicare Easy Pay. This payment option is free. Your Medicare payments will be automatically deducted from your checking or savings account at the monthly due date. You can sign up at any time as long as you receive your Medicare Reward Invoices from the Centers for Medicare & Medicaid Services (CMS).

An exception to this program exists; if you didn’t receive your invoice from CMS but instead from the Railroad Retirement Board (RRB), then you will not be able to use these payment options. You must send your payments to the office in St. Louis, MO. Get a supplement plan at

How do I enroll for Medicare Easy Pay?

Medicare makes registration easy and uncomplicated. To sign up for Medicare Easy pay, print out this form and enter the required information. Then submit the completed form to the Medicare Premium Collection Center using the following address:

Medicare Premium Collection Center

St. Louis, MO 63197-9000

PO Box 979098

The Authorization Agreement for Pre-Authorized Payments, entitles CMS to receive your monthly payments right from your savings or checking account. This gives you the permission to make your monthly premium payments fast, uncomplicated and thoughtless.

Note that this process takes some time. Processing your Authorization Agreement for the Pre-Authorized Payments Form can take between six and eight weeks. If you have a payment due during this time, you must pay your premium in the usual manner that you would normally pay.

Once the CMS has received your request for Easy Pay, a “Medicare Premium Bill” will be sent to you. It is not an actual invoice but will rather state that your premiums will be deducted from your checking or savings account every month from this month onwards.

CMS deducts the monthly payments on the 20th of each month from your account. If you search the transaction on your bank statement, this will be displayed as a withdrawal from the Automated Clearing House (ACH).

Do I have to do something after registration?

You do not have to make any further monthly premium payments after the request process. Every month, CMS automatically deducts your payments from your checking account or savings account.

In some situations, you may be required to make a direct payment to Medicare. For instance, if CMS attempts to withdraw the payment from your bank account but your bank returns or declines the premium payment, you are still responsible for the payment. Rather than withdraw automatically from your bank account, Medicare notifies you that your bank has declined the payment. This notification will also provide instructions on how to make the payment directly to Medicare.

Limit your medical care costs with Medicare supplement plan K

As Medicare original part A and B don´t cover all costs, private health insurance companies offer supplemental plans, which cover these costs that you would otherwise have to pay out of your own pocket. The premium rates for these plans vary on the type that you choose. Plans who cover more benefits tend to be more expensive and the ones covering less will also cost less. Which of these options is best really depends on the individual and their personal situation. While to some it´s important to have a supplement plan that covers everything, others find this to be necessary and would rather want a different type of security.

There are two available Medicare supplement plans, that have an out-of-pocket limit; plan L and supplement plan K. This means, that your costs for medical care in one year can only reach that firmly set limit. Everything you might require and that might cost above the limit you had already paid for the year, will be covered by these supplement plans. This is a great way of additional insurance for those who don´t really need to have full-coverage, but also want to avoid very high costs, for example in a case of an emergency surgery.

Medicare Supplement Plan K

In 2018, the Medicare supplement plan K limit was at 5,240$. There are benefits that are covered up to 50%, however after reaching this limit and depending on the case, the supplement plan K should cover the expenses to a 100% after having reached the limit. The benefits covered by supplement plan K are:

  • Costs for Medicare Part A deductible
  • Costs for Part A coinsurance or copayment, due to hospice care
  • Costs for skilled nursing facility care coinsurance
  • Costs for Medicare Part B copayment or coinsurance
  • Costs for first three pints of blood, necessary for a medical procedure (per year)


What Medicare Supplement Plan K doesn´t cover?

Bevor and after reaching the set limit, there are certain expenses that aren´t covered by Medicare supplement plan K at all. This is important to keep in mind, as should you be looking for a plan that covers exactly these expenses, plan K is not be the best option for you to lower your medical care expenses. The plan K doesn´t cover:

  • Medicare part B deductible
  • Medicare part B copayments
  • Prescription medication
  • Vision screenings
  • Hearing aids


Depending on the health insurance company, the cost for Medicare supplement plan K can vary. While health insurance companies don´t get to individually decide what benefits the plan covers, they are allowed to set their own prices for the plan. This can start at around 500$, with the highest premium for the Medicare supplement plan K laying at around 2000$. Also, prices may and can vary from individual to individual. Another thing to keep in mind is that this standardization is applied in 47 states only. Citizens of Massachusetts, Wisconsin and Minnesota have different standardizations. This Medicare supplement plan is also only available to those who are over the age of 65.

Part C

Medicare Part C, otherwise called Medicare Advantage, is a health plan supplied by Medicare-approved privately owned businesses. Medicare Part C is regularly picked by individuals who can’t meet all requirements for without premium Medicare Part A/Part B scope, or by the individuals who have exceptional needs or need extra scope. Since the plans are offered by various organizations, the guaranteed has numerous options, and can choose the coverage, the benefits, the standards and the costs best for him or her.


Medicare Advantage plans have a considerable lot of indistinguishable options from non-Medicare health protection. Choices are accessible for PPO (Preferred Provider Organization) plans, HMO (Health Maintenance Organization) plans, MSA (Medical Savings Account) plans and that’s just the beginning.


Part C is likewise prominently known as “Medicare + decision” in light of the points of interest this plan gives. Medicare Advantage plans must cover everything that unique Medicare covers, except for hospice care. (This is on account of Medicare Part A still covers hospice, regardless of whether you choose to take an interest in a Medicare Advantage plan.) With Part C, the Medicare Advantage plan likewise commonly covers specialist endorsed prescriptions, some hearing aids, glasses and strolling aids like walkers or sticks. A few plans offer scope for dental work, vision testing and glasses, hearing aids, and even preventive health-and-wellbeing programs. Numerous Part C plans incorporate doctor prescribed medication scope.

Find out more here

Medicare Part C, combined with private health insurance agencies, can help give significantly more prominent scope than Part A and Part B alone would offer. The main distinction is that it for the most part costs more to enlist with a portion of the health insurance agencies to get the extra benefits and scope. Likewise, in light of the fact that Medicare Part C works with private insurance agencies, the plans and fees are liable to change yearly. There is dependably the possibility that your plan provider could choose to quit participating in Medicare. On the off chance that this happens, you should re-join an alternate Medicare health plan or come back to being secured by unique Medicare as it were.

Since Medicare Part C/Advantage plans must be endorsed by Medicare, and work in conjunction with Part A and Part B, the standards for qualification are fundamentally the same as Part An and Part B. You can select in Medicare three months previously your 65th birthday celebration through three months after the 65th birthday celebration. With a couple of special cases, you can join a Medicare Advantage plan regardless of whether you have previous conditions. You can join a plan just amid specific circumstances of the year. Quite often, once you’ve enlisted, you are selected for a year until the following enlistment time frame.


Keep in mind, while these plans have extraordinary benefits, they can be all the more expensive. In the event that you are keen on a Medicare Advantage/Part C plan, you should accumulate as much information as you can and measure the monthly costs against the benefits carefully. When taking a gander at the costs, you ought to make certain to ask whether the Medicare Part B premiums are incorporated or should be paid independently. Each organization and each plan offered can be extraordinary, so ensure you see plainly the greater part of the costs and decides that you are consenting to.

Using Your Health Savings to Build Retirement Savings

Health Savings Accounts are a great method to assemble a moment retirement account. These assessment favored records, which have just been accessible since January of 2004, can be opened by anybody with a qualifying high-deductible health insurance plan. When you open a HSA account, you can put impose deductible commitments into it, which develop assess conceded like an IRA. You may pull back cash tax-exempt to pay for medical costs whenever.


The main motivation more individuals don’t resign before age 65 is absence of health insurance, and numerous Americans achieve age 65 woefully caught off guard for the medical costs they’ll confront once they do resign. A standout amongst the most imperative long haul purposes behind setting up a HSA is to develop some cash for medical costs acquired amid retirement.


Devotion Investments reports that the normal couple resigning in 2006 will require $190,000 to cover medical costs amid retirement. This accept life hopes of 15 years for the spouse and 20 years for the wife.


HSAs are, regardless, the most ideal approach to develop cash to pay for medical costs amid retirement. You ought not contribute any cash to your customary IRA, 401 (k), or some other bank account until the point that you have boosted your commitment to your HSA. This is on the grounds that lone health bank accounts enable you to influence withdrawals to tax exempt to pay for medical costs. You can take these conveyances whenever previously or after age 65.

Medicare Advantage plans 2018

Your HSA commitments won’t influence your IRA limits – $3,000 every year or $3,600 for those more than 55. It’s simply one more duty conceded approach to put something aside for retirement, with the additional favorable position being that you can pull back assets tax-exempt if they are utilized to pay for medical costs.


For early retirees who are healthy, a health investment account can likewise be a savvy choice to help bring down their health insurance costs while they sit tight for their Medicare coverage. The more established somebody is, the more they can spare with a HSA plan. For some individuals in their 50’s and 60’s who are not yet qualified for Medicare, HSAs are by a wide margin the most reasonable choice.


Get a quote at for Medicare Advantage plans for 2018.


Any cash you store in your health investment account is 100% expense deductible, and the cash in the record develops assess conceded like an IRA. For 2006, the top level augmentation for a solitary individual is the lesser measure of your deductible or $2,700. At the end of the day, if your deductible is $3,000, you can contribute a most extreme of $2,700; if your deductible is $2,000, at that point that is the greatest. For families, most extreme is the lesser of $5,450 or the deductible.


If you’re 55 and more established, you can put in an additional $700 make up for lost time commitment in 2006, $800 in 2007, $900 in 2008, and an extra $1,000 from 2009 forward. As far as possible is recorded to the Consumer Price Index (CPI), so it will increment at the rate of swelling every year.


The amount you aggregate in your HSA will rely upon the amount you contribute every year, the quantity of years you contribute, the speculation return you get, and to what extent you go before pulling back cash from the record. If you frequently support your HSA, and are sufficiently lucky to be healthy and not utilize a great deal of medical care, a considerable measure of riches can develop in your record.

How to choose Medicare Advantage plans

Determining a coverage type is the right way to approach Medicare Advantage plans. This is because it is very important to go through all the details of each plan. Very importantly, read also the fine prints and without fail compare the benefits, restrictions on each plan and the costs. Finally, check if the plan you narrow down offers service in your areas. In case you wish to use a particular hospital or a specific doctor, do check if they are in the Medicare Advantage plans network.


You should think out the medications you take before deciding on any of the Medicare Advantage plans so that you will know if they offer the coverage for prescription drug. Knowing this is important as some of the plans of Medicare Advantage do not offer the drug coverage. Thus, check the covers to know for prescription cover and compare the cost as it varies with each plan.


Am I eligible for Medicare Advantage plans for enrollment?

Qualifying in Medicare Advantage plans for enrollment requires you to be enrolled in Part A and B Medicare. However, people with end-stage renal disease are considered ineligible to get enrolled. Additionally, bear in mind to get enroled with Medicare Advantage plans, you must be residing in the same service area.


Decided for Medicare Advantage plans? Now, have you decides that you want, the plans with or without the coverage of prescription drug? The decision is completely based on your situation. Thus, learning more is essential and you can compare the plans that are eligible.

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Types of plans


  • HMO refers to the health care type that needs selecting primary care doctor.
  • See a specialist by taking a referral.
  • Adhere to the rules strictly to enjoy the services; else you have to bear full care costs.
  • Only in particular circumstances, you may not be covered for obtaining services outside the network of the plan.
  • The HMO is restrictive than other plans.


  • PPO plans allows visiting any hospital or doctor, but on using out of the plans network, you receive less coverage.
  • No need of referral for a specialist. However, you may end up paying more for than the network plan offering covered services.
  • PPO is less restrictive, but the premium is higher.


  • No need for referrals to get specialists treatment and also no rules to choose care from primary doctor.
  • Check with plans, before enrolling.


  • You have a chronic condition, dementia or chronic heart failure or dementia.
  • You live in a nursing home or institution
  • Enrolled in Medicaid and Medicare

How Medicare supplement plans work with Medicare

Medicare supplement plan is also known as Medigap. It is always offered through private insurance companies, unlike the original Medicare. You may consider getting a Medicare supplement plan since the original Medicare doesn’t pay for everything but only pays for your supplies and health care services. With Medicare supplement plan, you can pay medical costs that the original Medicare doesn’t cover, for example, deductibles for the year, emergency overseas travel, and copayments. Here is an overview of how Medicare supplement plans work with Medicare.

It is called Medicare supplement plan because it supplements your original Medicare benefits. In order to be eligible for Medigap coverage, you have to be enrolled in original Medicare for your medical coverage and hospital. If you are under the age of 65, you may not be able to get Medicare supplement coverage because of the state you are living in like disability. For those who are under 65 years of age and have enrolled in original Medicare, should find out with their state’s insurance department if they are eligible for to enroll in a Medicare supplement plan.

Medicare supplement plan doesn’t include drug prescription coverage so you should keep that in mind. You will need to enroll in a stand-alone Medicare prescription plan if you want help with your medication costs. Medigap is only used to cover costs in the original Medicare but, you cannot use to pay for costs you may have with Medicare Advantage plan. If you have both Medicare supplement plan and original Medicare, original Medicare will be used to make payments first and Medigap will be used to fill in the remaining cost.

In order to get a Medicare supplement plan, it is a requirement that you must have both Medicare part A and B. Medicare supplement plans covers one person only if you have a family you spouse and children are required to have separate plans. Generally, you can use Medicare supplement plan with any provider that accepts Medicare. But not all of them accept some types of Medigap require you to use your provider networks.

Medicare supplement plans 2018 are generally expensive and costs vary between plans with the same benefits. You can apply for a Medicare supplement plan any time you want so long as you are enrolled in Medicare part A and B. It is important to buy a Medicare supplement plan when the enrollment period is open which starts in the month you are 65.


Many Medicare Plans to choose from

As we age, an individual will be concerned with their health needs and the need for insurance to cover them. When we reach the age of 65, we can join Medicare. Medicare covers 80% of our medical treatments, hospitalizations and various tests our health practitioner may require. Currently Medicare Part A only covers 80% of those needs. This will depend on if you also have Medicare Part B coverage.

Without the benefit of Medicare A and Medicare Plan B, the added  20% costs will be the responsibility of the individual, which can be considerable and difficult to pay as an individual ages. Getting a Medicare supplement plan is definitely something to consider. Many Medicare supplement plans are available and are called Medigap plans. These plans are regulated by the Medicare rules and regulations.

As of now, there are 12 Medicare Supplement plans available called Medigap. The plans are known as letters A-L and offer many different costs according to the benefits in the plan and what is needed by the individual. Each plan offers an individual a wide array of services that should be looked at carefully before deciding what plan they might chose for their needs.

There also is another option known as Medicare Select. These plans can be more affordable, but have many restrictions that may not be desirable. They can restrict what medical practitioners an individual may need to see and the tests that may be needed will have to be approved before an individual can access them.

Insurance companies all carry the same plans and do not change between each company, but the costs of the premiums will vary depending upon where the insurer resides.

The time to consider purchasing a Medigap plan is within six months of joining Medicare A and Medicare B. If you were too wait too long, the premiums for you will increase considerably at one, three or five years. This may cause a problem of being able to pay the premiums in later years.

The amount of the premiums will depend on the age at which you join. Those living in the same area will be paying the same amount and not according to age.

It should be noted that every January, Medicare can change its benefit profile as the times change and benefits will go accordingly. Medicare Supplement Plans 2018 may also increase depending on Medicare rules and regulations. You will be notified prior to the increase.