Adler Insurance, your Medicare expert in Prescott, discusses Medicare Part F

If you’re 65 or older, you have probably learned about Medicare Parts A and B, but are you familiar with Medicare Part F? Adler Insurance, Prescott's independent Medicare broker, talks about why the extensive coverage provided by Medicare Part F makes this such a popular plan.

It's possible for beneficiaries to be left with no or only minimal hospital and medical debt because Part F covers most remaining hospital and doctor costs after Original Medicare (Part A and Part B) has paid its share.

Regardless of your location, you can expect the same exact basic benefits for a Part F supplement sold anywhere in your state. Even though the basic coverage is the same, premium costs may vary.

For those who don’t mind paying for out-of-pocket costs up front, there is also a different high deductible Part F choice. This variant of the regular Part F requires beneficiaries to pay every out-of-pocket expense till the deductible is reached (which for 2018 is $2,240). After meeting the deductible, the high-deductible Part F starts to pay for Medicare-covered costs.

What does not change between the standard Part F and the high-deductible Part F option are the basic benefits:   

• Part A hospital and coinsurance costs up to an additional 356 days after Medicare benefits are exhausted
• Part A hospice care copayment or coinsurance
• Part B coinsurance
• Part B excess charges
• Part A deductible   
• Part B deductible   
• First three pints of blood used in an approved medical procedure (annually)   
• Foreign travel emergency coverage (80%, up to plan limits)
• Skilled nursing facility coinsurance

   
If you see a doctor frequently, or you require a lot of health-care services, or are facing mounting out-of-pocket expenses, the comprehensive coverage of Part F generally offers the most help with your Original Medicare costs.

Still wondering what is the right Medicare plan for you? Call the experts at Adler Insurance today at 928-710-1455 to learn more about Medicare Part F or any Medigap plan coverage available to Prescott residents. Learn more at http://www.adlerlifehealth.com.

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Medicare Enrollment in Prescott; Who Needs it? - Adler Insurance

Most American citizens and legal residents become eligible for Medicare health coverage when they turn 65 years old.  The eligibility age may rise to 67 or 68 in coming years, but it's likely that any such increase will be phased in so that anyone who's already eligible can stay in the system. If you’re approaching the age of 65, questions about Medicare open enrollment in Prescott can easily be answered by experts at Adler Insurance. For now, we’ll cover some of the basics.

The Initial Enrollment Period for Medicare actually starts three months before you turn 65, so you can start applying for and setting up your coverage when you're 64 and nine months. Medicare is made up of four component Parts. Specifically:

Part A (Hospital Insurance) pays for part of any:

•    inpatient hospital care,
•    critical access hospitals,
•    skilled nursing facility care,
•    some home health care,
•    hospice care.
•   
Part B (Medical Services Insurance) pays for part of any:

•    doctor's services,
•    ambulance services,
•    outpatient hospital care,
•    x-rays and laboratory tests,
•    durable medical equipment and supplies,
•    some home health care,
•    certain preventive care,
•    other outpatient services,
•    other medical services Part A doesn't cover, such as physical and occupational therapy.

Taken together, Parts A and B make up "traditional" Medicare coverage. And they operate like an indemnity-style health insurance policy. They are flexible, giving you broad choice in the doctors and hospitals you use, but they require you to pay substantial amounts out of your own pocket. Part C— it's also called the Medicare Advantage program—is, essentially, a managed-care option. It puts various restrictions on the providers and hospitals you can choose but generally covers all (or nearly all) of the costs. Part C includes several sub-category options:

•    Medicare Health Maintenance Organizations. In these plans, you must get your care from primary care doctors, specialists or hospitals on the HMO's list of network providers, except in emergencies.

•    Medicare Preferred Provider Organization Plans. In most of these plans, your share of plan costs is lower when you use doctors, specialists and hospitals that are "in network." which means they contracted to accept the PPO fee schedule.  Using out-of-network providers is allowed but will cost you more out-of-pocket. The PPO option is designed especially for use in rural areas—which have been historically undeserved by Medicare providers and facilities.

•    Medicare Special Needs Plans. These plans generally limit enrollment to people in certain long-term care facilities (like nursing homes); people eligible for both Medicare and Medicaid; or those with certain chronic or disabling conditions.

•    Medicare Private Fee-for-Service Plans. Sometimes called Point of Service Plans. In these plans, you may go to any Medicare-approved primary care doctor, specialist or hospital that will accept the terms of the private plan's payment.

•    Medicare Medical Savings Account Plans. These plans include a high deductible plan that will not begin to pay benefits until the high annual deductible is met. They also include a medical savings account into which Medicare will deposit money for you to use to pay your health care costs. Medicare MSA Plans do not cover prescription drugs—you have to buy that coverage separately.

Part D is the Medicare Outpatient Prescription Drug Coverage. It's a fairly new coverage, begun in 2006, and is sold through private-sector insurance companies rather than directly by the government.

The most important thing to remember about Medicare is that enrollment should never be put off. The Government is constantly changing regulations regarding retirement as we know it. The retirement age has been increased to 67 and will likely go up from there. Adler Insurance wants to remind you that no matter at which age you retire; it is a requirement to enroll in Medicare at 64 and nine months of age. Learn more about Medicare by visiting Adler Insurance at http://www.adlerlifehealth.com/ or calling 928-710-1455

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Are you soon turning 65? Adler Insurance in Prescott discusses how he can assist you.

Turning 65 typically means you’re eligible for Medicare.  This includes both Part A & B. This federal program provides hospital insurance and some medical insurance to older Americans.  Adler Insurance explains some of your additional options in Prescott:

• Medicare Part C, also called Medicare Advantage. These plans are available from private insurance companies and must offer the same benefits as Part A & B, but may add more coverage like vision, dental, or prescription drug benefits. It is imperative that you know which private insurance companies are being used in your local area.  You don’t want to sign up for a plan only to find out there aren’t any doctors in town accepting that insurance coverage. 
• Stand-alone Medicare Part D prescription drug plan.  You can add this to your original Medicare to receive prescription medication coverage.
• Medicare Supplement insurance (known as Medigap) is also available to add to your Medicare coverage and help cover the “gaps” in original Medicare.

First-time Medicare beneficiaries have what is called an Initial Enrollment Period. This period starts three months before your 65th birthday and extends three months afterwards. It’s important to enroll during this time. If you do not enroll during the Initial Enrollment Period, you may incur late fees or have to wait until the General Enrollment Period which is between January 1st to March 31st of the following year.  Your coverage would then begin in July of that year.

If you or your spouse are still working when you turn 65 and you have health insurance through this employer, you might consider delaying enrollment in Part B. You may not wish to pay the Part B premium if you don’t need the coverage. Contact your current employer’s benefits department to see if your employers’ health coverage is sufficient and find out how it might work with Medicare Part B before making a decision.  Call us if you need some help with your decision.

When your employer coverage ends, you will be provided with a Special Enrollment Period that lasts eight months to sign up for Medicare Part B without incurring a penalty.

We encourage you to call us and talk further about your individual Medicare needs in Prescott.  Jessie and Dina Adler at Adler Insurance would love to assist you in making good Medicare decisions.  Please don’t hesitate to call 928-710-1455 or visit our website at http://www.AdlerLifeHealth.com today!

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Adler Insurance provides tips on what to do after getting denied life insurance in Prescott

It’s tough to learn that the life insurance company you applied to will not be offering you coverage, especially if you were fully expecting a yes!  Adler Insurance in Prescott helps consumers figure out the next steps on signing up for life insurance in Prescott.

You may fall into the “impaired risk market,” which means you have something in your background that makes you a higher risk for dying prematurely.  While many applicants with this type of history understand they’re up against a hurdle or two, it’s not any easier to be denied life insurance coverage. But, often times, it doesn’t mean the hunt for an approval is over.  Adler Insurance seeks to help provide clarity on the steps to take after getting denied life insurance in Prescott.

Here are three actionable steps you should take if you’ve been denied life insurance:

Collect information. Before an insurer denies an application, they collect lots of data from several sources to evaluate your risk. If the risk is high enough, you are either rated, postponed or denied. In any of these circumstances, requesting more information on the reason for denial is your right.


Confirm the results. Errors can happen. Wires can be crossed. Double check the data that was provided to the underwriter. If poor exam results were cited as the cause, confirm it with your primary care physician. In some cases, a company may simply deny coverage because of new, undiagnosed lab results, even if there is little cause for concern.

Work with an agent. Even with proper research, the first company you apply to isn’t always necessarily the best. Passing along detailed information to an agent can allow them to search into better options. A well-trained high-risk life insurance agent can assess information thoroughly and find a better fit for you.

If the root cause for denial is too great, a different type of life insurance policy altogether may be the last resort.  Give us a call at  928-710-1455 or visit us on online at http://www.adlerlifehealth.com.

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Adler Insurance provides the necessary information for consumers on qualifying for Medicare in Prescott

You must meet certain requirements for Medicare eligibility.  Adler Insurance in Prescott provides the necessary information to see what qualifications you meet for Medicare.

Generally, Medicare is available for people age 65 or older, younger people with disabilities.  You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:

• You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
• You or your spouse had Medicare-covered government employment.
• If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
• You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig's disease, your Medicare benefits begin the first month you get disability benefits.) You are a kidney dialysis or kidney transplant patient.

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.


For more information about open enrollment contact us at 928-710-1455 or by visiting us at http://www.adlerlifehealth.com. 

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Adler Insurance in Prescott helps consumers navigate the waters of Medicare Advantage Plans

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.  Adler Insurance prepares users for signing up for Medicare Advantage Plans in Prescott.

However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services.  Often these rules are subject to change every year.

Medicare Advantage Plans Drug Coverage:
You usually get prescription drug coverage (Part D) through the plan.  You can't have prescription drug coverage through both a Medicare Advantage Plan and a Medicare Prescription Drug Plan.

Medicare Advantage Plans and Medigap Plans:
Medigap policies can't work with Medicare Advantage Plans. If you have a Medigap policy and join a Medicare Advantage Plan (Part C), you may want to drop your Medigap policy.

What Medicare Advantage Plans Cover:
Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you're in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you're always covered for emergency and urgently needed care.  Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. 

Adler Insurance in Prescott can answer all of these questions.  Contact us at 928-710-1455 or by visiting us at http://www.adlerlifehealth.com. 

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Must Know Open Enrollment Dates for Medicare in Prescott Arizona provided by Adler Insurance

Open Enrollment and Medicare are often confusing, particularly if you haven't had to apply for them before.  Adler Insurance in Prescott wants to shine a light on important information that will help seniors not only apply, but also discuss the intricacies of Arizona Medicare numbers. 

Q: When is Medicare Open Enrollment for 2017 coverage?
A: For 2017 Medicare coverage, open enrollment is in the fall of 2016, from October 15 to December 7. (The specific dates changed in 2011, but have been the same ever since, and should remain as-is for the foreseeable future.)

During this annual enrollment period (AEP)  you can make changes to various aspects of your coverage.

• You can switch from Original Medicare to Medicare Advantage, or vice versa.
• You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.

If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.

• You must be enrolled in Medicare Part A and B.
• You must live in the plan’s service area.

Is auto-renewal available?

If you’re already enrolled in a Medicare Part D prescription plan or a Medicare Advantage Plan and you don’t want to make changes to your coverage for 2017, you don’t need to do anything during open enrollment, assuming your current plan will still be available in 2017.

In Arizona in 2017:

• 100 percent of people with Medicare have access to a Medicare Advantage plan.
• 71 Medicare Advantage plans are available.
• 22 Medicare Prescription Drug Plans are available.
• 83 percent of people with Part D have access to a plan with a lower premium than what they paid in 2016.
• 27 percent of people with Medicare Part D get Extra Help (also called the low-income subsidy, or LIS).
• $17 is the lowest monthly premium for a prescription drug plan.

If you are interested in more information regarding Open Enrollment for Medicare contact Adler Insurance at (928)710-1455 or by visiting our website at http://www.adlerhealth.com.

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Who is eligible for Medicare?

Adler Insurance in Prescott brings you these helpful tips about Medicare eligibility. Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease. Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance).

To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool.

If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A.

If you are under age 65, you can get Part A without having to pay premiums if:

•You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.

•You are a kidney dialysis or kidney transplant patient.

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.

Since January 1, 2006, anyone with Medicare, regardless of income, health status has had access to prescription drug coverage.

Medicare eligibility can be confusing, so contact Adler insurance today for more information and clarification for what is right for you. Call 928-710-1455 or visit our website http://www.AdlerLifeHealth.com.

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