The team of California health insurance professionals at Vitality Health Insurance includes trained professional health insurance personnel licensed to work with California Seniors on securing the right insurance Medicare supplemental plan thatâ€™s right for you and your spouse. Insurance supplements for seniors here in California go by a range of names such as:
California Medicare supplement, California Medicare supplement insurance, California Medicare supplemental, Medicare Supplement Insurance, Medigap Insurance, insurance Medicare supplemental, or insurance Medicare supplement!
Whatever you decide you want to call it when you call or write our offices about the health insurance plan thatâ€™s right for you after youâ€™ve moved past the need for insurance through an employer or perhaps the individual California health insurance you previously owned, weâ€™re standing by and ready to lend our professional expertise to matching you up with the insurance Medicare supplemental plan thatâ€™s right for your medical needs moving forward into a bright and active future as well as your budget.
Letâ€™s start with the basics, shall we? Weâ€™ll first look at the basic components of what constitutes the Medicare program as we know it today. There are four commonly recognized parts to the program. These can include:
Medicare Part A: This is your Medicare Hospitalization Insurance. Seniors 65 and older who have qualified for Social Security benefits are automatically eligible with no premiums necessary. With Part A insurance, benefits include: Inpatient hospital care; skilled nursing facility care; home healthcare; hospice care for terminally ill patients.
Medicare Part B: This is your Medical Insurance. Participation is optional for everyone enrolling in the Medicare Programâ€™s Part A. While Part A has no premiums there are premiums for Part B. Specific benefits offered in Part B include: Doctorâ€™s services including surgery as well as other items that would be part of the treatment regimen such as X-rays, drugs that are specifically a part of the treatment regimen and which cannot be self administered; outpatient services (such as an emergency room visit); ambulance services, as well a variety of other medical and health services.
There is also a roster of what Part B Medicare Medical Insurance does not cover and your insurance Medicare Supplement professional at Vitality Health Insurance can readily assist you in understanding what your basic Part A and Part B plans do and donâ€™t cover.
Medicare Part C or Medicare Advantage Plan: These are plans that are part of the Medicare program and offered by private insurers. Advantage plans provide all your Part A and Part B coverage along with other features which you might normally have to secure through an insurance Medicare supplement plan and may or may not offer prescription drug coverage which you might then have to secure through Medicare Part D. Â If you go with an Advantage Plan you cannot purchase an additional supplemental plan and if the plan offers drug coverage you are ineligible for Medicare Part D. These plans typically operate in the same way that any California health insurance plan offering might in that they come in a variety of styles such as a Preferred Provider Organization (PPO); Health Maintenance Organization (HMO); fee for service indemnity type plans, even high deductible plans matched with a Medicare Medical Savings Account (MSA) Plan. As you no doubt have already learned from your days shopping for Individual California health insurance, wherever you find insurance plans and insurance companies youâ€™ll find variety! While variety is great and offers you the opportunity to craft a California health insurance plan thatâ€™s right for your post-retirement years, it can also be somewhat confusing and even frustrating. Thatâ€™s where we come in: Our service to you is free and we receive no compensation from you in helping you understand the insurance Medicare supplement that is right for you.Â
Medicare Part D: Where certain insurance Medicare supplemental plans such as plans H. I. and J used to offer limited drug benefits, the government in 2006 recognized the incredible financial hardship that was visited upon seniors in our country who had to take regular prescription drugs and created Part D Medicare. Now Medicare-eligible seniors can purchase a separate Part D plan offered by private insurers that require you to pay a monthly premium. In exchange for that monthly premium your subsequent prescription drug costs will be less expensive (Costs and coverage will vary depending on the drug plan you choose.) and you only pay a co-payment, coinsurance, and/or deductible, if any. The plan also features the use of a member ID card that would be used at the location where you have your prescriptions filled. All in all very much like the plan you were used to from your pre-Medicare days when you used a prescription drug plan through your employer group coverage or your Individual California health insurance plan.
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Shopping for Medigap Insurance? Now’s also the right time to reviewÂ your California Long Term Care Insurance Strategies!
Okay! Weâ€™ve checked out the basics of what California Medicare health insurance has to offer you, the eligible participant. Letâ€™s now turn our attention to the available insurance Medicare supplement insurance policies that are available to you as you consider how best to purchase a insurance Medicare supplemental plan that fits your budget but also acts to â€śclose the gaps in your standard Part A and Part B Medicare plans.
Closing the â€?gapsâ€™. Thatâ€™s what the intended purpose is of insurance Medicare Supplement Insurance. So much so that the other readily accepted term for the product is California Medigap insurance.
Simply put, Medicare supplement insurance is a policy sold to you by private insurance companies (like a California Blue Cross or Blue Shield of California) that fill the gaps left by the Medicare plan insurance plan made available to you by the government in Plans A & B. Medigap policies are designed to pay some of the healthcare costs you would incur given what Medicare policies leave out. An example would be a standard Medigap plan that pays for the first three pints of blood not covered by Medicare Part A.
Your Medicare policy and your Medigap policy work in unison to try and provide you with the most comprehensive coverage for the health care costs you incur after achieving the age of 65.
If you look at standard individual California health insurance plans youâ€™ll see that it feels like there are enough different plans to basically represent all the grains of sand at the beach. Mercifully, thatâ€™s not the case with an insurance Medicare supplement. Insurance companies in the business of marketing Medigap policies are required to only offer up to 12 standardized Medigap policies (Medigap Policies A-L). Note that we said â€śup toâ€ť. Thatâ€™s because insurance companies need only offer the standard Medicare supplemental insurance policies offering the most basic benefits. They can, if they choose, offer the remaining set of policies that offer all 12 options that feature a combination of core/basic benefits and extra benefits.
Both federal and state governments are involved in designating what goes into the basic benefit policies as well as what basic and extra benefits will comprise the remaining Medigap policy offerings. So you can rest easy that you not only have the team at Vitality Health Insurance looking out for your best interest in helping you with your Medicare supplement insurance buying decisions, but you also have the power of the United States and California behind you, looking to make sure that your best interests are met with the Medicare supplement insurance policies that are offered to you. Typically, buying a Medigap policy requires that you have both Medicare Part A and Part B. In addition to your Medigap premium, you will also have to pay the monthly Medicare Part B premium. Also: You and your spouse must each buy separate Medigap policies. The Medigap policy you buy for you wonâ€™t cover any health care costs for your spouse and vice versa.
Medigap policies also differ from the California health insurance policies you might have been used to as an individual or policyholder of an individual policy. Insurers selling Medigap policies donâ€™t have the ability to look at your medical history and say â€śno thanksâ€ť to your business. Nor can they get huffy when you experience an illness and drop your coverage.
Okay letâ€™s start with the underwriting process. The very best time to buy that Medigap insurance policy is at the time of your open enrollment. This period lasts for 6 months and starts on the first day that you are both age 65 and enrolled in Medicare Part B. During this period the insurance company canâ€™t utilize medical underwriting to say â€śthanks but no thanksâ€ť to your business: They cannot deny you any Medigap policy that it sells to the public at large. Except where you have a pre-existing condition that was diagnosed or treated within 6 months of the start date of your new Medigap insurance policy, they cannot make you wait for the coverage to start (During this pre-existing condition waiting period the insurer can refuse to cover your out of pocket expense on that condition for up to six months, but you are still covered by Medicare Parts A and B!) Further, there is also a creditable coverage provision in which it is possible to shorten or avoid waiting periods for pre-existing conditions. If youâ€™ve had at least six months of prior creditable coverage – certain kinds of previous health insurance coverage – prior to your application for a Medigap policy the Medigap insurer cannot inflict a waiting period on you. Weâ€™ll help you consult with your Medigap insurance company and state agencies if necessary to help ensure that your coverage begins exactly when it is supposed to. Further, you cannot be charged more for your new Medigap policy based on your medical history.
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For seniors turning 65 this is almost like being medically reborn. You need not fear your own medical records anymore when it comes time to purchase your new Medigap Medicare supplement insurance policy. But like we said, the very best opportunity for this medical rebirth starts with taking full advantage of your open enrollment period. Now is a great time to utilize the skills and expertise of a health insurance professional who can advise you and your spouse on the insurance Medicare supplement policy that makes the most sense given your past medical history, your current and future financial situation and what medical challenges you might face in the years ahead. Thereâ€™s nothing that says you canâ€™t ponder these issues in concert with your California health insurance professional in the time leading up to your open enrollment period either: Weâ€™ll offer careful and considerate consultation and also provide neutral research and information on the subject matter so you can hit the ground running at the start of your open enrollment, make an unhurried choice and then start enjoying this great new phase of your life!
Letâ€™s now turn our attention to how your new Medigap policy will be priced both now and in the future. (Yes, even though you canâ€™t be denied coverage you can still expect rising premiums.) Letâ€™s examine this important facet of your Medigap policyâ€™s structure. Future premium adjustments can result from the type of rating system the insurer uses. The three rating methods in use include:
Community rated (also called â€śno-age-ratedâ€ť)
Issue age rated
Attained age rated
Community rated: The same monthly premium is charged of everyone regardless of age. Premiums can rise due to inflation and other factors (geography) but not age.
Issue age rated: Premium is based on the age you were when the policy was issued. Premiums are lower for the policyholders who bought the Medigap policy at a younger age. Premiums can rise due to inflation and other factors (geography) but not age. Â
Attained age rated: Premium is based on the age you attain so premium costs rise as you get older. Premiums are low at first but go up as policy holder ages. With a longer lifespan of the policyholder, this eventually becomes most expensive policy option. Premiums can also rise due to inflation and other factors (geography).
Pricing differences/use of different rating systems is where the real shopping experience begins for Medicare supplement insurance consumers. Understanding how policies are priced now for the same plans (Although the plans are standardized!) and how they are likely to rise in premium costs over the course of time from the various insurers that offer them in your area is where consumer research and the skill and expertise of a trusted California health insurance professional pays off for the client. Although the plan offerings are indeed standardized, the methodology used to adjust the pricing of the plan moving forward can have a significant impact on your fixed income. Thatâ€™s where consulting with a skilled Vitality Health Insurance professional and making the right long term financial decisions is vitally important and why we are dedicated to being your trusted resource in this process.