• Medicare

    Advance Beneficiary Notice of Noncoverage

    If you have Original Medicare and any provider or supplier thinks Medicare probably (or certainly) won’t pay for items or services because Medicare deems the treatment not medically necessary, that provider or supplier is required to provide you with a written notice called an “Advance Beneficiary Notice of Noncoverage” (ABN). There are exceptions, an ABN isn’t required for items or services that Medicare never covers. The ABN lists the items or services that Medicare isn’t expected to pay for, an estimate of the costs for the items and services, and the reasons why Medicare may not pay. The ABN gives you information to make an informed choice about whether or not…

  • Medicare

    Advantages of a Local Agent

    There are several advantages of utilizing a local licensed agent with your Medicare or other individual health insurance needs. Chief among them is trust, being able to put an actual face with a name connected with your local community and not dealing with a call center in Florida or even one outside of the country. Next is accessibility, unless I’m already speaking with someone, I answer my cell phone (the only number I give out) from 8am to 8pm. And if I am on the other line, I make ever attempt to call you back within an hour of your message. Experience is another advantage. While there are many experienced…

  • Medicare

    Medicare: In-Patient vs. Under Observation

    Under Observation Doctors place hospital patients under observation to determine if they should be formally admitted as inpatients or if they can be discharged without further treatment. In most cases, the decision to admit a patient can be made in under 48 hours, and many times in less than 24 hours, according to the Centers for Medicare & Medicaid Services. Hospital costs for admitted inpatients are covered under Medicare Part A after the patient pays a deductible ($1,260 for each benefit period for 2015). But observation care is considered an outpatient service, and Part A doesn’t cover such services. Instead, Medicare Part B helps cover the cost of outpatient services including observation care. The Medicare…

  • Medicare

    Missing Your Deadline for Part B

    Depending on your situation, your personal deadline for Part B enrollment is one of the following: The end of your seven-month Initial Enrollment Period (IEP) around the time you turn 65 The end of the eight-month Special Enrollment Period (SEP) that you’re entitled to if you were able to delay Part B beyond age 65 because you had health insurance from your (or your spouse’s) current employment For example, your 65th birthday falls in September. That month is the fourth month of your seven-month IEP, so the last day of you IEP is December 31. Or if you’ve continued working beyond 65 in your job with health benefits and retire…

  • Individual Health Insurance,  Medicare,  Our Community

    Warning: Avoid this combination

    When given by a doctor and taken exactly as prescribed, opioids may be a valuable part of a treatment plan. But they may also be dangerous. That’s especially true when they’re mixed with alcohol. In fact, alcohol was involved in more than 18 percent of opioid-related emergency room (ER) visits and more than 22 percent of opioid-related deaths, according to a 2014 study by the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration. Here’s some information that may be useful to help prevent one of these tragedies. Why opioids and alcohol don’t mix. On their own, opioids may slow — or even stop — a…

  • Medicare

    Medicare Initial Enrollment Period

    To get the most out of your Medicare health benefits, it’s important for you to understand how and when to enroll in Medicare. You will need to sign up for Medicare Part A and/or Part B during the Initial Enrollment Period (IEP) that begins three months before you turn 65 and lasts for seven months. Automatic enrollment for Original Medicare Initial enrollment in Original Medicare, Part A and/or Part B, occurs automatically if you are turning 65 and already getting Social Security benefits. You will need to sign up for Medicare Part B at the time that you apply for retirement benefits, and Medicare Part A enrollment occurs automatically if you…

  • Medicare

    Medical Supplies and Equipment Under Medicare

    If you require items that help you function such as a wheelchair, an oxygen tank, an artificial limb, or other items are considered under Medicare as Durable Medical Equipment. Durable means long-lasting, and Medicare covers only those items that will last a while. Outside of a few exceptions, Medicare does not cover disposable items that only have a one or two time use. For Medicare to cover durable medical equipment, it must be: Medically necessary for you, not just a convenience Prescribed by a doctor or other primary care professional Not easily used by anyone who isn’t ill, or injured Reusable and likely to last for three years or more…