Debbie Perlman Blog

Find out what you can expect at these local informational meetings and a few surprising things you might get out of them. I love hosting Medicare plan informational meetings. As a Health Partners medicare providers in pennsylvania , these events give me a chance to hear what people in my community are concerned about as they prepare for Medicare.  And, I get to help clear up any confusion around their health plan options. What’s in it for you? Medicare informational meetings are a great way to learn about different Medicare health plans before you sign up for one.  Many health insurance companies hold their own meetings in different locations around the areas they serve. The meetings are usually run by licensed sales representatives who know all the ins and outs of their company’s Medicare plans.  Since each company offers different plans with different provider networks and prescription drug coverage, you should plan on attending more than one meeting.

Enrolling in a Medicare plan is a big decision. While you’re able to switch plans each year if you’re unhappy (in some situations more frequently) you still want to choose the best plan for your needs the first time. This means taking your out-of-pocket costs into consideration along with other factors. Medicare covers a wide range of medical services, but most are not free. Here’s what you should expect to pay out-of-pocket throughout the year if you’re enrolled in a Medicare Advantage/Part C plan. Premiums Premiums are the amount you pay each month out-of-pocket for your Medicare Advantage (MA) plan. The estimated average monthly MA plan premium for 2019 is $28, this cost may vary significantly. Some could be $0, while others could have premiums over $200. To join an MA plan, you must also be enrolled in Medicare Parts A & B. It’s important to remember that Part B has a separate premium that you are responsible for paying even if you enroll in a Medicare Advantag

A few years ago, my neighbors were in a car accident. Nothing too serious, thank goodness. They were, however, out of commission for a few weeks. As both were in their 80s and neither one able to drive during recovery, they needed home care – and a little extra help around the house. It’s important to plan for your health care needs, but sometimes life throws unexpected curve balls. And when that happens, you’ll need to know what’s covered.   Fortunately, there are ways you and your loved ones can get the necessary care at home. Here’s what you need to know. What’s home health care? It’s a range of health care services given in your home for an illness or injury. Things like: Covered by Medicare Skilled Nursing care (when given on a part-time or intermittent basis) Medical social services (counseling, help finding community resources) Medical supplies (wound dressings) Necessary durable medical equipment (walker, wheelchair, hospital bed) Physical, occupatio

Like the first tree to turn color in the fall, the Annual Notice of Changes is the first sign of the season – open enrollment season, that is. Reviewing and understanding this important document is the first step in making sure you get the coverage you need from your Medicare plan next year. 1. What is it? If you have a Medicare Advantage, Cost or Drug plan, the Annual Notice of Changes (ANOC) tells you about changes to your current Medicare plan benefits and costs that will take effect Jan. 1. Not sure what plan you have? Check out the bottom of this post for resources. Changes to premiums, covered services and costs You should see a side-by-side before and after listing of services and costs. Depending on your Medicare plan, these may include: Premium (the amount you pay each month) Deductible (the amount you pay before your plan kicks in) Copay (a flat fee that you pay for each service) Coinsurance (as opposed to a flat fee, this is a percentage you have

Recently, my mom fell and broke both her wrists. Between the trip to the ER, X-rays and follow-up visits, the cost of her health care really added up. Thankfully, her Medicare plan had a medical out-of-pocket maximum that limits the amount she has to spend each year.  Once she hits her out-of-pocket maximum, her plan covers all the costs for her medical care. She’s financially protected, even if she has another unexpected or expensive health care need. That’s why an out-of-pocket maximum is so important for people with a Medicare plan, especially those living on a fixed income. What is an out-of-pocket maximum? This is the limit on how much you might pay for medical care through copays and coinsurance in a year. Some people never get enough health care to hit their out-of-pocket maximum.  Think of your out-of-pocket maximum like a bucket. Every time you spend your own money on medical services or care, it goes into the bucket. Once the bucket is full, you’v

You got the card in the mail and you’re officially a Medicare member. Congrats! Are you wondering what to do next? One of your first steps is to schedule your Welcome to Medicare visit. Everyone who signs up for Medicare can get one welcome visit covered by Medicare during their first year. For the visit to be covered, make an appointment with a doctor that accepts Medicare. If you want to see the doctor you’ve been going to for years, log on to your online account and search the list of doctors your Medicare plan covers (your network) or call your insurance company to double-check that your doctor accepts your Medicare plan. What happens at a Welcome to Medicare visit? The goal of a Welcome to Medicare visit is for the doctor to get an overview of your health. You’ll talk about your current health and anything else you might want to do to stay healthy. The visit includes: A review of your medical and family history A checkup to measure your height, weight, b

Officials point to rising employment, but the uninsured rate is climbing as families run afoul of new paperwork and as fear rises among immigrants. HOUSTON — The baby’s lips were turning blue from lack of oxygen in the blood when his mother, Kristin Johnson, rushed him to an emergency room here last month. Only after he was admitted to intensive care with a respiratory virus did Ms. Johnson learn that he had been dropped from Medicaid coverage. The 9-month-old, Elijah, had joined a growing number of children around the country with no health insurance, a trend that new Census Bureau data suggests is most pronounced in Texas and a handful of other states. Two of Elijah’s older siblings lost Medicaid coverage two years ago for reasons Ms. Johnson never understood, and she got so stymied trying to prove their eligibility that she gave up. “I’ve been on this emotional roller coaster,” Ms. Johnson, 34, said of Elijah’s loss of coverage, an error that hap

Every fall, the 60 million Americans who use the health plan can compare options and save money. Here’s what to consider. If you’re enrolled in Medicare but worry about the cost of health care, your chance to do something about it is right around the corner. Most people enroll in Medicare when they become eligible at age 65. But every fall, they have the opportunity to change their coverage during an enrollment season that runs from Oct. 15 through Dec. 7. This is the time of year when you can switch between original fee-for-service Medicare and Medicare Advantage, the all-in-one managed care alternative to the traditional program. You also can re-evaluate your prescription drug coverage — whether that is a stand-alone Part D plan, or wrapped into an Advantage plan. It’s a good idea to do a checkup on your coverage, even if you are happy with your current choices. Prescription drug plans often revise their lists of covered drugs, the rules under which they

When President Lyndon Johnson signed Medicare into law on July 30, 1965, he declared, “No longer will older Americans be denied the healing miracle of modern medicine” (Johnson, 1965). On that promise, and much more, Medicare has delivered (Oberlander and Marmor, 2015). Over the past fifty years, Medicare has provided tens of millions of older Americans with a crucial measure of financial security and access to medical care. Moreover, since 1972, Medicare has provided coverage to persons with permanent disabilities and end-stage renal disease. Medicare is a program that almost all American families come to rely on. At the same time, so too has the medical industry come to rely on Medicare. As the single largest purchaser of medical services in the United States, Medicare is an important source of income for hospitals, physicians, home health agencies, and other medical care providers. Changes made in Medicare policy reverberate through American medical care. Medicare spending cu

In July 2018, Better Medicare Alliance, a Washington, D.C.-based nonprofit, published research compiled by Avalere Health studying the treatment outcomes of chronic condition sufferers who have Original Medicare and compared them with a similar population of people who are enrolled in Medicare Advantage. The results could potentially affect how Medicare beneficiaries decide to receive their health coverage. Original Medicare Vs. Medicare Advantage Plans This particular study compared the two primary coverage options Medicare beneficiaries can typically consider. One option is to enroll in Medicare Part A and/or Part B (often called Original Medicare), which is the federally funded health insurance program founded in 1965. The other option is to enroll in a Medicare Advantage plan (full disclosure: one of my companies offers Medicare Advantage plans), which is sold by private insurance companies and offers the same benefits offered by Medicare Part A and Part B under one