Author Archives: Clyde Stevens

Enjoy Certainty with Medicare Advantage Health Plans

The biggest benefit that an Advantage plan offers is the function that ensures beneficiaries have Medicare Advantagea maximum annual direct disbursement amount. The original Medicare does not offer a maximum value from one’s own pocket. Knowing your costs in advance can give you peace of mind. Also, if you have an idea what your responsibility will be, you are more likely to seek medical treatment. In the case of outpatient services, you are responsible for 20% of the charges for covered services, no matter what.

Medicare Advantage health plans usually offer a dollar amount that indicates your maximum annual liability. When you reach this amount through deductibles, co-payments and co-insurance, your liability is discontinued and the plan pays the covered expenses 100%. When you turn 65, you are given some options regarding your health care coverage. Finally, the first option for seniors is “traditional” Medicare or Medicare Advantage. Although these two government programs are usually the same, in fact they are completely separate from each other. You cannot subscribe to both at the same time. The first step is to decide which of these plans you will use as your primary health care coverage.

The most preferred option is what is known as “traditional” Medicare, which includes parts A and B. One main comfort associated with this selection is the benefit of choice. You can choose the doctors you visit and the hospital of your choice for any appointment or procedure you may encounter. There are periods when a beneficiary obtains a guaranteed enrollment, but at other times that person may also be subject to regular health insurance, as with any other individual policy. This is important to understand, especially if you are considering moving from one plan to another.

The important thing to remember is that an insured person will continue to use their government-issued card in addition to the insurer’s ID card. Both parties work together to provide the coverage a person gets for their health. They are different because they really take care of a person’s health coverage. A beneficiary will place their government issued ID card on their wallet and use the Medicare Advantage plan card for coverage verification. These policies also come in diverse kinds and are also provided by private insurers. Although plan design varies from one Medicare Advantage health plan to the next, co-paid medical services may include: some outpatient exams, ambulance service, visits to an expert, visits to primary care physician, emergency room visits, urgent visits, and other services covered by Medicare.

AETNA ADVANTAGE PLANS IN MANCHESTER

Medicare Advantage plansMedicare is provided by the federal government of the United States to its citizens who are 65 years of age and older, or for those suffering from an end-stage renal disease. The medicare covers all of your medicare as well as hospital charges. However, in the past decade, many people have switched to Medicare Advantage plans. These plans are advantageous plans and provide extra benefits to their customers. Along with covering all of the original medicare services, the plans also cover extra benefits like prescription drug services, eye tests, glaucoma screening, fitness benefits, routine dental checkups, meals, and much more. Not only these plans are more beneficial but are also provided at a very affordable monthly premium by private organisations. One such private organisation is Aetna Medicare, which is one of the biggest in the United States. Serving more than 13 million people, Aetna has plans in all the 50 states of the US. Aetna Medicare Advantage plans in Manchester are discussed below.

 

  1. Aetna Choice H5216-138 (PPO)

With an overall rating of 4, the plan is offered at a monthly premium of $0. The annual deductible for the plan is $425, along with a maximum out of pocket expense of $6700. While visiting your primary doctor you have to pay a copay of $0, and a copay of $50 for specialist. The plan also covers your prescription drugs, with a deductible of $295. The deductible is applicable to preferred brand, non preferred drug and specialty tier. For generic and brand name you have to pay a coinsurance of 25%. The plan also provides cardiac and pulmonary rehabilitation services, occupational therapy services, as well as speech therapy services. The plan also covers up to 100 days of Skilled Nursing Facility.

  1. Aetna Choice H5216-058 (PPO)

With an overall rating of 4, the plan is offered at a monthly premium of $0. The plan has no annual deductible and a maximum out of pocket expense of $6700. While visiting a primary health care provider, you have to pay no copay and a $45 copay for a specialist. Along with this, the plan also provides prescription drug services, with a deductible of $300. The deductible is applicable to preferred brand, non-preferred drug, and specialty tier. For generic and brand name drugs you have to pay a coinsurance of 25%. The plan also covers your annual lab tests, radiology scans, outpatient surgery as well as rehabilitation services.

 

  1. Aetna Choice H5216-059 (PPO)

With an overall rating of 4, the plan is offered at a monthly premium of $0. The plan has no annual deductible, and a maximum out of pocket expense of $4500, for in-network services, and $10000 for providers out of the network. While visiting your health care provider you have to pay $0 copay and a $40 copay for a specialist, inside your network. The plan does not pay for your prescription drug coverage, and you have to take a part D plan separately. The plan covers your emergency room services at a copay of $90. This plan also covers additional services like dental, vision, hearing services, fitness benefits, over the counter benefits, as well as transportation costs. The plan provides in-network preventive and home health care at $0 copay.

 

  1. Aetna Value Plus H5619-065 (HMO)

With an overall rating of 4, this plan is offered at a monthly premium of $16.60. The plan charges medicare defined part B annual deductible and a maximum out of pocket expense of $6700. For visiting your primary care provider you have to pay a $0 copay and 20% coinsurance for a specialist doctor. The plan also covers prescription drug services, and provide a deductible amount of $435. The deductible amount applies to generic, preferred brand, non preferred drug, and specialty tier. For generic and brand name drugs you have to pay a coinsurance of 25%. Along with this it also provides vision services, dental services, over the counter benefits, transportation services, hearing services, as well as SilverSneakers program, also providing the skilled nursing facility at a $0 copay for the first twenty days.

 

  1. Aetna Gold Plus H5619-040 (HMO)

With an overall rating of 4, the plan is offered by Aetna at a monthly premium of $28. The plan does not have any annual deductible, and an out of pocket maximum of $6700. This health maintenance organisation plan helps you choose your primary care provider inside the network. This provider would have an overall picture of your health. The plan covers your prescription drug services as well, with a deductible of $400, along with covering urgently needed services at a $0 copay. The plan also covers oral exams, eyewear, eyeglasses, contact lenses, glaucoma screening, hearing aids, hearing exams, over the counter benefits, fitness benefits, and transportation services as well. You get 24 trips a year to your local health providers.

 

  1. Aetna Choice H5216-057 (PPO)

With an overall rating of 4, the plan is offered at a monthly premium of $58. The plan does not have an annual deductible, with an out of pocket maximum of $5400. For every visit to your primary health care provider you have to pay a copay of $0, and a copay of $40 while visiting a specialist. The plan also covers inpatient hospital stay for both acute disease as well as psychiatric for a $0 copay after the fifth day. The plan also covers your prescription drugs, with no deductible. For generic and brand name you have to pay a coinsurance of 25%. Along with all the basic benefits of dental as well as vision care, the plan also covers Skilled nursing facility and preventive care.

How to save money with Medicare Part D

You may have heard about Medicare Part D plans for medicine. Have you tried to find out what benefits it really brings? What are the things you should keep in mind when opting for Part D insurance? How can it be effective to save a lot of money? Medicare Part D is a prescription drug plan specially designed for seniors because this plan allows older people to buy their medications at an affordable and lower cost. To opt for Medicare Part D drug plans, you must be responsible enough to carry one of the other parts of Medicare that are A or B.

Part D of Medicare is managed by private insurance firms such as Healthsprings,  Wellcare, Humana, United Healthcare, BCBS, and many others. Now, they are specific to countries and their fees differ widely from one plan to another and from one region to another. All plans have a monthly fee. Also, write whether or not there is a deductible on the policy. In Part D plans, deductibles are common. The vital consideration in determining the best drug plan for you is to consider the costs, the formulary and your pharmacy option. A formulary is a list of drugs covered by the plan, as well as your coverage level or Level. Not all shapes are the same! Many times you will find your medicine in one form and not in another. Also, it is not uncommon to find your medicine in different layers in different forms.

Basically, the insurance providers that operate the various plans have a pharmacy and therapy committee that chooses which medications they will cover on their formulary and which medications they will not cover. There is a national standard for coverage of forms that insurance providers must follow when designing their forms under the new Prescription Drug Policy. They must offer a given standard level of drug coverage for certain categories of diseases/health conditions. This means that these plans must cover several medications in most categories of diseases that affect the health of the elderly. The great mystery that people qualified for Medicare must discover is: these plans will cover the medications prescribed by the doctor and that they have been taking for some time. There is a major problem in Medicare Part D which beneficiaries of Medicare should consider. As soon as a plan is chosen by a Medicare Part D beneficiary, he or she is “locked up” in that plan during that year. Even in a situation where the recipient has made all possible research to select the right policy which insures all their medications, insurance firms have the ability to alternate which medications are covered by the formulary (i.e. with a notification period of 60 days).

HUMANA ADVANTAGE PLANS IN ARKANSAS

Humana Medicare AdvantageOriginal Medicare provides the retired citizens of 65 years and older health care services. The medicare includes both the hospital insurance as well as medicare insurance. Medicare Advantage plans have a benefit over the Original Medicare plans because of the added advantages the plans provide. The medicare advantage plans are offered by private organisations, which are approved by Medicare. One such private organisation is Humana Medicare health insurance company, which is one of the biggest in the United States. Humana Medicare Advantage plans in the city of Arkansas is discussed below.

 

Humana Choice H5216-139 (PPO)

With an overall rating of 4, the plan is offered at a monthly premium of $0. The annual deductible for the plan is charged as per medicare defined part B amount, with an out of pocket maximum of $6700. While visiting your primary doctor you would have to pay a 20% coinsurance for both in as well as out of the network provider. The plan covers prescription drug services as well, with a deductible of $435. The deductible is applicable to preferred brand, non-preferred drug, and specialty tier. For generic as well as brand name drugs you have to pay a 25% coinsurance. For the urgently needed services, you have to pay a maximum copay of $65. The plan also covers outpatient mental health, at 20% coinsurance.

 

Humana Choice R1532-001 (Regional PPO)

With an overall rating of 3, the plan is offered at a monthly premium of $0. The annual deductible for this plan is $500 for both in as well as out of the network services, with a maximum out of pocket expense of $3900. The plan covers both emergencies as well as ambulance services at an affordable copay. The plan also covers oral exams, dental c rays, dental medicare covered benefits, extractions, eye exams, eyewear, contact lenses, glaucoma screening, routine hearing exams, in-network fitness benefits, and over the counter benefits as well. The plan, however, does not cover your prescription drugs.

 

Humana Honor (PPO)

With an overall rating of 4, the Humana honour plan has a monthly premium of $0. It is a preferred provider organisation plan, which lets you choose a healthcare provider of your choice. In this plan, you don’t even have to get a referral to see any special doctor. The plan has no annual deductible, and an out of pocket maximum of $4900. Under this plan, you also have to pay a $0 copay for visiting your primary doctor. Humana Honour plan provides added services like dental coverage, oral exams, vision care, hearing services, and transportation services. You are also entitled to fitness, and over the counter benefits. However, the plan does not cover prescription drug services and you have to enrol in a Part D plan separately.

 

Humana Value Plus H5216-165 (PPO)

With an overall rating of 4, the plan is offered at a monthly premium of $20.30. The annual deductible for the plan is charged as per medicare defined part B amount, with an out of pocket maximum of $6700. For every visit to your primary health care provider you have to pay a 20% coinsurance. The plan also covers inpatient hospital stay for both acute disease as well as psychiatric for a $0 copay after the third day. The plan also covers your prescription drugs, with a deductible of $435. The deductible is applicable to preferred brand, non preferred drug, and specialty tier. For generic and brand name you have to pay a coinsurance of 25%. Along with all the basic benefits of dental as well as vision care, the plan also covers your transportation costs and helps you limit your out of pocket expenses.

Humana Choice H5216-163 (PPO)

With an overall rating of 4, the plan is offered at a monthly premium of $34. The annual deductible for the plan is $1000, along with a maximum out of pocket expense of $6700. While visiting your primary doctor you have to pay a copay of $10 for an inside the network doctor. It would cost you 50% coinsurance for referring a doctor out of your plan’s network. The plan also covers your prescription drugs, with a deductible of $195. The deductible is applicable to non preferred drug and specialty tier. For generic and brand name you have to pay a coinsurance of 25%. The plan also provides cardiac and pulmonary rehabilitation services, occupational therapy services, as well as speech therapy services. The plan also covers up to 100 days of Skilled Nursing Facility.

 

Humana choice H5216-083 (PPO)

With an overall rating of 4, the plan is available at a monthly premium of $75. This preferred provider organisation plan has an annual deduction of $1000 and an out of pocket maximum of $6700.  While visiting your primary doctor you have to pay a copay of $10 for an inside the network doctor. The plan covers inpatient hospital services, providing services for both acute diseases as well as psychiatric care. The plan covers your prescription drugs as well, with a deductible of $195. The deductible is applicable to non-preferred drug and specialty tier. The plan provides dental care, vision services, hearing services, over the counter benefits, fitness benefits as well as enrollment into the SilverSneakers program as well.

 

Humana Choice R1532-002 (PPO)

With an overall rating of 3, the plan is available at a monthly premium of $90. The plan has an annual in-network deduction of $1000, along with an out of pocket maximum of 6700. You do not have to pay anything, while visiting your primary health care provider inside the network of your plan. The plan covers prescription drugs as well with a deductible of $390. The plan covers oral exams, prophylaxis, fluoride treatment, dental x-rays, medicare covered benefits, restorative services, periodontics, extractions, prosthodontics, eye exams, eyewear, contact lenses, glaucoma screening, hearing exams, over the counter benefits as well as fitness benefits.