Somebody May Be Saying You’re Sick With Something You Don’t Have

    If you have Medicare Advantage, you’re insurance company is being paid based on how sick you are.   The sicker they tell the government you are, the more money you get.   This has led to insurance companies, health systems, and doctors telling the government you have sickness you don’t actually have purely to make a buck.   Check the list of illnesses your doctor says you have whenever you can.   Your...

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New Hospice Rules Could Really Limit Your Choices

  Medicare Advantage is changing the ways it pays for hospice—and that could dramatically limit your freedom to choose the hospice you want.   When you re-enroll in your Medicare Advantage plan, ask your insurance agent about whether or not you get to choose your own hospice if you need.   This sounds morbid and unless you’re seriously ill the chances of you needing hospice in any given year is low. But the difference between...

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Personal Care Benefits in Medicare Advantage

  Starting next year, some Medicare Advantage plans will offer home care services such as housecleaning and personal care like showering and even personal shopping.   Expect those services to be heavily advertised.   Be careful. There’s a lot of overpromising going on.   Most people won’t qualify except for the very ill and infirm. And even they will have a hard time getting approval.   Question carefully under what circumstances home care will be...

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Big Medigap Changes Coming

  There are some big changes in Medigap policies coming in 2020.   And yes, they’re designed to drive people into Medicare Advantage plans.   Here is an excellent, easy to understand summary.   My recommendation? Visit your insurance home now to review the changes.   Judging from the degree of the changes, within a few months it’s going to be a very busy place.

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Protect Yourself Against Slamming

  Slamming is when someone fraudulently changes your Medicare Advantage coverage without your permission.   It can create a real hassle for you if you find out this has happened at the time you need care.   If you haven’t used your coverage in three months, call your PCP’s office and have them confirm your coverage. They should be happy to do so.   Then you can live your live for another three months in...

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Paying for Out-Of-Network Services Up Front

  Ask your insurance agent if you have to pay the full cost of non-emergent out-of-network medical care up front at the time of service.   It’s an increasingly common method that insurers are using to try to same themselves money and push the costs onto you.   Don’t ever sign up for a plan that does this.   The insurer may tell you that they will bill the government for you and pay you...

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The New Home care Benefit is Not What it Seems

    Beware of insurers trying to sell you on a new Medicare Advantage plan on the basis of the new home care benefit.     They will tell you that your insurance will pay for your bathing and housecleaning, but the conditions under which the coverage kicks in is very limited—and could be associated with some co-pays on your part.     Choose your Medicare Advantage plan on the access to clinicians you want...

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CMS Allow Your Medicare Advantage Plan to Pester You Even More

    This time, it’s about the price of your medication.     Starting next year, you’ll be receiving a monthly update regarding the least expensive  alternatives to the medications you’re on.     Will it help you lower you medication costs?  Perhaps.     But it will definitely take up a few minutes of your precious attention.     There’s no information on whether or not you can opt out of these contacts.  ...

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