Tuesday, June 12, 2018

Medicare.gov is not always accurate

Did you know that Medicare.gov is not always accurate?  Many of my clients try to look for drug and Medicare Advantage plans on their own during Annual Enrollment.  Doing so early in Annual Enrollment may cause you to choose the wrong plan. 

From personal experience, I can show that you can run the same drug list twice in the same day and get different results.  So, be extremely cautious and don't rely on those results.

The most reliable source is with the insurance companies.  Licensed and trained Medicare agents can check with the carriers to ensure all of your drugs and doctors are covered.  This is the most reliable way to ensure you make the right choice each year.

Thursday, June 7, 2018

How Medicare billing works

If you are on Medicare and have any type of additional insurance, the way claims are processed can be confusing.  Providers send the bills for processing to different places, depending on the type of additional insurance in place.  In addition, billing systems often generate bills to Medicare eligible people, even though the bills are not owed. 

If you have a Medicare Advantage plan, there is only one Explanation of Benefits from the insurance company.  With a Medicare Supplement, there is an EOB from Medicare and from the insurance company.  It is important to review the EOB(s) to make sure you know what you really owe the provider of medical services.

We can help navigate the confusion about this.  Let us know if you need the help of Alta Vista Benefits. You can reach us at 614-889-0934 or lucy@altavistaben.com.

Thursday, May 24, 2018

What is balance billing?

Balance billing is another term for Part B excess charges.  What does that mean?
If you have outpatient surgery, testing and other Part B services and you have a Medicare Supplement, the provider is not allowed to bill you for what your supplement coverage does not cover. 

For example, let's say you have a Plan G Medicare Supplement.  A bill comes to you for $500.00 from a provider.  Plan G has an annual Part B deductible of $183.  So, you are only responsible for $183 each calendar year for Medicare approved expenses.  The provider is not allowed to bill for any more than that.

It is import to look at two pieces of documentation:  the Medicare Explanation of Benefits and the insurance company explanation of benefits.  Medicare indicates what you MAY owe and the insurance company indicates what you do owe.  You should not pay any bills until you look at the insurance company's documentation.  A provider can bill you but you may not really owe them.

For more information, you can contact us at 614-889-0934.

Friday, June 9, 2017

Does Anthem's withdrawal from Ohio affect Medicare clients?

Does Anthem's withdrawal from Ohio affect Medicare clients?
I have been getting a lot of questions since Anthem announced it was leaving the Exchange Market for under 65 clients.  The answer is No, it does not affect anyone who has an Anthem Medicare Supplement, prescription drug plan, or Medicare Advantage plan.  It is only for an individual plan for someone under 65.

Friday, May 5, 2017

American Health Care Act of 2017 (AHCA)

There are many questions surrounding the details of the Obamacare Repeal and Replace legislation.
If you are on Medicare, there are very positive changes that will impact you. 

This new law, if passed, will repeal the taxes on prescription drug companies and medical devices. The largest expense of most Medicare eligible people are prescriptions, so this should start to lower prices on drugs which is good news.  Prices should also decline on durable medical equipment, such as wheelchairs and hospital beds.

There has been much confusion about the coverage for pre-existing conditions with regard to Medicare.  Keep in mind that the majority of this legislation does not affect Medicare.  This is true with regard to pre-existing conditions on Medicare and any changes to pre-existing conditions only affect people who are not Medicare eligible.

Passing the bill through the House of Representatives is only the first step in the process of legislation.  I will provide more updates as information is available.

Tuesday, December 6, 2016

Lucy Grosz appeared on NBC Daytime Columbus

On November 18, 2016, Lucy Grosz appeared on Daytime Columbus regarding Medicare.  This applied to open enrollment for this year, but is relevant to anyone who is choosing Medicare coverage.  To see the full interview, click on the link below.


Medicare Deductibles change for 2017

Medicare has announced changes in deductibles for Part B and other fees.  For example, the Part B deductible is increasing from $166 to $183 for 2017.  Here is the full press release: