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Employee benefits and Medicare Advantage Plans

Since many employers feel an ethical, if not just legal, obligation to offer benefits to their employees, they must resort to voluntary access by employees. The workplace can easily become the golden child for the insurance industry. By taking the time to understand what each part of Medicare covers and where it is exposed in everyone’s coverage, a solid position has been provided to plan a solution that works for your unique situation. The health insurance options for those with Medicare are very confusing. For those who first enroll in Medicare, the deadline is three months before their 65th birthday until the end of the third month after their 65th birthday. It is during this time period. Anyone wishing to enroll in a Medicare supplement plan or benefit plan can do so without worrying about medical conditions. If you attempt to apply after this open enrollment window, you may be denied acceptance to a Medicare supplement plan and will have to wait until the next annual open enrollment period to obtain an Advantage plan or prescription, which is November 15 to December 31 of each year.

To make things more confusing, there are specific periods of time for the respected senior citizen to apply for coverage. There are also other plans called tariff plans or services. They are not as popular as the first two plans. Unfortunately, this article in its attempt to simplify things is weak in detail; meanwhile the details are very important. It was the writer’s attempt to try to create a basic scenario for the respected elderly (R.E) so that he can approach his decision with fundamental knowledge. I strongly urge anyone who makes the decision to answer all questions before continuing. An independent insurance agent can be of great help because he has the opportunity to offer all plans and can clarify the differences. Advantage plans usually include coverage for additional services not covered by Medicare, such as: vision, dental, hearing, and sometimes gym memberships When you have a fixed income, these benefits can make a big difference.

If you are looking for a plan that guarantees predictable costs, consider a Medicare Advantage health plan.A recent online article noted that several large companies are considering canceling employer-sponsored health coverage in exchange for paying their government fines.If the price of providing employer-sponsored health insurance to your employees is higher than the total fine, what options do they have? They eliminate employer-sponsored coverage, pay the federal government a fine, and advance financially. But where does that leave your employees? No benefits!

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How does Medicare Part D work?

Part D is the latest and most complex of the four parts of Medicare. People still ask what Medicare Part D is, and this implies that the government is not doing a good job educating the elderly in this very vital and important aspect of Medicare. Part D of Medicare insures prescription drugs which are usually filled by mail or at a local pharmacy. The typical drug plan for Medicare part D plans
consists of four layers commonly referred to as layer 1, layer 2, layer 3 and layer 4. Level 1 is for generic drugs, level 2 is for the preferred brand, level 3 is for the non-preferred brand and level 4 is for specialized drugs. Now we are also beginning to see a 5-level structure with some of the Part D plans of Medicare. The additional layer is used together with generics, thus creating a non-preferred generic and a preferred generic.

Discuss your annual prescription costs with a pharmacist to find out what you would pay in retail if you had “Uninsured.” This is important because the basic Medicare Part D coverage is valid only up to $2,250 for most health insurance plans. After spending more than $2,250, enter the “Donut Hole” with most of our plans and this is where your coverage ends. You keep paying your monthly premiums when you are in the “Donut Hole” and you have a Medicare Part D, but you will have no insurance until you reach the catastrophic area that is linked to $5,100. A large number of seniors will not reach the catastrophic area in Medicare Part D and will pay 100% when they exceed $2,250 if they choose the wrong plan. The policies you choose during the open enrollment period may be the most important decision you make for your retirement years.

Talking with a qualified Medicare insurance agent will help you choose the right plan. You can take advantage of the correct Medicare Part D drug plan if you do your homework. You can save 60% or more with a Medicare drug plan, but it depends on how much you spend each year. Learn more about Medicare Part D plans for 2011 and 2012. Most basic plans are sufficient if your annual costs are close to $2,250. These insurance premiums are reasonable with the basic plans and range from a minimum of $12 or more to approximately $30 per month. If your annual expenses for prescription drugs exceed $2,250, you should consider a more expensive complementary plan.

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HUMANA ADVANTAGE PLANS IN DELAWARE

 Medicare AdvantageMedicare Advantage plans are the extra beneficial plans which are provided by privately-owned organisations. These organisations, registered and licensed by Medicare, provides tons of plans differing from region to region. Each plan is designed to suit the needs are requirements of individuals. Along with covering the part A and part B of the medicare, these plans provide extra benefits to its customers, thus looking after their overall health. Humana Medicare Advantage plans offer health insurance in all 50 states and are one of the biggest and the most popular in the United States. Humana Medicare advantage plans offered in Delaware are as discussed.

 

Humana Gold Plus H6622-010 (HMO)

With an overall rating of 4, the plan is offered at a monthly premium of $0. This plan has no annual deductible, and an out of pocket maximum of $3400. While visiting a primary care doctor you have to pay a copay of $0 and for a specialist a copay of $40. The plan covers prescription drug services as well and has a deductible of $165. The deductible is applicable to the non-preferred drug or specialty tier. For generic or brand name drugs you have to pay a coinsurance of 25%. It provides Medicare-covered dental benefits, eye exams glaucoma screening, or hearing exams. Along with this it also provides various fitness benefits absolutely free of cost and covers your chiropractic services as well.

 

Humana Honor (PPO)

With an overall rating of 4, the Humana honor 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 an annual deductible of $1000, and an out of pocket maximum of $6700. Under this plan, you also have to pay a $20 copay for visiting your primary doctor, and a $50 copay for visiting a specialist. Humana Honor 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 Choice H5216-028 (PPO)

With an overall rating of 4, the plan is offered at a monthly premium of $68. The plan has an annual deductible of $1000 and an out of pocket maximum of $6700. While visiting your primary doctor you have to pay a copay of $15 and for a specialist, you have to pay a copay of $45. The plan includes prescription drug services as well with a deductible amount of $265.  The deductible is applicable to the non-preferred drug or specialty tier. For generic as well as brand name drugs you have to pay a 25% coinsurance. The emergency services are also covered in this plan at a copay of $90. The plan also provides skilled nursing facility for up to 100 days, with a $0 copay for the first twenty days. The plan covers preventive care and home health care services as well. The plan also covers fitness benefits as well as over the counter benefits without paying any copay or coinsurance.

 

Humana Gold Plus SNP-DE H6622-051 (HMO D-SNP)

With an overall rating of 4 stars, this plan is offered at a monthly premium of $0. This gold plus plan is Special needs Plan which is specially added for people with particular chronic diseases. Not everybody is allowed to enrol in such plans. If you have a chronic disease like heart failure or end-stage renal disease, you can enrol in this plan. The special needs plan is specifically designed to cater to your needs depending on your particular situation. You have to pay a $0 copay while visiting your primary or specialty doctor. The plan also covers in-hospital stay and several chiropractic services as well. Along with covering the transportation costs, dental services, vision services, hearing services, over-the-counter benefits and fitness benefits are also covered in this plan. The plan also covers all of your prescription drug cost as well, provided you use the in-network pharmacies. The plan also provides preventive and home health care services at $0 copay.

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HUMANA ADVANTAGE PLANS IN LONG BEACH

Medicare Advantage plans are offered by private health insurance companies and differ from region to region. More and more people are switching to Medicare Advantage plans from Original Medicare, because of the fact that they provide much more benefits than the original medicare. Humana provides multiple advantage plans and they all cater to different sections of the society. Humana Medicare Advantage plans in Long Beach are discussed below.

 

  1. Humana Honor (HMO)

Medicare Advantage plansWith an overall rating of 4, the plan is offered at a monthly premium of $0. The plan has no monthly deductible and a maximum out of pocket expense of $6700 for in-network providers. The plan also pays for your inpatient hospital stays including both acute as well as psychiatric hospitals. You have to pay a copay of $20 every time you visit your primary health care provider and a copay of $50 for a specialist. The plan covers annual lab tests as well as radiology tests like CT scans and MRI scans, with a payable coinsurance of 20%. The plan also covers home health care, preventive services, and skilled nursing facility as well. At a coinsurance of 20%, you can avail chiropractic services through this plan. However, this plan does not include fitness benefits or prescription drug coverage, and you have to enrol into a separate part D program to get your medicines covered.

 

  1. Humana Gold Plus H5619-021 (HMO)

With an overall rating of 4, this plan is offered at a monthly premium of $0. The plan has no annual deductible and a maximum out of pocket expense of $990. For visiting your primary care provider or a specialist you have to pay a $0 copay. The plan also covers prescription drug services, with no deductible amount. For generic and brand name drugs you have to pay a coinsurance of 5%. Along with this it also provides vision services, dental services, over the counter benefits, fitness benefits, transportation services, meals, acupuncture, hearing services, as well as SilverSneakers program, also providing the skilled nursing facility at a $0 copay for the first twenty days.

 

  1. Humana Value Plus H5619-037 (HMO)

With an overall rating of 4, the plan is offered by Humana at a monthly premium of $16.80. The plan charges medicare defined part B 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. In this plan, you do not have to pay any copay while visiting your primary care provider or any special care provider inside your network. The plan covers your prescription drug services as well, without a deductible amount of $435, along with covering urgently needed services at a $0 copay. The plan also covers oral exams, prophylaxis, dental x-rays, non-routine services, restorative services, endodontics, extractions, prosthodontics, surgeries, eyewear, eyeglasses, contact lenses, glaucoma screening, hearing aids, hearing exams, over the counter benefits, fitness benefits, and transportation services as well. You get 36 trips a year to your local health providers.