How to Cut Health Care Costs

Transcription

1 How to Cut Heath Care Costs INSIDE: TEN TIPS FOR MEDICARE BENEFICIARIES What is one of the biggest financia surprises in retirement? Heath care costs. It s a growing concern among many Medicare beneficiaries, and it s no wonder. There is an aphabet soup of terms to earn - Part A, Part B, Part C, Part D - and an ever increasing choice of pans. And the average price tag for heathcare coverage for a 65 year od coupe retiring today is estimated to be $230,000* during their retirement years. And yours coud be more! These ten tips can hep you find ways to cut your heathcare costs, minimize your out-of-pocket costs and better predict what those outof-pocket costs wi be, so you can worry ess and enjoy ife more. *Retiree Heath Care Costs Estimate, Fideity Investments, Apri,

2 ❶ KNOW WHAT MEDICARE COVERS... AND WHAT IT DOESN T There are four Parts of Medicare that you hear a ot about. Get famiiar with what they cover and what they don t. Remember these two key points: Medicare does not cover a of your heathcare expenses. You may sti be iabe for deductibes, coinsurances, copayments, non-covered services, excess charges from your doctors and the cost of some or a of your prescription drugs. It does not generay cover ong-term care costs. The average annua cost of care in a nursing home or assisted iving faciity or at home has increased over the past four years to a new high of $87,235, according to MetLife s 2011 Market Survey of Nursing Home and Assisted Living Costs. Costs are even higher in the Northeast. Part A pays for inpatient hospita, skied nursing faciity, and some home heath care. For each benefit period Medicare pays a covered costs except the Medicare Part A deductibe (in 2012 it is $1,156) during the first 60 days and coinsurance amounts for hospita stays that ast beyond 60 days. Once your 60 Lifetime Hospita Reserve Days have been exhausted, you wi be iabe for the tota cost of hospita stays that extend beyond 90 days. Most peope have Part A coverage because they or their spouse paid Medicare taxes whie working. This coverage couped with Part B is often caed Origina Medicare. Part B covers Medicare eigibe physician services, outpatient hospita services, out-patient aboratory and diagnostic services, certain home heath services, and durabe medica equipment. This coverage is not automatic and you must sign up for it. The cost for 2012 is $99.90 per month. However, if your income is above $85,000 (singe) or $170,000 (married coupe), then your Medicare Part B premium may be higher. The deductibe for 2012 is $ per year and is expected to increase each year. You pay 20% of the Medicare-approved amount for most services after you meet the annua Part B deductibe. Part C was created in 1997 and these private company Medicare-approved pans, caed Medicare Advantage Pans, are an aternative to Origina Medicare (Part A and Part B). Part D provides coverage for prescription drugs. Medicare Prescription Drug Pans are offered by insurance companies and other private companies approved by Medicare. These insurance pans cover both brand-name and generic prescription drugs at participating pharmacies ocated throughout the United States, or by mai order. Medicare Prescription Drug Pans are discussed in greater detai ater in this booket. Your best source of information is the Medicare and You booket pubished by Medicare. You can find it onine at or ca Medicare at to request a copy. 2

3 ❷ DON T WAIT TO SIGN UP Missing sign up deadines can mean higher prices and fewer choices. Your 65th birthday is a key date for beginning Medicare coverage. If you are aready 65, the annua open enroment period (October 15 - December 7, 2011) is when additiona pans are open for enroment and you may find more choices in coverage. Here are the rues. Medicare eigibiity. You first become eigibe for Medicare on the first day of the month in which you turn age 65 (uness your birthday is the first of the month in which case you become eigibe for Medicare on the first day of the month of the month preceding your 65th birthday). You may enro in Medicare starting three (3) months before the month in which you turn 65 up unti three months after the month in which you turn age 65. If you get Medicare due to a disabiity, you can enro from three months before to three months after your 25th month of cash disabiity payments. Enroment is generay automatic for Part A. Part B: You shoud enro in Part B of Medicare as soon as you first become eigibe uness you have coverage from another source, such as through your or your spouse s empoyer or former empoyer. For most peope, this is the first day of the month in which you become 65. If you don t enro in Part B and if you have no comparabe coverage, you wi be iabe for the fu cost of outpatient services, such as doctors visits, and aboratory and diagnostic tests. If you deay enroment, you ikey wi have to pay a penaty once you do enro for as ong as you are enroed. Visit What you need to know if you are new to Medicare Tips on comparing Medicare pans Answers, advice and resources about Medicare Request a FREE consutation with a heath pan advisor Compare rates and enro onine in our most popuar pans Part C: If you choose a Medicare Advantage pan, sign up when you are first eigibe for Medicare. You can generay enro in a Medicare Advantage Pan during the Annua Eection Period each year from October 15 to December 7, If you move and your pan is no onger avaiabe, you wi aso be abe to enro in a different Medicare Advantage Pan which is avaiabe in your new ocation. Part D: Individuas who are eigibe for Part A and/or enroed in Part B are eigibe for a Medicare Prescription Drug Pan. If you don t sign up when you are first eigibe, you may have to pay a penaty when you do enro. If you didn t join when you were first eigibe, your next opportunity to enro wi be from October 15 to December 7, 2011 for pans to begin in 2012 with coverage effective on January 1 of Part D Pans come as stand-aone (PDP) or bunded within the Advantage Pans (MA-PD). HOW TO CUT HEALTH CARE COSTS 3

4 ❸ CHOOSE THE RIGHT PLAN Carefuy consider your choice of heath pan coverage. Don t make the mistake of focusing ony on keeping monthy premiums down. Many times a pan that is priced ess may easiy cost more. Try to reaisticay factor in deductibes and copayments. For prescription drug coverage, for exampe, factor in deductibes, copayments, formuary incusions/excusions and tier ratings, Initia Coverage Limit (donut hoe threshod), fu drug pan s costs and eigibe pharmacy choices. Consider a Medicare Advantage Pan. Medicare Advantage Pans are private heath pan aternatives that are part of the Medicare program. If you join one of these pans, you generay get a of your Medicare-covered heath care through that pan. This coverage can incude prescription drug coverage. Medicare Advantage Pans incude: Medicare Heath Maintenance Organizations (HMO) Medicare Preferred Provider Organizations (PPO) Medicare Private Fee-for-Service Pans (PFFS) Medicare Specia Needs Pans (SNP) Some MA pans incude extra benefits not covered under Origina Medicare (i.e., hearing, vision, denta and weness). Though some have ower copayments than Origina Medicare, you coud pay more or ess for the same covered services. However, you may have to see network doctors who beong to the pan or go to certain network hospitas to get services. Everyone who is eigibe for Medicare may enro in a Medicare Advantage Pan (except for individuas with End-Stage Rena Disease) without having to answer medica questions. Consider a Medicare Suppement (Medigap) Pan. If you are not comfortabe with a Medicare Advantage Pan, or if there is not one in your area that fits your needs, a Medicare Suppement Pan may be your best option. A Medicare Suppement poicy is heath insurance sod by private insurance companies to fi the gaps in Origina Medicare Pan coverage. Medicare Suppement poicies hep pay some of the heath care costs that the Origina Medicare Pan doesn t cover. If you are in the Origina Medicare Pan and have a Medicare Suppement poicy, then Medicare and your Medicare Suppement poicy wi each pay their share of covered heath care costs. If a Medicare Suppement Pan is right for you, enro in the first six months after you turn 65 and have enroed in Medicare Part B. During this period, you are guaranteed acceptance into any Medicare Suppement Pan offered in your geographic area by any company without your having to answer any medica questions. After the six (6) month period is over, you may have to answer medica questions, and the insurance company may deny coverage or charge you higher rates because of your medica conditions. Because Medigap pans are standardized by the government, comparative shopping is easy. Being highy portabe, any doctor accepting Medicare wi accept a Medigap poicyhoder for services. Typicay, there are no networks with Medicare Suppement pans. 4

5 ❹ ❺ ❻ ❼ GET COVERAGE FOR PRESCRIPTION DRUG COSTS Enro in a Prescription Drug Pan when first eigibe. A stand-aone Medicare Prescription Drug Pan (Medicare Part D) adds coverage to the Origina Medicare Pan, some Medicare Cost Pans and some Medicare Private-Fee-for-Service Pans. A MA pan is a Medicare Advantage pan. MA-PD wrap prescription drugs into the pan. These pans are offered by insurance companies and other private companies approved by Medicare. When you join a Medicare Prescription Drug Pan, you use the pan member card that you get from the pan when you go to the pharmacy. When you use the card, you wi generay get a discount on your prescriptions. Your cost sharing wi vary depending on the drug s tier rating and pan formuary. Different medications are cassified by a "Tier Leve" system. Generay the higher the tier, the higher the copays. If you have imited income and resources, you may get Extra Hep to cover prescription drugs for itte or no cost. CONSIDER SWITCHING TO GENERICS Tak to your doctor about the drugs you are currenty taking to find out if there are generic or ess-expensive brand-name drugs that woud work just as we as the ones you re taking now. Generic drugs are usuay much ess expensive than brand-name drugs and some Medicare Prescription Drug Pans provide them during the Coverage Gap for itte or no co pays. However, because Generics cost ess than brand-name medications, it coud deay or prevent you from entering into the Donut Hoe. LOOK FOR GOVERNMENT ASSISTANCE PROGRAMS Expore Nationa and Community-Based Charitabe Programs and other Assistance Programs. Nationa and Community-Based charitabe programs (such as the Nationa Patient Advocate Foundation or the Nationa Organization for Rare Disorders) may have programs that can hep with your drug costs. In addition, many of the major drug manufacturers are offering assistance programs for peope enroed in Medicare Part D. INVESTIGATE ELIGIBILITY FOR A LOW-INCOME SUBSIDY There may be government hep avaiabe to assist with your prescription drugs under Part D. If you have Medicare and have imited income and resources, you may quaify for Extra Hep with paying for your prescription drugs. If you quaify, you coud pay no more than $2.60 for each generic and $6.50 for each brand-name drug in To appy for Extra Hep, contact Socia Security by visiting or by caing Another resource woud be to contact your oca SHIP agency. (Go to HOW TO CUT HEALTH CARE COSTS 5

6 ❽ shop and compare With so many pans in the marketpace, this is not a make it and forget it decision. It is in your best interest to periodicay review your coverage to see if it is sti the best choice to cover your current heathcare needs. With the many choices in Medicare pans, it is important to first decide to be covered under Origina Medicare or aternativey decide if a Medicare Advantage Pan is right for you. Many of the Advantage pans wi require that you use in-network providers and faciities. Some wi have extra benefits ike vision, denta or hearing, but be sure to compare premiums, copayments, accessibiity and prescription coverage. Be sure your specific medications are covered. The Medicare website ( is a vauabe resource in identifying and comparing pans in your area. Medicare Suppement Pans: Premium Rating Methods When comparing premiums, you notice that pans utiize different rating methods. Community-Rated Pans The same monthy premium appies to everyone with a poicy, regardess of age, within a geographic area Issue-Age-Rated Pans The premium is based on the age you are when you first buy the Medigap poicy Attained-Age-Rated Pans The premium is based on your current age at first enroment and increases with each new attained age If you don t want the restrictions of a Medicare Advantage Pan, consider a Medicare Suppement Pan. Because of standardized Medigap pans, shopping is easy. For exampe, any Pan F offered by any carrier within a certain geographic area wi be exacty ike and perform the same as any other company s Pan F. The ony difference wi be what each company charges in premiums. Remember that after your Initia (guaranteed acceptance) Enroment Period has passed (usuay after the first 6 months past your 65th birthday), you may have to answer medica questions and coud possiby be denied coverage or charged more based on your heath status. There are many different Prescription Drug Pans in your area. Each Pan wi have different benefits, different covered drugs (formuaries), different premiums and copayments, and different rues pertaining to coverage during the Coverage Gap (aso known as the Donut Hoe ). Don t just pick the east expensive premium. You shoud actuay cacuate your projected out-of-pocket costs for each pan that you are considering. The Medicare Prescription Drug Pan Finder ( wi aow you to do this and to compare severa pans to one another. And try the quoting too at iquote ( to compare PDP pans. 6

7 ❾ CONSIDER DISCOUNT CARD PROGRAMS A discount card program provides you with a discount on certain types of services if you use the providers that the program specifies. You pay a fee - usuay monthy or annuay - to use the network discount. The types of services may incude denta, vision, hearing and home heath services. Rates and services can vary greaty. You wi aso want to make sure that the network has practitioners in your area before you enro and that the pan itsef is egitimate. ❿ CONSIDER A LONG-TERM CARE PLAN Medicare does not cover custodia care, such as assistance with activities of daiy iving. A ong-term care poicy can provide benefits for both nursing home confinements and in-home care. With the cost of ong-term care skyrocketing, this coverage can hep protect your hard-earned savings and your independence. Long-term care insurance is most affordabe when you are younger and heathy, so if you think this coverage is of interest don t deay. Premiums are based on your age when you appy and the oder you are, the higher the cost. Learn more at A Fina Word of Advice Stay as heathy as you can. You hear it... you read about it... you see it on TV. Take steps to eat heathiy, exercise reguary, take your medications and see your doctor reguary. Not ony wi you be better abe to contro your heath care costs, but you wi probaby find you have more options for insurance coverage. And you fee better too! Contact Longevity Aiance Sti have questions? Longevity Aiance speciaizes in heping peope find the right heath care soution. We can hep you identify choices in your area and seect the right pan. Ca one of our icensed advisors at to discuss your Medicare insurance needs, as we as ong-term care, ife insurance needs. To earn more about Longevity Aiance visit our website Government Resources Medicare Website: Medicare Hepine: MEDICARE ( ) Socia Security Administration: HOW TO CUT HEALTH CARE COSTS 7

8 Become a fan of Longevity Aiance. The iquote Difference Heath care costs increase with age. That is why it is so important to make sure you have the right Medicare heath insurance pan that matches your heath care needs at this stage of your ife. The ony way you can know that you have the right pan is to compare a choice of pans with the assistance of a knowedgeabe Medicare insurance speciaist. At Longevity Aiance you find a 3-STEP process designed to take the stress and confusion out of making this important decision. You fee confident that you have the right Medicare pan for this stage of your ife and gain the comfort of knowing you have assistance in the future if your heath care needs change. For a free consutation, ca or visit Educate and Inform Your iquote heath pan advisor wi provide information about Medicare and Medicare heath insurance pans. Te them about your heath care needs, any financia considerations and what s most important for you in a heath care pan. Advise You be provided with a choice of pans and quotes. Your advisor wi answer your questions and hep guide you to the most appropriate pan. ALL of this assistance is FREE to you. Enro Once you and your advisor have reviewed the pan options, and you are totay comfortabe with the information, you seect a pan. We hep you with a of the paperwork - no need for you to worry - and work on your behaf with the insurance company to get your poicy issued. ABOUT LONGEVITY ALLIANCE Longevity Aiance heps peope nationwide find the right insurance soutions for their Medicare, ongterm care and ife insurance needs. We do that by taking the often overwheming and confusing insurance marketpace and simpifying it for our cients. Each consumer receives the free service of a persona advisor who guides them over the phone through a simpe 3-Step process designed to make them fee confident about their insurance purchase. Our advisors have no financia incentive to recommend one pan over another; their goa is aigned with the consumer s and that is to match the consumer with the most appropriate pan. Longevity Aiance is an independent nationa insurance broker icensed to se insurance in a 50 states and DC. LA#44053, UT#260828, MA# Longevity Aiance does business under the name Longevity Aiance Insurance Agency in CA: CA#0F HH001