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[kellywarner]

Introducing Small Business Health Insurance

If your company is small, you can call the State Office of Insurance Affairs to find small business collective health insurance providers in your area, or find a joint health insurance purchase plan. These plans allow small businesses to purchase health insurance as part of a more massive conglomerate. 

Chamber of commerce group insurance plan provides small businesses with a way to purchase group health insurance at a lower than usual cost, meeting the needs of small businesses. is a member of its small business, which buys a health insurance plan and asks third parties to manage the program. Small companies should be prepared for such collective insurance. Preparation usually involves having all employees fill out a questionnaire about the health of individuals and family members. Besides, you need to check the operation status of the alliance to ensure the standard management of all funds.

To participate in traditional health insurance, employees must pay an absolute premium (usually $ 250 to $ 500 per year) before they can receive compensation from the insurance company. After spending the required premiums, the insurance company will pay 80% of the medical expenses, and the employees will pay the remaining 20%. There is usually a cap on the number of medical expenses an employee must pay each year. Once the cap is reached, the insurance company will pay the excess.

Traditional health insurance schemes may impose many restrictions on specific medical services, which is called “conventional fees.” If the cost of medical assistance provided by the doctor selected by the employee is higher than the average, the higher average price will be borne by the employee.

Choose your company’s health insurance plan

Finding good agents is essential when looking for a health insurance plan. Some agents can provide strategies for up to 15 insurance companies so that you can get more information about optional health insurance and compare them in detail. However, it should be noted that most insurance companies will only provide you with a quote, so be sure to choose the right agent before they ask the insurance company for a quote.

When looking at different insurance plans, you need to check the number of deductions and co-payments that the insured person has for each project. If the policy requires the employee pays more than 25% of the total cost of medical expenses, then you should look at other options to ensure that insured a more extensive range of pharmaceutical items and cover long-term illness and disease have insurance before. Paul The amount should be no less than $ 1 million. You should also go to your local doctor to check the number of charges for each medical item to ensure that the maximum compensation amount for a specific medical service item is not too low.

Second, you need to check the status of the insurance company. You can visit the Standard & Poor’s website to get the financial situation of the insurance company. In addition to the financial status of the insurance company, it is necessary to investigate its claim compensation record. No one will choose an insurance company that ignores the claims of the policyholder. Your company’s health insurance agent can help in this regard.

#small business #health insurance #insurance

[kellywarner]

Facts About Medicare Advantage

Medicare Advantage plans cover everything that Medicare Part A and Part B covers. Many medicare advantage plans have extra benefits like routine dental, vision, and fitness benefits.These plans are regulated by medicare only. You can switch to medicare advantage plans anytime during your initial enrollment period if you are not happy with your current plan. Enrollment in Medicare Advantage has nearly doubled over the past decade.

#medicare #medicare advantage #medicare policy

[kellywarner]

How Small Business Health Insurance Can Help You and Your Employees?

Health insurance is acknowledged as one of the most vital benefits a business can give to its employees. It shields employees from financial trouble when they undergo a medical emergency. Also on the other hand the difficulty with individual health insurance is usually very expensive and several employees may not be able to afford the premiums. Small business health coverage is less costly than individual coverage.

#health insurance #small business

[kellywarner]

Medicare Advantage Plan and other options

A Medicare Advantage plan is a type of Medicare Insurance plan in which Medicare pays a private insurance company a nominal fee every month to manage your care for you. You still pay your Medicare premiums however Medicare is not be your primary insurance. Medicare Advantage plans (with names like HMO, PPO, PPF, etc.) typically include the prescription plan, Part D. When you have a Medicare Advantage plan you still have Medicare and still pay for it; however, it is not your primary insurance anymore. The Medicare Advantage carrier becomes your primary insurance.

What is Medicare advantage?

Also known as Part C, Medicare Advantage plans are insurance programs that are administered by private carriers instead of through Original Medicare. To be eligible, you must:    Be signed up for Parts A & B   Live in the service area of the specific plan you choose   Not have end-stage renal disease

Medicare Advantage plans must cover the same services Medicare covers, just at a different cost share. With these plans, you will typically pay co-payments (set amount) for many services, as opposed to Original Medicare’s co-insurance (percentage) for everything. They may also come with some extra bells and whistles that Medicare doesn’t cover and typically have a specific network of doctors you may see. Each carrier in your area may offer different doctor networks, benefits, and medicine formularies. Because of this, it is important to consult with a local Medicare Advisor that represents different carriers. It’s not one-size-fits-all.

Remember: Medicare is paying a private carrier to manage your care for you. With a Medicare Advantage plan you show only your Medicare Advantage insurance card when you go to the doctor or pharmacy. You can even keep the Medicare card at home. Even though Medicare is not your primary, you still need to keep and pay for your Medicare Parts A and Part B.

Pros

These plans come with low or even so premiums. Medicare Advantage plans also typically come with extra benefits not covered by Original Medicare, such as dental, vision, transportation, OTC products, and hearing aids.

Cons

You must use carrier networks. Often, care must be received with in a certain geographical area. You will typically have co-payments for most services. If you want to switch to a Medicare Supplement in the future, you may need to go through Medical Underwriting.

#medicare #medicare plan #medicare advantage

[kellywarner]

5 Reasons to Offer Small Business Health Insurance

Offering small business health insurance provides significant advantages and cost savings for both small business owners and their employees.

Although offering group health insurance is optional for employers with less than 50 full-time or full-time equivalent employees, there are many practical reasons to provide health insurance plans. Learn about the top 5 reasons to offer small business health insurance.

1. Employee satisfaction and retention

A 2016 Glassdoor survey observed that “The factor with the single biggest impact on employee satisfaction was the quality of employer-provided health insurance plans.” Being enrolled in group health insurance is a core benefit highly valued by today’s employees.

The 2018 eHealth report on small business health insurance trends found that 66 percent of respondents said they offered small business coverage because it helps them recruit and retain top quality employees.

Providing a competitive compensation package that includes group health insurance can help small business owners attract new talent and promote loyalty and satisfaction among current employees.

2. Lower premiums per person

Group plans tend to have better pricing and be less expensive than individual plans, and small business health insurance policies often have lower premiums per person.

According to the 2018 eHealth report on small business health insurance:

The national average monthly premium for a small business health insurance plan per person was $409 in 2018.

This was 7 percent less than the national average premium of $440 for individual health insurance coverage for consumers not receiving government subsidies.

The national average small business plan deductible was 31 percent lower than the national average deductible for plans in the individual market.

Employers typically share premium costs with employees, meaning that employees may find small business group plans to be more affordable than purchasing their own individual or family plans.

3. Healthier employees

Healthy employees are a valuable asset for any business, and offering group insurance plans can help drive employees to perform at their professional best. Healthier employees tend to:

Be less absent – Healthy employees will take fewer sick days and be more likely to see the doctor for regular checkups and preventative care visits.

Be more productive – With their medical needs met, healthy employees are more likely to remain motivated and focused on their jobs.

Be more open – When employees have group health insurance, they will generally be more up front with their employer about any health problems.

By investing in the long-term health of their employees through offering health insurance, employers can gain from the benefits of building a more effective workforce.

4. You and your family can join the plan

Another reason to offer small business health insurance is that your own family can join the group plan. Depending on your situation, your family could join the plan as either dependents or employees (in the case of a family business).

Generally, small group plans allow qualified dependents to be added to any plan. In terms of group plans, it is worth noting that the employer has the choice of whether or not to pay for the dependents’ health insurance. Learn more about who qualifies as a dependent for small business health insurance here.

If you run a family business, you should know that your spouse cannot usually count as your one and only employee. If you have other employees, who may also be your family members, your spouse can generally enroll in the group plan.

5. Tax incentives

The Affordable Care Act (ACA) created the small business health care tax credit to provide incentives for small business owners to offer health insurance to their employees.

For eligible small business owners, the government may give you a tax credit to help you pay for your portion of employee premiums. A licensed health insurance agent can help determine if you qualify for a small business health care tax credit.

You will also likely be able to deduct health insurance costs from your taxes as a small business owner. This deduction could help you lower or offset the cost of contributing to your employees’ premiums.

The potential to save money through tax incentives serves as a major advantage for an employer considering getting coverage for his or her small business employees.

What to know if you decide to offer small business health insurance    

There are many reasons to offer small business health insurance, including the cost savings of lower premiums and tax incentives, as well as the long-term benefits of greater employee job satisfaction and the ability to add family members to a plan.

If you decide that a group plan is the right choice for your company, visit eHealth.com to find the best group health insurance plan for your employees, budget, and preferences.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

#Small business #health insurance #insurance

[kellywarner]

5 Steps For Choosing The Best Health Insurance Plan For Your Small Business

Small businesses employ nearly 60 Million people in our economy. We know that small businesses care about their employees and want to offer coverage. 82% of employers in a recent Metlife study reported that employers have a responsibility for the health and wellbeing of their employees. Small business owners want to attract and keep the best employees and offering benefits is a great way to do that. But many small business owners are unsure about how to begin or if they can afford any plans. In addition, those who do offer insurance to their employees already have to suffer through a lengthy back and forth processes.

Here are 5 steps on how to choose the best health insurance plan for your small business:

Where do I start?

The auto insurance industry has benefited from online auto insurance marketplaces like Progressive and Liberty Mutual, which are modernizing the auto insurance shopping process. Similarly, health insurance has profited enormously from online health insurance marketplaces, which are transforming and streamlining the health insurance shopping process as we know it.

Online health insurance marketplaces are useful tools to shop and compare plans and generate unlimited quotes in no time at all. These marketplaces exist to make things easier for small business owners and they are a smart way to begin the search for a health insurance plan that fits your team.

Start your search and see what carriers, products, and premiums are available, in an instant, whenever you want. You will be able to see quotes, side-by-side, so you can compare and make an informed decision on which plan is best for your team. You can choose 1 or 2 or 3 plans (depending on how many employees you have and their needs) from the same medical carrier to offer to your small business. The price of insurance varies for every employee based on their age, carrier and plan.

What information do I need to get an accurate estimate?

For an accurate estimate of your employees’ health insurance options, while using an online health insurance marketplace, you’ll need to be equipped with a specific set of information. Be sure to have the following information on-hand as you begin your search.

Zip Code

Number of Employees

Employee (+Families) Names

Dates of Birth or age of the employees

Enter the zip code of your company’s Headquarters to see which carriers are offering plans in your company’s location.

What is the number of employees you are looking to cover?

Are your employees looking to cover their families as well as themselves?

Understanding my plan options.

You’ve found some plan options but what does it all mean? Here are simple terms to help you understand what you’re actually shopping for:

What is a premium?

What is a high or low deductible?

What about copay or coinsurance?

What does Bronze, Silver, Gold, and Platinum mean?

Are my and my employees’ doctors in-network?

A premium is defined as the amount of money you pay per month for health insurance coverage. (This varies by age and smoking status of each individual employee covered.)

A deductible is defined as the amount of money you’re responsible for paying before your insurance starts paying for health services. The lower your deductible, the earlier your plan starts paying its share.

A copay is defined as the flat fee you pay for medical services. Copays can occur before or after a deductible depending on the type of plan you have chosen.

A coinsurance percentage reflects how much of the bill you pay for medical services.

Bronze plans have the highest employee costs at the point of care, but the lowest monthly premiums and typically high deductibles.

Silver plans have moderate employee costs at the point of care, moderate level monthly premiums, and lower deductibles than Bronze plans.

Gold plans have low employee costs at the point of care, but high monthly premiums and typically low deductibles.

Platinum plans have the lowest employee cost at the point of care, but the highest monthly premiums and very low deductibles.

A Health Maintenance Organization (HMO) is a plan that limits coverage to care from doctors who work for or contract with the HMO, meaning they generally do not cover out-of-network care, but consumers save money when accessing these providers.

A Preferred Provider Organization (PPO) is a type of plan that contracts with medical providers to create a network with a broad choice of providers. Benefits are available both in and out of network, but you pay less to use the contracted in-network providers.

How much will this cost me (and my employees)?

We know you may be on a tight budget and getting the most for your money is important. Employers usually cover 50-100% of the cost of benefits for their employees. You decide how much to contribute, and your employees pay the rest. According to KFF’s 2018 Employer Benefits Survey, small firm employers contributed an annual average of $5,681 to their employees’ premiums for single coverage, while their employees contributed an annual average of $1,133. For family coverage, small firm employers contributed an annual average of $11,957 to their employees’ premiums while their employees contributed an annual average of $6,781.

Finalizing Your Options and Getting Enrolled.

Once you have settled on a plan you like, how do you close the loop and finalize the health insurance shopping process? At this point, you need to find a licensed broker you can trust so you can get your company and employees enrolled.

Online health insurance marketplaces that offer a seamless transition from the shopping, comparing and quoting platform to a licensed broker via live chat, email or phone are ideal. Rather than suffer through disorganized call centers and waiting on a broker to return your call, it’s helpful to get connected to an insurance expert instantly who will answer any questions you might have and help you enroll in health coverage as quickly and efficiently as possible.

#Small business #health insurance #insurance

[kellywarner]

Can’t afford Medigap Plan F? Consider Plan G

Medigap Plan F was once the most popular, most comprehensive (and often most expensive) Medigap plan available. This has recently changed as Medigap Plan G is now a better deal in almost every market.  

Why? Because of M.A.C.R.A. The Medicare Access and CHIP Reauthorization Act is an acronym for a new law that stated that those new to Medicare after 2020 could no longer purchase Plan F. The only seniors that should make a decision between Plan F and Plan G are the ones that turned 65 before 2020. In almost every other case, Plan G is the best choice available. Let’s focus on those people that need to decide.

Plan G is identical to Medigap Plan F in every way but one. Plan G has the same network of doctors and the exact same benefits at F except it doesn’t cover the part B deductible. The Part B deductible is a one-time calendar year deductible that you pay when you visit the doctor for none preventive reasons and costs $198.

How is Plan G better?

Good Question! Insurance companies are currently pricing Medigap Plan G $30 to $60 less each month than Medigap G. Most times you can save $500 or more a year in lower premiums on Plan G. Yes, you still have to pay $198 if you go to the doctor for a non preventive visit on plan G but when you save over $500 it is worth it.

Plan G will (most likely) be even cheaper than Plan F than in the future

Since those new to Medicare cannot purchase Plan F after 2020 the risk pool of Plan F members will be older than Plan G. Older members typically have more claims than younger members so there is speculation that Plan F prices will increase at a greater rate than G. Plan G, on the other hand, will still be adding new members who turn 65 after 2020 so its risk pool will be younger and most likely healthier.

Next Steps

If you have a Plan F now, you should compare prices and consider switching to plan G.

If you turned 65 after 2020 and are unable to purchase Medigap F due to the new law, just know that Plan G will always be available to you and, as we explained above, is almost always a better deal. Call us at 800-930-7956 to get prices and apply

Medicare Supplemental Plan F is expensive but if you cannot switch to G, it’s still worth it

Until recently,  Plan F is the best coverage for seniors considering Medicare Supplement insurance (aka Medigap).  While we know it can be expensive, no one really explains how much Plan F or Plan G could save you…until now. We have done a back of the envelope calculations on what Plan F or G could possibly save you. The results are surprising.

Potential Medigap Plan F or Plan G Savings in One Year:

Here is what Medigap Plan F or G could save you in one year if you are a senior in need of significant medical treatment. Remember Plan F and Plan G are 100% identical in every way except Plan G will not pay for the Medicare Part B deductible of $198.

• Your Medicare Part A Hospital deductible: Medigap Plan F pays 100% of your Part A deductible. Those with just Original Medicare have to pay $1,408 for each 60 day benefit period. This means that if you enter the hospital for a second time after 60 days, you would have to pay that same $1,408 deductible again. Currently one of every five Medicare patients ends up back in the hospital shortly after being released, so this is a distinct possibility. It’s a stretch, but if you entered the hospital 5 times in one year.  That’s a lot.

• Extra Hospital Stay Costs During days 61-90: If you stay in the hospital for more than 60 days, without a Medigap plan F or G, you have to pay $352 per day in coinsurance Original Medicare fees. If you get a Medigap plan that covers this benefit, you would save 30 days x $352 per day.  Wow!

• Extra Hospital Stay Costs for Over 90 days: You have to pay $704 per day coinsurance per each “lifetime reserve day” after day 90 in the hospital with traditional medicare. You only get 60 lifetime reserve days without a Medicare Supplemental plan. Medigap Plan F and Plan G would pay the $704 per day benefit which would save you 60 days x $704 per day immediately.

Also it would extend hospital coverage for an additional 365 days. The price of these additional days can vary, but could cost as much as $4,100 a day (Money Magazine). The additional hospital days beyond your Medicare lifetime reserve days could be as high as 215 remaining days x $4100 = $881,500 if you spent the rest of the year in the hospital. Crazy huh?!

• Skilled nursing cost from day 21 through 100: You would have to pay $176 per day for days 21-100 if you didn’t purchase a Medigap plan with this benefit. This works out to 80 days X $176  that you would not have to pay with your plan F or G.

• Your Medicare Part B deductible. This amount is only $198 but you will not have to pay it if you purchase Plan F Medigap.  Here is where the two plans differ.  Plan G does not cover the Part B deductible.  Once again since you can save so much each month on lower monthly premiums, it is worth it to pay the $198 out of pocket.

• Doctor Fees. Traditional Medicare expects you to pay 20% of doctor fees. This is the most difficult benefit to quantify because the cost of the doctor visit depends on the services you need. Plan F and Plan G pays that 20% for you and will pay 100% of any fees your doctor may charge beyond the Medicare reimbursement rate. This is called Part B excess fees and, without this Medigap benefit, if a doctor wanted more than the reimbursement rate you would have to pay for it out of your own pocket. Exact savings here for someone with Plan F and Plan G is unclear but could be substantial depending on your medical needs and what you doctor charges.

• Blood:  (You could save $450) Traditional Medicare does not cover the first 3 pints of blood. We are not sure exactly what this costs but a good guess would be $150 per pint. Plan G and Plan F cover this benefit so it would save you $150 x 3 = $450

• Foreign Travel:  (You could save $50,000) Traditional medicare doesn’t cover any foreign travel benefits. Plan F or Plan G would save you up to $50,000 of foreign medical expenses.

Total up all the above additional costs covered by Medigap plan F and Plan G and you have nearly 1 million dollars in cost not covered by Traditional Medicare. Now, it would be impossible to have all those expenses in one year but you can see that if you had serious health issues and didn’t have Medigap F or G, the cost would add up.

#medicare #medicare plan #medicare advantage

[kellywarner]

What is original medicare?

Original medicare may not pay the entire amount, it only pays for person’s eligible healthcare expenses. This plan only supplements Medicare Parts A and B. Long-term care, private nursing, dental care, hearing aids and vision care are some of the treatments that this medicare doesn't pays for. One of the major benefits of Original Medicare is that a person can go to any doctor who is registered with medicare. This option is very beneficial for the people who frequently travel within the country. If you need any help in choosing the perfect plan for you, then you can get in touch with Medicare Providers in Pennsylvania.

#medicare #health #original medicare

[kellywarner]

Importance of Health Insurance to Small Business Entrepreneurs

The need of health insurance is overlooked by many business owners. According to them its better to spend the money somewhere else in the business. But smart business owners know the importance of business health insurance. By providing health insurance the business owners not only provides security to its employees but also to its company itself. It is a way of ensuring that the efforts that are made on the employees during the training period will not be wasted if they become ill. The medical expenses  will be covered with the help of the health insurance. 

#Small business #health insurance #group health insurance

[kellywarner]

What is Medicare Advantage?

Medicare Advantage Defined

Medicare benefits come in two forms: Original Medicare and Medicare Advantage.

With Original Medicare, Medicare benefits are paid by the federal government. This is different than Medicare Advantage plans, which are also referred to as “Part C” or “MA Plans”. Instead of being offered by the government, these plans are actually offered by private companies that Medicare pays to cover Medicare-provided benefits.

Medicare.gov, the official U.S. Government site for Medicare, explains that there is generally at least some cost to participants for each service provided under Original Medicare, between deductibles and copayments, with no yearly limit per person for out-of-pocket medical expenses.

However, Medicare Advantage plans do limit out-of-pocket expenses, though these limits are generally high. For instance, in 2018, the maximum out-of-pocket limit is $6,700, though some plans may offer lower amounts.

Although Medicare Advantage plans provide both Part A (hospital) and Part B (medical) coverage to participants, Original Medicare still covers services related to hospice care and certain new Medicare benefits and clinical research studies for these individuals.

Regardless of which plan is chosen, Original Medicare or Medicare Advantage, all Medicare recipients are covered in emergency medical situations.

 How much Medicare coverage will be depends on a number of factors. This guide covers costs from 2020.

Given that Medicare Advantage is provided by private insurance companies, there are many types from which to choose.

Types of Medicare Advantage Plans

Given that Medicare Advantage is provided by private insurance companies, there are many types from which to choose. However, most fall under one of these six categories:

Medicare Advantage HMOs

Medicare Advantage HMOs (Health Maintenance Organizations) are like other HMOs in that you must choose healthcare providers in the plan’s network unless it is an emergency. And if you need to see a specialist for a medical issue, a referral from your primary healthcare provider is required prior to seeing the specialized doctor, otherwise insurance may not cover the costs.

HMO Point-of-Service Plans

HMO Point-of-Service plans, commonly shortened to HMOPOS plans, are HMO plans that offer a bit more flexibility in choosing some out-of-network providers for certain, predetermined services. However, if this type of plan is chosen, it’s important to understand that higher copayments will likely apply.

Medicare Advantage PPOs

PPO (Preferred Provider Organization) plans offered through Medicare Advantage allow participants to go to any healthcare provider they’d like. But just like with HMOPOS plans, higher costs typically apply when providers outside the PPO network are seen.

Private Fee-for-Service Plans

If a Private Fee-for-Service (PFFS) plan is chosen under Medicare Advantage, the participant can go to his or her healthcare provider of choice, as long as that provider is willing to accept the payment terms and amounts dictated by that individual PFFS plan.

Special Needs Plans

People with chronic medical conditions or other special needs often require specialized health-related services. Special Needs Plans (SNPs) offered via Medicare Advantage help meet those needs, providing more focused care for specific populations.

Medical Savings Account Plans

Some participants prefer to pay higher deductibles in return for having money deposited in a health plan bank account, which is what a Medical Savings Account (MSA) plan does. This enables participants to simply bank the money and pay for their medical care services on their own as they arise.

#medicare #medicare plan #medicare policy

[kellywarner]

Does Medicare Part B Cover Any Dental Expenses?

Yes, but Medicare Part B only covers dental expenses that are a medically necessary part of another covered service. It does not cover routine dental services, such as cleanings, or other standard procedures like dentures, crowns, or fillings. These services will need to be covered through independent dental plans or through a Medicare Advantage plan that includes dental coverage.

Medicare Part B Dental Coverage Includes Some Oral Care

Medicare Part B dental coverage works in ways you may not expect. While there's no coverage for the regular care, treatment, removal, or replacement of teeth, Part B does cover dental services performed by a physician that are an integral part of another covered procedure. Examples include:

Oral exams in anticipation of a kidney transplant.

Extractions done in preparation for radiation treatments involving the jaw.

Reconstruction of the jaw following an accident.

Because none of these cases are preventative or common dental treatments, it would be beneficial for Medicare beneficiaries to invest in a stand-alone dental plan to help subsidize the cost of receiving the regular dental services that are essential to maintaining oral health.

Dental Coverage With Stand-Alone Plans

Although Original Medicare does not provide comprehensive coverage, that does not mean seniors will be left without dental care. There are senior dental plans that can be purchased as stand-alone plans, meaning they are not connected to your other forms of medical insurance. These standalone senior dental plans can cost around $20 - $60 per month and can cover preventive, diagnostic, and restorative services and procedures.Experts can help you save on your dental bills by finding you dental insurance that covers regular dental care. 

#medicare plan #medicare policy #medicare advantage

[kellywarner]

How do some Medicare Advantage Plans cost me nothing?

When it comes time for folks start looking for plans, they get shocked when they see some Medicare Advantage Plans that have $0 premiums. A lot of questions get asked behind those zero premium costs, and the "It's too good to be true" mentality sets in.

The reality is that it is real, it's not a trick. It's a great thing for members to see, but it's also important for them to understand why carriers are able to offer plans with no premium.  Medicare Advantage Plans, also known as Medicare "Part C" or "MA Plans", are offered by private insurance companies that take over the care of Medicare beneficiaries.

Each private insurance company that offers Medicare Advantage Plans must follow the rules set by Medicare to insure complainant care for its beneficiaries. By joining a Medicare Advantage Plan you still retain your Medicare Part's A and B, but the difference is that you go to approved physicians and facilities for care, unlike Original Medicare.

The benefit of this is that copays are much lower than Original Medicare.  Through the agreement that the private insurance carriers and Medicare agree upon, Medicare will pay a fixed amount for members coverage each month based on the average cost of medical expense typically filed in the service area.

These companies must follow Medicare’s coverage rules to be eligible for participation, and Medicare Advantage Plans have yearly contracts with Medicare that must be filed before the Annual Election Period (AEP) for that specific year.  The plan must notify you about any changes before the start of the next enrollment year.  

Medicare pays private Insurance carriers an agreed amount to provide care for Medicare Beneficiaries

 Medicare would never contract with private insurance companies if it was not in the best interest of the Medicare beneficiary. Medicare Advantage plans have many benefits that Original Medicare does not, and in many cases provide a more affordable way to receive care.

#medicare #medicare policy #medicare advantage

[kellywarner]

What is Medicare Part A?

Medicare Part A, also known as hospital insurance, is part of Original Medicare. Original Medicare consists of two parts: Medicare Part A and Medicare Part B (Part B will be covered in a later post).  

Medicare Part A Covers:

Inpatient Hospital Care​

Skilled Nursing Facility

​Nursing Home Care (inpatient care in a skilled nursing facility that's not custodial or long-term care)

Hospice Care

Home Health Care

In general, Part A will cover these services, but some exceptions may occur. There are resources available on Medicare's official website to find out if Medicare will cover your item, service, or supply.

Medicare Coverage is Based on 3 Main Factors:

Federal and state laws.

National coverage decisions made by Medicare about whether something is covered.

Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

There are services Medicare Part A doesn't cover

Medicare Part A does not cover physician visits, physical therapy, speech therapy, occupational therapy, and durable medical equipment.

 With ONLY Medicare Part A, you do not qualify for any type of Medicare Advantage Plan or Medigap Policy.   If you only have Medicare Part A (hospital insurance), you can still qualify for a Stand Alone Prescription Drug Plan. Great news about that is that you can still get help with the cost of your medication through a private insurer.

There are many options available to individuals to enroll into a Stand Alone Prescription Drug Plan.  If you are an individual that wants to know more about what Medicare Part A does and does not cover,  feel free to take the help of the experts.

#medicare #medicare plan #medicare policy

[kellywarner]

How to Get the Most Out of Your Medicare Plan?

Last year, Medicare benefits paid out over $688 billion. Millions of senior citizens in the United States rely on Medicare to get the medical attention they need. Many plans also offer preventative care and free yearly physicals.  If you are in the market for a new health insurance plan, you need to check out all of the options Medicare has to offer.

Working with professionals who have intimate knowledge of how Medicare works and how to get the best deal on a new policy is a wise move. Trying to make this decision without this guidance can lead to the wrong policy being selected. Once you have the right Medicare policy, you need to work hard to get the most out of it. The following are some ways you can accomplish this goal.

Selecting the Right Doctor Isn’t Easy. Getting quality medical care is only possible if you work with a knowledgeable and passionate doctor. Most people are surprised to learn just how many doctors are located in their general area. The first step in getting the absolute most out of your

Medicare insurance policy is finding the right doctor. While this may sound like an easy process, it is anything but.Narrowing down the selection of medical professionals in your area can be easy if you look at your Medicare policy’s network coverage. Looking at the list of doctors in your area that takes Medicare insurance is just the first step.

You also need to consider what the doctor in question specializes in and how well they have performed for other patients in the past. Asking friends or family members in your same age group about which doctors they use is a great way to make this process easier.

Get Familiar With Your Medicare Benefits

Once you select a Medicare policy you can afford, take some time to get familiar with what it covers. Many Medicare policies provide seniors with tons of extra benefits. These benefits typically include things like:

Coverage for telehealth appointments

Eye exams and glasses

Yearly wellness visits

Nutrition counseling

While you may have to pay more for a Medicare policy with these benefits, it will be worth it. With these perks, you can keep your body healthy and your mind happy.

Figure Out How to Avoid Surprise Medical Bills

There is nothing as frustrating as receiving an astronomical medical bill for a procedure you thought you were covered for. It is your responsibility to find out what your Medicare policy covers and how much out of pocket costs you have to contend with annually. By getting this information, you can set an accurate and detailed budget for your medical expenses. Failing to get familiar with your coverage can result in tons of overdue medical bills and higher levels of stress.

Start Using Your Medicare Coverage Today!

Do you need help finding the right Medicare policy? If so, it is time to contact the professionals of medicare providers in pennsylvania

#medicare #medicare plan #medicare policy

[kellywarner]

What is Medicare?

Medicare is a health insurance program from the federal government that covers most people that are of the age of 65 or older. If you’re younger than 65, Medicare will cover your health care costs if you’re disabled or have End Stage Renal Disease. People covered by Medicare are called the beneficiaries of the medical insurance program. Medicare will pay for most of the health care they are in need of, but not all of it.

Medicare will cover the majority of acute medical conditions that the patient will naturally recover from. It will not cover health care given in the beneficiaries’ home, in assisted living facilities, or any nursing homes, even if the person has a long term or chronic illness or disability. There are also long gaps of Medicare’s prescription drug plan that can complicate medical needs.

There are 4 types of Medicare benefits a person can receive, parts A, B, C and D.

Medicare Part A is for inpatient hospital care, hospice, some skilled nursing facilities, and some health care in other facilities.

Medicare Part B is normally covered by a monthly premium to help pay for the cost of doctors, outpatient hospital care, and physical and occupational therapy that one might need.

Medicare Part C supplements the top, but allows the beneficiaries to go to other health care organizations that normally only take HMPs, PPOs, and private health insurances.

Medicare Part D of Medicare provides prescription drug benefits through private insurance companies. Medicare providers in pennsylvania recognizes the importance of Medicare, so if you are confused regarding any plan or you need any kind of help, you can surely get in touch with their experts.

#medicare #medicare plan #medicare policy

[kellywarner]

Understanding small business health insurance

A solid benefits package attracts top talent. According to Glassdoor, almost 80 per cent of employees would prefer benefits to a pay increase – and that number increases to 89 per cent in employees under the age of 34. The best part is, offering benefits is becoming an increasingly easy and cost-effective option for small and even micro business owners, as new services and platforms emerge.

One of the most important components of any benefits plan is the health insurance. Here’s an overview of what you need to know when selecting a small business health insurance plan.

Types of coverage

There are many things you can cover with a health insurance plan, and it’s important to know the terminology. Here are your basic options:

Extended health care

Usually a basic health plan starts here. This is essentially the medical expenses not covered by an employee’s provincial health coverage. This can include prescription drugs, specialist visits, vision care, hospital stays, and emergency travel coverage.

Dental coverage

This coverage expenses from preventive and diagnostic dental treatments.

Accidental death and dismemberment

This covers an employee and their family in the event of a serious accident (paralysation, loss of a limb, etc.) and also provides benefits to an employee’s family if they die accidentally.

Life insurance

This coverage provides money to an employee’s family if they die.

Disability

Long-term or short-term disability provides employees with a portion of their income if they become injured and can’t work.

Types of plans

Most employers and employees are familiar with traditional, fully-insured benefits plans. However, that’s actually only one of several types of health insurance plans that are available. And, some of the non-traditional options might be much more suited to your small business. Here are the basic types:

Traditional employee benefits plans

In a conventional health care benefits plans, the employer usually pays a per-employee fee that is based on anticipated claims. All the administration is done by an insurance company, and it takes on all liability in the event of a lawsuit.

Administrative services only (ASO) plans

In this type of plan (also known as self-funded health care), an employer pays for benefits claims from its own funds – in other words, instead of paying a monthly or yearly fee for anticipated claims, they pay for actual claims only. They use a third-party company to administer the plan (hence the name of the plan type).

Health-care spending accounts (HSA or HCSA)

In this type of plan, employees are allocated a pre-determined amount of money to cover their medical and dental needs. Employees can then pick and choose from a variety of health benefits.

Hybrids

For small business owners looking for more flexibility, some insurance providers offer a traditional or ASO plan combined with elements of a health-care spending account.

Types of providers

When you’re ready to discuss these options in more detail, there’s also a range of ways to choose and purchase these health insurance plans, and integrate them into your small business.

Small business health insurance brokers and advisers

If you’re looking for some expert advice, a growing number of benefits brokers and advisers are specializing in small business options. Many insurance providers are going a similar direction, with new programs specifically suited to smaller companies.

Professional Employer Organizations

Another option is to use a PEO. A PEO is essentially an outside company that handles all your HR needs (it’s sometimes called a “co-employment” arrangement). The biggest advantage of a PEO is that your company’s benefits are part of a larger plan used by many small businesses, which means you can often access lower rates or more comprehensive services.

HR service platforms

One final option is a new wave of platforms offering HR services similar to PEOs, but with more flexibility. Some let employers bring in their own service providers to manage through a platform, while others let employees manage spending accounts via an app.

#small business #group health insurance #health insurance

[kellywarner]

How to Find Health Insurance for Your Small Business

Under the Affordable Care Act, if you have more than 50 employees, you're required to offer health insurance under the law. For small businesses with fewer than 50 employees, providing health insurance to employees is optional, but it's a great way to attract new talent, keep productivity up, turnover down, and make your staff happy.

The health insurance marketplace can be pretty confusing. Here's what you need to know to find the right plan and maximize tax savings, and why you should.

 How Health Insurance Benefits Your Small Business  

Worried if your small business can afford to provide health insurance? Although it is a valid concern, the cost can be offset by tax credits and other benefits you’ll reap.

Benefits of providing health insurance include:

Tax credits: If you purchase a plan through the Small Business Health Options Program Exchange, you’ll get a tax deduction.

Additional tax benefits: You can deduct employee benefits, including health insurance costs.

Boost productivity: Workers who are healthier and less stressed tend to be more productive and happier at work, which leads to the added benefit of higher customer satisfaction.

Reduce employee turnover: Employee churn is expensive. Finding and onboarding new employees, and loss of productivity while you’re short-handed can really add up. How are people lured away? By jobs with better benefits. In a 2018 America’s Health Insurance Plan (AHIP) study, 56% of respondents indicated health coverage remains a key factor in their choice to stay at their current job.

Recruit better talent: Only 55% of small businesses with fewer than 100 employees offer health insurance, according to the Bureau of Labor Statistics.  A survey by AHIP found that health insurance makes a big difference in accepting a job or keeping one.

You need it: Small business owners often put their own health and welfare last. Did you know that if you own a registered business, some states allow “groups of one” to purchase group coverage? Health insurance means financial security for both you and your employees.

 Getting Started  

Before talking to small business insurance providers, you’ll need to gather some information. In addition to your business information, payroll records, and Standard Industry Code (SIC), you’ll need demographic information about each of your employees. This includes names, ages, number of dependents, and the zip codes where they live. This information is used to evaluate risk and determine costs.

 Types of Health Care Insurance Plans  

Categories of health insurance plans include:

Health Maintenance Organizations (HMO)

Provides integrated care with focus on prevention and wellness.

Participants must choose doctors who work for or contract with the HMO.

Does not typically cover out-of-network care except in an emergency.

May require participants to live or work in its service area to be eligible for coverage.

High Deductible Health Plans (HDHP)

Higher deductible and lower monthly premiums

Point of Service Plans (POS)

Participants pay less if they use network doctors, hospitals, and other health care providers.

POS plans require a referral from your primary care doctor to see a specialist.

Preferred Provider Organizations (PPO)

Participants pay less if they use the network of participating health providers.

You can use doctors, hospitals, and providers outside the network for additional cost.

Exclusive Provider Organizations (EPOs)

Coverage is limited to care from providers in the EPO’s network (except in an emergency).

The best plan for your business depends on budget, number of employees, and employee demographics. For example, if most of your employees are young and healthy, an inexpensive health plan that covers catastrophic health events and offers minimal basic care might be a good choice, while older employees may require frequent care for common chronic illnesses.

 Finding a Plan  

Finding the right small business insurance plan can be time consuming and challenging. It will help to figure out how much you can afford and what best meets your needs and the needs of your employees. While you can just call around to insurers, there are better ways to approach the search for a provider:

 Meet With Insurance Brokers  

If finding a good plan, complying with regulations, and filing mountains of paperwork seem daunting, you can avoid the time and hassle by hiring a licensed insurance broker to do the heavy lifting for you. If you’re new to this, the expense may be well worth it. An insurance broker will do the paperwork and find the best options for your business. They work on commission, and only get paid when you purchase a plan. Insurance brokers should never demand a fee up front; it’s a good indication of a shady practitioner.

 Join a Purchasing Alliance  

Purchasing alliances or organizations are mini healthcare insurance marketplaces where small businesses can leverage the lower costs of group policies by partnering. With the purchasing power backed by a big pool of participants, your employees will get a wider choice of policies at a lower cost—but you’ll miss out on the government tax incentives

#small business #group health insurance #health insurance