Which is better, a Medicare Advantage or Medicare Supplement plan? Medicare Supplements are also called Medigap plans. This is a common question and the answer is “it depends”. Medicare Advantage Plans and Medicare Supplement plans are very different. They both have strengths and weaknesses. The key is to know the difference between them as well as how they work with your situation. We can start by pointing out how each plan works and how they are different.
Medicare Supplement plans are private plans that insurance companies offer. There are a number of different plans that range from A through N. All have different benefit structures although they are standardized in most states. This means the benefits must be the same regardless of the company that offers the plan. If 8 companies offer a plan N in a state, they must all have the same benefits. The only difference is price.
Medicare supplement plans are secondary to Original Medicare. When someone goes to the provider, they show their Original Medicare card. The provider bills the card and Medicare pays their portion of the benefits. Your Medicare supplement company will receive a charge for the portion that is left over and they will then pay that portion. It is a very simply process and offers some big positives over an Advantage plan. Below, we will list the advantages as well as disadvantages of using a Medicare Supplement.
In fact, Medicare Advantage plans are also called MAPD’s, Medicare Replacement Plans and Managed Medicare Plans. Medicare Advantage plans are not secondary to Original Medicare. The Medicare Advantage plan becomes the primary insurance. The insured is still in the Medicare program but Original Medicare is not used for insurance. An advantage plan works in a similar manner to a group or individual health insurance plan. (they are not the same but have a similar set up.) This means the client has set benefits which are in the form of co-pays and cost shares. There are some major pro’s and Con’s with Advantage plans which we have listed below.
In general, someone with minimum health care needs may want to try an advantage plan. They will not be laying out any premium on a monthly basis and will only pay a copay when they do see a provider. If someone does not want to be limited by a provider network or if they utilize a lot of healthcare, they may want to consider a Medicare supplement instead. The supplement allows them to go to any provider they want (as long as they accept Medicare) and they can choose a plan that leaves them with very little out of pocket. The negative is the premium they will pay for the supplement and Part D Rx plan regardless of if they utilize care or not.
A Medicare Advantage Trial Right can be a huge benefit to someone trying a Medicare Advantage plan for the first time. Unfortunately, most people do not know it exists. The Medicare Advantage Trial Right is applicable to those trying a Medicare Advantage plan for the very first time. If you decide you do not want the advantage plan within the first 12 months, you have a trial right that lets you dis-enroll from the Medicare Advantage plan and switch back to the Medicare supplement plan you had previously.
This means that during the first 12 months of your Medicare Advantage Plan coverage, you can change back to Original Medicare, Part A and Part B, and get your Medicare Supplement plan back (if it’s still available). If your original Medigap plan isn’t available, you can use your trial right to enroll in any Medigap Plan A, B, C, F,G K, or L, M, or N that’s sold in your state. You can make the change for the 1st of any month during the first 12 months.
For those that want to try a Medicare Advantage plan with the ability to change if they do not like it. Medicare Advantage plans typically have a very low or even $0 monthly premium. Advantage plans are very different from a supplement. Some folks may find they do not like them once they get into it. Having this 12-month trial period allows people to try the Advantage plan out. No medical underwriting is allowed when using the Trial Right which means the insurance company must enroll you regardless of your health.
Under normal rules you would not be able to change from your advantage plan to a supplement until the Open Enrollment Period ,which allows for a January 1 change every year. To learn more about the differences between a Medicare Advantage plan and a Medicare Supplement Plan CLICK HERE FOR AN ADVANTAGE VS. SUPPLEMENT COMPARISON
Please note that you can use a Trial Right regardless of when you first enroll in an Advantage plan. Some people may initially enroll in a Medicare Supplement plan and then decide to try a Medicare Advantage plan for the first time at age 68. If it is the first time in an Advantage plan, they will have a 12 month Trial Right.
In this post we will explain a little bit about Altrua Health Share Plans alternative coverage. This plan is the answer for some people who have problems with the high cost of health care and health insurance. This plan can save you from either having to reduce your coverage or having to pay a high deductible.
Thousands of people have discovered that Health Care Sharing Ministries is a viable alternative to the high cost of health insurance. In fact, sharing ministries much like Altrua have been in existence for almost thirty years. There has been billions of dollars of health care needs that fellow members have shared in. Although Health Care Sharing Ministries are NOT insurance they operate in a similar way.
Some times people refer to Individual Health Care Sharing Ministry as (HCSM). If you choose to become a member of an HCSM, your medical providers will consider you to be a self-pay patient. In general, self-pay patients pay lower fees than providers charge health insurance companies. The Members of a sharing ministry remain self-pay. Although they benefit from having other members who believe in caring for one another through the HCSM. Note: Some HCSM plans use providers networks. Altrua health share uses the PHCS/Multiplan national network. Any members going to an in network PHCS Multiplan provider will be able to visit the doctor for a cost share of only $35. They will also receive the PHCS Multiplan discount on any other medical services they receive.
Altrua does not require a pastor, elder or representative from your local church to verify your church attendance. Altrua also does not require the validation of your medical need by submitting it to the membership for sharing. If you are a member of Altrua, you do not have to wait for other members to send their individual checks to you to receive your medical payment. Each eligible medical expense you submit to the membership will be paid in accordance to the members’ escrow account instructions and the member guidelines.
Altrua is not exclusive for one denomination, religion or faith. This plan (Altrua) is a recognized HCSM under the guidelines of the Affordable Care Act. In other words, If you are a member you are eligible for exemption from the share responsibility payment penalty mandated by the Affordable Care Act. Altrua has a nationwide membership for both individuals as well as families.
You can click on this link to apply for the Altrua Health Share Plans coverage.
This information is important to you if, you have a Health Savings Account. You need to be aware of the Health Savings Account contribution limits 2018.
As a matter of fact, The amount that individuals may contribute annually to their health savings accounts (HSAs) for self-only coverage will rise by $50 next year. For HSAs linked to family coverage, the contribution cap will rise by $150.
In Revenue Procedure 2017-37, issued May 4, the IRS provided the inflation-adjusted HSA contribution limits effective for calendar year 2018. They also gave the minimum deductible as well as maximum out-of-pocket expenses for the high-deductible health plans (HDHPs) that HSAs must be coupled with.
2018 vs. 2017 HSA Contribution Limits
|Contribution and Out-of-Pocket Limits
for Health Savings Account contribution limits 2018
|HSA contribution limit (employer + employee)||Self-only: $3,450
|HSA catch-up contributions (age 55 or older)*||$1,000||$1,000||No change**|
|HDHP minimum deductibles||Self-only: $1,350
|HDHP maximum out-of-pocket amounts (deductibles, co-payments as well as other amounts, but not premiums)||Self-only: $6,650
|* You can make catch-up contributions any time during the year in which the HSA participant turns 55.
** Unlike other limits, the HSA catch-up contribution amount is not indexed; any increase would require statutory change.
Account holders who will be 55 or older by the end of year can contribute an additional $1,000 to their HSA. If a married couple are both age 55 or older they may both contribute the extra $1,000. Please note: An HSA is in an individual’s name—there is no joint HSA even when the plan provides family coverage. Therefore only an account holder age 55 or older can contribute the additional $1,000 in his or her own name.
Besides a high deductible, to qualify as an HDHP, a health insurance plan must not offer any benefit beyond preventive care before those covered by the plan (individuals or families) meet their annual deductible. “An otherwise high deductible plan fails the HSA qualification when it tries to be nice and it gives you some benefits before you meet the deductible. For instance, if the plan provides coverage in the following areas before the individual or family satisfies their deductible, it is not HSA-eligible.
There are a number of people age 65 and older still working. If they have a HDHP at work they may be tempted to put money in an HSA. Additionally, no one is eligible to contribute to an HSA account, if they are currently enrolled in Medicare A and/or B. In fact, the only way to avoid this issue would be for the person to defer the A and B enrollment until a later date.
This post will explain Healthshare Coverage in Connecticut so that clients can make informed choices.
Individuals and families not qualifying for an affordable care act subsidy may want to explore Healthshare Coverage. Healthshare plans are not traditional insurance plans. However, as an option these plans are ACA exempt. Members of a recognized Health Care Sharing Ministry are exempt from the requirement of maintaining health insurance. They are also exempt from the penalty that is now a requirement for those that do not have health insurance.
Healthshare Ministries are not insurance. Members make monthly contributions. Those contributions are placed into an escrow account, from which members’ medical needs are shared according to the membership guidelines as well as escrow instructions. Healthshare issues each Member an ID card. The providers of service receive pay direct from Healthshare.
Altura Healthshare is one of the nation’s leading ministries. In fact, they offer members access to national provider networks at an affordable cost.
Altrua offers these plans to clients at either bronze, silver or gold membership levels.
Today’s health insurance market has many looking for Obamacare alternatives in CT.
The federal government requires both Individuals and families to enroll in a qualified health plan. In fact, those people who choose not to enroll will be subject to a tax penalty.
Access Health CT is the health insurance exchange for the state of Connecticut. It is also called the state health insurance marketplace. This site offers insurance options for every individual. Although, some may qualify for reduced premiums, others may not. Individuals as well as families looking for coverage outside of Access Health will want to be sure that the option chosen meets the criteria to avoid a tax penalty. Below are some options to explore.
Individuals not qualifying for a premium subsidy may choose to purchase traditional insurance directly from an insurance company. Click here to learn about traditional health insurance plans available in CT.
Another option would be to enroll in a health share plan. These are not traditional insurance plans, but do work in a similar fashion. Individuals and families enrolled in a health share plan are exempt from the tax penalty. Click here to learn more about Altrua Health Share plans.
A third option applies to self-employed business owners. Click here to learn more about low cost health insurance plans available in CT.
No matter which route you choose, Crowe and Associates offers the expertise required to navigate the process. We can answer your questions and advise you which option is best suited for you and your family. Please email us at Admin@CroweAndAssociates.com or call us at 203-796-5403 to schedule a personal and confidential evaluation.
If you are unsure about acceptance for life insurance, we have the answer for you! It is called Guaranteed acceptance term and permanent life insurance.
There are some good reasons why some people keep coverage for a long period of time. People sometimes believe they don’t need insurance after they pay off the mortgage and the kids are out of school. In fact, your spouse may live for many years after your death and will still incur daily living expenses. This is a very real possibility with modern medicine today. You have to know if your spouse would be able to maintain the life style that you worked to achieve. Also, would you want to have something to pass on to your children or grandchildren?
In fact, cash value or cash-surrender value are terms people sometimes use to describe permanent insurance. These terms are used because these policies not only provide a death benefit to loved ones but also, can build cash value over time.
The cash value of this plan accumulates on a tax-deferred basis. It is considered similar to the assets in most retirement and tuition savings plans. You can use the cash for anything you want in the future. Also, you can borrow against the cash value of the plan. You can use the cash either to pay for further education, a down payment on a home, or to provide retirement income. If you borrow money from a permanent insurance policy, you use the cash value of the policy for collateral. Usually, the borrowing rates are relatively low. These loans do not depend on credit ratings or other restrictions, this differentiates it from other financial lending institutions. You are required to repay the loan amount plus interest charges. If you do not, your beneficiaries will not receive the full death benefit and cash-surrender value.
In fact, if you either need or want to stop paying premiums, you can use the cash value for a limited time to continue your current insurance protection. If you choose to do this, the policy will provide a lesser death benefit amount to your beneficiaries. If you choose not to pay your premiums and surrender your policy, you will receive payment of the guaranteed policy value. Please note, if you do surrender your policy too early it may have little to no cash value.
As with any permanent policy, the cash value of a policy and the policy’s face amount are two different things. The amount of the payment either upon death of the policy holder or maturity of the policy is the face amount. In most cases, permanent policies “mature” when the policy holder reaches 100 years of age. The cash value of a policy is the amount you receive if you surrender a policy either before death or its maturity. In addition, your insurance company’s experience or financial results (mortality rates, expenses & investment earnings) can have an affect on the cash value of your policy. The term Permanent insurance can actually apply to many types of life insurance products if they have the cash value feature
Universal Life rates Examples:
50 year old male: $10,000 of guaranteed issue Universal Life coverage is $18.77 a month (Example rate)
What term life insurance does is provide coverage only during a certain period of time. This type of policy is sometimes referred to as, pure life insurance. This coverage is in place to protect your dependents in the event of your premature death. If you purchase a term policy and then die within the term, your beneficiaries receive the payout. Term policies have no other cash value.
When you purchase a policy, you decide how long the policy will be in effect and when it ends. Usually, the terms last for 10, 20 or even 30 years. In most cases, when you purchase a policy, the death benefit payout, as well as the premium cost, remain unchanged during the whole term.
Things to consider when you shop for term life:
|Policies Offer||Term life||Whole life|
|Choice of policy length||✓|
|Provides coverage for life||✓|
|Premium cost stability||✓||✓|
|Low premium rates||✓|
|Guaranteed Life insurance payout amount||✓||✓|
|Cash value accumulates||✓|
|May offer annual dividends||✓|
Term life insurance is a less expensive alternative to permanent life. The price for term life is lower because, it is only for a specified time period and has no cash value. Usually, these policies don’t have to pay your beneficiaries. Because most people will live past the end of the policy term. In fact, the premiums for permanent life insurance are significantly higher. Permanent coverage lasts for a lifetime. The policy has cash value, as well as a guaranteed rate of investment return on a portion of your premium payment.
If you have questions or would like to enroll in a plan, please contact us. We can be reached either by phone(203)796-5403 or email Edward@croweandassociates.com.
This post will try and give you some help when you are applying for Medicare in Connecticut. This can be overwhelming for some people. We want to make it easy for you. If you are 65 years old, or are under 65 and qualify for Medicare because of a disability or other special circumstance, you are eligible for Medicare. (Note: You must be a US citizen or a legal resident for at least 5 consecutive years to be eligible for Medicare.)
Apply for Medicare can be done online by CLICKING HERE. You can also enroll by phone at 1-800-MEDICARE. Or, you can enroll in person at your local social security office. You can call 1-800-772-1213 for help locating your local social security office.
Crowe and Associates is offering it’s clients the opportunity to purchase Dental insurance with UnitedHealthOne Dental Plans, so you will have one less thing to worry about. The dental plans we are offering are either a PPO or an EPO. When it comes to finding dental coverage that fits your unique needs and budget the UnitedHealthOne Dental Plan gives you the coverage you need at a price you can afford. The newly expanded dental products have many features that will keep you smiling.
There are 4 new plan types to choose from.
UnitedHealthOne provides coverage for preventative and basic as well as major services.
Vision benefits are also available, if you want to add that option.
Additionally, you will have access to an extensive dental network.
The PPO plan is in the Solstice PPO Network and is available in all 50 states.
The EPO plan is the S500A network and is only available in NY, NY, CT and FL.
Please click on the links below for more information on the dental plans we are offering.
If you have any questions or would like to enroll in one of these plans, please either call us at (203)796-5403 or email us at Edward@croweand associates.com.
The information in this post will help clients who may need Short Term Medical Plans. UnitedHealthOne is offering short term coverage for anyone who finds themselves without insurance.
Short Term health insurance is sometimes called either Term health insurance or Temporary health insurance. This type of insurance is made to bridge gaps in your health care coverage when you find yourself without insurance for any reason.
Short Term health insurance plans can help when:
These policies are offered through the Golden Rule Insurance Company, which has been part of UnitedHealthcare since 2003. They have been in the personal insurance business for more than 70 years. For more than 30 years, this company has sold Short Term insurance policies.
Because, these types of insurance plans do not meet the minimum coverage requirements under the Affordable Care Act (ACA or Obamacare) you may still receive a tax penalty for not complying with the standard. These plans are for use only to provide temporary health insurance during coverage gaps. If you would like to avoid the risk of a penalty, you should apply for an ACA health insurance plan as soon as you are able
If you would have questions or would like to apply for coverage, please contact us either by phone at (203)796-5403 or by email at Edward@croweandassociates.com.
Because of the high cost of medical care, especially a hospital stay, we are now offering our clients the United Hospital Indemnity Plan.
Both the Hospital SafeGuard PremierSM plan and the Hospital SafeGuardSM plan can help fill some of the gaps in your health coverage.
These plans provide cash to help you pay both the deductible and non-covered expenses you incur from a hospital stay.
When you choose either a Hospital SafeGuard PremierSM or a Hospital SafeGuardSM plan:
You will receive benefit payments that you can use in any way you choose. There are many options, you could either save them, pay medical bills, or even pay expenses you incur because you are away from your job. The payment is not limited by provider networks. Your payment remaine the same no matter which provider you use. In fact, you will not have to meet any deductible before you receive payment. These plans are available to your whole family. The plans are guaranteed renewable up to the age of 65.
Did you know that the average length of a hospital stay in 2010 was almost 5 days? The cost for inpatient care per day was almost as high as $2,000.
This large expense could have lasting effects on your family’s budget and cause some people a real hardship.
Hospital SafeGuard PremierSM or Hospital SafeGuardSM pay you cash benefits for eligible hospital inpatient as well as ICU admittance. These plans are not a replacement for your regular health insurance. You can purchase these plans to have that extra safeguard against unforeseen illnesses.
If at any time you receive qualified medical care, all you have to do is, fill out the claim form, your carrier provides you. Submit the forms along with copies of your receipts. Your carrier will then send you a reimbursement check for the fixed amount as long as they do not exceed the calendar year maximum.
Please note, You must have ACA minimum essential coverage to qualify for either Hospital SafeGuard PremierSM or Hospital SafeguardSM.
If you decide to purchase Hospital SafeGuard PremierSM, you may be disqualified from making tax-deductible contributions to a Health Savings Account. Check with your accountant to be sure about the current tax laws.
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