Whether to enroll in Part B or use FEHB as primary coverage is a personal decision, based on your individual circumstances. You should look at the costs and benefits of each insurance plan and make the choice that’s best for you. When you become Medicare-eligible, you have a few options: Keep FEHB and turn down […]
Part D is Medicare prescription drug coverage you get through either: A stand-alone Part D plan Part of your Medicare Advantage Plan The cost of your Medicare Part D-covered drugs may change throughout the year. If you notice that your drug prices have changed, it may be because you are in a different phase of Part D […]
Ending Care Appeals: If you are receiving care in a hospital or non-hospital setting and are told that your Medicare will no longer pay for your care, you have the right to a fast appeal if you feel that continued care is medically necessary. There are separate processes for hospital and non-hospital appeals. Non-hospital care […]
Part A: Hospital Insurance Part A premium Free if you’ve worked 10 years or more $278 per month if you’ve worked 7.5 to 10 years $505 per month if you’ve worked fewer than 7.5 years Part A hospital deductible $1,632 each benefit period Part A hospital coinsurance $0 for the first 60 days […]
Dcember 2023: Part D Appeals Part D appeals at a glance: If your plan won’t cover your medication, you can appeal the decision. The process is the same whether you get your drug coverage through a stand-alone Part D plan or a Medicare Advantage Plan. Instructions for how to appeal will always be on your […]
November 2023: Choosing Doctors and Other Providers Depending on your coverage, you will have different considerations when choosing health care providers like doctors, hospitals, or medical equipment suppliers. Let’s review some of these factors, so you can get your care covered at the lowest cost. Even with this information in hand, remember to trust yourself […]
October 2023: Protecting Yourself from Marketing Violations During Fall Open Enrollment, you will likely experience more marketing from private Medicare plans, like Medicare Advantage Plans and Part D plans. Companies try to reach consumers in various ways, like television commercials, radio ads, events, mailings, phone calls, and texts. There are rules, though, to protect you […]
September 2023: Fall Open Enrollment Period Fall Open Enrollment runs October 15 through December 7 and is the time of year when you can make certain changes to your Medicare coverage. The last change you make will take effect on January 1. Take action during Fall Open Enrollment to make sure your coverage will meet […]
August 2023: Medigap Policies Medigap Policies Medigaps are health insurance policies that offer standardized benefits to work with Original Medicare (not Medicare Advantage). They are sold by private insurance companies. If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays first. Medigaps may also cover health care […]
July 2023: Medicare and Transportation Services Medicare covers emergency ambulance services if: It is the only safe way to transport you You are on the way to or back from receiving Medicare-covered care You are transported to and form certain places, like your home or the hospital The transportation meets Medicare’s ambulance requirements […]
June 2023: How to Lower Your Prescription Drug Costs Cost-saving checklist: Apply for Extra Help You may qualify if you have limited income and assets. Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. If you have Medicaid, Supplemental Security Income (SSI), […]
April 2023 Speaking to Your Doctor It is important to work with your doctor to get the best health care possible. Below are tips for building an effective relationship with your doctor and making the most of your visits. Communicate effectively Be prepared. Arrive at your doctor’s office prepared with your health insurance cards, a […]
March 2023 What does Medicare Home Health Care cover? Home health care includes health and social services that you receive in your home to treat an illness or injury. Medicare covers the following home health care: Skilled nursing services: Services performed by or under the supervision of a licensed or certified nurse to treat your injury […]
Medicare Enrollment Periods How to enroll in Medicare Parts A and/ or B Some people are automatically enrolled in Medicare. For example, you should be automatically enrolled in Medicare if you are already collecting Social Security retirement benefits when you turn 65, or if you have been collecting Social Security Disability Insurance (SSDI) for two years. If […]
Part A: Hospital insurance Part A premium Free if you’ve worked 10 years or more $278 per month if you’ve worked 7.5 to 10 years $506 per month if you’ve worked fewer than 7.5 years Part A hospital deductible $1,600 each benefit period Part A hospital coinsurance $0 for the first 60 days […]
Medicare and Health Insurance Marketplaces The Health Insurance Marketplaces were created by the Affordable Care Act. The Marketplaces allow people to buy insurance if they do not have insurance or do not have enough insurance. Some states have their own Marketplaces, and other states use the federal Marketplace. Plans sold through Marketplaces are also known […]
Medicare works with other forms of insurance in different ways, depending on the other insurance. Some people are eligible for multiple types of health insurance, including Medicare and military benefits, so it is important to know how they work together. Veterans Affairs benefits If you are a veteran—meaning you served active duty in […]
Changing Part D Plans Medicare Part D, the prescription drug benefit, is the part of Medicare that covers most outpatient prescription drugs. Part D is offered through private companies either as a stand-alone prescription drug plan (PDP) for those enrolled in Original Medicare or as a set of benefits included with the plan for those […]
Medicare Coverage of Durable Medical Equipment Medicare Part B covers durable medical equipment (DME), which is equipment that serves a medical purpose, can withstand repeated use, and is appropriate for use in the home. What kind of DME does Medicare cover? Medicare usually covers DME if the equipment: Is durable, meaning it is able to […]
Vaccines covered by Medicare Part B Medicare Part D covers most vaccines and immunizations, but there are certain vaccinations that are covered by Part B: Flu shots Medicare covers one flu shot every flu season. The flu season usually runs from November through April. Depending on when you choose to get your flu shot, Medicare […]
You can make changes to your Medicare coverage each year during Fall Open Enrollment, which runs October 15 to December 7. Around September, you will start to receive notices with information about any changes to your coverage for the coming year. Read these notices so you can decide if your coverage will continue to meet […]
Fall Open Enrollment runs October 15 through December 7 and is the time of year when you can make certain changes to your Medicare coverage. You can make as many changes as you need to your Medicare coverage during Fall Open Enrollment. The last change you make will take effect on January 1, 2022. Take action during […]
Understand your Medicare notices If you have Original Medicare, you typically receive a Medicare Summary Notice (MSN) from Medicare every three months. Your MSN is not a bill. To understand your MSN: Read the definitions and descriptions of services carefully. Check the notes section. This is where Medicare may further explain its payment decisions or […]
If you were denied coverage for a health service or item, you may appeal the decision. There is more than one level of appeal, and you have the right to continue appealing if you are not successful at the first level. Be aware that at each level there is a separate timeframe for when you […]
What is the Medicare Savings Program? Medicare Savings Programs (MSPs) are state programs that assist you with paying your Medicare costs. To qualify for a MSP, you must meet your state’s income and asset limits. Below are the baseline federal income and asset limits for each MSP. Most states use these limits, but some states […]
Moving within state If you have Original Medicare, notify the Social Security Administration (SSA) of your move to update your address. If you have a Medicare Advantage Plan or Part D plan, notify the plan of your change of address and see if you will still be in your plan’s area of coverage. If not, […]
Home health care includes a wide range of health and social services delivered in your home to treat illness or injury. If you qualify for the home health benefit, Medicare covers: Skilled nursing services provided up to seven days per week for generally no more than eight hours per day and 28 hours per week […]
Connexion would like to help you to get healthier in 2021 by offering our complimentary online health community, which incorporates principles of the Blue Zones methodology. Our private Facebook Group has been profiled on Q13 and KOMO, and is a safe place where you can receive tips on plant-based eating, watch daily yoga videos, hear […]
What is a grievance? A grievance is a formal complaint that you file with your plan. If you are dissatisfied with your Medicare Advantage or Part D prescription drug plan for any reason, you can choose to file a grievance. A grievance is not an appeal, which is a request for your plan to cover […]
Is this preventive service covered at 100% by Medicare? Preventive care is the care you receive to prevent illness, detect medical conditions, and keep you healthy. Medicare Part B covers many preventive services with no cost-sharing, as long as you meet the eligibility requirements and follow the guidelines below. Is it one of the services […]
Medicare Part B and job-based insurance The Part B Special Enrollment Period (SEP) lets you delay enrollment in Part B without penalty if you were covered by insurance based on your or your spouse’s current work when you first became eligible for Medicare. You can enroll in Medicare Part B without penalty while you have […]
Part A: Hospital insurance Part A premium Free if you’ve worked 10 years or more $274 per month if you’ve worked 7.5 to 10 years $499 per month if you’ve worked fewer than 7.5 years Part A hospital deductible $1,556 each benefit period Part A hospital coinsurance $0 for the first 60 days […]
Part A: Hospital insurance Part A premium Free if you’ve worked 10 years or more $259 per month if you’ve worked 7.5 to 10 years $471 per month if you’ve worked fewer than 7.5 years Part A hospital deductible $1,484 each benefit period Part A hospital coinsurance $0 for the first 60 days […]
If you are receiving care in a hospital or non-hospital setting and are told that your Medicare will no longer pay for your care (meaning that you will be discharged), you have the right to a fast appeal if you feel that continued care is medically necessary. Non-hospital care includes care from a skilled nursing […]
What should I know about Medicare’s coverage of skilled therapy? Skilled therapy are services that are reasonable and necessary to treat illness or injury, performed by or under supervision of a licensed therapist. There are three main types of skilled therapy covered by Medicare: Physical therapy (PT): Exercise and physical activities used to condition muscles […]
Fall Open Enrollment We hope everyone is staying safe and healthy. We look forward to supporting you during Fall Open Enrollment, which runs October 15 through December 7, and is the time of year when you can make changes to your Medicare coverage. The last change you make will take effect on January 1, 2021. […]
Over two thousand people in the Northwest have signed up to take the Northwest Connexion Challenge, which starts Tuesday September 1st. We encourage Connexion customers to join because who couldn’t use a fun, healthy activity right about now? There will be five live seminars from two world renown doctors who will share their program to […]
There’s no doubt about it. 2020 has been one challenging year. As we had written about in our newsletter recently, we’ve been thinking a lot about what we can do to serve you better during these unprecedented times. Connexion would like to bring something positive to our customers. The truth is, we actually started brainstorming […]
At Connexion, we have been thinking about our customers and attempting to factor in all the influences in your life that affect your health. How do we care for the whole person? With most of society at home, addressing some of the unfortunate impacts of sustained isolation has become more relevant than ever. We’re planning […]
People with Medicare can get their health coverage through either Original Medicare or a Medicare Advantage Plan. Here’s a look at the differences between these two options. Original Medicare: The traditional program offered directly through the federal government Medicare Advantage: Private plans that contract with the federal government to provide Medicare benefits Original Medicare includes […]
What is skilled nursing facility (SNF) care? Skilled nursing facility (SNF) care is post-hospital care provided at a SNF. Skilled nursing care includes services such as administration of medications, tube feedings, and wound care. Keep in mind that SNFs can be part of nursing homes or hospitals. Medicare Part A may cover your SNF care […]
CMS has amended the guidance to reflect additional information and flexibilities regarding Medicare coverage for Coronavirus. Some of these changes are a result of legislation, while others are decisions made by the agency. One update, as a result of the Families First Coronavirus Response Act, forbids Medicare Advantage plans from charging any cost-sharing, including deductibles, copays, […]
During this unprecedented time that the Coronavirus pandemic has disrupted all of our lives, please remember that Connexion is here to support your Medicare needs. Our team of specialists is fully operational working from home, and supporting customers everyday through phone consultations and online enrollment. If you have any needs or questions, please do not […]
What is the Part B late enrollment penalty (LEP) and how can I appeal it? For each 12-month period you delay enrollment in Medicare Part B, you will have to pay a 10% Part B premium penalty, unless you have insurance based on your or your spouse’s current work (job-based insurance) or are eligible for a […]
What is the difference between primary and secondary coverage? When you have Medicare and another type of insurance, Medicare will either pay primary or secondary for your medical costs. Primary insurance pays first for your medical bills. Secondary insurance pays after your primary insurance. Usually, secondary insurance pays some or all of the costs left […]
What are Medicare Advantage Supplemental Benefits? A supplemental benefit is an item or service covered by a Medicare Advantage Plan that is not covered by Original Medicare. These benefits do not need to be provided by Medicare providers or at Medicare-certified facilities. Instead, to receive these items or services, you need to follow your plan’s […]
What is a Grievance? A grievance is a formal complaint that you file with your plan. If you are dissatisfied with your Medicare Advantage or Part D prescription drug plan for any reason, you can choose to file a grievance. A grievance is not an appeal, which is a request for your plan to cover […]
Happy New Year everyone! At Connexion, we’re particularly excited for 2020 because we’re working hard on some exciting new projects that will help us serve our customers better in the second half of the year. We’ll keep everyone posted through this newsletter as updates become available. Now onto this month’s topic, which is what’s […]
2020 Open Enrollment is Here! Fall Open Enrollment opens today and runs from October 15 through December 7. This is the time of year when you can make changes to your Medicare coverage. It can be a good idea to be open to exploring other plan options in your area. You may find a more […]
Part A Premium Free if you’ve worked 10 years or more $240 per month if you’ve worked 7.5 to 10 years $437 per month if you’ve worked fewer than 7.5 years Part A hospital deductible $1,364 each benefit period Part A hospital Coinsurance $0 for the first 60 days of inpatient care each benefit […]
When can I sign up for Medicare Part A and/or Part B? If you are already receiving benefits from the Social Security Administration or Railroad Retirement Board at the time you become eligible for Medicare, you will be automatically enrolled in Medicare Parts A and B. If you don’t yet receive benefits or if you […]
How does Medicare cover emergency room services? If you have Original Medicare, Part B covers emergency room services anywhere in the U.S. Emergency room services are typically provided when you have a medical condition that requires immediate action, such as an injury or sudden illness. Medicare Advantage Plans must also cover emergency room services […]
Excluded from Medicare Coverage: Long-Term Care, Dental, and Vision Long-term care and Medicare Long-term care (LTC), also called long-term services and supports (LTSS), refers to a range of services that help you perform everyday activities. LTC can be provided in a nursing home, assisted living facility, or other setting, and may include medical care, therapy, 24-hour […]
What is the Medicare hospice care benefit? Hospice is a program of end-of-life pain management and comfort care for those with a terminal illness. Medicare’s hospice benefit offers end-of-life palliative treatment, including support for your physical, emotional, and other needs. It is important to remember that the goal of hospice is to help you live […]
What is the Medicare hospice care benefit? Hospice is a program of end-of-life pain management and comfort care for those with a terminal illness. Medicare’s hospice benefit offers end-of-life palliative treatment, including support for your physical, emotional, and other needs. It is important to remember that the goal of hospice is to help you live […]
Part B and Part D Prescription Drug Coverage Part A covers the drugs you need during a Medicare-covered stay in a hospital or a skilled nursing facility (SNF). Part B covers most drugs administered by your doctor or at a dialysis facility, but the provider or the facility must buy and supply the drugs. Part […]
What can I do if I get a denial for a health care service or item? If you receive a denial from Original Medicare or your Medicare health or drug plan, you have the right to appeal. An appeal is a formal request for review of a decision made by your Original Medicare, Medicare Advantage, […]
What are the Medicare Savings Programs? Medicare Savings Programs (MSPs), also known as Medicare Buy-In programs, are state programs that assist you with paying your Medicare costs. These costs include premiums, deductibles, coinsurance charges, and copayments for Part A and B. There are three main programs*, each with different benefits and eligibility requirements: MSP […]
What are Medigap Plans? Medigaps are health insurance policies that offer standardized benefits to work with Original Medicare (not Medicare Advantage). They are sold by private insurance companies. If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays first. Medigaps may also cover health care costs that […]
What are Medigap Plans? Medigaps are health insurance policies that offer standardized benefits to work with Original Medicare (not Medicare Advantage). They are sold by private insurance companies. If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays first. Medigaps may also cover health care costs that […]
Fall Open Enrollment You can also listen to the podcast on this topic here. Fall Open Enrollment runs October 15 through December 7, and is the time of year when you can make changes to your Medicare coverage. You can make as many changes as you need to your Medicare coverage during Fall Open Enrollment. […]
Whether to enroll in Part B or use FEHB as primary coverage is a personal decision, based on your individual circumstances. You should look at the costs and benefits of each insurance plan and make the choice that’s best for you. When you become Medicare-eligible, you have a few options: Keep FEHB and turn down […]
Connexion would like to help you to get healthier in 2021 by offering our complimentary online health community, which incorporates principles of the Blue Zones methodology. Our private Facebook Group has been profiled on Q13 and KOMO, and is a safe place where you can receive tips on plant-based eating, watch daily yoga videos, hear […]
What is a grievance? A grievance is a formal complaint that you file with your plan. If you are dissatisfied with your Medicare Advantage or Part D prescription drug plan for any reason, you can choose to file a grievance. A grievance is not an appeal, which is a request for your plan to cover […]