Does Medicare Cover Wellness visits ?

Once you have had Part B Medicare for more than 12 months you are entitled to get a yearly Wellness visit to prevent disease based on your current health and risk Factors. The Medicare Wellness visit is covered once every 12 months. You pay nothing for the yearly Wellness visit if your doctor or Health care provider accepts assignment. This Wellness visit is covered under a Medicare supplement plan as well as a Medicare Advantage Plan.
if other additional test or service a performed during the same visit and they are not covered under the Wellness benefit, you man have to pay a coinsurance and the part B deductible may apply.

Will Medigap Premiums Increase In 2020?

At the end of 2019 Medigap Plan F will no longer be available to people turning age 65. Plan F has been the most popular Medicare Supplement plan by far in the past . It has the least out of pocket health care cost. For those beneficiaries on Plan F the monthly premiums have continued to rise and most experts say this trend will continue. The option for those on plan F is to switch to plan G which is similar to Plan F except that it has a yearly deductible of $183 per year. Plan G seems to be a no brainer compared to Plan F which has been seeing monthly premiums increases from 6-8 % per year. Once Plan F is no longer available to purchase experts expect Plan G Premiums to start climbing also, Making maybe Plan N a better alternative. It seems the Government wants Medicare Recipients to contribute more out of pocket expenses to their health care. If Medicare Supplement plans continue to increase more and more beneficiaries may consider Medicare Advantage Plans as a better option in the future.

What is the Maximum of of pocket mean in a Medicare Advantage Plan ?

Most Medicare Advantage Plan's have a maximum out of pocket or (MOOP) which is the total amount you will spend in a year on co-payments, and co-insurance for covered medical expenses. When the MOOP limit is reached the Medicare Advantage plans covered expenses are at no cost to the beneficiary. Keep in mind that if the Advantage plan is a HMO or POS, the expenses paid to non network providers do not count toward the MOOP limit 
the same goes for Prescription Drug coverages the co-payments for Prescription Drugs within the plan do not count toward the MOOP limit.

Medicare Advantage plans can change the MOOP limit yearly, the good news is that Medicare sets a limit on the MOOP limit for all Advantage Plans.

How is Medicare Funded ?

Most people turning 65 know that Medicare pays for medical expenses, but not all seniors know how the program receives funds. Where does the U.S. Government get the money to pay for health care for People 65 and older. Some of the money comes from the General Revenue, from income taxes that Americans pay. Additional funds come from Payroll Taxes, Employers who pay payroll taxes contribute to Medicare funding. Premiums paid by Beneficiary"s the Part B premiums paid by medicare enrollees also help fund Medicare. When employed the employer withholds a percentage of money from your paycheck, which includes Social Security and Medicare, the Medicare part helps pay for health care cost when you start to use the program. All the funds go into the Medicare Trust Fund, which the Government manages. When you start receiving Medicare benefits you will not have to pay the total health care costs because the trust pays providers on your behalf, Usually 80%. a lot of Medicare Beneficiaries enroll in Medicare Supplement Plans offered by private insurers like AARP, Aetna, Humana, and Mutual of Omaha which help cover the Remaining 20% the Medicare Does not Pay.

What will Medicare cost in 2019?

Tens of million of people get healthcare coverage through Medicare. It is one of the most important benefits for older Americans. But Medicare is not free, Medicare enrollees pay a lot of different charges such as co-payments, coinsurance, and monthly premiums. Most of these cost have risen over time. Medicare Part A has no monthly premium and is free if the enrollee worked for 40 quarters for which they paid Medicare payroll taxes or are married to a spouse who had 40 quarters of Medicare taxes deducted from their pay check. Medicare Part B which covers doctor visits and outpatient services has a standard premium of $135.50 for 2019, up $1.50 from 2018. The cost of Medicare will more than likely Rise again in 2020.

What is Medicare For All ?

Medicare For All is an ever increasing popular term to describe a Health system in which every American, not just the older turning 65 or disabled, get Health Insurance through the Government's Medicare System. 
Bernie Sanders has supported such a plan in his 2016 Run for the presidency. His plan would both expand traditional Medicare to cover all Citizens, and also to offer more services and do away with most deductibles and co-payments. This would change the structure of the Medicare older people are getting now. There would be no Private Health Insurance, The new Government system would cover everyone.
This type of Health Insurance is similar to the health care system in Canada. Maybe another option would be the option for citizens 50 and older to have the option to buy into Medicare as it exist now. you can bet politicians will be debating these issues in the upcoming election.

Kentucky and Medicare Advantage Plans

When a person enrolls in a Medicare Advantage plan in Kentucky, they can rest assured that they will get the same Medicare Part A Hospital Coverage and Part B Medical benefits as they would from the Original Medicare government Program. Plus, they will still be enrolled in the Medicare system.
More than 900,000 people have enrolled in Medicare programs in Kentucky and more than 200,000 are enrolled in Medicare Advantage Plans.
There are more than 50 Medicare Advantage Plans to pick from in Kentucky, with companies like AARP, Aetna, Humana and other top Insurance companies. Most Medicare Advantage plans in Kentucky include Prescription Drug Coverage, and some even offer extra benefits such as basic Vision, Dental and Hearing Coverage. It should be good to know that Kentucky Medicare eligible citizens have a wide choice when it comes to Medicare Advantage plans.

How Do Medicare Prescription Plans Work and what is the cost

You are eligible to enroll in a Medicare prescription plan as soon as you are entitled to Medicare Benefits. There are two types of private plans you can get benefits through, A Prescription Drug Plan (PDP) that provides Drug coverage only, or a Medicare Advantage plan with prescription drug coverage (MA-PD) also called Medicare Part C. some companies like AARP, Aetna, Cigna, and Humana offer $0 deductibles and offer immediate coverage. 
Medications can have a copay or coinsurance, but not both. Make sure you check with your Insurance agent and see if your medications are covered under the Plan.

How much should a Medigap Policy Cost?

The Government has approved 12 standardized Medicare Supplements Plans (A through K) meaning that all Insurance Companies offering Medigap Insurance, by law have to offer the same coverage. An example would be, Humana Medigap Policy Plan G, has the exact same coverage as the AARP United Health Care Plan G. The only difference would be the premium charged from one company to the next. Some things that could effect the cost would be the area of the country in which you live and whether the company bases the prices on issue age, or community rated based on the community in which you live. My Aunt in Boone County Kentucky, age 65 pays $110.00 per month for Plan G from Mutual of Omaha. It is always best to compare prices because there can be huge differences in cost from one company to the next. It is best to talk to licensed agent to help you determine the best Medigap Plan for you.

Do Medicare Advantage plans include Prescription Drug Coverage?


David Wethington

(859) 393-5125

Most, but not all companies that offer Medicare Advantage Plans in Kentucky, also offer Prescription Drug Coverage. In Boone County Kentucky, companies like AARP, Humana, Aetna, and United Health Care all offer prescription Drug coverage. However, in some of the more rural areas of Kentucky, prescription drug coverage may not be Included in the Medicare Advantage Plan.

If drug coverage is not included, you may need to enroll in a separate stand alone prescription drug plan. Before enrolling in a Medicare Advantage Plan or stand alone Part D prescription drug plan, make sure you check with a licensed Insurance agent to make sure all your Prescription Drugs are covered in your Drug Plan.

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Are Medicare Advantage Plans in Kentucky Different than other States?

If you enroll in a Medicare Advantage Plan in Kentucky it is a federal law that you will get the same Medicare Part A hospital and Medicare Part B medical benefits as any where else in the Country, you will still be enrolled in Medicare. Most Medicare Advantage Plans will include Medicare Part D, Prescription Coverage. A lot of the Medicare Advantage Plans that are Available in Boone County Kentucky and other counties, such as AARP, Aetna, and Humana, include some extra benefits, like basic Vision, dental and hearing aids.. You can be confident when enrolling in a Medicare Advantage plan in Kentucky that you are still receiving Medicare Benefits.

Medicare Dual Eligible in Kentucky

Dual Eligible Describes beneficiaries that are eligible for both Medicare & Medicaid, usually because of low income status. In Kentucky a person that is disabled or 65 or older may qualify for a Medicare Dual Eligible plan. usually in these types of Plans Medicare pays for covered cost first and then Medicaid would pay for cost not covered by Medicare including part or all for the Part B Premiums. Dual Eligible benefits are different from State to state. In Kentucky there is a managed Medicaid plan that is used to pay benefits. You should check with the Boone county Health Department to apply or see if you qualify for Medicaid assistance with your Medicare Plan. Many Companies in Kentucky like AARP, Humana, and Anthem Blue Cross Blue Shield have custom Dual Eligible Advantage Plans.

What is the best Medigap Plan In Kentucky?

Agents in Kentucky are asked this question a lot. The best answer is that there a many Medigap Plans and it depends on many factors. The first consideration is how good is your health? When you turn age 65 you are entitled to a guaranteed enrollment period, meaning you cannot be rated for preexisting conditions, and if one can afford the premiums I usually recommend Medigap Plans F,G, or N. These plans will cover most all out of pocket cost that Original Medicare does not Cover. Make sure that you check with a agent that is licensed to sell Medicare Supplement Plans in Kentucky.

What type of Medicare supplement Plans are Available in Kentucky

When you turn 65 and sign up for Medicare, all of the Government approved Medigap plans are Available to enroll into. the plans offered are Plans A ,B, C, D,F, G, K, L,M, & N Also High Deductible F is Available. This will change in 2020 Plans C & F will no longer be available, this includes High Deductible Plan F. If You log onto Medicare.Gov there is a easy to read chart that list the benefits that each plan offers.The Government regulates the Medicare Supplement plans and it makes no difference which Company in Kentucky that you choose to enroll with. All Companies have to cover the exact same benefits. The only difference from One company to the next company will be the price you pay. In Kentucky some of the more popular plans are, Mutual of Omaha in kentucky it is called United World Life, Cigna Health and Life Insurance, and AARP United Healthcare Insurance Company. There are many others that offer Medigap Plans in Kentucky. if you enroll into a Medigap plan, you will also need to enroll into a Prescription Drug Plan. Check with a licensed Insurance Agent and ask them to help you choose a Medigap plan and a Prescription Drug Plan that is right for you.

What are Medigap Plans?

Medigap is additional health insurance that a person on Original Medicare can buy to help pay health cost that is are not covered by Original Medicare.
Medigap plans are offered by Private companies like Mutual of Omaha, Cigna Health and Life insurance Company, AARP-United Health Care and others. They help pay health care cost not covered by Original Medicare, such as co-payments, deductibles, and health care is you travel outside the U.S. Medigap plans will not cover long term care, dental care, vision care, hearing aids, eyeglasses, and private Nursing. You will also need to purchase a Prescription Drug Plan to cover the cost of Your Medications. Medigap plans offer different plans labeled A through N which offer different levels of health coverage. Some of the Companies offering Medigap insurance plans in Kentucky are, Bankers Fidelity Assurance Company, AARP United Health Care Insurance Company and Aetna Health and Life Insurance Company. Some of the more popular Prescription Drug Plans are Wellcare, Express Scripts Silver Script, and EnvisionRX plus.
It is best to consult a licensed Insurance agent in Kentucky to help guide you through the plans that are right for your situation.

Medicare Supplemen Plan or Medicare Advantage Plan

I get this question for seniors turning 65 all the time. Fortunately for people in the Northern Kentucky and Cincinnati Metro area there are a lot of Medicare Supplement Plans and Medicare Advantage Plans available of either one. This includes Boone, Kenton, Campbell and Grant counties in Kentucky and also Hamilton, Clairmont, and Butler Counties in Kentucky. Some of the Companies offering Medicare Advantage Plans are Aetna, United Health Care, Anthem Blue Cross Blue Shield, and Humana. These plans are tailored to fit almost any situation both health wise and budget wise. In fact some of the Plans have zero premiums and can include additional coverages such as Prescription Drug Plans, and even Some basic vision and Dental care. 

Some of the more popular Medicare Supplement plans in Kentucky include, Cigna, Mutual of Omaha, and others. The most important thing to remember is that when you turn 65 you have a 7 month initial enrollment period where you can enroll in any of the plans with guaranteed acceptance you cannot be turned down for preexisting health conditions.

Check with a Licensed Insurance agent to help you make a wise choice when you turn or are turning age 65.