SCVInsurance.org by Genine Chambers

How does Retiree Insurance and Medicare work together? Read on to learn more:

Are you living outside of the U.S. when it’s time to claim Medicare? Learn more here about how it works if you live overseas.

Medicare Part D 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 plan, for those enrolled in Original Medicare, or as a set of benefits included with your Medicare Advantage Plan. Unless you have creditable drug coverage and will have a Special Enrollment Period, you should enroll in Part D when you first get Medicare. If you delay enrollm...ent, you may face gaps in coverage and enrollment penalties. Each Part D plan has a list of covered drugs, called its formulary. If your drug is not on the formulary, you may have to request an exception, pay out of pocket, or file an appeal. A drug category is a group of drugs that treat the same symptoms or have similar effects on the body. All Part D plans must include at least two drugs from most categories and must cover all drugs available in the following categories: HIV/AIDS treatments Antidepressants Antipsychotic medications Anticonvulsive treatments for seizure disorders Immunosuppressant drugs Anticancer drugs (unless covered by Part B) Part D plans must also cover most vaccines, except for vaccines covered by Part B. Some drugs are explicitly excluded from Medicare coverage by law, including drugs used to treat weight loss or gain, and over-the-counter drugs. Note: For certain drugs or under specific circumstances, your drugs may be covered by Part A or Part B. For more information call 818-458-4377 or email [email protected]

You’ve heard Medicare Parts A, B, C, & D referenced, but what do they meanand what do they cover? Find out more here:

How to prevent injuries Getting older doesn't mean having to give up activities you enjoy. According to the CDC, you can prevent many common injuries by taking simple steps, so you can stay healthy and independent longer. Here's how to age without injury:... 1) Talk with your doctor about fall prevention, and health conditions like osteoporosis or hypotension (low blood pressure) that can increase your risk of falling. Medicare covers bone mass measurement, the best way to know if you have (or are at risk for) osteoporosis, if you meet certain conditions. 2) Ask your doctor or pharmacist to review the medicines you take. Some medicines may make you dizzy or sleepy, which can increase your risk of injury. 3) Stay active. Do exercises to strengthen your legs and improve your balance.

Medicare doesn’t cover all the health-care expenses you may experience. Enter Medigap.

Aging into Medicare(or transferring from Covered Ca into Medicare) If you have a Qualified Health Plan (QHP) (This is just a fancy name for Covered California), deciding what to do as you approach Medicare eligibility depends on your...

If you need mental health care, don’t let having Medicare prevent you from taking action. Read more here:

It is a great idea to look more closely at your Medicare notices. Understanding what they mean can help you avoid and resolve issues with your Medicare coverage! We won’t discuss every kind of notice you may receive about your...

In May, stocks traded in a narrow range as technology and other high-valuation companies were under selling pressure.

Prescription coverage is handled under Medicare Part D. Unsure if you need this coverage? Read on to learn more:

It can be difficult to know what to ask when you’re new to Medicare. We have a handy list of questionsand answersto help you get started. Learn more here:

The key to #healthcare in retirement might be a patchwork of different choices.

It's time to get your flu shot The flu can be very serious, especially for people who are 65 years and older. This flu season, protect yourself and your loved ones by getting the flu shot. It's the best way to help keep you from getting sick and spreading the virus to others. Medicare covers the flu shot when you get it from a health care provider that accepts Medicare or your Medicare plan.... You can safely get the flu shot at multiple locations, like doctor's offices and pharmacies. These locations should be following CDC guidance to ensure you have a safe place to get vaccinated. This includes asking patients to wear a face covering and practice social distancing. Call me at 818-458-4377 if you need help from a licensed agent.

7 Things Medicare Doesn’t Cover Medicare covers the majority of older Americans’ health care needs from hospital care and doctor visits to lab tests and prescription drugs. Here are some needs that aren’t a part of the program and how you might pay for them. 1. Opticians and eye exams...Continue reading

NEW IN 2020 Limited acupuncture coverage In 2020, Medicare added coverage for acupuncture for enrollees with chronic low back pain. Beneficiaries who have had lower back pain for 12 weeks or longer will be able to get up to 20 acupuncture treatments each year. Allowing doctors, physician assistants, nurse practitioners and other qualified personnel to provide acupuncture to these beneficiaries is one alternative, federal officials say, to the increasing use of prescription opioids to handle chronic pain.

Why it's important to compare plans for 2021 Open Enrollment is your chance to review and compare your current Medicare coverage with other plan options for 2021! Even if you're happy with your current plan, it's important to check for any changes next year, and compare with other available options. You may even find plans that save you money! With plan premiums at historic lows, now's the time to explore your options and find the best fit for your needs and budget.... Call me at 818-458-4377 for your FREE plan review today!

Flu season is here!!! Getting a flu shot doesn't just protect people against seasonal flu, it also contributes to the overall health of the community and minimizes the impact on health care resources. We strongly recommend getting a flu shot. A flu shot decreases the likelihood of getting sick from influenza. And while people who get a flu shot may still get sick, a vaccination is effective in preventing the most severe forms of the flu. In addition, widespread flu vaccinati...ons help minimize the impact on health care resources affected by COVID-19. Getting vaccinated against influenza contributes to a healthier work environment, too. The Centers for Disease Control and Prevention reports that employers can expect a 40 to 60 percent reduction in the risk of flu illnesses among their overall population with the flu vaccine. Stay Healthy Everyone!!!

Medicare Reminder!!! Everyone who enrolls in Medicare receives a red, white, and blue Medicare card. This card lists your name and the dates that your Original Medicare hospital insurance (Part A) and medical insurance (Part B) began. It will also show your Medicare number, which serves as an identification number in the Medicare system. (If you get Medicare through the Railroad Retirement Board, your card will say Railroad Retirement Board at the bottom.) If you have Origina...l Medicare, make sure you always bring this card with you (only if you have Medigap) when you visit doctors and hospitals so that they can submit bills to Medicare for payment. If you have a supplemental insurance plan, like a Medigap, retiree, or union plan, make sure to show that plan’s card to your doctor or hospital, too, so that they can bill the plan for your out-of-pocket costs. Note: Medicare has finished mailing new Medicare cards to all beneficiaries. However, if you have not received your new card, you should call 1-800-MEDICARE (633-4227) and speak to a representative. If you are enrolled in a Part D plan (Medicare prescription drug benefit), you will use the Part D plan’s card at the pharmacy. If you are enrolled in a Medicare Advantage Plan (like an HMO, PPO, or PFFS), you will not use the red, white, and blue card when you go to the doctor or hospital. Instead, you will use your Medicare Advantage Plan card, which you should receive in the mail. You will also use this card at the pharmacy if your plan serves as your Part D coverage. If you have a supplemental insurance plan, like a retiree or union plan, make sure to show that plan’s card to your doctor or hospital, too, so that they can bill the plan for your out-of-pocket costs. Your Medicare card, Social Security card, and other health insurance cards are very important documents. Make sure to keep a photocopy of your important identification and insurance cards, write down any important numbers (like your Medicare number), and keep everything in a safe place so that you have a record for future reference if anything gets lost. If your card is ever lost, stolen, or damaged, you can get a replacement card by calling 1-800-MEDICARE (633-4227). You can also order or print a card by logging in to your mymedicare.gov account. Remember: Do not give your Medicare or Social Security numbers or personal data to strangers. Medicare will never ask for this information over the phone.

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 a set of benefits included with your Medicare Advantage Plan. You should make sure to find a Part D plan that meets your specific health care needs. Before you start looking at plans, gather a list of the prescriptions... you take, including their dosages and usual costs, and the pharmacies you regularly use. Here are some questions you should ask before choosing a Part D plan: Drug coverage >Are my prescriptions on the plan’s formulary? >>The formulary is the list of prescription drugs for which a Part D plan will help pay. >Does the plan impose any coverage restrictions, such as prior authorization, step therapy, or quantity limits? >>Prior authorization means that you must get approval from your Part D plan before the plan will pay for the drug. >>Step therapy means that your plan requires you to try a cheaper version of your drug before it will cover the more expensive one. >>Quantity limits restrict the quantity of a drug you can get per prescription fill, such as 30 pills of Drug X per month. >If the plan does not cover a medication I take, does it cover one that will work for me? (Ask your doctor.) Costs >How much will I pay at the pharmacy (copayments or coinsurance) for each drug I need? >How much will I pay for monthly premiums and the annual deductible? >How much will I have to pay for brand-name drugs? How much for generic drugs? >What will I pay for my drugs during the coverage gap? >If a drug I take has a high coinsurance, is there a drug I can take that will cost less? (Ask your doctor.) >Am I eligible for Extra Help or a State Pharmaceutical Assistance Program (SPAP)? Pharmacy network >What is the service area for the plan? >Can I fill my prescriptions at the pharmacies I use regularly? >Can I fill my prescriptions when I travel? >What will my coverage options and costs be if I visit out-of-network pharmacies? >Can I get prescriptions by mail order? Coordination with other insurance >Will Part D work with other coverage I have to lower my costs? >Do I need to enroll in Part D if I have other creditable coverage? >Do I need to enroll in Part D if I have job-based drug coverage? There is no one best Part D plan for everyone. Instead, you should ask questions and make sure to find a Part D plan that meets your specific health care needs.

Protect yourself and your loved ones this flu season Getting a flu shot is an essential part of protecting your health and your family's health this year. Reducing the spread of illnesses like the flu is more important than ever. Remember, the flu shot is covered for people with Medicare from providers that accept Medicare or your Medicare plan. You can safely get a flu shot at multiple locations, like at your doctor's office or pharmacy.... All places offering flu shots should be following CDC guidance to ensure you have a safe place to get vaccinated. This includes that patients wear a face covering and maintain social distance in areas like waiting rooms. Getting your annual flu shot as soon as possible gives you and your loved ones the best protection throughout the flu season.

Preview plans ahead of Open Enrollment Medicare Open Enrollment starts October 15 but you can get a head start by previewing 2021 plans today! Now's a great time to review your coverage and see if there's a better fit for you. Plans have historically low premiums dropping an average of 34% over the last 3 years, and in some states up to 60%! Here's something new for Open Enrollment: Many participating drug plans will offer a 30-day supply of insulin for $35 or less in 202...1. Visit www.SCVinsurance.org now to preview participating plans ahead of Open Enrollment. Remember: When comparing plans, look at the estimated "Yearly Drug & Premium Cost." A plan with the lowest premium may not always provide the lowest total cost to you.

QUESTION: I have had Original Medicare for a few years. I’m considering enrolling in a Medicare Advantage Plan during Fall Open Enrollment this year. What should I consider when I’m looking at Medicare Advantage Plans? ANSWER: Fall Open Enrollment runs from October 15 through December 7 each year. During this time, you can make changes to your health insurance coverage, including adding, dropping, or changing your Medicare coverage. Even if you are happy with your current ...health and drug coverage, Fall Open Enrollment is the time to review what you have, compare it with other options, and make sure that your current coverage still meets your needs for the coming year. Ask yourself the following questions before choosing a Medicare Advantage Plan: >> How much are the premium, deductible, and coinsurance/copay amounts? >> What is the annual maximum out-of-pocket cost for the plan? This amount may be high, but can help protect you if you have expensive health care costs. >> What service area does the plan cover? >> Are my doctors and hospitals in the plan’s network? >> What are the rules I have to follow to access health care services and my drugs? >> Does the plan cover additional health care benefits that are not covered by Original Medicare? >> How will this plan affect any additional coverage I may have? >> What is the plan’s star rating? Medicare Advantage Plans usually include prescription drug coverage. You should also consider these questions when choosing a Medicare Advantage Plan to make sure that the prescription drug coverage that the plan offers meets your needs: >> Does the plan cover all the medications I take? >> Does the plan have restrictions on my drugs (i.e. prior authorization, step therapy, or quantity limits?) >> Prior authorization means that you must get approval from your Part D plan before the plan will pay for the drug. >> Step therapy means that your plan requires you to try a cheaper version of your drug before it will cover the more expensive one. >> Quantity limits restrict the quantity of a drug you can get per prescription fill, such as 30 pills of Drug X per month. >> How much will I pay for monthly premiums and the annual deductible? >> How much will I pay at the pharmacy (copay/coinsurance) for each drug I take? >> Is my pharmacy in the plan’s preferred network? You pay the least if you used preferred network pharmacies. >> Can I fill my prescriptions by mail order? >> If I have retiree coverage, will the Medicare drug plan work with this coverage? >> What is the plan’s star rating? You may find it helpful to use my help in answering all these questions and more. Call me at 818-458-4377 for a personal free consultation.

Get ready for Open Enrollment! Medicare Open Enrollment begins October 15! This year, Medicare plans have historically low premiums dropping an average of 34% over the last 3 years, and in some states up to 60%! Starting October 1, you'll be able to take a sneak peek at plans available in your area. If you're among the 1 in 3 people with Medicare who has diabetes, here's some more good news: many participating drug plans will offer a 30-day supply of insulin for $35 or less... starting January 2021. Think you'll need help comparing plans once Open Enrollment begins? Contact me at 818-458-4377 for a FREE personal consultation.