International Major Medical Coverage

March 29, 2013 By Leave a Comment

what is major medical coverageWhat Is Major Medical Coverage?

Major medical health insurance  offers catastrophic health care coverage with high deductibles and low monthly premiums.  A major medical policy typically only covers major hospital and medical expenses after you have met your deductible with some preventative care coverage.

Are Routine Doctor Visits Covered?

Clients pay out of pocket for routine doctor visits and prescription drugs.  For example, if you have a $10,000.00 deductible and you have surgery that costs $8,000.00, you must pay for that surgery unless you’ve already paid $10,000 toward covered medical expenses this year.  The most popular deductibles are typically $2,500.00 to $5,000.00.

What If I Need To Go To The Hospital?

The majority of major medical health plans cover expenses for hospital stays, surgery, intensive care, diagnostic X-rays and lab tests.  Prescription drug coverage within major medical health plans often carries a separate deductible you must meet, then a co-insurance amount.

What Will A Major Medical Policy Do For Me?

Older adults who purchase major medical plans are primarily concerned with potential financial losses from a critical illness or accident. Many times, they do not qualify for Medicare yet, so a mid-range deductible option protects them from potential health care disasters.   These types of plans generally attract healthy people who take few prescription medications and do not mind paying out of pocket for office visits.

Medicare recipients who live outside their home country for half the year also apply for international major medical coverage as   Medicare only provides coverage in the U.S.  People with second homes in foreign countries find this kind of policy comforting as it will provide coverage for the health care they need abroad until they are healthy enough to potentially fly back to the U.S. to continue treatment.  Medicare will once again take over coverage upon returning to the U.S.

Not all pre-existing conditions mean denial of coverage.   If you have not received treatment within the last couple of years for a pre-existing condition, an exclusion for that health condition only may apply, but after 1 year of holding an active policy, the pre-existing exclusion may be dropped.

If you live outside your home country for 6 months a year or longer, you should apply for international major medical coverage.  If you are already living outside your home country, you can apply now.  If your move is in the future, you should apply 30 days before your departure date.

 

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Great News for Medicare Patients on Anti-Depressants

October 15, 2012 By Leave a Comment

Medicare for the first time will cover screenings for depression and anxiety.  Plans now may cover benzodiazepines, a class of drugs that includes Valium and is used to treat anxiety and insomnia.  Also covered are certain barbiturates such as those used to treat chronic mental disorders.

This is important news since many seniors suffer from depression,  anxiety and sleep disorders.   In the past, these prescriptions have been out of pocket, so the expanded drug coverage, along with mental health testing,  are the type of services that have a big impact on the quality of a seniors retirement and length of life.

Causes of Depression in the Elderly

Chronic illness is a big cause of depression in seniors.  Not feeling well, day after day, can wear on any person’s desire to stay social and interact with others.  If an elderly person stops being social feelings of lonliness can creep in.   Seniors facing loneliness start to believe that they are insignificant, unloved, and not worth anyone’s time.

Senior citizens who depressed often lose interest in the world around them will start to isolate themselves eve more.  Isolation can deplete one’s sense of purpose, usefullness and feelings of belonging.  Fear of dying is another factor that can lead to depression or anxiety in the elderly.

Look Into Which Medicare Policy is Best

The fact that Medicare will now covers these costs signals a shift in understanding the issues seniors face and may encourage some seniors to get diagnosed.   If you need help determining which policy will be the best for you or the senior in your life, contact Broker’s Assistance.  Broker’s Assistance has qualified professionals ready to sit down and listen to the issues you are currently facing.

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New Part D Coverage in 2013 For Medicare Recipients

October 14, 2012 By Leave a Comment

October 15 – December 7th is open enrollment for anyone needing to sign up for or  change their Medicare benefits.  Brokers Assisance, Inc. in Westminster, Colorado, has been busy preparing for the annual event.  One of the most recent changes is the Part D prescription drug coverage and new Medicare Advantage plans.

In 2013, drug plan basic premiums will be $30, compared with $29.67 in 2012.  Premiums for Advantage plans  are projected to go up 5% to $32.59 a month.  However, if beneficiaries choose lower cost plans at the same rate as they did this year, the average would go up only 57 cents.

Among the 10 most popular drug plans, seven will have premiums rise by as much as 23%.   On the bright side, United Healthcare is offering a low cost option averaging around $15 a month.  The less expensive drug plans usually involve limited pharmacy networks that don’t let beneficiaries go to any drugstore they choose.

When choosing a new drug plan, seniors need to focus on premiums,  copays and deductibles, as well as plan formularies, which tell them which drugs are covered.  Beneficiaries should also watch out for restrictions such as prior approval, which requires that the insurer sign off on a medication before it’s covered.  Another limit to pay attention to is only allowing beneficiaries to get a month’s supply of a drug at a time, so they get hit by the copayment each time.

Choosing the right Part D, prescription drug coverage is important for seniors because it can make a big difference in the amount they spend annually on drugs.   The professionals at Brokers Assistance, Inc. have years of experience researching the best private companies with the benefits that are best suited to a seniors individual needs.

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Medicare and International Travel

August 10, 2012 By 8 Comments

When Medicare was originally drafted,  international travel was not as prevalent as it is today, and was not drafted into the plan.   Today, many more seniors travel internationally, and limited coverage has been drafted into the Medigap policies of C,D,E,F,G,H,I and J.   Medicare supplement plans include a specific benefit for Emergency Foreign Travel.  However, the key words here are “Emergency Foreign Travel.”

If your chosen Medicare supplement insurance plan has the Emergency Foreign Travel  benefit, it will pay 80% of certain qualified emergency medically necessary medical services outside the U.S. after a $250 deductible is met.  The lifetime cap for total emergency foreign travel benefits is $50,000.00.  The care must be included in the first 60 days of the trip to make sure that it’s foreign travel and not foreign residency.  If you go on longer trips than 60 days,  travel insurance may be beneficial to you.

However, the care must be deemed an emergency.  For example, let’s say you go to the hospital with what you believe to be a heart attack.  It turns out, you ate some spicy thai food that did not agree with you.  Your Emergency Foreign Travel policy may not pay for this hospital visit as it turned out not to be an emergency.

Many U.S. seniors today live in Mexico or or other foreign countries at least part of the year, if not most of the year.  In this instance, a more robust, permanent major medical international health care policy will be better suited for you.  Long term international health insurance  will be a better choice as travel insurance is really designed for travel and not residency.

Long term international medical health insurance is the better approach for either longer stays outside the country or for more robust coverage than just emergency based coverage.  Otherwise, for pure short term medical travel insurance coverage, the Medicare supplement Emergency Foreign Travel coverage can provide some piece of mind while you’re taking the trip of a lifetime, for less than 60 days.

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Seniors Should Take Advantage of Walgreens Take Care Clinics

April 13, 2012 By Leave a Comment

Walgreens has two preventative wellness programs available to Medicare and Medicaid participants, located in each Walgreens pharmacy.  The programs are not new, however, they have not been well advertised as many seniors have not taken advantage of the programs.  To date, only 6.5% of eligible members have taken advantage of the programs.  The programs are called “Medicare Preventive Visit” and “Medicare Yearly Wellness Visits”.    Take Care Wellness, a subsidiary of Walgreens, started the preventative care clinics.

The program benefits are available upon enrollment with Medicare or Medicaid and then once a year with no out-of-pocket costs.  Each wellness clinic is open 7 days a week at any Walgreens, with  board certified family nurse practitioners and physician assistants on site that can offer preventive services such as vaccines and physicals and are licensed to write prescriptions, when necessary, that can be filled at the patient’s pharmacy of choice, not only at Walgreens.

After the visit, the nurse practitioner will give a personalized wellness plan to each patient with clear explanations of findings and recommendations. A summary of the visit will also be shared with the patient’s primary care provider. Information sharing between Take Care Health and a patient’s Medicare provider is enabled by the medical record system utilized at all Take Care Clinics.

Each Take Care Health wellness program is designed to help prevent illness by utilizing preventative care clinics.  For seniors who live outside the country for more than 6 months a year, who carry international health insurance, also qualify for this wellness program.

 

 

 

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