Plan C or Plan F For Your Medigap Coverage?

We all know that Medicare was never intended to pay for all of your medical expenses.  However, according to a recent study by the Department of Health and Human Services, Medicare Part A, B and D pays for a little less than half of the average medical costs for seniors age 65 and older.  For this reason, it is important to have supplemental insurance coverage.

On June 1, 2020, Medicare changed when the Federal government mandated states to force insurers to stop sales on the “old” plans and begin offering a new set of plans.  These new plans eliminate the plans that offered pharmacy protection which is now covered under Part D.  Before Part D, we had to look at the H, I, or J plan for medication coverage but is no longer the case.  The new plans feature certain cost sharing elements designed to lower premiums.  Some new plans also offer eye wear or hearing aid benefits as well.

With the new Part D for medication, subscribers can concentrate on the core benefits for Medicare supplements.  Today, Plan F is a very good value because it offers coverage for Medicare key gaps such as the 20% co-insurance, 15% allowable excess charges (amount providers can charge up to 15% higher than what Medicare allows) and the two deductibles (Part A and B).

The best value on the market tends to be the F plan and that is why 85% of Medicare supplement purchasers go that direction.

Difference Between Plan C and Plan F

Today, by law, a provider can charge up to 15% higher than the standard Medicare rate and still be considered participating.  This is a big deal for two reasons:   First, you do not want to pay 15% of a $100K hospital bill ($15,000). Secondly, as the Medicare program finds itself under more financial pressure, reimbursement to providers will be under pressure. This means that more providers will likely charge the excess in the future. This is the sole reason we recommend the F plan over the C plan. The C plan does not cover Excess where the F plan does cover Excess. For the small monthly premium difference between C or F, it makes sense to cover this potential amount.

Below are the eight gaps covered by Standardized Medicare Supplemental Insurance plans. 6 of these 8 gaps are covered by Medicare Supplement Plan F. The two gaps that aren’t covered (At Home Recovery and Preventative Care) are not covered by Medicare Insurance at all.

Covered by Medicare Supplemental Plan F

1) Basic Benefits:

  • Part B Coinsurance (Generally 20% of outpatient expenses)
  • Hospital Coinsurance
  • 365 Additional Days Hospitilization Coverage
  • Blood Deductible Coverage

2) Skilled Nursing Coinsurance

3) Part A Deductible

4) Part B Deductible

5) Part B Excess

6) Limited Foreign Travel

Not Covered by Medicare Supplement Plan F

1) At Home Recovery

2) Preventative Care

Plan A Plan B Plan C Plan D F F* Plan G Plan K Plan L Plan M Plan N
Basic, including 100%
Part B co-insurance.
Basic, including 100%
Part B co-insurance.
Basic, including 100%
Part B co-insurance.
Basic, including 100%
Part B co-insurance.
Part B co-insurance.
including 100%
Part B co-insurance.
Hospitalization and preventative care paid at 100%; other basic benefits paid at 50% Hospitalization and preventative care paid at 100%; other basic benefits paid at 75% Basic, including 100%
Part B co-insurance.
Basic, including 100%
Part B co-insurance except**
Skilled Nursing Facility Co-insurance Skilled Nursing Facility Co-insurance Skilled Nursing Facility Co-insurance Skilled Nursing Facility Co-insurance 50% Skilled Nursing Facility Co-insurance 75% Skilled Nursing Facility Co-insurance Skilled Nursing Facility Co-insurance Skilled Nursing Facility Co-insurance
Part A Deductible Part A Deductible Part A Deductible Part A Deductible Part A Deductible 50% Part A Deductible 75% Part A Deductible 50% Part A Deductible Part A Deductible
Part B Deductible Part B Deductible
Part B Excess (100%) Part B Excess (100%)
Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency
Out-of-Pocket limit at $4,620; paid at 100% after limit reached Out-of-Pocket limit at $2,310; paid at 100% after limit reached

*Plan F also has an option called a high deductible Plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year $2,000 deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed $2,000. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan’s separate foreign travel emergency deductible.
**Plan N includes Basic, including 100% Part B co-insurance, except up to $20 copayment for office visit, and up to $50 copayment for ER.

Foreign Travel

There is not a supplemental plan that offers more than 60 days of coverage outside the U.S., and the maximum benefit is $50,000.00 within that 60 days.  The supplemental plans that offer this limited foreign travel protection are C,D,F,G,M and N.

International Long Term Medical Insurance Options

If you are a senior that lives outside the U.S. for more than 6 months of the year, there is another option available to you.  Long term international health insurance acts as your Medicare Supplemental insurance but also covers you outside the U.S.

Global Medical Insurance offered by IMG covers you outside the U.S. and within the U.S.  To qualify, you have to live outside the U.S. at least 6 months out of the year.  You need to provide a foreign address but you do not need to own a home.  Renting is O.K.  If you have to submit a claim, your passport stamp is proof of your time outside the country.  Home ownership is not necessary.

When you are in the U.S., Medicare is your primary insurance provider, and your Global Medical Insurance is your secondary, or supplemental, provider.  Within the U.S., you have access to a P.P.O. network of doctors who accept Medicare.  Outside the country, you may seek treatment any where you need to in a foreign country.

When choosing between Medigap Plan C or Plan F, Plan F is the most comprehensive supplemental insurance available today if you live full time in the U.S.  International health insurance is another robust option for seniors that live outside the country for at least half of the year.

The Difference Between Unsaturated and Saturated Fats

At some point in our aging process, our cholesterol levels  come into consciousness.  The kind of fat we eat, and how often we eat it, plays a roll in controlling our cholesterol levels.   Some fats can raise cholesterol levels, while other fats lower cholesterol levels. The good news is that you do not have to cut fat out of your diet entirely.  Including fat in our diet is actually good for us as long we don’t over do it and we eat the correct types of fat.  Also, when traveling abroad, make sure you have good international medical coverage in case of an emergency.

Triglycerides, the main form of fat in our bodies and in our diet, provide us with energy, insulation, and protect our internal organs from damage as well as enable our bodies to metabolize proteins and carbohydrates. Triglycerides play an important part in our blood circulation.  However, when our triglyceride levels get too high, they can cause major health problems, such as heart disease, stroke and even cancer.  Saturated, Monounsaturated and Polyunsaturated fats can raise or lower your triglyceride levels.

Saturated Fats

When you are reading food labels, you need to watch out for the three types of fats.  Saturated fats or trans fats are the worst for your body.   It is recommended that you limit your intake of saturated fat to 20 grams per day, which is met fairly quickly.  Some common foods that are high in saturated fats are straight butter, lard, shortening, cheese, processed meats such as sausage and bratwurst, and whip cream.  Watch out for boxed cereals and baked goods like packaged cookies, crackers, granola bars, breakfast bars and candy bars.

Monounsaturated Fats

Monounsaturated fats are better for you and help lower “bad cholesterol” (LDL) and leaves the “good cholesterol” (HDL) levels the same.  These are usually liquid at room temperature.   Some healthy foods that contain monounsaturated fats include vegetable oil, olives and olive oil, macadamia nuts, hazelnuts, pecans, avocado and avocado oil, almonds and almond butter.  Monounsaturated fats are also typically high in vitamin E, a beneficial antioxidant vitamin.

Polyunsaturated Fats

Polyunsaturated fats  lower both LDL and HDL levels.   They include essential fats that your body needs but can’t produce itself – such as omega-6 and omega-3.  These essential fats are only obtained through food. Omega-6 and omega-3 play a crucial role in brain function and in the normal growth and development of your body.  Foods high in polyunsaturated fat include a number of vegetable oils like soybean oil, corn oil and safflower oil, as well as fatty fish such as salmon, mackerel, herring and trout.  Other sources include some nuts and seeds such as walnuts and sunflower seeds.

For a heart healthy diet, avoid foods with Saturated or trans fats.  Think natural foods rather than packaged, processed foods.  When you do your grocery shopping, try to primarily buy foods that are included on the perimeter of the store (fruits and vegetables, seafood, chicken, low fat dairy, soy) and limit the packaged, processed foods in the middle aisles.





Yoga is an Activity for the Elderly Too

You do not need to be a young, nimble gymnast to participate in a yoga class.   A lot of people worry they are too out of shape or too old to do yoga.   However, you are never too old to improve flexibility and strength and yoga is a wonderful tool to increase both.

Strengthen Your Core

Asanas are a series of yoga poses that stretch your muscles.  These poses are designed to increase joint lubrication which in turn increases your range of motion in the joints.  Along with lubricating the joints, the stretches warm up muscles which can also release lactic acid  build up that cause stiffness and pain.   As you continue to practice the asanas, your increased range of motion will allow you to perform the asanas more precisely for continued flexibility and strength.

Yoga stretches not only work your muscles and joints, but all of the soft tissues of your body including ligaments, tendons, and the fascia sheath that surround your muscles. And no matter your level of yoga, improvements in these areas will begin in around 8 weeks or less.

Ashtanga or Power yoga are more vigorous than Hatha or Iyengar.  Ashtanga will improve muscle tone, while Iyengar or Hatha improves strength and endurance because although there is less movement, you hold the poses precisely and for a longer period of time.

Poses such as downward dog, upward dog, and the plank pose, build upper body strength. This is very important as we all age. The standing poses build strength in the hamstrings, quadriceps, and abdominal muscles. Poses that strengthen the lower back include upward dog and the chair pose.  Nearly all yoga poses increase strength in the core of your body.

Improve Your Lung Capacity

Although yoga is not typically performed as an aerobic activity, lung capacity also improves because of the mindful, deep breathing throughout the excercises.  Concentrating on your breath is a practice that brings oxygen into your lunges and into your muscles.  Along with oxygenating your body, it also induces a relaxation response to reduce adrenaline.  Breathing deeply also improves oxygen flow to the brain which adds clarity of thought along with a sense of calm.  Recently, researchers have begun exploring the effects of yoga on depression, a common problem with the elderly.

Lower Blood Pressure

Yoga also lowers blood pressure and slows the heart rate, which in turn has a positive effect on heart disease and stroke. Yoga can be a key treatment in significantly reducing heart disease and levels of cholesterol when combined with proper diet, a much better alternative to surgery.

Thirty minutes a day of stretching and strengthening asana poses will increase flexibility and strength significantly and is the recommended amount of exercise according to AARP.  Check with your doctor before starting any exercise program, but make sure you start one to slow the aging process.

You Can Practice Anywhere

Yoga is an activity you can practice in your own home, or where ever you happen to travel.  All you need is a yoga mat or soft towel to practice.  In case you injure your self practicing, make sure you have proper health care coverage through a company that will help you locate a qualified doctor no matter where you are.

Look how yoga was able to help this gentleman gain control of his life:




Go Traveling and Add Richness to Life

Traveling outside your home country is full of excitement and uncertainty!  A lot of preparation goes into international travel, from saving hard earned dollars, to familiarizing yourself with the area, down to making sure the bills have all been paid. To ensure safe and secure travels, purchasing international travel insurance is another necessity. It’s not about whether or not you should consider purchasing it before your international trip, it’s about what type of international health insurance should be considered. Young people participating in student exchange programs, missionaries, cruise directors, consultants, expatriates, government contractors or anyone traveling outside the country needs adequate medical protection.

Reasons You Need To Purchase International Health Insurance

Anything can happen when traveling abroad and exciting experiences can quickly become frightening if you are miles from home without proper medical coverage. Illnesses like Influenza, Hepatitis A, Malaria, Yellow Fever, dehydration and food poisoning are just a few of the most common health hazards. There are also auto accidents, water sport injuries, burn injuries and everyday accidents. Even the healthiest of us can experience these common health issues that could end up with a visit to a critical care facility. The potential of being stranded thousands of miles from home and needing treatment in a local clinic or hospital with language barriers, uncertain fees for service and uncertainty of qualified staff are all reasons to purchase international health insurance.

Domestic Health Insurance Does Not Travel

Chances are your domestic coverage will not follow you to a foreign country. Medicare offers no coverage outside the U.S. and supplemental coverage is only good for up to 60 days outside the U.S.  Private individual or group coverage is very limited, quite possibly covering only life threatening emergencies. There is generally no coverage for evacuation or return of mortal remains in worst case scenarios. Evacuations can cost upwards of $100,000.00, and return of mortal remains can cost as much as $10,000.00. With these scenarios in mind, the benefits of obtaining international travel insurance are many.

Qualities of a Good International Health Insurance Company

A good international health insurance agency will have service centers located in multiple areas of the world and be staffed and available according to local time zones, 24/7/365 a year. Staff members fluent in the native language in order to communicate with local doctors and hospitals is vital.  An international health insurance company should offer multi-lingual claims administration and emergency medical assistance that can be accessed by those traveling or living all over the world, anytime of day.

An array of available technology is also critical in an international health insurance agency. A secure member web site that is quickly and easily accessible in real-time status of claims is important. Make sure that e-mail, live chat, phones and fax are all ways to access international travel insurance customer service and claim representatives.

Travel Insurance or Permanent Coverage

If you already have health coverage in the United states, but need coverage for the limited amount of time you will be out of the country, travel insurance will cover your needs. If you are planning on relocating or accepting work outside of the U.S. for most of the year, you will want to look into permanent, international health insurance.

Permanent International Health Insurance

American Insurance for ExPats has permanent international health insurance that will cover you where ever you are in the world, as well as coverage when you return to visit the United States. When you are out of the country, you may visit any local health care facility available. When you return to the United States, there is a comprehensive P.P.O. network of doctors to choose from. The policies are all good for one year, with renewals possible each year by continuing to pay the premiums. In fact, American Insurance for ExPats is not only for American citizens, it is also available to foreigners as well, truly international health coverage.

What if I Have Been Turned Down in the Past?

Pre-existing health conditions do not automatically disqualify applicants. Exclusionary riders for specific health conditions can be issued, so that coverage for all scenarios not directly involving the exclusion are covered. There is also a Flexible Underwriting Option Rider that allows acceptance of an applicant that has been declined for coverage in the past. The Flexible Underwriting Option Rider will exclude any condition that exists on or prior to the effective date. However, once an applicant has remained symptom, advice and treatment free for up to a period of 24 consecutive months, pre-existing conditions will be covered up to $5000.00 per period of coverage with a $50,000.00 lifetime maximum.

There are a few disqualifiers in applying for permanent international health care coverage. If an applicant is disabled and unable to perform normal activities, are presently hospitalized and in need of surgery during application, have been diagnosed or treated for AIDS or HIV or are currently on a waiting list for any organ transplant, may be disqualified for coverage. However, if for any reason coverage is not possible, a full refund of the premium paid will be givin in full.

How Do I Sign Up

Now that you understand the importance of good health insurance coverage while traveling outside of your home country, either temporarily or permanently, the next step is to sign up for coverage. Short term travel insurance and permanent health care coverage can be initiated online.

Short term travel insurance is automatic issue and does not require medical underwriting. The policy will be e-mailed to you within 10 minutes of the application being submitted. A hard copy will be mailed to your address within 24-48 hours which includes the Declaration of Insurance, an identification card, emergency contact numbers, a claim form, visa letter and an Insurance Certificate. Approximately 30 days before expiration, notification will be sent in case you need to renew or extend coverage.

To receive permanent international health care coverage, you may also fill out an application on line. Licensed agents are available to assist you in making the best choice for your health care coverage needs. The first step is to provide a little pre-liminary information, followed by choosing a health care plan that is within your budget. The benefits included within each budget are listed in the top right hand corner of the page. To sign up for coverage, simply click on the price, which will bring you to a more comprehensive health questionaire so that coverage may be begin. Coverage is initiated by your completed questionaire and payment of your initial premium.

Safe and Secure International Travel

Traveling outside your home country is full of adventures, new flavors, new sites, and new challenges. To ensure safe and secure travels, purchasing international travel insurance or permenant international health care coverage will add a layer of protection to your new adventures. It’s not about whether or not you should consider purchasing it before your trip, it’s about what type of international health insurance should be considered. International health care coverage is important for young people participating in student exchange programs, missionaries, cruise directors, consultants, expatriates, government contractors or anyone traveling outside the country in need of adequate medical protection.


Seniors Should Take Advantage of Walgreens Take Care Clinics

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.




Medicare An Important Issue In the Upcoming Election

For most citizens, jobs and the economy are the most serious issues facing our nation today but for seniors, it is health care and Medicare.  Presidential contenders are portraying themselves as protectors of Medicare for seniors, with each of them casting a different approach to it’s survival.

President Obama has spent the last two years trying to counter the Republican claim that the new health law cuts Medicare coverage. Barack Obama states that the law slows the rate of spending increases largely at the expense of medical providers and gives seniors improved benefits such as free preventive services and lower prescription costs.

The president wants to preserve Medicare’s current set of  benefits while decreasing costs through greater efficiencies.  Strengthening privately managed health care plans like Medicare Advantage and Medigap are one area he wants to tighten up.  One quarter of Medicare recipients are enrolled in these privately managed health care plans and the government spends roughly 7% more per beneficiary in those plans.   People who buy Medigap would pay a higher price because this policy has been found to increase use of health care.  The president also believes their will be more savings through increasing premiums for higher income beneficiaries, raising the price for some home health care services and increasing efforts to reduce fraudulent claims.

Health insurance abroad, for citizens living outside of the United States, will also be included in the Obamacare health care law.  More and more seniors are travelling to places outside of the U.S. looking to reduce living costs such as housing, food and utilities, while maintaining a high quality of life.

The appeal for the senior vote will only intensify as the general election draws closer. Senior voters turn out in much larger numbers than younger Americans as 34% of voters are age 60 or older.  Medicare will certainly play a large part in this years election.


ObamaCare Reforms Health Care

On March 23, 2020, President Barack Obama signed into law The Patient Protection and Affordable Care Act (PPACA). Senate worked in cooperation with President Obama with a vote of 60-39.  All Democrats and 2 Independents voted in favor of the new act, and all Republicans voted against it.  The vote passed 219-212.

The PPACA reform law requires all individuals to maintain minimal essential health insurance coverage.  If citizens do not choose a health plan, they will have to pay a penalty.  The only people that will be expempt from the law are people with contrary religious beliefs or extreme financial hardship, a provision referred to as the “individual mandate”.

The PPACA also reforms certain parts of the private health insurance industry and public health insurance programs, increases insurance coverage of pre-existing conditions, is expected to add 30 million Americans into the insurance paying pool and increases national medical spending while lowering Medicare spending.

A majority of the states have filed actions in federal court challenging the constitutionality of PPACA for government interference into a persons freedom.  As of January 2012, two of four federal appellate courts have upheld it, however, a third declared the law unconstitutional, while a fourth ruled the law prevents the issue from being decided until taxpayers begin paying penalties in 2015. The Supreme Court has scheduled six hours for oral arguments March 26–28, 2012, and will issue its decision by the end of June.

It will be interesting to see what the Supreme Court rules in June, and how this affects persons living abroad.  International health insurance is available with distinguished carriers, affordable premiums, flexibility in coverage and personal agent services.  Whether you are planning a vacation or planning to move abroad, continuous coverage or travelers health insurance is available.  It will be interesting to see how existing plans are affected in the years to come while ObamaCare is refined.