Medicare Advantage Networks

Some Medicare Advantage networks are large and some are small.  Some Medicare Advantage networks change often while others rarely lose doctors. About once each month, someone calls me to say they are moving from California to Arizona and they [...]

Your Primary Care Physician

I have had several calls recently from people who were moving to Arizona and needed to enroll in a local Medicare Advantage plan. Picking a new plan is not difficult in Arizona – but finding a primary care physician is another matter. Most [...]

Medicare Advantage Network Law Proposed

Medicare Advantage enrollees in Florida and Connecticut have been faced with losing their doctors or local hospital when their Advantage plan cut its network.   Congresswoman Rosa DeLauro of Connecticut is proposing a Medicare Advantage Participant [...]

What’s the future for Medicare Advantage?

The New York Times has an article about how payment cuts to Medicare Advantage plans are raising questions about the future of Medicare Advantage. I say, “Only time will tell”, and that time will be next September when all Medicare [...]

Medicare Advantage Cuts: Bad news or not?

The Obama administration has proposed payment cuts for Medicare Advantage plans in 2015 and this could mean big changes for $0 premium Advantage plans in Arizona and around the country – or maybe not. These announced payment reductions for [...]

Medicare Advantage Changes Coming for 2014

Changes are coming to Medicare Advantage plans. I’ve been attending meetings for independent brokers who represent Medicare Advantage plans in Southern Arizona and my head is spinning with news of changes big and small. I need to contact my [...]

What home health services does Medicare cover?

An article by David Sayen, Medicare Regional Administrator: Medicare covers a variety of heath care services that you can receive in the comfort and privacy of your home. These include intermittent skilled nursing care, physical therapy, speech-language [...]

Medicare Advantage Billing Mistakes

Most Medicare Advantage plans have set co-pays for services like doctor visits and outpatient surgery.  This plan design should make it simple for people to understand the bills they receive from doctors, hospitals, and outpatient surgery facilities. Yesterday [...]

Choosing a Medicare Advantage plan

How does a person pick a Medicare Advantage plan?  Is the hospital network the most important factor?  Is having the biggest network of doctors important?  Is the plan with the lowest co-pays for doctor visits and hospital stays the top choice?  [...]

How will Obamacare affect Medicare Advantage?

I have lost track of the number of clients who have asked me how Obamacare will affect their Medicare Advantage plan. They saw so many advertisements during the election campaign about how millions of seniors will lose their Medicare Advantage [...]

Mitt Romney likes Medicare Advantage

Yesterday, Mitt Romney did his white board presentation comparing President Obama’s plans for Medicare to his own. Romney painted a bleak picture of Medicare under Obama, and offered his own vision for the program that provides health [...]

You can appeal Medicare and Medicare Advantage decisions.

Here is an article by David Sayen, Medicare’s regional administrator for Arizona, California, Hawaii, and Nevada. As a person with Medicare, you have certain rights and protections. And it’s worth knowing what they are. You have rights whether [...]

Medicare Advantage Enrollment in Tucson and Pima County

In Tucson and Pima County, competition is fierce among the four major players in the Medicare Advantage market. Medicare Advantage is popular among Pima County seniors, with 45% being enrolled in these private plans. TO SEE THE 2015 MEDICARE [...]

Medicare Advantage: Enrollment is still growing.

Enrollment in Medicare Advantage increased by over 1 million people from 2011 to 2012.  Medicare Advantage plans are run by insurance companies which are paid by Medicare to replace a person’s “Original Medicare”. These private [...]

Is there a future for Medicare Advantage?

Medicare Advantage plans will be paid less money by Medicare next year, and the year after that. The Affordable Care Act will limit Medicare Advantage administrative costs and profits to 15% of revenues (almost all it coming from Medicare). [...]

Medicare Story: 24-hour hospital stay, $126,241 bill !!

When you spend the night in the hospital, you would assume you had been “admitted” to the hospital – but you could be wrong.  And this definition of your status could cost you thousands of dollars if your Medicare Advantage [...]

Part D Problem: How much should eye drops cost?

A client of mine sent me an email about a problem he ran into with his Part D coverage. The problem involves his prescription for Azacite, which comes in the form of eye drops. Eye drops, or any liquid medication that is measured by “drops”, [...]

Who should not change their Medicare Advantage plan?

This is my week to tell people they don’t need my services.  I talked to three people who have the state Medicare retiree plan because they are retired teachers. They thought they were paying too much for their Medicare Advantage plan [...]

Why change your Medicare Advantage Plan?

Medicare Advantage plans in Arizona are not changing a lot for 2012. But everyone enrolled in these plans must check to be sure their Advantage plan will work for them next year, because the time to change plans is coming up. The Open Enrollment [...]

Medicare Advantage: Changes for 2012

Most seniors seniors enrolled in Medicare Advantage and Part D have already received mailings from their plans documenting how their coverage will change for 2012.  From what I have learned thus far, changes for plans in Arizona are not major, [...]

Medicare Co-pays Discourage Treatment

My shoulder has been aching for five months and is getting worse.  Luckily for me, I have good health insurance, so I got a referral for physical therapy.  The physical therapist did an evaluation and set up a schedule for me to see her twice [...]

Medicare Advantage: What to do when you move.

Last week I met with a new client who recently moved to Arizona from Colorado.  Jerry was enrolled in a Medicare Advantage plan in Colorado and was pleasantly surprised to discover that most Advantage plans in Tucson don’t have monthly premiums. Jerry [...]

Medicare Advantage: A Risky Business?

Some critics of Medicare Advantage point out that these Medicare replacement plans offered by insurance companies tend to enroll healthier seniors. Healthier seniors with lower medical costs would lead to higher profit margins for insurance [...]

Medicare Advantage: Planning for 2012

The Centers for Medicare & Medicaid Services (CMS) has put out a 153-page letter that provides instructions and information for insurance companies as they design their Medicare Advantage plans for 2012.  Details and costs for 2012 Medicare [...]

Medicare Beneficiaries Can Lodge Complaints Over Care

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would require most Medicare-participating providers to give Medicare beneficiaries written notice about their right to contact a Medicare Quality Improvement [...]

Don’t Like Your Medicare Advantage Plan?

In past years, people enrolled in Medicare Advantage plans had the months of January, February, and March to change to another Advantage plan.  That is no longer the case, and only one option is available to those who are unhappy with their [...]