October 21, 2013
1. Medicare Window for Enrollees
2. Medicare Replacement Plans
1. Medicare Enrollees: We are presently in the Medicare window for those first Medicare enrollees or for present Medicare patients to change their Medicare Coverage and/or Supplemental insurance. If a Medicare patient goes out of Medicare into a “Medicare replacement” plan, you may wish to inform them of their cost factors. (Medicare replacement plans, both in Medicare and out of Medicare, are cheaper than regular Medicare. The reason...both have a co-pay and other coverage not as complete.)
If your Medicare patient does a “Medicare replacement plan” for example, three (3) years before they realize the coverage is poor and not as good as Medicare....when they return to Medicare, their premium now in Medicare increases 10% each year they have been out of Medicare for the rest of their life. (Out of Medicare for 3 years...now the premium in Medicare is 30% higher for the rest of their life.)
2. Medicare Replacement Plans: There is Medicare Part A: Hospitalization; Medicare Part B: Physician Services;Medicare Part D: drug Coverage and Medicare Replacement Plans in Medicare and Medicare Replacement Plans out of Medicare.
Those Medicare patients in Medicare, we must follow all Medicare guidelines, even though they may have a $35.00 Co-pay and reimburse nothing.
However, some Medicare patients bail out of Medicare into a private P.P.O. called “Medicare Replacement”. They also have a co-pay and usually reimburse little or nothing. This replacement is out of Medicare and we are not required to bill or follow Medicare guidelines unless....you bill this company for your non-Medicare patient. Now you have agreed to follow all the Medicare guidelines on this NON-Medicare patient in a Medicare replacement PPO outside of Medicare.
Most Medicare carriers have a program you can access online to check eligibility, get duplicate remittance advice, etc. and it is also where you can find if your patient is in a Medicare Replacement in Medicare or in a Medicare Replacement out of Medicare. Example: WPS has C-SNAP and NGS has CONNEX. Look for yours with your Medicare carrier or call them and ask when it will be available for your area.
Date: Thursday, November 21, 2013
Time: 8:00 AM - 12:00 PM
Location: Dayton, Ohio
Hampton Inn Dayton/Dayton Mall
8960 Mall Ring Road
Dayton, OH 45459
Hotel phone: (937) 439-1800 for direction purposes only
To register or for questions please call: (618) 395-3162