Jul 212016
 

Seniors are patiently waiting for CMS to release the pricing for Medicare Supplements for 2017.  We will provide updated pricing as soon as it comes available.  It is likely that prices will increase this year.  Many seniors may find the plan cost offerings to have jumped in price more than would be preferred, but utilizing this year’s pricing will provide insight into pricing and allow for some level of budgeting. Their is not an exact date that rates are published, but they are released in the fall each year. It is important to watch for the rates so that you have time to decide what will work best for you.

2016 California Medicare Supplemental (Medigap) Rates Los Angeles County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from State Farm Insurance Company from $1756.00. Second best is USAA Life. This compares with the highest cost plan offered from $4468 from Physicians Mutual Insurance Company. This is a huge difference for the same plan!

Their are many other companies that offer Medigap or Medicare Supplemental plans in Los Angeles County. This includes Aetna Life, Blue Cross, Gerber, and Humana.

 

Orange County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from USAA Life Insurance Company from $1846.00. Second best is Stonebridge Life Insurance Company. This compares with the highest cost plan offered from $4459 from Physicians Mutual Insurance Company. This is a considerable difference in cost.

Ventura County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from State Farm Insurance Company from $1706.00. Second best is Globe Life Insurance Company at $1846. This compares with the highest cost plan offered from $4466 through Physicians Mutual Insurance Company. This is another significant difference.

San Bernardino County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from California Physicians Service from $1200.00. Second best is Colonial Penn Insurance Company at $1216. This compares with the highest cost plan offered from $2089 through Sentinel Security Life Insurance Company. This is another significant difference.

Riverside County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from State Farm Mutual from $938.00. Second best is Stonebridge Life Insurance Company at $1133. This compares with the highest cost plan offered from $2327 through Physician’s Mutual Insurance Company. This is a $1,389 difference from highest to lowest.

San Diego County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from Blue Cross of California from $1431.00. Second best is Loyal American Life Insurance Company at $1445. This compares with the highest cost plan offered from $2387 through Physician’s Mutual Insurance Company. The difference between the highest and lowest is not as great as in some counties. 

Imperial County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from Health Life Insurance Company from $1080.00. Second best is State Farm Mutual Insurance Company. This compares with the highest cost plan offered from $2006 through Physician’s Mutual Insurance Company. This is a $926 difference from highest to lowest.

Inyo County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from State Farm Insurance Company from $901. Second best is Stone Bridge Insurance Company at $956. This compares with the highest cost plan offered from $2006 through Physicians Mutual Insurance Company. This is over a $1,000 difference from least expensive to most expensive.

Santa Barbara County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from Colonial Penn Insurance Company from $1106.00. Second best is California Physicians Service at $1128. This compares with the highest cost plan offered from $1877 through Thrivent Financial Company. This is another significant difference.

Tulare County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from Health Net Life Insurance Company from $1080.00. Second best is United American Insurance Company at $1130. This compares with the highest cost plan offered from $1765 through Physicians Mutual Insurance Company. This is a $685 Difference. Not as high as some counties, but still a significant difference.

Kings County

  • Male or Female age 65 (smoker OR non-smoker) — Best Price Medigap Plan A offering is from State Farm Insurance Company from $901.00. Second best is Globe Life Insurance Company at $902. This compares with the highest cost plan offered from $1794 through Sterling Life Insurance Company. This is an $893 difference.

When searching for plan rates, it’s important for seniors to note the potential for wide variability in plans. Factors such as age, sex, smoker and zip code can influence rates. Because of the types of plans offered, seniors should note first what type of plan they wish to seek out (designated by the letter type found at Medicare.gov or at our article here).  After choosing the medicare supplement plan that is most desirable, seniors can compare the same plans across the full breadth of insurance companies in their county in California.  Plans with a designated letter will share the same attributes regardless of the insurance company that offers them!  Therefore, price should be the main characteristic that shoppers should use to decide on a plan. Other factors, h0wever, such as reputation of the insurance company and plan network may be an additional consideration for seniors to consider when comparing medicare plans.

 

 

 

 

$1 Billion Medicare Scam Largest in US History – Miami FL

 Medigap by County Information, Medigap in Florida  Comments Off on $1 Billion Medicare Scam Largest in US History – Miami FL
Jul 232016
 
Charges were filed against one of Florida’s wealthiest healthcare operators in a $1 billion Medicare care fraud scheme, announced the U.S. Attorney’s Office during a press conference in Miami, Florida on July 22, 2016. Federal prosecutors stated this is the biggest Medicare fraud scheme in the nation’s history. This has cost Medicare hundreds of millions of dollars due to fraudulent payments. Medicare is the U.S. governments medical program for the elderly and disabled.

Philip Esformes, 47, was charged at his ocean front estate. Along with two other defendants, he is accused of exploiting his network of about 20 Miami-Dade skilled nursing and assisted living facilities to fleece the taxpayer funded Medicare system by filing false claims for services that were not necessary and in some instances not provided. This has been happening over the past 14 years.

Esformes is charged with conspiring with Arnaldo Carmouze, 56, a Palmetto Bay physician’s assistant, and Odette Barcha, 49, a former director of outreach programs at Larkin Community Hospital in South Miami.

Esformes is also being accused of referring his own network of patients to other convicted healthcare fraud offenders, who had swindled Medicare for mental health, prescription drug and home healthcare services and ended up helping federal investigators target the Miami Beach business executive. According to the indictment, the kickbacks were “disguised” as payments for escort services for Esformes as well as related travel and hotel expenses.

Healthcare fraud has been a battle for a long time. This case is the nation’s largest in regards to heathcare and Medicare fraud. It was noted that while his healthcare network billed $1 billion for fraudulent medical services, Medicare paid Esformes’ skilled nursing and assisted living facilities about $500 million since 2009.

“This is the largest single criminal healthcare fraud case ever brought against individuals by the Department of Justice,” the criminal division’s assistant attorney general, Leslie R. Caldwell, said Friday during a news conference at the U.S. attorney’s office in Miami.

Medicare plans already cost the government and US citizens a lot of money. Fraud continues to drive the costs up. It is important that law enforcement continues to target this problem.

New Walgreen’s Opening in Raleigh NC

 Uncategorized  Comments Off on New Walgreen’s Opening in Raleigh NC
Jul 212016
 

Walgreen’s has opened a new location at the intersection of Leesville Rd. and Strickland Road in Raleigh NC. CVS and Rite Aid also have stores at this intersection. Two additional Walgreen’s stores are within three miles of the new location. The new store located at 13301 Strickland Road, Raleigh, NC 27613, is open from 8AM until 10PM during the week. They have limited hours on the weekend. This location features a drive thru pharmacy, cosmetics area, and a photo department. Passport photos are available.

2013 Medicare Advantage Plans — Best Rated Florida Plans from AARP UnitedHealth, Blue Cross Blue Shield, Humana and Coventry

 Medicare Advantage Plans  Comments Off on 2013 Medicare Advantage Plans — Best Rated Florida Plans from AARP UnitedHealth, Blue Cross Blue Shield, Humana and Coventry
Oct 152012
 

Seniors who are turning 65 and are newly eligible for Medicare Part B are looking for the best rated 2013  Medicare Advantage plans from large insurers like Blue Cross Blue Shield, AARP, Humana, Cigna and many others. Rates for the plans are available for seniors to compare.  While the rates are now available on the Medic are.gov website, rate updates are available on the Florida State insurance website, so Florida seniors that are searching for low cost Medicare Advantage plans can compare offer all available Medicare Advantage plans from a wide range of insurance companies.

For Florida seniors, there is good news. Seniors in that state have access to very many plans from large, trusted insurers. These plans include standalone health plans and Medicare plans that include drug coverage.  Some are HMO plans, while others are PPO’s.

What is the difference between an HMO and a PPO?

Generally, HMO’s (health maintenance organizations)  provide broader coverage for less money per month and with few out-of-pocket costs. HMO’s often limit choice and have much more restricted networks. PPO’s (Preferred Provider Organizations) offer more choice and less restrictions, but usually cost more.


Also, many PPO’s have a deductible of several hundred to a few thousand dollars. This means that the PPO doesn’t pay for coverage until the patient meets their deductible.

 How do I choose the best Medicare Advantage Plan? What does the 5 star Medicare Advantage rating system mean?

Here is a useful video that explains the CMS rating system:

 

Here is a sampling of Medicare Advantage Plans offered:

AARP offers three plans. These plans include their Medicare Complete Choice Plan 1 and Plan 2 (which are HMO plans), and their MedicareComplete Plus which is an HMO – POS plan.

Aetna offers a PPO Medicare Advantage Plan called Medicare Premier, as well as an HMO plan called “Aetna Medicare Value Plan.”

BlueMedicare offers both an HMO and in some Florida regions a regional PPO plan.

Carefree Plus and CareOne Plus offer HMO plans.

Coventry has several choices for seniors. These include the Coventry Summit Ideal Plus HMO plan, a Coventry Vista Ideal HMO plan.

Freedom offers FIVE plans in Florida, providing one HMO plan called the Freedom Medicare Plan.  Four other Medicare Advantage plans are HMO SNP plans called VIP Care, VIP Care for those with COPD, and VIP Savings and VIP Savings COPD.

What is an HMO SNP plan? What does HMO SNP stand for?

HMO SNP plans are Health Maintenance Plans Special Needs Plans. These types of plans are intended for people that have both Medicare A and B and also receive Medicaid. 

Humana offers two HMOS (Humana Gold Plus plans), three PPO plans (HumanaChoice) including two that are regional plans (Humana Reader’s Digest Healthy Living Plan and HumanaChoice Regional PPO.  Finally Humana also offers one plan that is a PFFS plan. The Humana Gold Plus Plans are very highly rated by CMS, rating four-and-a-half stars.


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What is a PFFS plan? What does PFFS stand for? 

It stands for “Private Fee for Service Plan,” and refers to a Medicare Advantage plan offered by private insurers.  When using this type of plan, seniors can see any physician that accepts their plan’s terms and conditions for payment. Many PFFS plans may offer a network of physicians and hospitals that have agreed, but the senior may go outside of that network and see whomever they wish, provided that the provider is Medicare-approved AND they are willing to accept the PFFS plan’s terms and conditions of payment.

Medicare Masterpiece Premier plans offer several HMO SNP plans including MMP COPD, MMP Dementia, MMP Diabetes, CHF, and CVD ( for those  seniors with congestive heart failure and cardiovascular disease)

Preferred Choice offers an HMO – POS.  Preferred Gold Option, Preferred Premium Advantage plan and Special Care are available to those in Miami Dade.

New Jersey Medicare Supplement (Medigap) Rate Comparison

 Medigap by County Information, Medigap New Jersey Rates  Comments Off on New Jersey Medicare Supplement (Medigap) Rate Comparison
Sep 182012
 

Seniors and medicare recipients in New Jersey will find a large and diverse group of health insurance companies offering Medicare Supplement and Medigap policies to retirees residing in the state.   Please note that the current rates are for 2012, as the 2013 medigap rates have not yet been released. Expect these rates to be updated here soon — we’ll post them when CMS releases them to the public sometime this fall.


2012 New Jersey Medicare Supplement Plan Offerings (by county)

Sussex County A 65 year old non-smoking senior will find a medicare supplement rate from AARP via United Healthcare starting at 94.50 for plan K and up to 220 for a plan F choice

Passaic County  Horizon Blue Cross Blue Shield offers medigap rates starting at 81.40 for plan K and going up to 197.98 for plan C

Bergen County

Warren County

Morris County

Essex County (Newark area) Plan rates offered by Colonial Penn include plans, A, B, C, F (high-deductible plan), G and N.  Rates start at  43 per month for high-deductible plan F for a 65 year old female smoker and go up to175 per month  for plan C.

View Larger Map

Hudson County (Jersey City Area)

Union County (Elizabeth City Area)

Somerset County



Hunterdon County

Middlesex County (Edison and Woodbridge Township areas) Numerous plan offerings include Genworth Life medicare supplement rates starting at 75.07 per month for a non-smoker male aged 65. Men older than 65 will see higher monthly premium costs, while women generally see lower medigap monthly premiums. The highest cost Medigap plan offered by Genworth is the 190.22 plan for a non-smoker (male).

Mercer County

Monmouth County

Ocean County

Passaic County (Paterson City Area) Plans offered include Forethought Life Insurance.   For instance Forethought Life plan A starts at 141.75 for a 65 year old female tobacco user.

Burlington County

Camden County

Gloucester County

Atlantic County

Salem County

Cumberland County

Cape May County

Medicare Supplement Plan Comparison Explanation

 Medigap Plan Choice Comparison  Comments Off on Medicare Supplement Plan Comparison Explanation
Jun 252012
 

One of the choices that seniors and other Medicare recipients face is choosing the proper Medicare Supplement (Medigap) plan for their budget and medical needs.  Because the Center for Medicare and Medicaid Services (CMS) has called for standardized plan choices, it is easier to compare between plans offered from different private insurers like AARP or Blue Cross Blue Shield Anthem.

For questions about what Medigap is, click here.

What is the difference between Medicare Plan Supplements A and B?
Is Plan F better than Plan D? How does a high deductible Plan F compare to regular Plan F?


Each Medicare supplement plan type is denoted by a letter.  Insurers may offer many several Medigap plans, but the letter allows for easier online Medigap plan comparison.  The different plans help cover costs (such as co-insurance costs) not covered by regular Medicare Part A and Part B.

Since each Medigap plan F, for instance, offers the same coverage, the only differences are the actual companies that administer the plan and the price of Medicare Supplement Plan F that the companies offer.

Generally, seniors will find it best to choose the lowest price among the letter plan chosen — although many seniors may wish to thoroughly check online Medigap insurance company reviews carefully.  Seniors may also consider asking others who have Medigap plans(friends  at their church, or other peer groups) their experiences with individual insurers.  Some seniors may feel that it is more important to find the best Medigap insurance customer service than a rock bottom price.

What is co-insurance?

Co-insurance is the portion of a total bill that the patient is expected to pay.  As opposed to a flat dollar amount per service, Medicare co-insurance is generally a fixed percentage of the total allowable charges for a healthcare service.

Here is a breakdown on individual Medicare Supplement plan choices:

Medicare Supplement Plan A  is a Medigap plan choice that offers basic coverage. This covers all of the coinsurance that regular Medicare Part B doesn’t cover. Plan A is generally the most affordable Medigap plan.

Medicare Supplement Plan B is a Medigap plan choice that offers basic coverage. Like Plan A, Plan B covers all Part B coinsurance costs, but also covers the Part A deductible cost as well.

Medicare Supplement Plan C is a Medigap plan choice that offers basic coverage. It improves upon Plan B by offering additional coverage;  Plan C also covers skilled nursing facility co-insurance and both Medicare Part A and Part B deductibles, and foreign travel emergency coverage. This is a type of coverage that seniors who like to travel to foreign countries or take cruises should consider.

Medicare Supplement Plan D is a Medigap plan choice that offers coverage like Plan C, only this plan does not cover the Medicare Part B deductible.


Medicare Supplement Plan F is a Medigap plan choice that offers the most comprehensive coverage for seniors.  This plan covers all costs that regular Medicare doesn’t cover. For this reason, it is generally the most expensive plan. Many seniors who don’t want to risk worrying about additional costs may consider plan F the best Medigap plan or best Medicare Supplement plan  offered.

High Deductible Medicare Supplement Plan F offers the same coverage as the regular Medigap plan F, but has requires the patient to pay the first $2000 dollars toward out-of-pocket expenses. This is another strong choice for seniors searching for a plan that provides across the board coverage, and prevent concerns about a patient being unable to meet excessive medical costs.

Medicare Supplement Plan G is similar to Medigap Plan F, although it doesn’t offer coverage for the Medicare Part B deductible.

Medicare Supplement Plan K is a Medigap plan choice that is quite a departure from the previous plans. This plan offers comprehensive preventative care coverage, part A hospital co-insurance and  hospitalization coverage for one year. It covers up to half of costs from the Medicare Part A deductible and half of skilled nursing facility costs.  Covers 50% of first 3 pints of blood.  This plan has a maximum out-of-pocket limit of $4,660 per year, at which point plan covers 100% of covered costs that calendar year.

Medicare Supplement Plan L is a Medigap plan choice that is very similiar to Plan K. Instead of covering half of  the K expenses, Plan L pays %75 of Medicare Part B coinsurance, Blood, Part A co-insurance, Skilled nursing care and Medicare Part A deductible. Also, it has an out-of-pocket limit of only $2,330.

Medicare Supplement Plan M is a Medigap plan choice that covers all of the Medicare Part B coinsurance, Blood, Part A co-insurance, skilled nursing care and half of the Medicare Part A deductibleThis plan also provides emergency foreign travel coverage. However, it does NOT have an out-of-pocket limit like plan K or plan L!

Medicare Supplement Plan N is a Medigap plan choice that covers Medicare Part A coinsurance,  Blood, Part A hospice care coinsurance, skilled nursing care coinsurance, Part A deductible and foreign travel emergency care. It also covers Part B coinsurance, although under this plan, the patient is expected to pay up to a $20 copay for office visits and up to $50 for emergency room vis

Medigap and Medicare Supplement Rate Information

 Medigap by County Information, Medigap in Florida  Comments Off on Medigap and Medicare Supplement Rate Information
May 302012
 

Introduction

Seniors that are new to Medicare and eligible to enroll may have a lot of questions about Medicare, Medicare Advantage plans, and Medicare supplements (Medigap).  Seniors are often very confused in comparing plan premiums. This is a daunting task, as rates and available companies will vary widely depending upon the state,  county and zip code that the senior resides in.  Other factors also contribute to price variances, such as the age and sex of the Medicare recipient, and whether the patient is a smoker or not.  

What is the difference between traditional Medicare and Medigap?

Medicare supplements help to cover the costs that regular Medicare Part A and B don’t (such as  doctor visits and outpatient lab tests).  Most of those who worked and paid Medicare taxes will find that there is no cost for Medicare Part A when they retire at age 65.

  • Medicare Part A is often referred to as hospital coverage. It covers a Medicare patient for care that occurs inside a hospital or other inpatient facility (such as a nursing home) as long as the patient was formally admitted into the hospital as an inpatient.  This is an important distinction — patients that are admitted as an outpatient for a procedure then stay in the hospital overnight might find a dramatically different bill! Always ask your hospital whether you are being admitted as an inpatient!


  • Medicare Part B is often referred to the medical insurance coverage component of Medicare.   Per Medicare’s website:

Part B helps cover medically-necessary services like doctors’ services, outpatient care, durable medical equipment, home health services, and other medical services. Part B also covers some preventive services.

Premiums for Medicare Part B have a standard amount, although some higher income individuals may find that they have a higher premium.

Medicare Part B covers diagnostic services and supplies, and preventive care (such as vaccinations for influenza and shingles or tests for early detection of conditions).

  • Medicare Part C is an optional choice for patients that are more commonly referred to as “Medicare Advantage” plans. They are plans offered through private insurance companies  (either a PPO or HMO plans) that envelop both Medicare A and B, but also provide additional services that may include dental coverage, eye coverage, hearing coverage, and urinary catheters and drainage bags. These plans often include Medicare Part D prescription drug plans.  For more information about these types of plans, see our post about Medicare Advantage Plan Rates. They are offered by many HMO such as Cigna or Humana.


  • Medicare Part D plans are plans that cover Medicare patient’s prescription medications. They may be utilized as stand-alone plans or attached to other coverage (such as Medicare Advantage plans). For more information about Medicare Part D see our post about Medicare Part D Plan Rates.

Medicare Supplements cover areas where the other Medicare      options do not.  They cover the costs for care that aren’t covered by Medicare Part A and Part B. This is why such supplement plans are commonly knows as “Medigap” plans — the plans cover the “gaps” that traditional Medicare doesn’t cover.

Click 2013 Medigap plan information for part 2.

Palm Beach County

  • Male smoker aged 69 — Prices for Medicare Supplement plan C offered from these companies:
  1. Hartford Life Insurance has retiree health coverage starting at 2922.
  2. Mutual of Omaha Insurance has coverage that is quite high for this market 5173.00
  3. Humana also offers a plan that is high at 5036
  4. Blue Cross Blue Shield of Florida has plans starting at 3634.
  • Female smoker age 69 — Prices from:
  1. United Healthcare sells Medicare supplement plans for 3461.
  2. Government Personnel Mutual Life Insurance at 3641.52

 

Ok, if all Medicare supplement  plans are standardized, why are the prices different?

This is an excellent question that EVERY senior should ask. The answer is that while the Medigap plan offerings are standardized, all of these companies are competing for your business.   That means that some companies will try to compete for your business on price.

However, it is also important to consider the insurance company’s reputation for customer service.  While one company may be slightly cheaper, previous patients may have a higher opinion of a competitor.  This is why it is important to consider:

  • The standardized plan that offers the overall coverage a senior desires
  • The online Medigap price quotes offered for that plan
  • The reputation and customer service rating for the best priced plans
  • Online reviews of Medigap insurance companies from other seniors

Hendry County
Lee County
Martin County
Glades County
Lee County
Charlotte County
St. Lucie County

What’s the difference between Medicare and Medicaid? Can a person have both?

Medicaid is another program for patients who may qualify based on income means testing. In general, Medicaid  is much more comprehensive than Medicare. However, patients that qualify for Medicare are considered to have both.




Indian River County
Okeechobee County
Highlands County
Desoto County
Sarasota County
Manatee County
Hardee County
Polk County
Hillsborough County

Fewer medicare supplement plans seem to be offered in Hillsborough County, but here are some  of the available plans:

  • Male smoker aged 71:
  1. Gerber Life Insurance offers supplement plans F and G at 2771 and 2556 respectively.
  2. United Healthcare Plan C at 2171 and Plan F at 2187.
  • Female smoker aged 71: (more plan offerings from MOMA than any other company)
  1. Mutual of Omaha has plan C ($3472), plan D ($3151) and plan F ($3483)
  2. Columbian Mutual Life Insurance has Plan F ($2911) and Plan G ($2716)

Pinellas County

  • 2012 Medicare Supplement Rates for seniors in St. Petersburg, Largo, Clearwater
  1. For a Non-smoker Male Age 70 : Sterling Investors Life Insurance has a rate at $3687
  2. In Oldsmar, FL consider TransAmerica Life Insurance at 2366.97
  • For a non-smoker Female age 70 best Medigap Plan D rates include:
  1. Blue Cross Blue Shield of Florida for $2265
  2. Hartford Life Insurance for 2013.

COMING SOON PENDING UPDATES

Indian River County
Pasco County
Osceola County
Brevard County
Volusia County
Seminole County
Lake County
Sumter County
Hernando County
Citrus County
Marion County
Levy County
Alachua County
Putnam County
Flagler County
St Johns County
Clay County
Bradford County
Duval County
Nassau County
Baker County
Union County
Gilchrist County
Dixie County
Lafayette County
Taylor County
Hamilton County
Suwanee County
Columbia County