Many times we hear individuals say they receive correspondence from their health insurance carrier that has large print stating “This is not a Bill” believing the document is not important and dispose of it. In fact, this correspondence received from the health insurance carrier is the explanation of benefits statement that explains how a claim, or claims, was processed for services received from a healthcare provider and indeed is very important to keep.
From time to time we do get questions from individuals asking why their Medicare
Part B premium differs from the premium a neighbor or friend pays. On average, most people pay the standard premium amount, $104.90 for 2013, however there are some individuals that pay a higher amount based on their Modified Adjusted Gross Income (MAGI).
It is very important that you understand exactly what the benefits of your health insurance policy are so you do not end up with any unexpected out of pocket expenses. If you have not looked at your summary of benefits page of the policy in a while, or if you recently purchased a new policy to reduce premiums, now would be a good time to review it. This holds true for major medical insurance policies as well as traditional Medicare supplement (Medigap) plans or Medicare Advantage plans.
The following information to avoid being a victim of a scam was obtained from the Federal Trade Commission. We are passing this important information on so as many people as possible can be informed. We have to do everything possible to help protect seniors from losing their valuable assets to scam artists that thrive on them as a target.
Medicare has announced that the Part B annual deductible for 2013 will be $147.00, an increase of $7.00 from the annual deductible in 2012. This means that once a Medicare beneficiary has paid $147.00 for medical care covered by Medicare Part B, Medicare will begin to pay for services at 80% of their approved amount; some services are paid at 100% by Medicare and not subject to the Part B deductible. Medicare Part B approves items such as doctors' services, outpatient services, ambulance services, etc.
Medicare has announced the changes to deductible and coinsurance for Medicare Part A. Medicare Part A covers facility type charges such as inpatient hospital stays and skilled care in a skilled nursing facility.
The inpatient hospital deductible will increase to $1,184.00 in 2013, an increase of $28.00 from 2012. It important to understand that the Part A deductible is NOT an annual deductible. Medicare uses a period of 60 days to determine patient responsibility; therefore a patient could be responsible for this deductible more than once in a year.
During the period of October 15th to December 7th, individuals entitled to Medicare have the option to switch or enroll in Medicare Advantage Plans, switch prescription drug plans or enroll back into traditional Medicare. Once a change is made, the choice becomes effective January 1st of the next year.
Here we will discuss some of the things to consider when looking at:
Prescriptions Drug Plans
One of the services we offer is monthly bill pay and bookkeeping for our clients. Since many of our clients are seniors, we are constantly on the look out to make sure they are not taken advantage of financially. By meeting with our clients monthly, we are able to monitor suspicious activity and inform them or their family members.
Twenty six years ago on this day, Carol Hess founded Medical Claim Service to assist those who were confused and frustrated with their medical paperwork. Through this period, Medical Claim Service has helped hundreds of clients sort through the maze of insurance and medical papers assisting clients with understanding insurance terms, informing them of what bills to pay and explain insurance benefits.