ComPro offers Medicare Supplement Products from Blue Cross Blue Shield of Nebraska and Mutual of Omaha. Each person is entitled to a “once-in-a-lifetime” open enrollment to select the Medicare Supplement plan of their choice with no underwriting for health conditions. This open enrollment happens on your 65th birthday or when you discontinue participation in an employer plan following your 65th birthday.
The benefits offered in Medicare Supplement plans do not vary from company to company. Each company is required to offer the same schedule of benefits.
When selecting a Medicare Supplement plan, you will want to compare the companies that you are considering based on the following criteria.
- Premium – each company determines their own rates
- Financial strength of the company – financial rating data is available
- Your expectation of service – you may have this plan for the rest of your days, so choose well. Be certain that you have selected the company that you believe will provide you with the best service.
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No, the over 65 market is not subject to the Affordable Care Act laws.
If you are not enrolled in a compliant plan, you will be penalized on your tax return $695 per person or 2.5% of your total income.
An EOB is an Explanation of Benefits. It explains how the insurance company processed your claim.
Those who have dental insurance are more likely to see their dentist on a regular basis than those who do not. The dental insurance plans that are available to individuals offer more limited benefits than group dental plans. The decision to have dental benefits should be based on your desire for good dental health and the cost / benefits of the insurance. One popular plan offers coverage for $27 per month. Annually that is $324. Preventive care (A services) is paid for at 100%. B services (extractions, fillings, etc) require a 6 month waiting period and are then paid at 80%. C services (crowns, root canal, etc) have a 12 month waiting period and are paid at 50%. The maximum benefit is $1000 per year. Compare the annual cost to what you would pay if you did not have dental insurance and consider how likely it is that you will need more than preventive services.
Give our office a call and we can assist with researching the formulary of your prescribed medication. Also suggest to contact your prescribing doctor to find other alternative medications that may be covered.
If a family member loses eligibility for Medicaid benefits, he will be eligible to enroll in a health insurance plan through the Health Insurance Marketplace. You will have 60 days in which to select a new plan or add him to an existing policy. This is a qualifying event that creates a Special Enrollment Period for those who are losing their benefits. Contact us and we can assist with getting your children added to your current medical coverage or look into getting them their own coverage.
Most people are eligible for Medicare benefits when they turn 65. Benefits can begin on the 1st of the month in which you turn 65. Step one would be to get signed up for Medicare A and B. Typically, you will enroll in Medicare Part A and Part B which provide benefits for medical expenses associated with being in the hospital, outpatient services, doctors, and other medical services. You can do this as soon as 90 days ahead of your 65th birthday. Second step is to research the Medicare Supplement options. We recommend either Mutual of Omaha or BCBS of Nebraska supplements.
Coverage can vary from one insurance company to another, so check it out before you travel. It is typical for US based coverage to provide benefits for emergency services only when you are out of the country. It is wise to purchase a travel policy that provides additional medical insurance benefits plus coverage for other expenses you might incur if a medical event happens while you are traveling. Benefits such as emergency travel home or evacuation expenses may be available on travel policy. The cost is minimal and provides valuable benefits when something unexpected happens.
A formulary is a list of prescription medications that are covered by an insurance plan. The medications are categorized as Tier 1 through Tier 4 with Tier 1 being the least expensive and Tier 4 being the most expensive. Some insurance companies use more than 4 tiers. If your pharmacy tells you that a drug is not covered, then the first step is to call the customer service number of your insurance company to find out why the medication is not covered. The most common reasons are that a drug is new and not yet on the formulary, has been replaced by a generic medication, or requires that you try less expensive medications before the more expensive one will be approved. There is also a process where your doctor can submit a request that the medication be approved because of special circumstances.
Every insurance company offers benefits through a specific network of physicians, hospitals and other providers. Your benefits will be reduced if you use a provider that is not in the network. Each insurance company’s website offers a “Provider Search Tool.” You can also contact your doctors’ office to find out if they are in your network. Look on your insurance card to find the website URL.
Most insurance companies have Member portals where you can view claims, see benefits, find an in-network doctor and print an ID card. Many sites also include options for viewing the cost of different procedures and finding the best priced facility for a certain service.
If you misplaced your card you can visit your carriers website to print out a temporary card. To get a new card you may contact us or your carrier to replace the old one.