Turning 65? The ABC and D of Medicare

If you’re turning 65, you’ve been inundated with correspondence from insurance companies offering supplements and prescription drug plans.  Here is why.  Original Medicare only covers about 80% of many healthcare services.  

Original Medicare includes Part A and Part B.  

Part A is hospital insurance that helps cover inpatient hospital care, skilled nursing facility care, hospice and home health care.  If you or your spouse has paid 40 quarters into the Social Security Program, then Part A has no monthly premium.

Part B is medical insurance that helps cover medically necessary doctor services and outpatient care.  It also includes some preventive services to help you maintain good health.  There is a premium for Part B.  The premium is based on your household income.  In 2020, the base premium is $144.60 per month.  This premium may be waived if you are eligible for assistance like Medicaid.

Part C is a Medicare Advantage health plan, such as an HMO or PPO, which replaces Original Medicare.  These plans are offered by private insurance companies that are approved by Medicare.  You are still responsible for the Medicare Part B premium.  Most plans also include the Part D prescription drug benefit.  Premium amounts vary by carrier. 

Part D is prescription drug coverage that helps cover the cost of prescription drugs.  These plans are offered by private insurance companies that are approved by Medicare.  With Part D, the government pays a portion of certain prescriptions.  If you don’t enroll in a Part D plan during your initial enrollment period or don’t have creditable coverage like through an employer or through the VA, you will have to pay a premium penalty when you enroll in the future.  Premiums vary based on your prescription drug needs.  You may also pay more based on your income.

Medicare supplement insurance also known as a Medigap policy helps cover expenses such as copayments, coinsurance and deductibles that Original Medicare does not cover.  It does not include Part D Medicare prescription coverage so a Part D plan must be purchased separately.  Medicare supplement plans are standardized plans and are regulated by federal and state law.  For example, a Plan G offered by any insurance company provides the same standardized benefit.  The difference is premium cost, customer service, and attractive extras like exercise programs and hearing aid discounts.

Bottom line... in order to fill in the gaps of Original Medicare, you will need a supplement along with a Part D Prescription Drug Plan, OR switch from Original Medicare to a Medicare Advantage plan.  

I will help you decide whether Original Medicare or a Medicare Advantage plan is right for you.  I am happy to help!

Stay well,

❤

Tara

$25 Blue Rewards Incentive Still Available

Interested in a virtual doctor visit?  Go to mdlive.bcbsnc.com — or text “bcbsnc” to MDLIVE (635483) to set up your account with help from Sophie, MDLIVE’s personal health assistant chatbot.  You will earn a $25 gift card from Blue Rewards.

Read more about the Blue Cross NC virtual doctor incentive program along with  additional resources to support you during COVID-19.

Call me with questions!

Stay well,

❤

Tara

Blue Cross NC Virtual Doctor Visit Incentive

Blue Cross and Blue Shield of North Carolina  (Blue Cross NC) sent emails to members to address concerns about access and affordability due to COVID-19.  One of the highlights included earning a $25 gift card from Blue Rewards when you activate your MDLIVE^® account if you haven't already signed up.  

Excerpts from "Count on the Support of Blue" email.

• Virtual doctor visits are covered the same as face-to-face visits according to your health plan. (This applies to all members.) Virtual visits include appointments with primary care providers, specialists, behavioral health providers and any North Carolina-licensed providers who can deliver services via secure video or telephone.
• Call your doctor to ask about virtual options - or if an upcoming visit or procedure should wait.  It's not just for doctor visits when you're feeling sick.  Ask about virtual options for wellness visits, behavioral health visits and physical therapy, too!
• You also have additional telehealth benefits through MDLIVE^®. Blue Cross NC is waiving cost-sharing (such as deductibles, copays and coinsurance) for services provided through MDLIVE. This includes behavioral health consults.

Many doctors are already encouraging virtual visits due to the COVID-19 outbreak.  If you don’t have a doctor, or your doctor is not set up for virtual visits, take advantage of MDLIVE.  This is a new benefit for 2020 members.  

Visit mdlive.bcbsnc.com — or text “bcbsnc” to MDLIVE (635483) to set up your account with help from Sophie, MDLIVE’s personal health assistant chatbot.  You will earn a $25 gift card from Blue Rewards.

Here are additional resources:

Benefits of Telehealth

COVID-19 Resources for Members

Stay well,

❤

Tara

BCBSNC Extends Deadlines for Customers

BCBSNC is taking steps to ensure customers can maintain their coverage and access to care during the COVID-19 public health emergency.

BCBSNC will allow a 30-day extension to pay premiums.  Members are encouraged to notify customer service if they need assistance.  888-206-4697

In addition, 30-day extensions will be added in relation to:

• Claims submissions
• Appeals filing
• Authorization requests
• Additions of newborn and adopted children to a policy

Additional provisions apply.  For more details you can visit BlueCrossNC.com/Coronavirus.

These measures are in accordance with requirements from the North Carolina Department of Insurance following a State of Disaster declaration and are effective March 27th for 30 days.  BCBSNC will continue to monitor for extensions.

If you have a plan through Healthcare.gov and are experiencing an income change, please call me.  I can help you update your application to get a subsidy increase if available.  704-436-4136

Take care,

Tara

BCBSNC and COVID-19

Please take a moment to check out the special Coronavirus website BCBSNCⓇ created for its members and providers.

BCBSNC - What You Need to Know About Coronavirus

The website is updated regularly with resources and guidance from the CDC during this ever changing environment.

As an agent, I am pleased with the quick response and preparedness that BCBSNC has provided.  And I'm especially glad that Telehealth with MDLive was already incorporated as a new benefit for 2020.  See Blog Telehealth with MDLive

There is a lot of misinformation circulating the Internet and cable news.   Please continue to take care and follow any guidelines provided by Federal and State authorities to keep our families and communities healthy during this time.

Here are additional reputable resources.

Centers for Disease Control and Prevention

World Health Organization

John Hopkins Center for Health Security

Stay well,

❤

Tara O'Neill 

Special Enrollment Period

Open Enrollment for 2020 ended December 17, 2019.

You can still enroll in an ACA plan as long as you qualify for a Special Enrollment Period due to a Qualifying Life Event (QLE).  Here are a few examples:

• Getting married
• Having a baby, adopting a child or placing a child for adoption or foster care
• Losing other health coverage
• Gaining citizenship or lawful presence in the US

If you’re not eligible for the special enrollment period, consider enrolling in a short term plan.  Short term plans do not provide minimum essential benefits required by the Affordable Care Act, but many of my clients use this option if they missed open enrollment or if they only need it as a stop gap before their employer coverage begins.  Coverage can begin within 48 hours and there are a number of plans to choose from including ones with copayments to see primary physicians.

BCBSNC adds Telehealth with MDLive

Telehealth with MDLive is being added as a covered benefit at the Primary Care Provider cost share.  MDLIVE connects Blue Cross and Blue Shield of North Carolina® members to a national network of U.S. board-certified doctors who average 15 years' experience.  Their specialties include primary care, pediatrics, emergency medicine, family medicine and behavioral health.

Telehealth represents a convenient, cost-effective alternative to in-person doctor visits.  Virtual visits ease the burden by being available quickly and easily.  This is available for all plans except Blue Local Atrium Health because that network already offers their own telehealth benefit.

Treatment includes non-emergency conditions such as acne, allergies, cold and flu, constipation, cough, diarrhea, ear problems, fever, headache, insect bites, nausea/vomiting, pink eye, rash, urinary tract infection, respiratory problems, sinus problems, sore throat, depression, stress, grief and loss, anxiety and more.

If appropriate, a prescription can be sent to a pharmacy of your choice.

Members will have standard access to MDLive 24 hours a day, seven days a week (including holidays).

Members are required to setup an MDLive account before using their services.  MDLive Care Coordinators are available to walk them through the registration process.

Options to access MDLive:

• Download the MDLive app on a smartphone or tablet
• Go to MDLIVE.bcbsnc.com and click “Activate Now”
• Call 888-910-9722

Take advantage of this great added benefit for our members in 2020!

Schedule a call with Tara

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