Cutting Health Care Spending Without Cutting Coverage


During these tough economic times, as America continues to look at cost cutting options, many people will be shopping for a health insurance plan. It’s important to know that there are health plans that are affordable and are a fit for you and your family while still offering the coverage you need to protect your family.

Know your needs. What types of coverage are most important to you? Do you or a family member take a prescription regularly? Knowing how much coverage you need is important when deciding which health care plan is best.

Learn the lingo. Some insurers are working to use more consumer-friendly language. Learning how a high-deductible plan tied to a health savings account (HSA) that offers choice among physicians and hospitals and how it works best with your needs, is important.

Availability when you need it most. Many insurers are working hard to ensure customers have health-related information when they need it, such as:

  • Use of understandable consumer-friendly language
  • Access to customer call centers and nurse hotlines 24/7, 365 days a year, giving constant access to a nurse or person to help solve a claims issue
  • Online tools to search for claims information and check for benefit qualifications, co-pays, and deductibles
  • Tools to compare prices on the drugs you need, helping find the best prices available

Schedule that yearly appointment. Regular checkups can help prevent potential problems or catch conditions early, saving money.

Look for “extras.” Many insurers offer discounts for programs such as smoking cessation, weight loss, fitness club memberships and other services already being used by an individual.



Medicare Supplements for Less Since 1984

Elderly Mother Inspires With Active Life

Author: Bonni Brodnick

My mother has been touted for her amazing energy, eagerness to learn and positive thinking. Aka “Ever-Ready Betty,” she inspires everyone who meets her with a sunny outlook … and how about that style? She’ll coordinate mink and neon plastic accessories and look fantastic. She can also pull off wearing heirloom baubles with blue jeans and snappy flats. Listen up, folks, this gal — who was born 1/1/31 — knows the ropes.

“You just have to look in your closet and mix it all around,” she said.

After an overnighter in NYC, my mother mentioned that she had on “good walking shoes,” but after walking from Lincoln Center to the Museum of Natural History “… (my) back hurt a little bit.”

My sister, who lives in Princeton, said that she had recently seen a 94-year-old woman sitting on her walker in the midst of an open field on campus. Thinking she might need assistance, my sister went up to her and asked if she was okay, and whether she needed anything.

“Oh, no, I’m fine,” the elder woman responded. “I’m just taking a break from walking and enjoying the day.”

Don’t you love it?

I mentioned this anecdote to my mother and said that maybe a walker would be helpful when she’s in the city. Without skipping a beat, and showing no vanity, she replied, “That’s a great idea. My friend has an extra one. I’ll try it. Will make getting around easier. Plus, there’s an upcoming senior trip to Central Park in the spring. They said the tour takes breaks. If I have the walker, I’ll be fine.”

Last January, my siblings and I hosted an 80th birthday tea party for Mom. Many of her friends range from lower-80s to mid-90s. They are gorgeous women, full of life, fashionable, connected and Fun (note the capital “F”). When I met one of them, she said, “Thank goodness December is over. So many parties!”

The remarkable thing is that my mother had a brain tumor 36 years ago. Along with deafness in one ear, she was left with partial paralysis in her right side that made it difficult for her to walk, blink and swallow. It took years to get back on the other side of life, but with determination and strong will, she regained her tenacity. Her only-child sassiness remained intact throughout.

Mom awakens every single day grateful to be alive. Every sunrise and every sunset is a blessing to her. She shares her optimistic glow with everyone she meets — from the doorman to the Governor. With punch and panache, Mom inspires us all. She is a lesson on how to live your life to the max: at full-speed. Even if it’s with a walker to get from West 65th Street to the museum on West 79th.

And knowing Mom, she’ll even tie a ribbon on the handle of that new walker so that it coordinates with her outfit. In her ever-growing book of mantras, “Why take a cab when you can make tracks with a walker?”


Medicare Part A: Hospital Coverage


Medicare Part A covers institutional care in hospitals and skilled nursing facilities, as well as certain care given by home health agencies and care provided in hospices.

Any person who has reached age 65 and who is entitled to Social Security benefits is eligible for Medicare Part A without charge. That is, there are no premiums for this part of the Medicare program.

Medicare pays for 90 days of hospital care per “spell of illness,” plus an additional lifetime reserve of 60 days. A single “spell of illness” begins when the patient is admitted to a hospital or other covered facility, and ends when the patient has gone 60 days without being readmitted to a hospital or other facility. There is no limit on the number of spells of illness. However, the patient must satisfy a deductible before Medicare begins paying for treatment. This deductible, which changes annually, is $1,216 in 2014.

After the deductible is satisfied, Medicare will pay for virtually all hospital charges during the first 60 days of a recipient’s hospital stay, other than telephone and television expenses. What Medicare covers includes:

  • a bed in a semiprivate room, meaning a room with at least one other patient. (Medicare will pay for a private room only if it is “medically necessary.”)
  • all meals
  • regular nursing services
  • operating room, intensive care unit, or coronary care unit charges
  • medical supplies
  • drugs furnished by the hospital
  • laboratory tests
  • x-rays
  • the use of appliances
  • medical social services
  • physical and occupational therapy
  • speech therapy
  • blood transfusions after the first three pints of blood

However, Medicare will not pay for treatments or procedures that it considers medically unproven or experimental.

If the hospital stay extends beyond 60 days, the Medicare beneficiary begins shouldering more of the cost of his or her care. From day 61 through day 90, the patient pays a coinsurance of $304 a day in 2014. Beyond the 90th day, the patient begins to tap into his or her 60-day lifetime reserve. During hospital stays covered by these reserve days, beneficiaries must pay a coinsurance of $608 per day in 2014. This reserve is not reset after each “spell of illness.” Once it has been exhausted, the beneficiary will receive coverage for only 90 days when the next spell of illness occurs. However, studies show that the average length of a hospital stay covered by Medicare is eight days.

Medicare Part A also pays for stays in psychiatric hospitals, but payment is limited to a total of 190 days of inpatient psychiatric hospital services during a beneficiary’s lifetime.



Medicare Supplements for Less Since 1984

Health Care Consumes Over a Third of Social Security Checks

Author: Ben Veghte 

Growth in seniors’ out-of-pocket health care costs has outpaced Social Security’s cost-of-living adjustments by more than a third since 1992, according to a new analysis by Social Security Works of data from the Center for Medicare and Medicaid Services. Beneficiary spending on Medicare premiums, deductibles, co-pays, all private premiums, and all other services covered and not covered by Medicare, has grown in real terms from $3,865 per year in 1992 to $5,261 per year in 2010, an increase of 34 percent.

The vast majority of seniors and people with disabilities live on modest, fixed incomes.Median household income for seniors is $34,000, and for Social Security Disability Insurance beneficiaries just under $30,000. Our Social Security and Medicare systems are designed to provide seniors and people with disabilities with a measure of economic and health security, as well as predictability with regard to their budgets in retirement – insurance protections which they earned by contributing to Social Security and Medicare throughout their working years.

Seniors’ high out-of-pocket expenses, however, undermine their economic security in retirement. Social Security benefits were never intended to go largely toward medical bills. Yet in 2010, even with Medicare (including prescription drug coverage which took effect in 2006), out-of-pocket health care costs consumed over a third (37%) of the average Social Security check of seniors and their surviving spouses. If the cost-shifting proposals on the agenda now – such as requiring ill seniors to have “more skin in the game,” or increasing Medicare premiums for middle-class beneficiaries – become law, this would cut net Social Security benefits even further.

What proponents of further cost-shifting misunderstand is that the cost problem we face is not a Medicare problem - Medicare is actually better at controlling costs than our private health care system. The problem, rather, is that our system of health-care provision is inefficient: we spend twice as much as those of similar countries, with worse health outcomes. The New York Times’ Elisabeth Rosenthal, and Time Magazine’s Steven Brill, have published revealing exposes detailing the manifold perverse incentives and inefficiencies in our health-care system, and showing how these are perpetuated by an army of provider lobbyists in Washington, DC.

True courage on the part of policymakers would be demonstrated by taking on these vested interests to improve the efficiency of our health-care delivery system – which would be a boon to the entire economy – rather than asking seniors and people with disabilities to bear an ever greater share of the rising amounts billed by providers. For example, we could allow Medicare to negotiate with drug companies for lower prescription drug prices, which is prohibited under current law. Medicaid and the Veterans Administration already do so, as do most other countries’ health care systems. Allowing Medicare to also use its market power on behalf of beneficiaries could save the federal government between $230 and $541 billion – and beneficiaries another $48 to $112 billion – over 10 years.

And if policymakers want to ask upper-income Americans to contribute more to financing Medicare, they should do so through progressive income or payroll taxes on working-age Americans, not higher premiums for seniors living on a fixed income. And they should limit their proposals to the truly upper income, not those with incomes of $47,000.

The vast majority of America’s seniors have little or no ability to cope with further increases in health care costs. They have paid into Social Security throughout their working lives. Congress has a sacred obligation to protect them from out-of-control health care costs in retirement. There is ample scope for improving the efficiency of our health care system. We should control costs, rather than shifting them onto our seniors and people with disabilities.



Medicare Supplements for Less Since 1984


Medicare Part D

Having Medicare is a great insurance for people age 65 or older, and have met the required 40 quarters, or 10 years of paying into social security. But having Medicare alone does not mean that you are fully covered.

Money-in-medicineChances are that as you get older you will need some medication from time to time, or maybe even for the rest of your life. In which case that can become very expensive and could alter the quality of your life dramatically.

Medicare Part D is what you will need to cover any medication you may need. In order to qualify for Part D, you will need to be enrolled in Medicare Part A or B plans. Also good to know is that, if you do not sign up for Part D when you enroll in Medicare, you could be penalized with paying a higher premium by signing up at a later date.

You are not required to take a physical examination, not can you  be denied for past or current health reasons.

Even though some Medicare plans don’t charge extra for drug coverage, keep in mind that some do, so it’s better to do your homework and shop around so you know you’re getting the best coverage for the best price.

Your annual deductible will be about $325 a year. You also have a copay expense until you reach a certain dollar figure per year; current that maxes out at $2,970 from the beginning of the year.

Also, if you fall below a certain income level, you Part D costs could be lower as well, you may even qualify for “Extra Help” benefits that will help defray the costs.

There are many different plans to choose from and can very state-by-state. Some of the plans can be confusing to understand so it’s important that you find an agent that can explain it all in simple terms.

Medigap Limits – Will It Cost Seniors Money

Will Medigap Limits Cost You Money and Health Care Coverage?


As the debate over the debt ceiling, budget cuts, and economic stimulation wages on in Washington, DC, it’s hard to escape the fact that Medicare is often “on the table” during almost all discussions regarding “deficit reduction.” There are a range of proposals that would affect Medicare, but there are questions as to what those proposals will actually mean for beneficiaries. One federal deficit reduction plan would limit Medicare supplemental insurance (Medigap insurance) plans by restricting coverage of deductibles by those plans.

As with most arguments, those in agreement lock on to a set of positives, while those opposed turn to the negatives. So, let’s take a look at both sides to try to get a clearer picture of who will benefit and who won’t. By restricting Medigap coverage, the government could save money and reduce the debt. However, as a recent report on potential Medigap Limits points out, not all those who depend on Medicare and Medigap coverage will be able to make up for the added personal costs:

“…restricting coverage of deductibles by Medigap plans could save anywhere from $1.5 billion to $4.6 billion a year, depending on how much out-of-pocket expenses elderly beneficiaries would be required to pay.” (from Reuters).

In fact, the study goes on to say that “about one in five Medigap enrollees would pay more.” The hardest hit would most likely be families with a moderate income. Along with financial concerns, others are afraid that enrollees will simply pass up on healthcare treatment that they need in order to avoid the added cost. Those in support of the proposal insist that it will simply reduce unnecessary trips to the doctor and elective care.

There’s very little question that changes to Medicare are on the horizon, which means Medigap coverage could also see changes. Many have taken the “wait and see” approach to it all, but it’s a good idea to stay up-to-date on the latest proposals. After all, these potential changes to the system could change how you have to budget and how you have to look at healthcare.

Click Here to Compare Medigap Rates!



Last year my monthly insurance premium was going to over $200 and I
could not afford it so I went looking.

I found a broker in TX who advised me to sign with another that cut my
monthly premium to $137/mo BUT this month I got a notice it was being
raised to $157/mo

SO I called the broker and have just signed up for Plan G..for $118/mo.
same coverage as Plan F. This goes into effect June 15 for me. This is
a financial blessing for me.

If anyone is curious – you can contact Mike Turner, 1-888-875-4463. He is the Regional Manager of Medigap360.

If anything – he will just brighten your day to talk with him.

and – for skeptics- I’m not getting anything but personal pleasure in
helping y’all save money.


Baby Boomers Take On the Digital World

Seniors and Technology

Seniors Embrace Digital Media

Seniors hear a lot about “Gaps” these days. There’s the Medicare Gap (which often leads to the need for Medicare Supplemental Insurance coverage), the Employment Gap (seniors who want to stay in the workplace are often finding it harder to do so), and there’s the Technology Gap, which is basically the belief that Baby Boomers can’t keep up with the tech changes embraced by Gen-Xers and Millenials. Well, Baby Boomers are proving that “Gap” to be a bit of a myth.Baby Boomers and technological innovation go hand-and-hand, and others are finally starting to realize it. In many cases, it’s simply a question of numbers. Despite the “employment gap” we just mentioned, large numbers of Baby Boomers are still running major companies all over the world. In that capacity, they’re dictating the course that technology takes. Other important numbers involve the all-powerful “$.” Baby Boomers are still major consumers, and in some cases they’re the ones who can most easily afford the latest tech products flooding the market.Of course, Boomers are closing the technology gap in purely social ways, as well. Check out Mashable’s How Baby Boomers are Embracing Digital Media and you’ll see just how quickly Boomers are growing their numbers online:

“Social network use among Internet users 50 years old and older has nearly doubled to 42% over the past year. In fact, in the U.S. alone there are nearly 16 million people 55 and older using Facebook.”

So, let them keep throwing out the latest “Gap” and telling the world where Boomers are lagging behind this time. You know the truth. It’s a digital world, and we’re not going to just sit on the sidelines and let it pass us by.

Medicare, Medigap Insurance, and Finding the Coverage You Need

What Does Medicare Cover?

Healthcare continues to be a major topic of discussion on Capitol Hill, across the 24 hour news channels, and in homes all over the country. Unfortunately, a lot of these conversations and debates turn into political attacks, and some of the basic concerns get lost in the mix. Concerns like, “Does Medicare provide the coverage I need right now, or do I need to look into Medigap coverage?”
What is Medigap

Navigate Your Way Through Medicare

What is Medigap?

As the focus of the Medicare debate remains, for the most part, in the future tense, we try our best to focus on the here and now (at least from time to time). The fact is that as of right now, Medicare coverage doesn’t provide the full range of care that some seniors need. In fact, according to a recent report “about 1 in 6 Medicare beneficiaries purchased [Medigap policies] in 2008. (from Philly Burbs and Partnership to Protect Medigap)

Not everyone (seniors or otherwise) has the same healthcare needs or is in the same economic situation. However, everyone has the right to get all of the information on all of the options out there. As talks about the future of Medicare heat up as we approach the next Presidential election, don’t lose sight of the present state of Medicare.  2012 Presidential Election

  • Does it offer you all of the coverage you need? 
  • What options could Medigap coverage provide? 
  • Does Medigap coverage make financial sense for my specific situation? 

These are just a few of the questions you need to ask yourself and an expert in the field, even if the politicians and pundits aren’t asking them.