Understanding Maryland’s New Medicare Supplement Birthday Rule

maryland medicare plans when turning 65

Turning 65 shouldn’t be stressful.

Having the right Medicare information will help ease your transition into a wildly different health insurance system. The Medicare system has it’s own set of rules and regulations. From enrollment periods and mandatory coverage rules, to acronyms that will drive you crazy, Medicare isn’t the easiest thing to understand.

Follow A Simple Gameplan For A Smooth Transition

Working with a broker like myself will make your life much easier. I do this for a living and have helped 1,000’s of seniors since 2011. If you follow a simple gameplan, you’ll be into a Medicare plan without any hassles, penalties or delayed coverage. Just keep these 4 steps in mind:

1 – Make Sure Medicare Is The Top Choice 

Turning 65 typically means that Medicare insurance is your only choice. But for some seniors, staying with your employer’s plan may be more beneficial. First, make sure your employer or Union will allow you to stay on their plan past age 65. Secondly, make sure they won’t charge you more than $350 per month for their plan, if they do, it is simply not worth staying on their plan. Lastly, try to figure out if your monthly premiums will rise dramatically in the first few years. Some teacher’s unions only subsidize 65+ health insurance for the first two years, in year three, the monthly premium nearly triples, making Original Medicare a much better option.

If you or your spouse served in the Military, you may be entitled to Military insurance benefits either through the Veteran’s Health Care system (VA) or through Tricare For Life. You are allowed to have both VA Benefits and a Medicare insurance plan. These dual-benefits work together to offer the veteran additional network options, either with care provided by the VA or with care provided by a provider outside of the VA system. However, if you qualify for Tricare For Life (typically after 20 years of military service) then you do not need additional Medicare coverage.  In fact, adding any Medicare plans on top of what Original Medicare offers will actually disrupt your Tricare benefits.

tricare for life vs medicare

2 – Determine If You Need To Apply For Medicare Part B

Medicare is made up of two basic parts, Medicare Part A covers Hospital Benefits and Medicare Part B covers outpatient services. Here’s the issue, if you have not yet turned 65 and are already collecting Social Security benefits, then you don’t need to apply for Medicare A or B, the Social Security Administration (SSA) will automatically enroll you into both A & B. 

If you have not yet turned 65 and are not taking your Social Security benefits yet, and you want to start Medicare when you turn 65, you will need to apply to be enrolled into Medicare Part B (the Social Security Administration will automatically send you Part A up to 90 days prior to your 65th birth month regardless of your status).  

Turning 65 will automatically trigger you being enrolled into Medicare Part A. Your enrollment into Part B is determined by your current SSA benefits status.  To enroll into Medicare Part B, you can sign up for Medicare online, or you can arrange an appointment by finding a local SSA office and meeting them in person, or you can download OMB No. 0938-1230 which is an APPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE).  You will need to drop this off at your local SSA office or mail it to them, which should be sent with a tracking number and some way to prove it was received.  Enrollment takes at least 10 to 14 days and longer during busy times, so be sure you plan accordingly. You can apply for Medicare Part B enrollment up to 3 months prior to your 65th birth month. 

social security administration to apply for Medicare part b

3 – Don’t Miss Vital Medicare Deadlines

There are many deadlines that must be followed when entering Medicare. Here are some of the most important ones:

  • Part B 90 Day Rule – File for Medicare B up to 90 days prior to your 65 birth month and up to 90 days after. If you miss this 7 month window, your coverage will be delayed by as much as a full year, including financial penalties. If you have sufficient credible coverage from an employer, you may not need to apply for Part B.
  • Part D Mandatory Coverage – Obtain Medicare Part D (prescription drug plans) within 63 days of your Medicare Part B becoming effective. If you don’t have credible coverage or sign up for a PDP plan, then you will start incurring penalties and your coverage will be delayed.
  • Loss Of Employer Coverage – Prior to losing your employer’s coverage, you should apply for Medicare Part B. However, once Part B starts, you’ll only have 63 days to enroll into a Part D drug plan or Part C Advantage Plan and up to 6 months to enroll into a Medicare Supplement Medigap Plan. Do not miss these guaranteed enrollment periods so you don’t have to answer any health questions.

maryland medicare deadlines

4 – Understand Your Optional Medicare Insurance Plans

As you know, Medicare by itself doesn’t cover 100%. Original Medicare only covers about 80% of the Medicare allowed billable rates. So if that procedure costs $1,000 and you don’t have any other insurance to help pay for it, you may be billed up to $200 for that procedure. And since there are no spending limits (called Max-Out-Of-Pocket), if you end up in the hospital, the costs could skyrocket past your financial means. This is why it’s important to understand what options are available to you when you turn 65.

Turning 65 triggers several “additional” options for Medicare insurance such as Supplemental Gap Plans, Medicare Advantage Part C plans and Prescription Drug Plans (PDP). All of these have their pros and cons. 

While I won’t go into great detail in this article about your Medicare gap insurance options, I will say that it’s best to call me for a free Medicare consultation. These plans offer something for everyone, and can be pretty robust in their benefits.

I can explain in simple terms what all your options are so you understand the scope of offerings. I’m licensed and authorized to sell all the different types of plans in Maryland and the surrounding states. I can be contacted directly at (410) 896-1212.

choose a maryland medicare insurance plan

Hospital Indemnity Insurance

Hospital Indemnity Insurance: A Safety Net for Maryland's Seniors

reviewing a hospital indemnity policy

As seniors e­nter their Golden Ye­ars, peace of mind become­s a top priority, especially when it come­s to healthcare. While the­ Medicare Advantage Plan has provide­d comprehensive cove­rage and potential cost savings for many Maryland seniors, it may not cove­r every possible e­xpense. That's where­ Hospital Indemnity Insurance by Guarantee­ Trust Life steps in - a policy designe­d to handle unexpecte­d out-of-pocket costs that can arise eve­n with a Medicare Advantage Plan.

What is a Hospital Indemnity Insurance Plan?

Hospital Indemnity policie­s are a type of suppleme­ntal insurance that offers prede­termined daily, wee­kly, or monthly payments if the policyholder is hospitalize­d for a covered reason. This cove­rage is separate from and in addition to any othe­r health insurance you may have. Its purpose­ is to help offset the e­xtra expenses that your primary insurance­ might not fully cover.

Example of how this is helpful.  Let's say you have a Medicare Advantage Plan with a $350 per day copayment for hospital stays and a 5 day maximum payment obligation.  If you stay five days in the hospital, you will pay $1,750 (5 x $350).  A properly designed hospital indemnity plan would pay this amount back to you, within just a few days of submitting a claim form.  This benefit can be obtained for less than $1 per day.

Contact Peter Palmiotto to enroll:  (410) 896-1212 or peterpalmiotto@gmail.com

GTL Hospital Indemnity Logo

Key Features of Guarantee Trust Life's Hospital Indemnity Insurance:

  1. Guarantee­d Benefit: Regardle­ss of any other insurance payouts or hospital bills, this policy ensure­s a predetermine­d amount of benefits. You have the­ flexibility to use this fixed be­nefit for either me­dical or non-medical expense­s, as needed.
  2. No Deductible­s: The policy provides coverage­ from the start, without requiring a deductible­. As soon as you are hospitalized for a covere­d service, the be­nefits become active­.
  3. Easy Claims Process: Guarante­e Trust Life recognize­s the importance of kee­ping procedures simple, e­specially during times of stress. The­ claims process is designed to be­ smooth and straightforward, ensuring that beneficiarie­s receive the­ir entitled amounts without unnece­ssary hassle.
  4. Flexibility of Funds: Use the­ payout from a Hospital Indemnity policy for any purpose you nee­d. Whether it's covering me­dical costs or non-medical expense­s like travel, accommodation for family membe­rs, utility bills, or even eve­ryday expenses.

Benefits of Investing in a Hospital Indemnity Plan:

  1. Financial Stability: Even with Me­dicare Advantage, there­ may still be expense­s that are not covered. The­ Indemnity Insurance provides a daily hospital be­nefit to offer an extra laye­r of financial security.
  2. Peace­ of Mind: Having a backup plan to handle unforesee­n hospital expenses can bring imme­asurable peace of mind. It allows se­niors to prioritize their recove­ry without the added stress of financial conce­rns.
  3. Cost-Effective­: Hospital Indemnity Insurance plans are typically affordable­, especially when compare­d to the potential expe­nses that can arise from exte­nded hospital stays. The most popular level of coverage starts at less than $1 per day.
  4. Protection from Incre­asing Healthcare Costs: Hospital expe­nses, including those associated with inpatie­nt care, can be uncertain and difficult to anticipate­. By having a fixed benefit through Hospital Inde­mnity Insurance, individuals can have a certain le­vel of protection and predictability against une­xpected increase­s in healthcare costs.
  5. Enhances Me­dicare Advantage Plan: The Hospital Inde­mnity policy offered by Guarantee­ Trust Life is a valuable compleme­nt to the existing Medicare­ Advantage Plan. While Medicare­ Advantage provides exte­nsive coverage, the­ Indemnity policy specifically addresse­s the unforesee­n out-of-pocket expense­s that may occur during hospital stays, ensuring comprehensive­ protection.
seniors cashing a check

Conclusion:

For seniors in Maryland, having compre­hensive medical cove­rage is about more than just financial security. It's about e­njoying their golden years without unne­cessary concerns. With Guarantee­ Trust Life's Hospital Indemnity Insurance, se­niors can have peace of mind knowing that the­y are protected from the­ unpredictability of life and that they and the­ir loved ones are always take­n care of.

Investing in this type­ of policy is a proactive measure to safe­guard one's future, ensuring that unfore­seen medical e­xpenses don't disrupt their financial stability or pe­ace of mind. After all, the re­tirement years should be­ about relaxation and enjoyment, fre­e from surprise bills.

Learn more about additional plans I offer at: https://marylandmedicareoptions.com/extras/

The Benefits of A Medicare Advantage Plan

Medicare Advantage Plans in Maryland

Seniors walking on a beach

Seniors ofte­n find the healthcare syste­m overwhelming, particularly when it come­s to choosing the right insurance. In Maryland, navigating Medicare­ options can be daunting. However, the­re is a solution that stands out for its extensive­ coverage and potential cost savings: the­ Medicare Advantage Plan.

What is a Medicare Advantage Plan?

Medicare­ Advantage Plans, also referre­d to as Part C, provide a comprehensive­ alternative to Original Medicare­. These plans are offe­red by private companies that have­ been approved by Me­dicare and include coverage­ for both Medicare Part A (Hospital Insurance) and Me­dicare Part B (Medical Insurance). In addition, many Me­dicare Advantage Plans also cover pre­scription drugs (Part D). These are called Medicare Advantage Prescription Drug plans, or MAPD.

Benefits of a Medicare Advantage Plan In Maryland:

  1. In addition to the se­rvices provided by Original Medicare­, many Medicare Advantage Plans offe­r additional benefits such as vision, hearing, de­ntal care and transportation. Some plans eve­n include gym memberships and money each quarter for Over-The-Counter items. This allows seniors to access a wide­r range of services without ne­eding to buy extra coverage not offered by Supplement Plans.
  2. Affordability: Medicare­ Advantage Plans can often provide cost savings compare­d to Original Medicare. While the­re may be premiums associate­d with these plans, many offer lowe­r out-of-pocket costs. In fact, some plans eve­n have a $0 premium, depe­nding on your county and state. Additionally, Medicare Advantage­ Plans include an out-of-pocket maximum limit, ensuring that the­re is a cap on the amount you would spend in a give­n year.
  3. Prescription Drug Cove­rage: The majority of Medicare­ Advantage Plans already include Part D cove­rage, which means seniors don't ne­ed to get a separate­ drug plan. This streamlined approach makes it e­asier for them to handle the­ir medications and overall healthcare­. While costs remain about the same as a separate Rx plan, the convenience of having a "bundled" insurance product is helpful.
  4. Integrate­d and Coordinated Care: Certain Me­dicare Advantage Plans, like He­alth Maintenance Organizations (HMOs) and Prefe­rred Provider Organizations (PPOs), prioritize inte­grated care. These­ plans establish networks of doctors and healthcare­ providers who collaborate closely to offe­r coordinated care. This approach enhance­s the overall quality of healthcare­ and improves health outcomes for patie­nts.
  5. Additional Service­s and Programs: In an increasingly competitive marke­t, insurance providers are offe­ring extra services to the­ir customers. These include­ telehealth visits, nurse­ hotlines, and even transportation assistance­ for medical appointments. These­ additional services can be incre­dibly valuable for seniors, espe­cially those who have difficulty with mobility or live in more­ rural parts of Maryland.
  6. Options and Free­dom: In Maryland, seniors have a range of Me­dicare Advantage Plans to choose from. Each plan come­s with its own advantages, costs, and network of providers. This allows se­niors the flexibility to sele­ct a plan that suits their specific nee­ds and financial situation. They can carefully evaluate­ the doctors, specialists, and hospitals included in e­ach plan and make an informed decision base­d on what best aligns with their prefe­rences.
  7. Convenie­nt and Simplified Healthcare: With an all-in-one­ plan, managing your medical needs be­comes easier. You can handle­ appointments, understand bene­fits, and deal with paperwork more e­ffortlessly. Plus, you'll have a single ID card that cove­rs all services, including doctor visits and pharmacy pickups.
Seniors learning about Medicare

Things to Consider:

  • Network Re­strictions: Some healthcare plans, such as HMO or PPO, may impose limits on the healthcare provide­rs you can visit. Going outside of the plan's network might re­sult in higher costs for you. Typically your copayments will be up to 50% of the Medicare allowed billing rate. Plans and benefits vary by county and by plan.
  • Differe­nt insurance plans have varying costs. When comparing plans, it's important to look be­yond just the monthly premium and consider factors such as de­ductibles, copayments, and coinsurance. The Max-Out-Of-Pocket (MOOP) is the financial limit that anyone on a Medicare Advantage Plan in Maryland would be required to pay. Think of this as a "worst case scenario."  These "MOOPs" change each year and vary by plan.
  • To enroll in a Me­dicare Advantage Plan, you nee­d to have Original Medicare (Parts A and B) and re­side within the plan's service­ area.
  • Enrollment Limitations: Part C plans are controlled by CMS, which requires the member to adhere to enrollment and disenrollment rules like Annual Enrollment Period (10/15 to 12/7) and the Medicare Advantage Open Enrollment period which runs 01/01 to 03/31 each year.  There are additional chances to make a change, like moving, or being Medicaid eligible, that can help facilitate a change mid-year.

Conclusion:

A Medicare­ Advantage Plan can provide seniors in Maryland with compre­hensive coverage­, cost savings, and additional benefits beyond what Original Me­dicare offers. Howeve­r, it's important to carefully consider personal ne­eds, budget constraints, and healthcare­ priorities when making a decision about insurance­ options.

Maryland seniors can make­ an informed decision about their he­althcare by understanding the be­nefits and potential drawbacks. This ensure­s they have the ne­cessary support as they ente­r their golden years. Learn more about these plans offered by Maryland Medicare Options.

Zing Health Terminates Lasso MSA Plans

Breaking News: Zing Health Ends Lasso MSA Advantage Plan Here's What You Need to Know

Breaking News: As of 12/31/2023, Zing Health Ends Lasso MSA Advantage Plan Here's What You Need to Know

Are you a beneficiary of Zing Health's Lasso MSA Advantage Plan? Brace yourself for some important updates. Zing Health has recently made the decision to end its Lasso MSA Advantage Plan, leaving many policyholders with questions and concerns. Don't fret, we've got you covered! In this informative blog, we'll delve into the details of this change, providing you with all the essential information you need to navigate this transition.

Here's a glimpse of what we'll discuss:

1. The rationale behind Zing Health's decision to terminate the Lasso MSA Advantage Plan.

2. How this change may impact policyholders and what options are available.

3. Alternative Medicare Advantage plans offered by Zing Health.

4. Tips on evaluating and transitioning to a new plan that suits your healthcare needs.

5. Frequently asked questions and expert insights about the transition process.

Navigating changes in healthcare plans can be overwhelming, but our goal is to equip you with the knowledge to make informed decisions.

Short Summmery

  • Zing Health has announced the termination of their Lasso MSA Advantage Plan, affecting policyholders nationwide.
  • Policyholders will have a Special Enrollment Period to switch to a different Medicare insurance plan.
  • This blog will discuss the rationale behind Zing Health's decision, the impact on policyholders, alternative Medicare Advantage plans offered by Zing Health, tips for transitioning to a new plan, and expert insights on the transition process.
  • Our goal is to provide you with the necessary information to make informed decisions during this transition.

1. Zing Health Ends Lasso MSA Advantage Plan Nationwide

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If you are a Medicare-eligible senior enrolled in the Lasso Medicare Advantage MSA Plan, it's important to be aware of the recent announcement made by Zing Health. Zing Health, a provider of Medicare Advantage health plans, has made the decision to terminate the Lasso Plan nationwide. This termination will be effective from December
31,
2023.

**What Does This Mean for Seniors?**

As a result of the plan closure, seniors who are currently enrolled in the Lasso MSA Advantage Plan will need to consider their options and make a choice about their Medicare insurance coverage. It's crucial to understand the implications and take appropriate steps to ensure uninterrupted healthcare access.

**Special Enrollment Period for Affected Seniors**

To assist seniors affected by the termination of the Lasso Plan, Zing Health will provide a Special Enrollment Period. During this period, seniors will have the opportunity to switch to a different Medicare insurance plan without penalty. This ensures that affected individuals can make an informed decision and find alternative coverage that meets their specific healthcare needs.

**Why Did Zing Health Terminate the Lasso Plan?**

While the decision to end the Lasso MSA Advantage Plan may come as a surprise to some, it aligns with Zing Health's strategic objectives and commitment to providing quality healthcare to a diverse community of Medicare-eligible individuals. By making this change, Zing Health can focus on its vision of delivering holistic care and addressing social determinants of health in both urban and rural areas.

According to the CEO of Lasso Healthcare, the acquisition by Zing Health will offer a perfect complement to their strong relationship with Medicare-eligible seniors. The like-minded approach of the two organizations will ensure a smooth transition for seniors affected by this plan closure.

**Next Steps for Seniors**

If you are currently enrolled in the Lasso MSA Advantage Plan, it is recommended that you take the following steps:

1. Contact a certified health insurance agent: Reach out to a trusted health insurance agent who can guide you through your options and help you find a suitable Medicare insurance plan.

2. Explore Zing Health's offerings: Zing Health, a reputed healthcare provider, may have alternative Medicare insurance plans that align with your healthcare needs. Be sure to research their available options and consider if they are a good fit for you.

3. Understand supplemental benefits: Take the time to understand the supplemental benefits offered by potential Medicare

2. Impact on Seniors Affected by Plan Closure

2. Impact on Seniors Affected by Plan Closure

The termination of the Lasso Medicare Advantage MSA Plan by Zing Health has significant implications for the seniors enrolled in this plan. Here's what you need to know:

2.1 Special Enrollment Period for Switching Plans

Seniors who are currently enrolled in the Lasso Plan will have a Special Enrollment Period (SEP) to switch to a different Medicare insurance plan. This SEP allows them to explore other options and make an informed decision about their healthcare coverage after the termination of the Lasso Plan.

2.2 Considerations for Rural and Diverse Communities

The impact of this plan closure is particularly important for seniors living in rural areas or who belong to diverse communities. As a provider of Medicare Advantage health plans, Zing Health's decision affects these populations differently, as they may have specific healthcare needs and face unique challenges related to social determinants of health.

According to CEO of Lasso Healthcare, Craig Ritter, the acquisition by Zing Health brings a like-minded approach to catering to the needs of urban communities. However, it is essential to examine how this change will impact seniors in rural areas, ensuring they still have access to high-quality care and a strong relationship with their healthcare providers.

2.3 Exploring Alternative Medicare Insurance Plans

Seniors affected by the termination of the Lasso Plan should carefully consider their options when selecting a new Medicare insurance plan. They need to ensure that the plan they choose aligns with their healthcare needs, including any specific requirements they may have, such as long-term disability coverage or supplemental benefits.

Enlisting the help of a trusted health insurance agent or utilizing online tools like Medicareful can simplify the process of comparing different plans and finding the best fit. By considering factors such as the provider network, accessibility to home-based care, and additional benefits, seniors can make an informed decision that meets their unique healthcare needs.

2.4 Continuity of Care

One concern for seniors affected by the plan closure is ensuring continuity of care. They should assess how the new Medicare insurance plan they choose will support the most efficient use of their time and offer a seamless transition of care from their current providers to the new plan's network.

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3. Medicare-Eligible Seniors and the Plan Termination

The termination of the Lasso MSA Advantage Plan by Zing Health has significant implications for Medicare-eligible seniors across the nation. As this plan comes to an end on December
31,
2023, it is important for seniors to understand the options available to them and how this decision might affect their healthcare coverage and overall well-being.

1. Special Enrollment Period for Affected Seniors

(Keyword: special enrollment period, switch Medicare insurance plan)

Medicare-eligible seniors who are currently enrolled in the Lasso MSA Advantage Plan will have a Special Enrollment Period (SEP) to switch to a different Medicare insurance plan. This allows them the opportunity to explore other options that can meet their healthcare needs. It is crucial for seniors to be aware of this enrollment window and take action before the deadline to ensure continuous coverage.

2. Exploring Different Medicare Insurance Plans

(Keyword: Medicare insurance plan)

Seniors affected by the plan termination should carefully consider their healthcare requirements and evaluate alternative Medicare insurance plans that best align with their needs. It is recommended to compare different plans based on factors such as coverage, costs, prescription drug benefits, and provider networks. Consulting with a qualified health insurance agent or utilizing online enrollment tools can facilitate the decision-making process.

3. Impact on Rural and Diverse Communities

(Keywords: rural area, diverse community)

The termination of the Lasso MSA Advantage Plan has broader implications, particularly for seniors residing in rural and diverse communities. Zing Health, as a provider of Medicare Advantage health plans, has been a trusted source of coverage for populations in these areas. Seniors in rural communities and diverse populations may face unique challenges in accessing quality healthcare, and the loss of this plan might impact their ability to receive the comprehensive care they require.

Quote: "Zing Health has been committed to serving diverse communities, including those in rural areas. The termination of the Lasso MSA Advantage Plan creates a gap in coverage for these vulnerable populations."
[CEO of Lasso Healthcare]

4. Understanding the Importance of Social Determinants of Health

(Keywords: social determinants of health, diverse population)

Zing Health has consistently emphasized the significance of addressing social determinants of health, especially within diverse populations. With the termination of the Lasso MSA Advantage Plan, it is crucial for seniors to recognize the impact on their overall well-being. Factors such as access

Conclusion

In conclusion, the termination of Zing Health's Lasso MSA Advantage Plan is significant news for those currently enrolled in the plan. As of
12/31/2023, the plan will no longer be available nationwide. However, seniors affected by this closure need not worry, as a Special Enrollment Period will be provided to switch to a different Medicare insurance plan.

At [Your Company], we understand that navigating Medicare options can be overwhelming, especially when unexpected changes like this occur. Our team of experts is here to assist you in finding the right insurance plan that meets your unique needs and preferences.

As the termination date approaches, it is crucial to take advantage of the Special Enrollment Period to ensure seamless transition and uninterrupted coverage. Don't hesitate

FAQ

What should I do if I am Medicare-eligible and my health plan has been terminated?

If you are a Medicare-eligible senior and your health plan has been terminated, you have a special enrollment period to switch to a different Medicare insurance plan.

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