Many of the major providers of Virginia Medicare Advantage plans have decided to withdraw from the market in 2010. These are "private fee for service" plans available to those covered under Medicare. Funding to these companies has been cut causing a number of companies to make the business decision to no longer offer these plans. More companies are likely to follow suit after 2010 in light of efforts by the government to discontinue these plans. Over 10 million consumers had opted for these plans and many of these will be forced to change insurance plans as their plans expire at the end of 2009. There are essentially two options for those who are losing coverage:
* Move to another Virginia Medicare Advantage plan carrier - Despite the withdrawal of a number of companies, some major insurers have decided to continue offering plans. There are many good plans with exceptional benefits remaining. The annual election period from November 15th to December 31st of each year allows customers to switch plans with no medical underwriting. The premium for these plans are not based on age or health conditions, therefore, these plans are competitively priced.
* Return to original Medicare - Virginia Medicare Advantage customers who are losing their plan can always return to the "tried and true" system of original Medicare along with a Virginia Medicare supplement or Virginia Medigap plan. Although these plans are priced based on age, a good plan will pay the deductibles and 20% coinsurance that Medicare does not pay. This means that most medical expenses are covered in full, unlike the Virginia Medicare Advantage plans that have co-pays and other out-of-pocket expenses. Here is the best part-there is no medical underwriting for a customer that is losing their advantage plan. Even those with uninsurable conditions are guaranteed the plan of coverage with the insurer of their choice. For those who have not been happy with Medicare Advantage, this is the perfect opportunity to return to Medicare and the most competitive Virginia Medicare insurance supplement plan available.
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How to Stay Out of the Dreaded "Donut Hole" on Your Part D Virginia Medicare Prescription Drug Plan
By Mark W. Brooks
Now that we are several years into the Part D prescription drug program, Virginia Medicare customers have found many reasons to be dissatisfied. The biggest fear is ending up in the dreaded coverage gap commonly known as "the donut hole". Simply put, your plan stops paying once a certain amount, just over $2800 for 2010, has been spent on prescription medication. It is extremely important to understand that the full retail price of medicine is used to calculate the amount towards the coverage limit, not the co-pay amount that your plan provides. With this in mind, it's easy to see how just a couple of brand name medications could put you over the limit. Consumers have become savvy in finding ways to stretch their benefits and thereby beating the system. Here are some techniques that everyone covered by a Part D plan should consider:
o Speak with your physician about any of the brand name medications that you take to find out if there is a generic alternative medication that would work as well for you. Lower cost generics and alternatives can save hundreds or thousands of dollars.
o Speak with your physician about increasing the dosage of your medication and using a pill splitter. Since most Part D plans charge a co-pay, regardless of the dosage, splitting pills can stretch a one month supply to last two months. This can be done for both brand and generic drugs thereby cutting the number of times you get refills in half.
o Do not use your prescription drug plan for low-priced generic drugs. Many pharmacies are offering these medications at extremely low prices, however, presenting your drug card allows the pharmacy to file a claim with your insurer and the full retail price is applied towards your coverage limit. The low cost specials being offered on generics is available to anyone with or without a prescription drug plan. TIP! In order to avoid confusion, it may make it simpler to purchase the low cost drugs from one pharmacy which never has your coverage information and purchase the brand names from another pharmacy with which you use your Part D plan.
o Take advantage of lower prices by using mail order and 90-day supply offerings by your pharmacy and prescription plan. Some may provide buy two, get one free specials or even give you the generics for free.
o Make a year-end purchase of a 90-day supply on any medication you take regularly if you are not currently in the coverage gap. This will allow you to be ahead for a few months of the new year when your coverage limits start over. This will be of tremendous help should your medication usage or cost increases in the new year.
o Ask your physician for samples. They are usually glad to help if all else has failed and you ended up in the gap.
Much time and effort is spent trying to pick a plan based on the premium cost and plan features, however, using the techniques described in the article can potentially save as much or more money than the plan itself.
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Mark Brooks specializes in affordable Virginia Medicare Insurance.
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Should I Buy a Virginia Medicare Supplement Plan Or a Virginia Medicare Advantage Plan?
By Mark W. Brooks
Individuals covered by Medicare Parts A (hospital charges) and Part B (medical and physician charges) should not rely on Medicare alone. Medicare has deductibles and only covers 80% of approved expenses after the deductible. A large, catastrophic medical expense could leave you with hefty medical expenses to pay off. There are two options that you can use to limit these large, potential losses. Let's examine each one in detail:
o Virginia Medicare supplements - also known as Virginia Medigap coverage, these plans pay most of the expenses or gaps left unpaid by Medicare. The government standardized Medicare supplement plans years ago so that the benefits would be the same from one insurance company to another. There are currently 10 plans available with the letter designations A-J. The most common plan is F and is offered by practically all Medicare insurers.
Not all Virginia insurance companies offer all 10 plans. Plan F covers both the Part A and B deductibles as well as the 20% coinsurance gap left by Medicare. For the individual that would like to have all doctor visits, hospital charges and other medically necessary testing and expenses covered in full, a medigap plan would be the best choice. Most insurance companies in Virginia, such as Mutual of Omaha, offer plans based on age and medical underwriting is required to be approved for a plan unless you are applying during an open enrollment or guarantee issue period of time.
It is important to note that underwriting is not required if you apply for coverage within 6 months of your 65th birthday or enrollment is Part B of Medicare, whichever comes later. There are also special guaranteed enrollment periods in situations where another coverage is lost at no fault of the insured. Individuals that require more medical attention seem to be better satisfied with a Medicare supplement plan although these plans provide little or no coverage for routine dental, vision, hearing or preventative care.
o Virginia Medicare Advantage Plans - While these plans are part of Medicare (Part C), they work drastically different than original Medicare paired with a supplement plan. First of all, no claims are submitted directly to Medicare. Medicare Advantage plans in Virginia are private-fee-for-service plans and you deal directly with the insurance company. The Virginia Medicare advantage plan is responsible for handling all of your medical claims. These insurers are being subsidized by Medicare since they are paying your medical expenses.
There are some advantages and disadvantages of these types of plans. One advantage is the low premiums. Most plans cost significantly less than a traditional Medicare supplement plan-some even have a $0 premium. There is also no medical underwriting required to purchase one of these plans. Although the plans must cover all medial procedures normally covered by Medicare, most plans provide some additional benefits for dental, vision and hearing screenings as well as preventative check-ups.
These extra benefits vary widely from one insurer to another. The one major disadvantage of these plans are the co-pays and out-of-pocket expenses left for the insured to pay. While the out-of-pocket expenses are limited to a maximum amount, these expenses can be considerable compared to having them covered in full by a traditional supplement plan. Simply put, these pans work best for those individuals in good health and need very little medical attention.
Which plan is best for you? That all depends upon the amount of medical expenses that you incur each year. If the out-of-pocket expenses in a Virginia Medicare Advantage plan cost you more than the premium on a traditional supplement plan in a given year, you would have been better off paying for a Virginia Medicare supplement insurance plan. This is an important decision which deserves valuable consideration and the advice of an experience broker.
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