COBRA and Medicare: Know the Basics

Over the last few weeks, we have seen a handful of people who have unknowingly made a crucial Medicare mistake.  Currently, there seems to be plenty of confusion surrounding Medicare & COBRA. In fact, most employers don’t know whether to suggest their employees’ COBRA or Medicare or a combination of both. Very few people know that COBRA & Medicare don’t go well together.

In case you’re considering an enrollment in COBRA & are also interested in the benefits offered by Medicare, it’s crucial to know how the eligibility of your Medicare will influence your COBRA coverage.  Without any doubt, COBRA can be a great option for the right individual. COBRA is a health-care policy which offers coverage for individuals when they’re leaving an employer coverage which has over 20 employees.

Among the major challenges with the coverage under COBRA is that although a person can stay with COBRA even after the age of 65, it fails to meet all the guidelines under Medicare.  The thing is, most companies avoid mentioning to their staff that by registering for COBRA their Medicare policy coverage might be delayed for as many as 15-months & these delays may result in Medicare penalties which apply for the lifetime if a person misses their timeline.

SEP and Medicare:

SEP occurs whenever a person participates in Medicare past the age of 65. Typically, SEP happens when a person leaves their employer plan. For qualification, your company completes a form which states you won’t be working anymore & that your insurance period will be terminating. Here, you’ll become eligible for Medicare with all the rights that first-time joiners have.  But, after the termination of COBRA coverage, there is nobody to finish this paperwork mentioning that you’ll be leaving the employer coverage since you’re technically terminating a COBRA plan. So, you won’t be eligible for SEP. Get an Aetna supplement plan for 2019 at

Now, as long as you first participate in Medicare, you’ll be able to get COBRA coverage. Even in case you decide to purchase Part A only.  Not having enough information about how the eligibility for Medicare works, irrespective of whether you’re enrolled or not, might affect how the other benefits & also increase your final costs if you fail to get the appropriate advice.

Medicare Hopes to Increase Coverage for Depression

Depression is among the major issues for seniors across the US. But, in most seniors, the disorder has gone undiscovered because, despite Medicare, the required measures weren’t covered to address the mental health requirements.  Already, you can find people who are being treated for depression under Medicare need to pay huge out of pocket costs. Seniors with Medicare Supplement Plans can manage the cost better, however, those without this insurance often tend to skip the treatment.

Medicare is hopeful to rectify this scenario with better policies which rely on preventative measures & early detection of the disease as compared to just treatment after the patient is diagnosed.  In addition, depression may last longer in senior citizens as compared to other age groups. It might also increase the risk of cardiac disorders by two times in seniors. Many times depression tend to reduce the willingness, or even a person’s ability to recover from an injury or sickness.

With the new policies, the government is hopeful that covering things like screenings & early-detection tests under Medicare can help reduce the number of undiagnosed patients. Also, it’ll help people suffering from the disease get the required help. In case you’ve questions about supplemental insurance or even Basic Medicare coverage for mental disorders, you must communicate with the insurance provider or an experienced professional who can tell you exactly which policy you must choose for your requirements.

Healthcare is among the most debated topics on all major news-channels across the country. However, the majority of these debates & conversations transform into political   The truth is, Medicare policy is not able to offer the required range of services which some seniors want. The healthcare requirements and the economic position of each person are different. Each person has equal rights for getting all of the info on every option present online as well as offline.

When picking a 2019 Aetna Medicare plan, always ask yourself these questions. Does the policy provide you with all the coverage you require? What additional options you can explore through a Medigap or Supplemental plan? Does the Supplemental plan make financial sense & fulfill my particular needs? The above are some of the most important questions you want to ask yourself prior to picking the right Medicare or Medigap plan.

Services That Medicare Does & Does Not Cover

Services Covered by Medicare:

  1. Therapy

Although Medicare does cover physical, speech & occupational therapy, we saw them covered up-to a particular amount only. But, not long ago, Medicare has raised the capital amount on therapy & now you can expect them to pay a bigger amount.

  1. Chemotherapy

Very few individuals are aware of this, however, chemotherapy can be covered by Part B Medicare. As chemotherapy need to be administered by health-care experts, it’s covered under Part B & not the prescription coverage.

  1. Preventative Services

You can see some preventative services which are a component of the Affordable Care Act. A person needs to pay nothing for taking advantage of these services as long as they’re in line with the guidelines.

The services include:

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Different cancer screening tests

Screenings of Cardiovascular disease

Glaucoma exams


Diabetes screening (a person can participate in up-to two screenings per year)

Obesity counseling & screening


  1. Limited Travel to a foreign country:

Medicare may cover medically essential ambulance transportation if a person is in a foreign hospital provided he/she requires admission to a medically essential service covered under part A Medicare. So although Medicare might pay for certain services outside the country, most of them won’t be covered. So, it’s best to know exactly what is covered by Medicare and what’s not prior to traveling overseas.

Services Not Covered by Medicare:

  1. Chiropractic Care

Although, if essential, manipulation of the spine might be covered by Medicare to correct your spine in case the bone changes its position. But, you’ll need to pay for other tests or services suggested by the chiropractor (for example massage therapy and X-rays).

  1. Cancer screenings That Are Too Frequent

For instance, Medicare compensates for 1 clinical breast examination every 2 years. If a woman is at greater risk for vaginal or cervical cancer, Medicare will pay for these screenings on a yearly basis.

Note: Most physicians overlook this rule, thus whenever they suggest you a screening during each of your yearly visits, you’ll need to cover the additional exams.

  1. Services available at particular health-care providers:

Though Medicare pays for medically essential services, it won’t cover treatment from a particular hospital or doctors.

  1. Vision, hearing & dental:

Neither Medicare nor Medicare Supplement Plan pays for medically essential vision, hearing & dental services. But, it won’t cover vision, hearing & dental services that are non-essential (including annual check-ups, eye-wear, hearing aids & dental fillings). You might want to consider Medicare Advantage coverages for these.

Purchasing a Medigap Plan in Missouri

Buying a Medigap Coverage might seem like an overwhelming process in case you are not familiar with it. In order to be eligible for Medicare Supplement Plan, you need to be at least 65-years old. People with a Medical disability may also apply for this plan. Additionally, an individual needs to be enrolled in Parts A Medicare and Part B Medicare with the government.


As of now, you can pick any one of the 10 available plans (A- N). It’s necessary for you to request an overview of this policy from your broker in order to understand what is covered under each plan. Also, you must note that not all the plans will be offered by every insurance agency. Out of all the plans, Medicare Plan F seems to be the most popular & comprehensive among seniors eligible for Medicare.


The rest of the supplemental plans tend to cover only a few of the Medicare gaps & hence you might experience more out-of-pocket expenditures with them.


Medigap Plans in Missouri:


The thing which makes Missouri unique from the rest of the states in the country is the annual anniversary rule. Every year, a person is able to switch their supplemental plan in the state without having to worry about medical underwriting. So, you’re free to change your current coverage and pick an alternative one to lower your premium each month.


The yearly anniversary will be unique for each person and will occur on the date when he/she enrolled in the Supplemental coverage.


Supplemental Plan for people under the age of 65 who are disabled:


The Missouri state lets people who’re enrolled in Medicare disability to purchase a Supplement or Medigap policy. Similar to people above celebrating their 65th birthday, you need to enroll while the period for open enrollment is still on in order to become eligible for the policy.


It’s vital for people who’re disabled to get enrolled during this period. Otherwise, they might not be approved for the coverage later on if they’re required to be medically under-written. The yearly anniversary rule is also applicable for those on disability.

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In case you’re considering a supplement coverage, it’s wise to consult an independent agent. Since they’re not tied to a specific insurance agency, they might help you in the process of deciding the best supplement coverage for yourself.


This way, you should have face any issues when it comes to selecting the right supplement coverage.


Will My Medicare Cover Mammogram Screenings?


Mammogram screenings can be very crucial for women, particularly after the age of 40. Mammograms capture x-ray images of a woman’s breast for checking the signs of breast cancer, if any. Mammograms although might not fight breast cancer, however, they help save lives by identifying the signs of cancer to the earliest.


Identifying breast cancer in its early stages with this test also means that a lot of women who are being diagnosed can avoid mastectomy. If caught in its initial stages, it is possible to eliminate localized cancerous cells without requiring mastectomy (removal of breasts).


Mammograms: Things to Remember:


  1. Can be a lifesaver. Identifying the signs of cancer in its early stage can minimize the odds of death by 25% to 30% (sometimes even more).


  1. Since the test doesn’t take much time, it can be completed quite quickly without much discomfort.


  1. The screening is proven to be safe with a very minimal amount of exposure to mammogram radiation.


The screening can be quite expensive, hence women above the age of 65 who are eligible for Medicare should know if Medicare will cover the costs of this exam and if yes, how much will they need to pay out of their pocket.


Does Medicare Cover Mammogram Screenings?


Yes. Medicare not only covers the screenings but also offers the annual exam at no cost whatsoever. But women requiring a diagnostic mammogram will need to pay twenty percent of the final cost. Talking of the exact amount, it can be difficult to answer since every healthcare provider offering diagnostic mammograms is free to charge their own price.


Will My Medigap Pay for Mammogram Tests?


Medicare Supplement Plans can pay for the remaining twenty percent that is not covered under Original Medicare.


Part B copays, coinsurance & deductible can be covered by Plan F & C. This way, you won’t need to pay any additional amount besides your monthly premium for Supplemental coverage. Be sure to compare the Medicare Supplement plans parallelly to know which one covers copays & coinsurance for Medicare Part B.


Will My Medicare Advantage Plan Cover Mammogram Screenings?

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No. Mammograms won’t be covered by Medicare Advantage Plan. Although you’ll still be able to take the free preventive test; since MA plans aren’t standardized, it becomes your responsibility to research how each insurance company covers diagnostic mammogram tests. Although everything covered by the Original Medicare will be covered by MA plan, still the pricing may vary from one insurance company to other.


Medicare Advantage Plans: The Good and the Bad

The Good:


1: You can easily pack your health-care benefits inside a single plan.


Quite a few Advantage plans cover your hospital and doctors insurance along with prescription drugs. Also, these plans feature their individual deductibles, & co-pays.


2: Coverage for Vision, Gym, Hearing and Dental services


As we’re already familiar with, Medicare simply pays for medically essential health-care for dental, hearing & vision. Most Medicare Advantage coverages pay for the above services at an additional price. Also, they can cover stuff like glasses, dental fillings & hearing aids.


3: Rules are less stricter


As opposed to a Medigap or Medicare Supplement plan, any senior above the age of 65 can participate in a Medicare Advantage policy without having to prove they’re healthy.


After a period of 6 months, Medigap plans may ask the enrollee about their various pre-existing health conditions. Based upon your particular scenario they might charge a person more or reject to offer any type of coverage. You won’t need to worry about any rejection when it comes to Medicare Advantage Plans.


The Bad:


1: Network restrictions


The Advantage plan primarily acts similar to PPO’s or HMOs. As opposed to Normal Medicare where a person can visit any hospital or doctor who accepts Medicare, Advantage coverage requires a person to only see a doctor or hospital within the network of the program.


2: They change every year

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Due to how these plans are regulated, you can see changes in such coverages more often. Specifically, in some areas, you can see the Advantage plan dropping health-care expert & health-care expert dropping the Advantage plan. This might add a lot of frustration to policyholders since the moment the relationship between insurance agency & the doctor ends, you’ll have to find another doctor who might cover your insurance.


3: Maximum out-of-pocket expenses can be high on most plans


The maximum out-of-pocket expenses can be $6,700 for most Advantage Plans. Thus, they might quickly empty your savings when you fall sick.


As listed above, there are a number of things which you may want to take into account before making your final choice. So, it is essential for you to know exactly what your requirements are and consult with an expert who can help you locate the best plan based on your current financial state.

Are Telehealth Services Covered by Medicare?

Understanding Telehealth:


Telehealth is basically the utilization of telecommunication & electronic info in order to aid health care at a longer distance. In addition, telehealth may refer to the technology used by doctors in order to enhance the health care of their patients.


Telehealth and Medicare:


For Medicare enrollees, a number of e-health services will be covered just like in-person appointments. In general, Part B of Medicare covers live telemedicine & telehealth services which can be compared to office consultations or visits. Medicare states they need to be using a 2-way telecommunication system by the health-care professional which is interactive and located elsewhere. A few regions have additional guidelines for coverage. As long as your service satisfies all the requirements, it will be treated similar to in-person health-care services. Also, you must note that a few Medicare Advantage policies provide further e-health coverage which includes things such as 24hr nurse-lines.


Telehealth Pros:


For seniors who find it difficult to move out of their house, telehealth offers a number of benefits. It allows a person to communicate with a specialist without requiring to make an expensive or strenuous trip. This is invaluable for seniors who are homebound with mobility issues. Besides, it lets them access health care even in the most isolated areas which might otherwise require traveling a large distance for receiving even a basic health-care service.


Telehealth can also be beneficial for those with chronic issues that have symptoms & health info which must be monitored. For instance, a senior suffering from a disease like diabetes might use an app which lets them monitor their blood-sugar levels each day. Likewise, physicians can pay attention to their patient’s health & stay informed about their progress.

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Telehealth Cons:


Medicare Supplement plan gOne of the biggest con when it comes to telehealth is that it does not offer hands-on tests which a doctor gives their patients. As the appointment is organized through online or video chat, a diagnosis is largely made off what the doctor is able to see & the symptoms reported by the patient. In a few cases like flu or other basic diseases, this might not be a concern. However, if a patient requires diagnosis that is more complex, the ability to actually test the patient physically can be quite beneficial. No doubt, telehealth should never be seen as a replacement to an emergency service.


Medicare Surveys: Do They Help?

A number of health care systems utilize the results of surveys for future planning. It allows them to understand the areas where they need to improve & make healthcare better. Some of the points included are how easy it is for the person to get the required care, the final cost of the care, quality of customer support, etc. Basically, you can expect everything that helps make health care plans work in this surveys. So as long as you answer honestly, they will know what’s great as well as what’s not through these surveys.

Star Ratings

Each Medicare plan features a Star rating that goes from 1 to 5. This tells you how was their performance during that specific year. So, your surveys play a crucial rule in determining this ratings.  You can see star ratings being posted on the company website so that each individual can identify the plans with the highest ratings. When you’re picking a policy, these Star ratings play a bug role since they help you identify the plans with the highest ratings.

The more the better

In case Medicare doesn’t receive enough responses from their surveys, it might not post the final results. This will make it further difficult for you to pick the right plan. This is another reason why the number of responses matters for each survey.

Huge Impact

Whenever someone completes a survey, he/she’s doing a great job not only for himself/herself but for the overall health care industry. The basic idea behind surveys is to make things more efficient and better for common people.

Know its ACTUALLY s survey

Enroll for a 2019 supplement plan here:    All of us get junk mails every now and then. So, it’s important for you to identify that it’s a real deal.  Each of these surveys features a cover letter. The cover letter includes a 1-800 number that the receiver can call for knowing who sent that particular survey. In addition, there are specific times of the year when you will receive these surveys. Hence, in case someone sends you a survey that does not come on any of these timelines, then you may want to contact the sender prior to completing the questionnaire. You will be receiving most of these Medicare surveys related from CMS or the Center for Medicaid & Medicare Services – the government organization which monitors how the Medicare plans across the United States are working.

Medicare and Long-Term Care: Things to Consider

Medicare is undoubtedly a crucial health-care plan offered by the US government for helping seniors get the health care which they deserve & need as they age. Medicare covers various medical requirements quite well, however one area which it fails to address is long-term care.


There seems to be a common misconception among most individuals that long-term medical care costs are covered under Medicare but the fact is that it offers little to no protection in these cases.


When it comes to Medicare, is primarily focuses on offering health-care for acute requirements. In short, Medicare will help if a person has an accident or disease which requires a care service or a visit to a hospital or doctor, and the person’s health is likely to be enhanced as a result.


But, in case the health situation of a person deteriorates to a point where they require help with activities of day-to-day living which includes bathing, eating, continence, dressing, transferring, and toileting, it becomes a long-term custodial care where a Medicare is cover might not be enough.


Medicare only pays for the cost of the skilled-care nursing facility for initial 100 days (the person is paid in full for the first 20 days only), & pays for visits by home health professionals only in case of skilled care. Basically, a skilled care is one of those situations in which the health of a person is expected to get better day by day. This includes IVs, speech or physical therapy, etc. Once the progress comes to an end, the case becomes custodial where the assistance provided by the Medicare ends.


Remember that on average, Medicare only pays for nursing home care for the initial 23 days only days as per the 2001 Nursing Care Source- Book.


So what’s the reason Medicare doesn’t want to pay more when it comes to long-term care? The fact is, the US government just can’t afford it. The costs of long-term care are one of the highest medical expenditures which any individual may face in their life.

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As seniors age & require more custodial-care, it’s obvious there won’t be sufficient funds from either federal or state government in order to properly pay for the required care.


Thus, both the federal & state governments want to motivate more and more seniors so that they are able to take responsibility and pay for their own long-term care requirements & ensure quality care is received wherever it’s required.


How to select Medicare Supplement plans?

You have a couple of decisions when the time looks for you to choose in Medicare Supplement plans. For a couple of individuals, Medicare enrolment is modified, while for other individuals, it may depend upon when and how they wind up qualified.

There are two or three conditions where Medicare enrolment may happen normally:

  1. Tolerating retirement benefits:
  • You will normally be enrolled Medicare Part A and Medicare Part B if that you consent to acknowledge Medicare Part B at the time you consent to acknowledge retirement benefits. This just occurs if that you’re starting at now gathered Railroad Retirement Board or Social Security retirement benefits when you turn 65.
  1. Tolerating powerlessness benefits:
  • You will be normally enlisted in Medicare Supplement plans which are Part A and Part B together with the accompanying two years of powerlessness benefits. This occurs if that you are under 65 and tolerating certain insufficiency benefits by Social Security or the Railroad Retirement Board. The extraordinary case to this is if that you have the end-stage renal infection (ESRD).
  • If you have ESRD and had a kidney transplant or need typical kidney dialysis, you can apply for Medicare. Besides, if you have amyotrophic horizontal sclerosis, you will thus be chosen in Medicare Supplement plans around a similar time that your powerlessness benefits start.
  1. Medicare Part B late-enrolment discipline:
  • If that you don’t consent to acknowledge Medicare Part B when you are first qualified, you may need to pay a late selected discipline for whatever period of time that you have Medicare Supplement plans. Consequently, your month to month intend to Part B premium could be 10% higher for each entire year time period that you were met all requirements for Part B. Be that as it may, the technique didn’t take it. This higher premium could be in fact for whatever period of time that you are chosen in Medicare Supplement plans at


  • For the people who are not subsequently enrolled, there are diverse Medicare enrolment periods in the midst of which you can apply for Medicare. However, there are late enrolment disciplines for not consenting to acknowledge Medicare Supplement plans when you are first qualified.


One exception is if you can put off Medicare Part B selection without paying a late-enrolment discipline if that you have social insurance coverage through a business wellbeing plan or through your buddy’s administration plan. This social insurance coverage must be established on current business, inferring that COBRA or retiree benefits aren’t seen as present boss medicinal services coverage.