Tag: health plans

  • A Toolkit for Choosing Health Plan Options

    Preparing yourself with the proper tools helps to make any job a bit easier. If you are baking, you need the proper ingredients. When building something, you need hammers, nails and other related items. It’s the same when you are preparing for your Health Plan Open Enrollment session; or if you are a caregiver, for your person’s Medicare Annual Enrollment. The proper tools include questions you will need to ask yourself and those relating to available options.

    Be sure you compare benefits before just looking at the premium amount.

    ■ Are you considering the best plan for you and your family?
    ■ What are the annual, maximum, out-of-pocket costs for the plan?
    ■ Is the plan mostly co-pays (set amounts) or co-insurances (percentage of the cost)?
    ■ Does the plan have a proactive prevention model that includes wellness classes, a fitness program, basic dental coverage and various ways to access the provider (your doctor or healthcare team), such as in-person and phone appointments, e-visits and video visits?
    ■ Are the provider locations convenient for you (doctor’s offices or medical facilities)?
    ■ Are there multiple services offered under one roof to help you spend less time in traffic and more time with family and friends?
    ■ Are you responsible for helping others find an option that fits their needs?
    ■ Do they have Medicare? The annual enrollment begins in October, so start looking at options.

    Important question you’ll want to ask about health plans:

    ■ Do all of your providers accept Medicare and new patients throughout the year?
    ■ Does this plan have social workers or coordinators who can help you, the caregiver, meet the needs of the person you are caring for?
    ■ Is there a copay or coinsurance for this service?
    ■ Is there someone locally who you can meet with virtually or on the phone (for your convenience as a caregiver) regarding your questions?
    ■ Can they mail or email you the materials before you talk so that you have time to study the benefits and write down all your questions?

    The complexities of Medicare and a group health plan can be daunting. Preparing the right questions can be one of your most effective tools.

    KAISER FOUNDATION HEALTH PLAN INC.— HAWAII
    Medicare Sales: 808-432-5915 | www.kp.org
    For more information on resources available to everyone, visit healthy.kaiserpermanente.org.
    This information was provided by the Hawaii Kaiser Permanente Medicare Team as an educational resource.

    Preparing yourself with the proper tools helps to make any job a bit easier. If you are baking, you need the proper ingredients. When building something, you need hammers, nails and other related items. It’s the same when you are preparing for your Health Plan Open Enrollment session; or if you are a caregiver, for…

  • Medicare Health Plans & Caregiving

    With National Caregivers Month quickly approaching, let’s remember former First Lady Rosalynn Carter, who said it best in 2012—“There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”

    As a caregiver, what questions should I ask to help me assess the best Medicare Advantage (health plan) possible?

    n Is the plan comprehensive? Does it include prescription drug coverage? Does it have those extra benefits that are important for the person I am caring for? Hearing aid coverage? Prescription glasses? A gym membership?

    ∗ Are there social workers to help me navigate the system to ensure that the person I am caring for receives the care and services they need? Is there a cost for those services to understand and navigate the systems?

    ∗ Is the plan an integrated health program? Can my physician see the notes from other physicians? Are they able to see when I last filled a prescription for my loved one? If I need a new prescription, can the pharmacy notify the physician directly and in a timely manner so there isn’t a delay in medication coverage? Can the physician email an order for an X-ray, so that it’s waiting for me when I arrive for services?

    ∗ What is the Medicare Star Rating? The Centers for Medicare & Medicaid Services (CMS) uses a Five-Star Quality Rating System to track every health and drug plan very closely each year. Measures include various health plan screenings, care for older adults, member satisfaction and complaints, medication adherence and more. In mid-October each year, CMS reports the Star Ratings to the Medicare Health and Drug plans for the next calendar year.

    › If a plan receives one or two stars, it means, on average, the plan’s scores declined (got worse).

    › If a plan receives three stars, it means, on average, the plan’s scores stayed about the same.

    › If a plan receives four or five stars, it means, on average, the plan’s scores improved.

    These are just some of the questions to consider asking your current health plan provider or if you are researching other options in preparation for the Medicare Advantage Annual Enrollment Period this fall, which spans Oct. 15 to Dec. 7 in 2019.

    KAISER FOUNDATION HEALTH PLAN — HAWAII
    Medicare Sales Info: 808-432-5915 | www.kp.org
    Information provided by the Hawaii Kaiser Permanente Medicare Team as an educational resource.

    With National Caregivers Month quickly approaching, let’s remember former First Lady Rosalynn Carter, who said it best in 2012—“There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.” As a caregiver, what questions should…

  • Understand Your Medicare Options

    Medicare serves more than 60 million people nationwide. Hawai‘i has 268,000 Medicare beneficiaries in 2019 — nearly 19 percent of the state’s total population. About 45 percent of Hawai‘i’s beneficiaries select Medicare Advantage plans. The remaining 55 percent are covered under Original Medicare.

    Every year during Medicare’s Annual Election Period (AEP) — Oct. 15 to Dec. 7 — Medicare beneficiaries can add, drop or switch plans. Medicare health plans and prescription drug plans can change in cost, coverage and services every year, so look at your plan’s coverage for 2020 and compare it with other plans.

    Hawai‘i residents can chose from between six and 19 Medicare Advantage plans in 2019, depend- ing on their county. Fourteen insurers offer Medigap plans in Hawai‘i.

    When looking at other plans, check the provider’s network and formulary. Unless you are willing to find a new doctor, make sure your doctor is in that network. Every plan has a different formulary — a list of prescription drugs covered by a prescription drug plan. Make sure the drugs you are taking are in that plan’s formulary or else you will need an exception or another drug. Check the cost; prices vary between plans.

    Other Medicare options are Medicare Supplement Insurance policies, also known as Medigap policies. Original Medicare pays for much, but not all of the cost of covered healthcare services and supplies. Medicare Supplement Insurance policies sold by private companies can help pay some of the remaining costs.

    The 2020 “Medicare & You” book that comes in the mail in early October lists all the Medicare health plans and their costs. It also compares service areas, monthly premiums, out-of-pocket limits, primary care visits, specialist visits and so forth.

    Medicare beneficiaries can also compare plans using the Medicare plan finder at www.medicare.gov. Compare up to three plans at a time by sorting by lowest estimated annual costs.

    Medicare rates all health and prescription drug plans each year based on quality and performance. Use these ratings to compare plans.

    If you have limited income and resources, you may qualify for help to pay for some healthcare and Medicare prescription drug costs. If you qualify for Extra Help and join a Medicare drug plan, you will get help paying your Medicare drug plan’s costs, have no coverage gap and have no late enrollment penalty.

    Start researching now to see if you have all the benefits and services you deserve.

    FINANCIAL BENEFITS INSURANCE INC.
    1311 Kapiolani Blvd., Ste. 504, Honolulu, HI 96814
    808-792-5194 | emotosue@fbihi.com
    www.fbihi.com
    Facebook: Financial Benefits Insurance

    Hawai‘i has 268,000 Medicare beneficiaries in 2019 — nearly 19 percent of the state’s total population. About 45 percent of Hawai‘i’s beneficiaries select Medicare Advantage plans. The remaining 55 percent are covered under Original Medicare. Every year during Medicare’s Annual Election Period, Medicare beneficiaries can add, drop or switch plans. Medicare health plans and prescription…