medicare colorado

Medicare Part D Doughnut Hole Is NOT Going Away

Medicare Part D Doughnut Hole Is NOT Going Away!



It has been widely reported by the media that Obamacare is closing the Medicare Part D prescription drug plan coverage gap or “doughnut hole”, in 10 years. According to the reports the doughnut hole “will effectively be closed”.

Medicare Part D Some Facts

But not so fast! Let’s look at the facts. In 2010 beneficiaries got a $250 check if they fell into the doughnut hole. Starting in 2011, the manufacturers gave a 50% discount on all brand name drugs for people who fell into the doughnut hole. This was a deal with the White House, which will net the drug companies billions in price concessions.

Medicare Part D Over 10 Years

In 2013, Obamacare starts to subsidize brand name drugs at 2.5% for Medicare Part D beneficiaries who hit the doughnut hole. Each year after, it will slowly increase until 2020 when the subsidy will be 25%. Generics will also be subsidized up to 75% by 2020. So according to reports, in 10 years “the doughnut hole will effectively be closed”. But beneficiaries are still paying 25% of the cost of their prescriptions. To me, this is a play on words. If you’re paying 25% for the cost of your drugs, the coverage gap didn’t go away. I suppose this is another way to justify Obamacare and the deals it has made with the Pharmaceutical companies. Reference: 1) 2) (Exhibit 7. Prescription Drug Benefit, 2020) ————— The author, John Giarratano is a Pueblo Colorado native and Independent Health Insurance Agent that specializes in Medicare healthcare solutions. He has lived in Pueblo Colorado all his life. He has over 12 years experience in healthcare insurance. If you live in the Pueblo Colorado area please call him for a no obligation discussion about your best Medicare options. Continue Reading 2 Comments

A Brand New Website Theme

We’ve been planning to unleash the new look on our website to correlate with our parent site eMedicareInsurance. Medicare Insurance is the cornerstone of our services.  As insurance agents, we help our clients by providing education as to their options.  Once they decide which options make the most sense for them, we then present various plans from multiple companies that best fits what they need in their Medicare supplemental insurance. We’ve reached the point at where we are expanding to new markets, hence the hierarchy change to eMedicareInsurance.  Don’t worry, we still live in Colorado and provide tremendous customer service to our Colorado clients, the only change is that we are recruiting agents in other markets to provide the same commitment to excellence Medicare Colorado agents provide to our clients here in Colorado. The new website has better functionality, as well.  It’s much easier to find and get in contact with an agent near you.  It doesn’t cost our clients extra money to work with our local agents.  The premium is the same whether a beneficiary goes directly to the insurance company or works with our agents.  The benefit to working with a Medicare Colorado agent is education, multiple companies and plan options, and customer service throughout the year.  Not too bead, eh? Thanks for visiting the site and help us spread the word!!   Continue Reading No Comments

Pueblo, CO Has New Primary Care Clinic

New Primary Care Clinic Coming To Pueblo In June

A new Primary Care Clinic is coming to Pueblo, CO on June 4th. Parkview Adult Medicine Clinic will be staffed by Dr Teresa Braden Dr. Caro Venable and Nurse Practitioner, Marian Heesaker.. Residency physician will come to Pueblo, CO for a 3 year program. The clinic hopes to build up to 30 residents over the 3 years. The residents may stay on and make Pueblo their permanent home after completion of the program. Most of the Residents will come from Rocky Vista University.

Full Services at Pueblo, CO Clinic

The Clinic in Pueblo, CO will have a full-range of medical services, an in house laboratory and a state-of-the-art electronic medical records system. All providers will be accepting new patients. They will operate very similar to the Pueblo Community Health Center Clinics that are now in Pueblo. There will also be easy access to Parkview Medical Center. This will give access to specialty groups, behavioral medicine programs, diagnostic imaging and community education. On-site clinical care advocate, Melissa Alcon will be assisting patients in choosing a plan that works for them. She said they will accept all types of insurance including Medicare and Medicaid. Parkview Clinic in Pueblo, CO is now scheduling for June. Anyone 15 years of age and older can call 719.595.7585 to schedule an appointment.

Location of Pueblo, CO Clinic

Parkview Adult Medicine Clinic 311 W 14th St Pueblo CO 81003 719 595 7585 by: John Giarratano Colorado Medicare for: Medicare blog post Continue Reading No Comments

FREE Instant Medicare Insurance Quotes is Live!

We have been very busy behind the scenes here at Medicare Colorado dot com. We have added agents, insurance companies, and now — a Medicare Insurance Quoting Tool!  We are currently showing the rates for the top Medicare Supplement (Medigap) plans in Colorado, including Gerber, Sentinel, Genworth, Aetna, Woodmen, and Anthem Blue Cross Blue Shield.  There are a few Medicare insurance companies that still don’t allow their insurance rates to be shown in the quote engine, so we will send their rates via email when a quote is requested. Our goal is to help find the best Medicare insurance plan for your needs.  Whether you need a Medicare Supplement, Medicare Advantage, or Part D prescription drug plan, we will help educate you on your benefits and present options to help you make a confident decision.   We also strongly believe in the spirit of competition.  This is why we represent multiple companies as agents.  This sets us apart from employees of insurance companies only representing one plan. At this time, Medicare Advantage and Part D drug plans will not be represented in the Medicare quote engine.  We hope in the near future those plans can be added.  However, if you request a quote we can send you information on Medicare Advantage and Part D to you via email. Every county and city in Colorado is represented in the Medicare Insurance Quoting Tool.   Interestingly, you’ll find different plans and rates depending where you live.  Denver will have different rates than Greeley, Fort Collins has different rates than Colorado Springs, and Lakewood has different rates than Boulder. Please call us if you have questions.  We’re here to help!   Continue Reading No Comments

May 2011: Medicare Colorado Community Meetings

May will be a busy month for Medicare Colorado with community meetings scheduled in Boulder, Lone Tree, Colorado Springs, Canon City, Longmont, Pueblo, and Broomfield. Get answers to your questions on Medicare Advantage, Part D Prescription Drug plans, and Medicare Supplemental coverage at an upcoming Medicare Colorado Community Meeting in May. Discussions will include: the ABCs of Medicare, how Medicare is different than other health care, prescription drug coverage options, Silver Sneakers benefits, how to supplement Medicare, and upcoming changes — including the new Open Enrollment Period. We will also discuss a local Medicare Advantage plan and how it works in real life situations. Please join us at an upcoming Medicare Colorado Community Meeting and help spread the word by emailing or tweeting this post. Hope to see you soon!           Continue Reading No Comments

65 and Working? 5 Steps to Prepare for Medicare

Is there a birthday more stressful than 65? Today people are healthier than ever at 65 and are living longer, which introduces new pressures for those about to turn that magic number.   Many people choose to put off retirement because of unforeseen financial burdens. The Sandwich Generation, as Baby Boomers are now being referred to, often have financial obligations not only to themselves, but to their parents, children and grandchildren.  Many have no choice but to continue working. Others are not ready for retirement from a physical and social aspect. A complaint often heard from those who have just retired is that of boredom. After working for 45 years and developing habits, it’s difficult to change gears. No matter the situation,  if you are 65 and still working, here are the 5 steps to prepare for Medicare:

1)  Talk with your employer about your health benefits

Most employers offer health insurance plans to their employees.  These plans are extremely affordable for older employees compared to individual plans.  Not only is the employer contributing to the premium, but most health insurance plans are based on the average age of the employees in the group.  If the average age in the health insurance plan is 37, then a 64 year old and 23 year old are paying the same exact rate for insurance based on the average age of 37. Those who are self-employed know that is not the case with individual health insurance plans.  Individual plans are based on your exact age and health condition, and can be prohibitively expensive at age 64. An employee usually has the option of staying on an employer health plan after turning 65, but is it the right decision?  It all depends on need and price.  Gathering the plan benefits and cost from the person who handles the health insurance benefits is the first step before making a decision. Timeframe:  5 months prior to turning 65

2) Meet with a Medicare Advisor

Medicare can be confusing.  There are many sources online that will explain Medicare options for those turning 65, but that should only be a starting point.  Make an appointment with a local Senior agency or a Medicare Insurance agentPlans and premiums vary depending where you live. A local representative will not only explain options and plans available in the county and state you live, but also have insight on trends in the industry and local providers to help you make the best decision for your needs. When meeting with a local Medicare advisor, the goal is to gather information regarding your options to supplement Medicare.  Most people choose to supplement Medicare to receive prescription drug benefits (Part D or Medicare Advantage) or lower their exposure to high-dollar medical procedures.  A Medicare Advantage plan or a Supplement Plan coupled with a Part D prescription drug plan will often provide better benefits at a lower cost than an employer health insurance plan. Once the Medicare Insurance options are compared to your current employer health plan, make an appointment with your primary care doctor. Time frame: 4 months prior to 65

3)  Visit your doctor for a check up

A physical prior to making changes to your health care is always a good idea.  While you are there, find out which Medicare insurance plans the office accepts.  Medicare Advantage plans primarily have networks which you must stay in.  It is important to verify the office accepts any plan you’re interested in. It is also important to get an alternate prescription list.  Your doctor may have prescribed a certain brand of generic high blood pressure medication based on the formulary of your current health plan.  A new plan you are considering may have a different brand of generic high blood pressure medication on their formulary, but can be just as effective.  When looking at the formulary of a new plan, it is important to know your drug needs are covered.  Even if it is a generic drug with a different name you’re used to seeing. Time frame: 4 months before turning 65

4)  Visit your local Social Security office

If you decide to drop your employer plan in favor of a Medicare plan, you must enroll in Part B in order to have access to most Medicare Advantage and Medicare Supplement plans.  Enrolling in Medicare Part B prior to the month of your Medicare eligibility will ensure your eligibility into other Medicare insurance plans.  Enrolling after your eligibility month will delay your Part B, and hence your insurance options.  For most people turning 65 in 2011, the Part B premium is $115.40 a month.  This could vary based on income and ability to pay. If you decide to stay on your employer health insurance plan, contact your local social security office to learn your options about delaying Medicare Part B.  If you have credible coverage, you can delay your Part B without having to pay the $115.40 a month premium.  But this is only true if you are on the employer plan and are still currently working.  The rules change if you retire and decide to stay on your employer plan. Time frame:  3 months before turning 65

5)  Make an appointment with a local Medicare Colorado Insurance Agent to enroll

If you made the decision to enroll in a Medicare Insurance plan, then the last step is to contact a local insurance agent to enroll.  It is important to enroll through a trusted, local Medicare insurance agent instead of going direct to the insurance company. Have you ever had to dispute a claim with an insurance company?  It’s not fun.  Any plan you enroll in will have the element of human error.  Whether the error occurs with the doctor, insurance company, pharmacy, or Medicare — errors will occur.  A local agent can help fix those errors, as the agent can better understand the problem and speak to the necessary people in the proper context to fix it. A local agent can also give guidance when needed, as the agent understands how the plan works in real-life situations within the community.  A two-minute phone call to a local agent is often preferred to being placed on hold with multiple voice-prompts and transfers before you may, or may not, get the answer you need from the insurance company. An agent will receive a commission from the insurance company upon enrolling you in a plan.  In most cases, the agent will continue to receive a commission for a set-time if you stay on the plan.  Therefore, there is a financial reward to keeping clients happy.  A local agent stays engaged with the changes to Medicare laws and plan options, as well.  As plans and premiums change, the agents adapt and will keep you up to speed with changes and provide support as needed. Time frame:  2 months before turning 65

What happens next?

If you enroll in Medicare Part B prior to your eligibility month, usually the month of your 65th birthday, then your Medicare Part A and Part B coverage will begin on the first day of your eligibility month.  If you enroll in a Medicare insurance plan during your initial coverage enrollment period, prior to the first day of your eligibility month, then your insurance coverage will also start on the first day of the month.  This is why it is important to enroll in a plan prior to your eligibility month. For more information on Medicare, keep visiting us at Medicare Colorado or follow us on Twitter.  And please help spread the word by retweeting this post or emailing it to a friend! Continue Reading No Comments

Medicare Eligibility Article from 1965

I just came across an article about Medicare from 1965

The article is written by John Troan and published in Salt Lake City’s “The Desert News.”  It’s interesting to see how Medicare was first rolled out in 1965. Anyone born before 1903 at that time were given Medicare benefits, even if they had never worked a day in their life, at no cost.   Those born after 1929 had to have 40 quarters of work history to qualify, which is still the criteria today.  The age to qualify for Medicare has also stayed the same at 65. Interestingly, members of subversive organizations were not allowed to enroll in Medicare.  Also, persons convicted of high crimes could not enroll. To read the full Medicare article and to clip a coupon for an upright giant freezer, follow this link:  Who’s Eligible For Medicare? Continue Reading No Comments

Medicare Enrollment Period is Changing in 2011

The Open Enrollment Period — or Annual Enrollment Period — will begin on October 15, 2011, and end on December 7, 2011, for Medicare Advantage and Part D plan enrollments for 2012. For the past few years the enrollment period has been from November 15th to December 31st.   As a Medicare Colorado agent, I’m doing what I can to get the word out about the change.  I imagine we will be bombarded with public service announcements and commercials announcing the change, as well, during the enrollment. Of course, there will be a few people who will not hear about the change and be “stuck” in their current plan.  So if you’re reading this, do your part to link to this post and tell friends and family of the change. The change in the enrollment period will create less confusion as January 1st approaches.  Most Medicare members who enroll in a plan will have their cards prior to the new year.  Also, if there are any enrollment “glitches,” this will allow more time to fix any problems. And from a completely selfish point of view, I actually get to spend the holidays with my family!!   Continue Reading No Comments

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