SilverSneakers in Maine

August 3, 2015 Blog Article

The SilverSneakers Fitness program is an insurance benefit.

Through this program health insurance plans provide a gym membership to their members, usually at no additional cost. A SilverSneakers membership allows you access to more than 13,000 participating locations nationwide, and includes all the basic amenities plus group exercise classes geared specifically towards the active older adult. Members get access to amenities such as fitness equipment, pools and saunas, SilverSneakers classes designed specifically for active older adults and led by certified instructors, guidance and assistance from a “Program Advisor” and other fun social activities. If you are enrolled with one of these insurance companies all you need to do is call the toll free number on the back of the card and ask a Member Services representative to help you identify which facilities in your area are participating and how to get your SilverSneakers card. You can also order your card online at https://tools.silversneakers.com/Eligibility/GetCard

Which insurance companies offer this program?

You can check here to see if your current plan is listed: https://tools.silversneakers.com/Eligibility/HealthPlans?state=ME. If not, then keep reading…

When Can You Enroll?

Every year in October, the insurance companies release their new offerings and plans. Sometimes a plan will add this great program for their members but it does not always get communicated clearly that it is available. I can contact you in October with an updated list of the insurance plans that offer the Silver Sneakers program. But to do that I would need your permission. I do not send unsolicited email or call people unless they have asked me to call. Click here to request an update. Also, if you would like to change your insurance to a plan that would give you more options I am able to help you with that process as well. I work with all the top health insurance companies that offer plans in Maine and New Hampshire.

I work very hard to educate people about all the different options available so they understand all the benefits and can make the best decision about which plan to choose. I would be happy to sit down with you and go over these details or help you compare other health plans. When it comes to understanding the differences in these plans I work very hard to make sure my clients are well taken care of. Open enrollment for Medicare begins Oct. 15th in 2015 and with that will come the familiar deluge of promotions and conflicting advice about how much you could be saving by changing your plan. I am here to help you sort through it all. Pose your questions by clicking here.

When contacting Maine Medicare Options, you understand you may be directed to a licensed insurance sales agent.

Longer Life Expectancy with Increased Fitness Level.

Studies have shown that older adults with even a moderate fitness level have a longer life expectancy than physically inactive seniors. Moderate levels of physical activity can help reduce the risk of heart attack and stroke, lower cholesterol levels and blood pressure, improve balance and flexibility, and reduce back pain, among many other benefits. Seniors who remain physically active experience less disability and a higher quality of life than those who lead a sedentary lifestyle. In fact, the older you are, the more you need to exercise regularly.

Silver Sneakers is a safe, fun program that provides a wide variety of options for this kind of beneficial exercise, especially designed for seniors. More than 40 Medicare plans offer this benefit to seniors across the nation, with over 11,000 gyms, fitness centers, YMCAs and Curves facilities participating. If you belong to SilverSneakers, you have access to basic fitness center memberships at any participating location, as well as special fitness classes, activities, and health and nutrition education designed for older adults. Whether your goals are to lose weight, increase strength and stamina, improve flexibility and range of motion, or just to remain physically and socially active, a SilverSneakers membership can help you reach those goals.

Silver Sneakers Locations

Silver Sneakers locations are chosen for their safety, accessibility, amenities, and overall welcoming environment. They have a variety of fitness equipment available, varying by location. Members may have access to weight machines, free weights, treadmills and other cardio machines, pools, saunas, and even whirlpools. To become a certified SilverSneakers participating location, each gym has to go through an extensive process to show it is capable of providing the level of access, guidance and support that older adults need to exercise safely and effectively. Each participating location also has a trained Program Advisor who is usually available Monday through Friday to help you make the most of your SilverSneakers membership.

As well as providing equipment for independent exercise, SilverSneakers locations provide classes that can be components of your membership. These fitness classes are specifically designed for older adults, and taught by certified instructors who are specially trained in leading fitness programs for aging adults. All SilverSneakers class instructors undergo an in-person training and evaluation process. They are all CPR-certified, and are trained in the procedures to follow in case of emergency.

Silver Sneakers Classes

Silver Sneakers classes range from 45 minutes to an hour in length, vary in intensity, and offer multiple formats to fit your personal needs and interests. You can choose from Muscular Strength and Range of Movement, Cardio Circuit, Yoga Stretch, and Silver Splash (available at locations with pools). Depending on which classes you choose to participate in, you can increase your muscular strength, endurance, range of movement, flexibility, balance, agility and coordination.

Social interaction can be almost as beneficial to the health and well-being of older adults as is exercise. SilverSneakers programs offer ongoing activities like potlucks, raffles, dances, and speaker events, providing a good variety of options to add to your social calendar.

Life is too short to waste it feeling unwell, lethargic, or afraid to do things because you feel weak or brittle or unsure of your balance. Get out there and get active. You will be amazed at what you can do in and out of the gym after taking advantage of the SilverSneakers program.

SilverSneakers & Medicare

Now here comes the good news: many Medicare insurance plans cover the full cost of the SilverSneakers program! That means you get gym membership for free. Not all Medicare Advantage insurance plans offer the SilverSneakers program. Please check with your medicare insurance company to see if they offer SilverSneakers.

Would you like my help?

If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message. The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available. I am paid by the insurance companies in the form of a commission if you enroll in a plan. You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.

“My goal is to help you and I have found great joy in being able to offer my services to people who need my help.”

Medicare Enrollment – Timing

July 8, 2015 Blog Article, Medicare, Part D Prescription Drug Coverage

How to Correctly Plan Your Enrollment

Most people getting close to retirement know that Medicare coverage starts when you turn 65. But that’s not the whole story. If you want to enroll in Medicare without hassles and costly penalties, you need to know exactly when to sign up for the program you want. There are different enrollment periods, so it’s trickier than you might think.

…it’s trickier than you might think.

Not everyone needs to sign up at age 65. You may still be covered by your employer’s health care plan, for example, or if you are eligible for Medicare due to a disability, you can actually sign up earlier.

Initial Enrollment Window

Medicare has established a seven-month Initial Enrollment Period, which includes the three months before you turn 65, your birthday month, and the three months afterward. This window applies to all forms of Medicare—Part A (hospital), Part B (doctor and outpatient), Part C (Medicare Advantage), and Part D (prescription drugs).

Medicare Supplement (Medigap) Enrollment

There is a separate six-month open enrollment period for Medicare Supplement policies (also called Medigap), which begins when you’ve turned 65 and are enrolled in Part B. During this period, insurers must sell you any Medigap policy they offer, and they can’t charge you more because of your age or health condition. This guaranteed enrollment period may be crucial because if you miss this window and try to buy a Medigap policy later, insurers may not be obligated to sell you a policy and may be able to charge you more money.

General Enrollment

If you missed enrolling in Part A or B during the Initial Enrollment Period, there is also a General Enrollment Period from January 1 through March 31 each year. Waiting until this period could, however, trigger lifetime premium surcharges for late Part B enrollment, which can end up costing you thousands of dollars more. Also your coverage won’t begin until July!

Part D drug coverage may not be something you need when you first retire. But if you don’t sign up for it when you are first eligible, and later decide you want it, you will face potentially premium penalties (surcharges). For example, if you missed enrolling during your initial enrollment period and then bought a policy, a premium surcharge would later take effect if you were without Part D coverage for 63 days. And this surcharge is added to your premium for the rest of the time you have a Part D plan.

Special Enrollment Periods

There are lots of special conditions that can expand your penalty-free options for when you sign up for Medicare. And there also are what’s called Special Enrollment Periods for people who’ve moved, lost their employer group coverage or face other special circumstances. These special periods may have enrollment windows that differ in length from the standard ones.

If you’re turning 65 and still working click here to learn more.

Would you like my help?

“My goal is to help you and I have found great joy in being able to offer my services to people who need my help.”

Low Cost Insulin Alternatives

June 13, 2015 Blog Article, Medicare, Part D Prescription Drug Coverage

Medicare Part B covers some diabetes supplies, including:

Blood sugar (glucose) test strips
Blood sugar testing monitors
Insulin
Lancet devices and lancets
Glucose control solutions
Therapeutic shoes or inserts

Note: You may need to use specific suppliers for some types of diabetic testing supplies.

If you’re diabetic then you know how expensive it can be.

While Medicare provides testing supplies to monitor your blood glucose levels at no cost the drugs to treat diabetes are covered under Part D so there is a cost associated with these medications. Insulin and the syringes to administer self-injections are very expensive and often times can contribute to you entering the “donut hole” which means these drugs get even more expensive.

Blood Glucose Test Strips

If you don’t have insurance or Medicare, test strips are obscenely expensive and the cost seems to be getting worse every month. Still, used properly they can be the most powerful tool you have in the battle to avoid high blood sugar levels and the damage that can cause.

The ReliOn brand meters and strips sold at Walmart are much cheaper than the name brand strips. Currently you can get a box of 50 test strips for about $9.00. (http://relion.com/products/relion-prime-blood-glucose-test-strips-50-ct)

Type 2 Diabetes Drugs

With most pharmacies and supermarkets selling generic drugs for $4 per prescription, you can afford these effective diabetes drugs.

The most prescribed drug for people with Type 2 diabetes is Metformin. Plain Metformin and Metformin ER, the extended release form that is easier on the stomach, are both available as generics. Some generic brands appear to be stronger than others, so if you aren’t happy with the results you are getting with one brand, ask the pharmacist to try another, or if that isn’t a possibility, switch your prescription to another pharmacy that dispenses a different generic brand. The pharmacist will tell you which brand they dispense if you ask.

Insulin

Analog insulins which most doctors prescribe are very expensive. The ones I see prescribed most often are Lantus, Levemir, Humalog, and Novolog. Fortunately there are other insulins that are much cheaper which you may be able to use instead. These cheap insulins are sold at Walmart under the ReliOn brand name. Currently a vial of ReliOn Novolin is $24.88. (http://relion.com/products/?subcategory=insulin)

The pharmacy at Walmart also has a 100 count box of syringes for $12.58. (http://relion.com/products/relion-insulin-syringes-0330g-mis) as well as a 50 count box of Pen Needles for $9.00 (http://relion.com/products/relion-pen-needles-32g4mm)

CAUTION: Always consult with your doctor before switching medications.

Ken Inchausti, director of media relations, communications and public affairs for Novo Nordisk, Inc., which is the maker of Novolog warns, “There are going to be some distinctions,” he says. “… You can have variations in terms of, one NPH is constructed this way, one NPH is constructed another way.”

Most doctors recommend any time you are switching medications in any situation, it requires delicate and close monitoring and care to make sure you will have a consistent outcome. Always consult with your doctor before switching medications.

The patient information sheet for Humulin states in bold capital letters: “Any change in insulin should be made cautiously and only under medical supervision. Changes in strength, manufacturer, type (e.g., regular, NPH, analog), species or method of manufacture may result in the need for a change in dosage.” Likewise, printed on the Novolin box is the warning: “Any change in insulin should be made cautiously and only under medical supervision.” The same warning appears on the website for ReliOn.

What if the cheap insulin is not for you?

If these cheaper insulins are not an option for you for whatever reason, ask your doctor to file the paperwork to get insulin via one of the hardship programs that help people who are insulin dependent. If he cannot or will not, call the largest regional hospital in your area and ask to speak to a social worker about how to sign up for one of these programs.

If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or go to the CONTACT page of this site to send an email message to me.

Call me today and I will explain all your options and help you understand those options so you can get the coverage you need for the most affordable price.

Call me today at (207) 370-0143 or toll free at (866) 976-9038.

If you have VA coverage do you need Medicare?

June 9, 2015 Blog Article

We often get folks asking us this question. And the answer is yes. With coverage through the Veterans Administration you should also enroll in Medicare Part B and you might also want to consider adding a supplement plan.

The Department of Veterans Affairs strongly urges everyone who gets VA health care to join Medicare Part B upon reaching age 65. By doing so, you broaden your health insurance coverage and receive many potentially valuable health care benefits. Here are some of those:

Medicare Part B insurance helps pay for doctors’ services and outpatient care. It will cover you if you have an emergency and are taken to a non-VA hospital. Without Part B, you might have to pay some of those costs yourself. In future years, you also may have need to use medical providers outside the VA system. Those costs would be covered by Medicare.

VA medical care depends on an annual congressional appropriation. There’s no guarantee that the VA will always receive enough funds to provide care for all veterans.

Although the VA is not permitted to bill Medicare for the care it provides you, it is allowed to bill your Medicare supplemental (Medigap) insurance plan. If you have both Medicare and a Medigap policy, it could provide you with valuable health insurance package.

As a low-income person, you may be able to get help paying your Part B premiums through the state-run Medicare Savings Program. Go to this Medicare webpage to find out which agency in your state runs the program.

You can discuss your situation both with Social Security at 1-800-772-1213 and with the Veterans Administration health benefits office by calling 1-877-222-8387 toll-free. Don’t be surprised if they both urge you to enroll in Part B as soon as you’re eligible.

Click here to read more about when to enroll in Medicare.

Do you need additional Coverage?

Whether or not it’s a good idea for you to purchase additional health insurance may vary based on your proximity to the nearest V.A. Medical center. It is our experience that all veterans should at least consider it. If one lives close to the V.A. they can often get a Medicare Advantage plan which will allow them access to other doctors and hospitals outside the V.A. at a small copay or cost sharing amount without having to always go to the V.A. and in turn it does not effect that coverage. Some of these plans also over $0 monthly premiums which means if you do not use it then it costs you nothing. We also recommend these plans to our more rural folks to help offset the medical costs that can be incurred.

Click here to read more about the differences between Medicare Supplement (Medigap) and Medicare Advantage plans.

Not every situation is the same, but we do feel taking a look is certainly in your best interest even with V.A. medical coverage. Call me today and I will explain all your options and help you compare plans so you can choose the coverage you need for a price you can afford.

Call me toll free at (866) 976-9038. Call right now.

I look forward to hearing from you soon!

Veterans Benefits

Looking for a new Doctor?

May 26, 2015 Blog Article

5 Things to Consider When Searching for a New Primary Care Physician. (PCP)

1. Ask Around

If you know a doctor, nurse, pharmacist or dentist, ask for the names of doctors or practices in your area whom they like and trust. That can be more insightful than recommendations from friends or family. You should also consider what kind of doctor you want. Maybe you need someone who can care for your whole family or someone who focuses on women or seniors?

2. Make sure your new doctor is “In-Network”

Often times your insurance is an HMO (Health Maintenance Organization) and uses a network of doctors to provide care. Some insurance plans do not cover visits to doctors outside of this HMO network so use your insurance carrier’s physician directory. (They will provide a printed copy if you call and request it.) Or search on their website for doctors in their HMO network. If you are working with an insurance agent or broker they can also help you determine which doctors are in network and even help you change to a more flexible plan so you can see the doctor you choose.

Here are the top insurance plans in Maine and their search sites for in-network doctors. (Because doctors often add or drop plans, call the office to verify that the doctor still accepts your insurance.)

On-Marketplace Plans (Obamacare)

Anthem

Harvard Pilgrim

Maine Community Health Options

Off Marketplace Plans (Private Health Insurance)

Aetna

Anthem

Harvard Pilgrim

Maine Community Health Options

Medicare Advantage Plans (Part C)

Aetna

Anthem

Harvard Pilgrim

Humana

Martin’s Point Generations Advantage

Today’s Options

Wellcare of Maine

3. Location Location Location!

I chose my doctor based on convenience. My doctor’s office is 6 miles from my home so it’s easy to fit it into my schedule either in the morning on my way to an appointment or in the afternoon on the way back. Sort your list of in-network doctors by location and check out which one’s are nearby. Also look at their office hours – what days and times can the doctor see you?

4. Meet the Doctor

Most doctors will offer a 15 min consultation visit (generally at no charge) so you can get a feel for whether you’ve selected the right doctor. Discuss any current medications you are taking and your medical history to be sure you are on the same page when it comes to managing your health. Also ask about office policies. Ask how long it takes to make an appointment for a routine visit (it should be less than a week), whether they offer same-day appointments, and how long patients are kept in the waiting room. Once you’re a patient, if the reality doesn’t meet your expectations, consider shopping around. That’s important not only to save you time but also for your health. In practices that waste patients’ time, research shows that “patients are less likely to follow up on recommendations to prevent or manage chronic conditions,” said L. Gordon Moore, M.D., chief medical officer at Treo Solutions, a data analytics firm.¹

NOTE: While you are making the initial phone call to meet your potential new doctor and when you arrive at the office notice how they treat you and other patients in the office. They are the people who will schedule your appointments, check you in and out, give the doctor your messages, and address insurance concerns. Look for a staff that’s friendly, efficient, and respectful.

5. Remember to Factor in Technology

Many doctors now use email or an online portal to communicate with patients, which may be another important thing to ask. Electronic health records let your doctor track your medical history, share info with specialists, and monitor all of your drugs. A patient portal is a secured website that gives you 24-hour access to your health information, allowing you to book and track doctor appointments, get lab results, request prescription refills, and e-mail questions to your doctor. The government requires that health information be protected with passwords, encryption, and other technical safeguards. Still, it’s a good idea to ask how your information will be safeguarded.

Many people looking for insurance choose to meet with someone who can help them find which plan is best for them. Choosing between the many different types of insurance plans is a difficult decision. What is the best plan for you may not be the best plan for your partner or spouse.

If you would like me to come to your home and meet with you one-on-one please Contact Me. My phone number is (207) 370-0143 or call me toll free at (866) 976-9038. I am available anytime to chat. There is no obligation to you and no cost to meet with me.

Do you need help from an Insurance Agent?

¹ Source: October 2014 issue of Consumer Reports on Health.

When and How to Enroll in Medicare

May 4, 2015 Blog Article, Medicare, Part D Prescription Drug Coverage

It’s always best to start early because the rules and deadlines for Medicare enrollment can be confusing. Here’s what you need to know…

Firstly, Medicare has two parts: Part A, which is your hospital coverage and has no monthly premium for most people, and Part B which is your Medical coverage (doctor’s visits and other medical services). Part B costs $104.90 per month for most enrollees in 2015.

When to Enroll in Medicare

Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later.

You can enroll any time during the Initial Enrollment Period (IEP), which is a seven-month period which starts three months before your 65th birth month, includes the month of your birth and three months after. It is a good idea to enroll when you are first eligible (three months before your birth month) to make sure your coverage starts when you turn 65.

If you miss this seven-month sign-up period, you will have to wait until the next “General Enrollment” which starts each year on January 1st and runs through March 31. Your Medicare benefits will begin the following July 1st. You also might incur a 10% penalty for each year you wait beyond your initial enrollment period, which will increase to your monthly Part B premium by the penalty amount.

Still Working and Have Employer Insurance?

If you are eligible for Medicare and still working then you may have an exception to the penalty. If you have group health insurance coverage through your employer or your spouse’s employer, and the company has 20 or more employees, you have a “special enrollment period” in which you can sign up. This means that you can delay enrolling in Medicare Part B, and are not subject to the 10 percent late-enrollment penalty as long as you sign up for within eight months of losing that coverage. This would generally happen when either you or your spouse eventually retire.

Part D Drug Coverage

Original Medicare does not cover prescription medications, so if you don’t have creditable drug coverage from an employer or union, you’ll need to buy a Part D drug plan from a private insurance company during your initial enrollment if you want coverage. Some health plans include drug coverage and some do not. You will want to compare each of your options carefully because drug prices and co-pays can vary between different companies. If you don’t enroll in a Part D prescription drug plan when you are eligible you’ll also have a penalty. This is 1 percent of the average national premium ($33.13 in 2015) for every month you don’t have coverage and will also be added to your monthly premium at the time you enroll in a plan. So, even if you do not take any medications it is wise to consider the plans available weigh the costs of the plan with the eventual penalty you may incur.

Medicare Supplements

When you enroll in Medicare it is also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B to help pay for things that aren’t covered by Medicare, such as co-payments, co-insurance and deductibles.

“All-In-One” Plans

Instead of getting original Medicare, plus a stand-alone Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan that covers everything in one plan. These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper monthly premiums, but their deductibles and co-pays are usually higher which makes them better suited for healthier retirees.

How to Enroll

If you’re already receiving your Social Security benefits before 65, you will automatically be enrolled in Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have group health coverage through an employer that qualifies you for late enrollment without a penalty. If you’re not receiving Social Security, you’ll need to enroll either online at http://www.ssa.gov/medicare/, over the phone by calling Social Security Administration 800-772-1213 or through your local Social Security office.

Help is Available!

Finding a trusted source for help can be frustrating, with all the “noise” generated from mailers, TV ads and radio spots. My name is Todd Reagin, a Licensed Insurance Agent specializing in Medicare plans for residents of Maine and New Hampshire. I actually qualify as a Broker because I’m independent, and I represent the top Medicare insurance plans in Maine and New Hampshire.

If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or go to the CONTACT ME page of this site to send an email message to me.

Best Part: It Will Cost You NOTHING!

The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available. I am paid by the insurance companies in the form of a commission when you enroll in a plan. You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans when we meet. Everyone needs help because there are so many different plans to choose from and I want to help. I have found great joy in being able to offer my services to people who want my help.

Book an appointment with Maine Medicare Options using SetMore

Call me today and I will explain all your options and help you understand your options so you can choose the coverage you need for a price you can afford.

Call me today at (207) 370-0143

or toll free at (866) 976-9038.

Call right now. I’m waiting! 🙂

Medicare Supplement Plan G vs. Plan F

April 28, 2015 Blog Article

Are you paying more than you have to?

More often than not, Plan F is the “go-to” plan when considering a Medicare Supplement. However, Medicare Supplement Plan G is a great option that many seniors don’t know about because some agents don’t understand how it works so they don’t explain it. To make it easy, let’s start by looking at how they’re similar.

Plan G and Plan F actually have a lot more in common than your agent may think. In fact, they provide identical coverage. The only difference between the two options is the Medicare Part B deductible. Plan G does not cover the Part B deductible, which is $183 in 2017. However, there can often be more than a $200 difference in the annual cost of a Plan F versus a Plan G.

Here are some things you should know about Plan G:

You receive the same coverage with Plan G as you would with Plan F.
Plan G has fewer guaranteed issue situations than Plan A, C, and F, rewarding you with more stable rate increases.
Even though with Plan G you will pay the Medicare Part B deductible, often you will save more in monthly premiums by choosing Plan G over Plan F.

How do you know if Plan G might be right for you?

When the annual premium difference between Plan F and Plan G is more than the Medicare calendar year Part B deductible, choosing Plan G would actually save you money! If you are willing to pay the Part B deductible out of pocket, Plan G might be right for you.

Still have questions?

Give me a call at (207) 370-0143 or toll free (866) 976-9038.

I’m here to support you and help it all make sense.

Want to change plans now?

March 18, 2015 Blog Article

You don’t have to wait!

Medicare has a new way for you to get the coverage you want instead of having to wait for this year’s Open Enrollment in October!

At any time during this year you can switch to a Medicare Advantage Plan or Medicare Prescription Drug Plan that has a 5-star rating and your new insurance will take effect on the first of the following month.

This means that if you are unhappy with your current insurance you can change right now to a 5 star rated plan and you don’t have to wait. Change today and start using a top rated Medicare plan NEXT MONTH!

Plan ratings are based on member surveys, information from doctors and health care providers, and other sources. The plan ratings are scores that show the quality and performance of the plan, on a scale of 1 to 5 stars, with 5 being the highest rated plans.

If you or a family member would like to learn more call me today. There is no cost or obligation to talk with me. I would be glad to talk to you and answer Medicare-related questions in Maine & New Hampshire. You can use the Contact Me page to send me a confidential email or call me toll free (866) 976-9038 or call me direct at (207) 370-0143.

Will Medicare Pay for Protective Underwear?

February 2, 2015 Blog Article

Urinary incontinence is problematic for many seniors and unfortunately the answer is no, Medicare will not pay for disposable absorbent products (adult diapers) except while you are in the hospital or in a skilled nursing facility or if you have a home health nurse. There are other incontinence supplies which are covered such as catheters, but disposable absorbent products are largely, if not entirely, the financial responsibility of the individual.

Medicare may not cover your supplies

but the right insurance plan could…

If you are like most and dealing with urinary incontinence yourself, there are some Medicare Advantage plans that could help with these costs. Some Medicare Advantage plans offer over-the-counter benefits for non=prescription drugs and supplies. These plans offer you a monthly allowance of supplies to help manage your incontinence or other over-the-counter needs such as vitamins, cough syrup, bandages, heating pads, and other items that are not covered by Medicare or your prescription drug plan. You should talk with a plan representative to determine how the plan covers incontinence supplies.

Click here to have a representative contact you to explain which plans are available in your area.

Check other sources of assistance.

If Medicare is not a possible payer for incontinence supplies and you are left wondering, “How will I pay them?” Fortunately there are some third parties who might be able to offer you some assistance.

Veterans Administration

The Veterans Administration is one third party that provides help. While the VA does pay for adult diapers, many veterans advise caution with regards to the quality. Specifically, the standard issued brand of adult diapers is not considered to be of high quality. However if a veteran has a preferred brand such as Attends, Depend, Prevail, Tena or Tranquility it is possible to have those paid for by obtaining a prescription or statement of medical justification that explains the medical reasons for which a particular brand of adult diaper is necessary.

Medicaid

Medicaid for individuals in nursing homes will supply adult diapers and other disposable, absorbent products. Most Medicaid Waivers, which provide assistance to individuals living at home or in the community, also provides assistance typically under the category of home healthcare supplies. However, Medicaid Waivers and rules change from state to state and in some states the program may limit the brands or quantities of product available to an individual for a set period of time. Individuals on Medicaid should check with their local Medicaid office. MaineCare covers disposable incontinence products for those who are twenty-one (21) years and older are as follows:

Disposable briefs or “pull ons” are limited to 8 units per day for adults; Disposable personal pads, liners, shields, guards and undergarments are limited to 1 case (of 150) per 36 day period for adults; Large sized disposable underpads are limited to 1 case (of 150) per 36 day period for adults. Disposable non-sterile gloves are limited to 5 boxes (at 100 per box) or 500 gloves per member per 36 day period for adults.

When all opportunities for financial assistance have been exhausted and you must pay out-of-pocket for your supplies, the following may be of help.

Look for adult diaper coupons.

You can search by brand for coupons online at the following site: http://www.needymeds.org/Coupon_keyword.taf?_function=list&id_cat=29

Try using a discount prescription drug card.

Often times medical supplies as well as prescriptions are discounted. Discount cards can be ordered here absolutely free: http://goo.gl/forms/yZmOvyxPmk

Shop online.

Purchasing in bulk online can reduce the cost by as much as 50%, or even 80% over purchasing in a local pharmacy or grocery store. Furthermore products can be shipped free of charge and in discreet packaging. The lowest prices we found at the time of this writing for adult diapers and other incontinence supplies is from TotalHomeCareSupplies.com. Amazon.com also had some competitive pricing but there are shipping costs unless you are a prime member.

IMPORTANT NOTE: Keep all receipts because the total cost for adult diapers are tax deductible.

Click here if you would like to have a representative contact you to explain which Medicare Advantage plans offer Over-The-Counter benefits.

You might have to pay back some of those Obamacare Tax Credits.

January 29, 2015 Blog Article

Folks who received tax credits for a health plan through healthcare.gov in 2014 should be receiving a Form 1095-A in the mail within the next few weeks. This form will indicate the amount of tax credits you have received in 2014 and you will need to report this amount on your taxes. Make sure that the information on the form is accurate. If it is incorrect you can call the Healthcare Marketplace at 1-800-318-2596 to request a corrected form.

If you underestimated your income and received too much in premium tax credits, you'll have to pay some or all of it back.

Health policy experts say there is currently no provision in the health law that would excuse someone from repayment if an error was made by the online marketplace. This does not mean a new rule may be in place by April 15th. If you encounter a situation where you are going to have to pay back some of the tax credits you received I would suggest you wait and do not file your taxes until closer to the deadline in April in case a rule is created allowing some reduction in what you need to pay back or offering some sort of payment plan.

But there is a limit on the amount that you must pay back.

The amount you'll have to repay is capped based on your income. A couple with an income between 200 and 300 percent of the federal poverty level ($31,460 to $47,190 for a family of two in 2014) would only have to repay up to $1,500. (People with incomes above 400% of poverty — $62,920 for a couple — would have to repay the entire amount.)

There has been a lot of confusion on how to determine your income when applying for insurance on healthcare.gov. For example, Social Security Disability Income (SSDI) counts as income when figuring your eligibility for premium tax credits, but disability insurance payments received from an employer policy may or may not count as income depending on who paid the premium. You should consult a tax accountant for clarification on how much of your income is taxable.

If you discover there was an error in your premium tax credit last year call the Healthcare Marketplace at 1-800-318-2596 to change your tax credit for 2015 so the same thing does not happen to you next year.

If you need any help determining which health insurance plan is best for you please contact Todd toll free at (866) 976-9038 or by using the contact form on this site.

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