More and more of my clients are asking about coverage for vitamins and dietary supplements because their doctors are recommending vitamins and nutritional supplements, such as vitamin D and calcium.

Original Medicare doesn’t cover vitamins and supplements. However some of the insurance plans do offer coverage for them.

If you have a Medigap and a Stand-alone Part D Prescription Drug Plan

Some Medicare Prescription Drug Plans will cover certain vitamins and supplements. Every Medicare Prescription Drug Plan has its own list of covered drugs called a formulary. Check your plans formulary to see what is covered.

In general, Medicare Prescrption Drug Plans will not cover vitamin supplements.  But Part D plans that have “enhanced alternative coverage” included in their benefits may include coverage for some vitamins and supplements. Enhanced alternative coverage means the plan’s formulary contains additional items that go beyond the standard Medicare Part D coverage.

You should contact the agent who helped you find your plan to find out if it offers enhanced alternative coverage and what, if any, prescription vitamins and supplements are covered.

A plan’s formulary may change from year to year. Each year you will receive notice of plan changes and it’s a good idea to review those changes and talk to your agent if you have any questions or concerns.

Feel free to contact me if you would like to learn more about your Medicare coverage and options.  I am always happy to answer questions.

If you have a Medicare Advantage Plan (MA-PD)

Sometimes referred to as a Part C plan, Medicare Advantage plans have your prescription drug coverage built into the plan.  These all-in-one plans also sometimes offer other the counter drug benefits as well as enhanced alternative coverage.  To access the over-the-counter (OTC) benefit you usually have a cataloge of covered items, such as vitains, aspirin, cough syrup, antacidis, bandages, cotton swaps and more expensive things like heating pads or incontience supplies.

Generally the plans that offer this type of coverage give you a set dollar amount ($200 per year, $50 per quarter or $25 or $40 per month) and you simply order each month from the catalog and they ship it to free of charge.

If you would like to know if your plan includes these benefits you can give me a call at (207) 370-0143 or reach out to me via email using the CONTACT button on the menu at the top of this webpage.

And if you have any questions about this topic or need help finding a better plan or making a change, I will be happy to help you.

And it won’t cost you anything!

I do not charge anyone the assistance that I provide. I am an independent agent so I don’t work for the insurance company. I work for you. Just like your car insurance agent – I help you search all the different compaies to find the best price and the best coverage. I help you fill out the application and then turn it into the insurance company and follow up on it for you. If there are any difficulties I help you thtough them. Working with me makes Medicare easy!

Are you turning 65 and still working?  Read this.

If you need to change your Medicare Advantage plan or want to leave your Medicare Supplement or Medigap plan but are worried that you missed the December 7th deadline you can stop worrying right now!

You still have time to make a change!

Medicare’s Annual Election Period (AEP) ended on December 7th – that’s true – but there are some other less commonly known Election Periods or Enrollment Periods during the year that can help you!

This is why I tell all my clients to call me if they need to make a change – no matter what time of year – because there are many opportunities within the Medicare rules and Congress changes these rules every year.

I joke with my clients that, “You don’t have to remember everything I tell you, just remember my phone number!”  That usually gets a laugh but it’s absolutely true.  

So, how do you keep up with the changes?

You don’t have to. That’s what your insurance agent does!

Each year in the fall Medicare will mail you a copy of the Medicare and You Handbook but some of the information is a year behind because they print it before all of next year’s changes are known.

As part of my job, I keep current on all the changes within the Medicare system and the changes that effect my clients and the Medicare insurance plans and prescription drug plans.  I am always reading and researching ways to help people compare and get the coverage they need and find the best plans and best prices. 

Starting January 1, 2019 you have a new opportunity to make one change.

If you have a Medicare Advantage plan and need to change to a different plan or if you want to leave your Medicare Advantage plan and return to Original Medicare and get a Medigap plan with a new Part D prescription drug plan you can do this at the beginning of the year.

That’s right. You can still make the changes you need. But you must act quickly because each different plan has a different timeline on when the changes can be made.

The rules and deadlines are different depending on the type of plan you currently have so if you want to call me we can discuss your specific options. My number is (207) 370-0143.

If you want to read more on your own before we talk you can review these new rules on Medicare.gov.

If you would like to talk to me or schedule a meeting at your home of in my office come to my office, you can reach me at 207-370-0143 or use my simple form on the CONTACT page of this site to send me an email message.

The best part about working with me is that it will not cost you anything to meet with me or 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 – just like your car insurance agent. I get paid by the insurance companies to help you!

My goal is to help people and I have found great joy in being able to offer my expertiese and knowlege to people who need my help.

You can call me at 207-370-0143 or you can book an appointment online – it’s quick and easy!

Here are the Part D changes for 2019 that you need to know!

If your plan has a deductible it may go up. The initial Part D deductible will increase by $10.00 to $415 for 2019.

What does this mean to you?

If your Medicare Part D Rx drug plan has a deductible, you may pay more out-of-pocket in 2019 before your insurance plan begins covering your medications. For example, if you are taking Xarelto which costs about $500 and your plan has a $47 copay then the first refill will cost $462 ($415+$47) and then will be $47 each month after that until you reach the Initial Coverage Limit and enter the “Donut Hole.”

Not all Part D Prescription Drug Plans have a deductible and many plans exclude lower-cost generic drugs from the deductible, giving you coverage for these Tier 1 or Tier 2 drugs before you need to pay your deductible.

Beginning January 1, 2019 your Initial Coverage Limit (ICL) will increase from $3,750 to $3,820.

This means that you will be able to buy slightly more medications before reaching the 2019 Donut Hole or Coverage Gap.  A good rule of thumb is that if the full retail cost of your medications is less than $320 per month, you will not enter the Donut Hole before the end of the year.

Good news! The Donut Hole discount will increase 10% in 2019!

The discount you get on brand-name drugs will increase from 65% to 75%. So, if you are using a brand-name medication such as Advair which has a retail cost of around $400, you will pay $100 for your medication or if you take Lantus which has around a $300 price tag, you will pay $75 while in the Donut Hole.

What is the end result?

In 2019 you will have to spend only about $25 more to get out of the Donut Hole than you did in 2018.  The Out of Pocket Threshold (or TrOOP) has increased from $5,000 to $5,100 which will trigger entry into the Catastrophic Coverage Phase where you will remain for the rest of the year.

While in the Catastrophic Coverage Phase you will pay either 5% of the total retail cost of the drug OR $8.50 for brand-names and $3.40 for generics, whichever is higher.

If you need a more in-depth explanation of how Part D works or want to review what plans have the lowest costs and will help you avoid the Donut Hole, give me a call. My number is 207-370-0143. I will be happy to help you.

Be sure to read your Annual Notice of Change Letter (ANOC) that should arrive in the mail each year at the beginning of October to see how your plan is increasing – this may help you determine how much you need to budget in 2019 to cover the costs of coverage. [READ MORE …]

If you would like to ask a question or schedule a meeting at your home or a nearby meeting place, you can call me directly at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message.

The best part about working with me is that it does not cost you anything to talk with me to discuss your options and review the plans that are available.  My services are free to you. I am paid by the insurance companies in the form of a commission when you enroll in a plan.  You pay nothing for my help!

And you will not pay any more than anyone else and you are under no obligation whatsoever to change your plan if you talk with me.

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

Do you receive a bill labeled Notice of Medicare Premium Payment Due?

If you did then keep reading to understand what this is and how you can pay it.

NOTE: If you receive benefits from Social Security, Railroad Retirement Board, or Civil Service your Medicare Part B premium will be automatically deducted from your benefit each month.

But …what if you have postponed your Social Security?

If you are not collecting your Social Security, Railroad Retirement Board, or Civil Service benefits, but you have enrolled in Medicare Part B, or if you owe a Part D Income-Related Adjustment (IRMA) then you will receive a notice from Medicare called “Notice of Medicare Premium Payment Due”.

You can expect to receive this bill around the 10th of the month. 

Here is a sample of what the bill will look like:

You can download this official brochure here:  https://medicare.gov/pubs/pdf/11659-Understanding-CMS-500.pdf

How Can I Set up Payment for My Medicare Premiums?

By mail

Follow the instructions on your Medicare premium bill and mail your payment to the address listed on the form.

Pay Online, through your bank

• Contact your bank, or go to your bank’s website, to set up automatic payments.  Here is the Payee information you’ll need:
• Your Medicare Number (It’s the combination of letters and numbers on your red, white and blue Medicare card.
• The payee name: CMS Medicare Insurance
• The remittance address:  Medicare Premium Collection Center, P.O. Box 790355, St. Louis, MO 63179-0355

Pay By Credit or Debit Card

• Refer to the bottom portion of your Medicare bill and complete the instructions for paying by credit or debit card.
• You’ll need your credit or debit card handy so you can fill in the account number and other information.
• Mail your payment to the address above.

Sign up for “Medicare Easy Pay”

This is a free electronic payment option that auotmatically deducts monthly Part B premium payments from your savings or checking account each month.

To sign up go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4727.)  They are available 24 hours a day, seven days a week.

If you have questions about your bill or the status of your coverage call Social Security at 1-800-772-1213.

If your bill comes from the Railroad Retirement Board

The payee’s mailing address is: Railroad Retirement Board, Medicare Premium Payments, P.O. Box 979024, St. Louis, MO 63197-9000.

If you receive Civil Service retiree benefits

Contact the Center for Medicare & Medicaid Services (CMS) via e-mail at OPMMailbox@cms.hhs.gov or Call Medicare at 1-800-MEDICARE (1-800633-4227), 24 hours a day, 7 days a week.

Need Local Help? Have Medicare Questions?

I can help you!

If you changed Medicare plans this year and received a letter from Social Security saying they will no longer deduct your Medicare prescription drug plan premiums from your monthly benefit, then this blog is for you.

So, What’s going on?

It’s January and if you changed your Medicare Part D prescription drug plan or your Medicare Advantage plan during open enrollment then you may have received a bill from the insurance company instead of having the monthly premium deducted automatically from your monthly Social Security check as it had been in the past.

What do you have to do?

When you changed your Medicare Part D prescription drug plan or changed your Medicare Advantage (Part C) plan you may have chosen to have the monthly premiums automatically deducted from your Social Security check.

But now you have received a letter from Social Security saying: “We will no longer deduct money for your Medicare prescription drug plan costs from your monthly benefits.”

This letter also says, “If you have any questions about your Medicare prescription drug plan costs, please contact your Medicare prescription drug plan.”

You should do just that!

Call the insurance company’s Member Services phone number (usually found on the back of your new insurance card) and they will instruct you to either pay your monthly premium by sending in a check (possibly with a coupon book) or set up automatic electronic funds transfer from your bank account (or a debit card).

This is because your new Medicare plan may not have had time to organize the automatic Social Security deductions and so you will be asked to use another form of premium payment.

But don’t worry. You can have it deducted from your Social Security payment. All you have to do is ask them to start having your monthly premiums deducted automatically from your Social Security check.

Please note: It can take up to three months to coordinate these automatic deductions with Social Security so you will need to continue paying your monthly premiums until then to avoid any lapses in coverage.

Want to know more?

The Centers for Medicare and Medicaid Services (CMS) has published a guide entitled, “Withholding Medicare Prescription Drug Premium from Your 2018 Social Security Payment” that outlines why some people are being denied automatic Social Security check deductions as their chosen form of premium payment.

You can download a copy of the document here: https://www.medicare.gov/Pubs/pdf/11400-Withholding-Medicare-Drug-Premium.pdf

This Medicare guide says that if you changed your Medicare Advantage (Part C) or Medicare Prescription Drug (Part D) plans, “depending on when you made your enrollment decision, you may be asked to pay your new plan directly for a while. If that happens, you’ll get a bill or payment book from your new drug plan telling you the amount you owe. Your new plan will expect you to pay premiums directly until premium withhold is started with your new plan. You may need to contact the plan to let them know you still want to have premium withholding.”

They continues with the example: “You enrolled at the end of Open Enrollment and chose to have your premiums withheld from your Social Security payment. However, you just got a payment book from your drug plan saying you owe $36.50 each month, starting in January 2018.

You call the plan, and the plan says that it didn’t get your request for enrollment in time to arrange for your January premium to be withheld. The plan says it will request to have the premiums withheld from your Social Security payment starting in February. You’ll need to send your premium payment for January directly to your plan.”

So some Medicare plans may not allow Social Security check premium deduction at the start of this year, even though this was chosen by you as the payment method on your application.

Instead, you will be told to either send the first premium payment by check or submit the Electronic Funds Transfer request. When you call the Medicare plan Member Services representatives they will send you the forms necessary to request the Social Security payment option – as per the new rule.

If you live in Maine or New Hampshire and would like more answers or if you’re looking for help choosing a Medicare plan or just have some questions, I would be more than happy to help you.

You can fill out this form to send me an email message or call me.

Please note: We are only able to give general information about Medicare related issues. If you have questions about your Social Security Benefit, please contact your the Social Security Administration directly.

Still have questions or want help comparing Medicare Supplement plans?  I can help you!