Health insurance options for the disabled  

Listen to the interview and learn
All about Medicare A,B,C and D 
How to avoid getting scammed into the wrong plan 
What your health insurance options are before you’re Medicare eligible 
Why the Medicare donut hole is not so tasty
What is a Medigap policy
How to confirm that your properly insured and what to do if your not.

Interview Overview
About Transition Assist
A Massachusetts company works throughout the USA helping the retired and disabled manage changes in their health insurance through education and consultation.  Transition Assist has been successful at reducing the intimidation many retirees and disabled feel and making certain you’re educated about all the options so you can choose the best Medicare solution for your needs.

About John Connor    
John Connor has been working in the health insurance industry for the past 11 years. Prior to starting Transition Assist, John implemented Long-Term Care Insurance initiatives at Lockheed Martin, Sherwin Williams, and Halliburton. With the introduction of Medicare Advantage and Part D in 2006, John has been working with American companies to address retiree health insurance issues. He recently designed Medicare-based health insurance programs for John Deere, NSK Corp, and H.B. Fuller. The populations of these clients have given John considerable experience in working with people under 65 who have access to Medicare.

Medicare overview 
A. Part A Hospital Insurance - Most people on Medicare don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (but not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

** you may qualify for Medicare Part A if you have 40 quarters of work while having Social Security premiums withheld during that time.  If not, then the Social Security Administration will charge a premium for Medicare Part A.    

B. Part B Medical Insurance - Most people pay a monthly premium for Part B ($96.40 per month in 2009. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $96.40 per month.) If you have retired and signed up for Social Security, or if you are disabled and receive Social Security Disability payments, and have selected Medicare Part B, the cost for Part B is automatically deducted from your monthly benefits check. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Many of these supplies are considered “durable medical” items and can include orthotics, canes, crutches, wheelchairs and other items to assist with your mobility, or respiratory items to help with your breathing, for example.  

** you can decline Medicare Part B but it is not recommended as the premium deducted each month can increase each year that you decline it. So, by the time you finally decide that you do need it, it can be quite expensive.

C. Part C Medicare Advantage - This portion of the Medicare suite replaces part A and B with major private insurance from companies like Aetna, AARP, Mutual of Omaha, Humana.   These insurance companies are appointed and monitored by Medicare to make sure that the services are at least as good as Medicare.  This is an ideal program if your Doctor is in the network.  

** this is an optional program.  Many Medicare C plans also include part D ... so you could have one plan that covers both at a low premium. For some this means you could qualify for a better plan for less money.

D. Part D Prescription Drug Coverage - (also know as the drug plan)
Most pay a monthly premium for this coverage. Medicare prescription drug coverage will be available to everyone with Medicare. Everyone with Medicare can get this coverage that may help lower prescription drug costs and help protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

** you pay a monthly premium, perhaps a deductible, you pay 25% +/- of prescriptions until your cumulative out of pocket cost reaches $2700, then you pay 100% until you reach $4350.00 out of pocket.  Then you pay 5% for the medications. This resets every year.   There are dozens of options sold by private companies, probably 15 - 20 companies.

When do you qualify for Medicare if disabled
From the day you’re approved for Social Security Disability there is 24 month waiting period.  After 24 months, you are automatically enrolled in Medicare.  The Social Security Administration will send you the applications when the time is nearing for you to be put on Medicare. Be prepared to make a definite decision regarding Medicare Part B. Reversing that decision once you see what items are not covered in Part A but are covered in Part B can be a real headache. 

What options are there for the disabled from the time they apply for Disabled until they are approved?
Your insurance solutions from the time you apply for Disability until you're approved are possibly low cost no cost treatment options, (see resource area), Cobra plan or Medicaid.

When to Apply for Medicare
If retiring, you can apply up to 90 days before your Medicare eligibility begins, based on your age.  Be prepared to make a definite decision regarding Medicare Part A and Medicare Part B so there are no mistakes setting those portions up properly.   

All about Medicare insurance supplements and how they may help you 
The Original Medicare Plan pays for many health care services and supplies, but there are many costs it doesn't cover. To help cover extra health care costs, you might want to buy a Medigap policy. Note: Neither the Social Security Administration nor Medicare cover costs for a Medigap policy.

A Medigap policy is health insurance sold by private insurance companies to fill "gaps" in the Original Medicare Plan coverage. Medigap policies help pay your share (coinsurance, copayments, or deductibles) of the costs of Medicare-covered services and some policies go further and cover certain costs not covered by the Original Medicare Plan. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will both pay their shares of covered health care costs. Insurance companies can only sell you a "standardized" Medigap policy. These Medigap policies must all have specific "core" benefits.

Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You or someone on your behalf (like a former employer or union) will have to pay the monthly Medicare Part B premium. You will also have to pay a
premium to the Medigap insurance company.

In most states, you may be able to choose from up to 15 different standardized Medigap policies (Medigap Plans A through L). Medigap policies must follow both Federal and state laws.

**Medigap Summary: Covers all co-pays associated with Part A and Part B,  so if your Medigap premium would be less than your copays you save money, and is applicable for those on Part A and Part B. 

What this all boils down to is you have three options for adequate health care

1. Take Medicare Part A and Part B and do nothing else
2. Choose a Medicare Advantage Part C plan 
3. Stay with Part A and Part B and get a Medigap plan to cover your co pays

To help you choose the best option and simplify this critical decision, it pays to talk with a Transition Assist benefit specialist to
 
      get updated on the new rules and regulations
       understand your options 
     learn if it's possible to save money 
       discover if there is a better plan that will cover your needs

Transition Assist is a trusted source for heath insurance information that will help you avoid selecting the wrong plan, overpaying for health insurance and avoid getting caught in a health insurance scam.   

So that Transition Assist can best address your health insurance needs,  both today and in the future and send you updates please take a moment to complete all the questions below.

Must Be Medicare Eligible Now Or Within 90 Days To Quality For A Benefits Review
Name:
Email:
Gender:	Choose Male Female
Phone :
State:
Date of Birth:
Have you been approved Social Security Disability?
What is your Medicare eligibility date?
Please tell me,  what is your most pressing health insurance concern and what information  would be most helpful to you (This Is Optional)

     This really is a free benefit review from the same team that has implemented major insurance initiatives at Lockheed Martin, Sherwin Williams, Halliburton John Deere, NSK Corp, and H.B. Fuller.  

My goal is to restore your peace of mind that you're properly insured and isn't adequate health care something we all deserve?

Brian Therrien 

To schedule your Medicare review click here

Resourses Mentioned
A. Low Cost And No Cost Treatment Options
B. Medicare.gov 
C. The How To WIN Your Disability Mini Course Is Here!!!