Medicare

Post related to Medicare health insurance, Part A, Part B, Part C, and Part D prescription Drug Plans, Medicare Advantage and Medicare Supplement plans.

Medicare and Medi-Cal Confusion At Covered California

October 26, 2017 By Kevin Knauss 2 Comments

One of my clients received a letter from Covered California notifying her that her monthly premium would jump from $63.64 to $993.45 per month. The letter casually stated that the premium increase was 147.2%. The client is a household of two people one eligible for Covered California and the spouse is on Medicare. When I went through the renewal procedure on the updated Covered California website, I had to re-confirm that the spouse was on Medicare. The final eligibility results were that the Medicare spouse could select a plan at the full premium amount while the primary applicant could select a plan with the monthly subsidies.

Navigating The Medicare Maze Of Options

June 7, 2017 By Kevin Knauss 7 Comments

This high level overview and will not address every situation that a Medicare beneficiary may find them self in. This short primer is meant help you understand the different parts of Medicare and how they work, or don’t work, together. The following information can also be found in the Medicare and You Handbook.

Medicare Advantage Health Plans As Blueprint For Replacing Affordable Care Act

April 21, 2017 By Kevin Knauss 5 Comments

The similarities between Medicare Advantage plan and the ACA plans through the Marketplace are straight forward. Individuals are enrolling in private ACA health insurance and the federal government is subsidizing part of the cost of the health insurance to make it affordable. One of the main differences is how the federal government reimburses the insurer. Medicare beneficiaries receive an indirect subsidy to purchase a Medicare Advantage plan according to county they live in and based on historical health care cost data. Individuals and families enrolling in a health plan through an Affordable Care Act exchange receive a subsidy based on their income.

Comparing California Health Insurance Companies

October 7, 2016 By Kevin Knauss Leave a Comment

The Department of Managed Health Care (DMHC), who regulates most of the individual and family plans offered through Covered California, has developed a website to allow consumers to compare health insurance companies. The Health Plan Dashboard website does not assign any performance review ratings. But it does give consumers a high level view of some of the data collect on the health plans such as enrollment, complaints, and enforcement actions for medical, dental, and vision plans.

Removing a household member from Covered California

March 29, 2016 By Kevin Knauss 5 Comments

There are a variety of reasons why a household member needs to be removed from a family’s Covered California account. In some unfortunate instances a family member has died. Other times a young adult ages-off the plan or a spouse gains other coverage such as Medicare.

Mixing health plans from Covered California, Med-Cal and off-exchange

September 21, 2015 By Kevin Knauss 12 Comments

Every family is unique in their health care needs. There are situations when each family member may require a different health plan to meet their particular health challenges. Unfortunately, many families who enroll in a health plan through Covered California are unaware that not all the family must be on the same health plan.

Accessing benefits under dual eligible special needs plans

August 20, 2015 By Kevin Knauss Leave a Comment

Anthem Blue Cross of California Medicare Advantage dual eligibility with Medi-Cal Special Needs Plans May 30, 2015 This guidance is generally applicable for all health insurance companies that offer Medicare Advantage Special Needs Plans for dual eligible beneficiaries. Dual Eligibles (Duals) are individuals who are entitled to benefits from both the federal Medicare and state-run […]

Medicare Coordination of benefits, payments, and denials

August 18, 2015 By Kevin Knauss 1 Comment

There are certain situations where Medicare will pay for your health care services after another insurance plan pays first. There are also situations where Medicare will pay for your health care services, but you will have to pay them back after an insurance settlement reach after an accident you are involved with that is not […]

Making sense of Medicare’s Prescription Drug Plan with training

August 17, 2015 By Kevin Knauss Leave a Comment

2015 CMS PDP Training Prescription drug coverage for Medicare beneficiaries can be confusing. Under different health care scenarios some drugs may be covered by Part A, Part B or Part D of Medicare. In addition, many Medicare beneficiaries may be unaware that they might qualify for extra help to pay for their medications. The Centers […]

Five paths to California health insurance

June 28, 2015 By Kevin Knauss Leave a Comment

In California there are essentially five different paths to getting health insurance. Each of the different options have varying conditions and restrictions. Below is a summary of the five paths to California health insurance. There is also a short video you can watch titled California Paths to Health Insurance which also explains the five different […]

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