Most Medicare Insurance Beneficiaries Pay Too Much for
Medicare Supplement Insurance (aka "Medigap Plans")

The majority of Medicare Insurance beneficiaries who have Medicare Supplemental Insurance pay more than they need to for the exact same coverage.

The truth is, Medicare Supplemental Insurance plans are standardized in most states. This means that no matter which company that a Medicare Insurance recipient chooses for their Medicare Supplemental Insurance, the coverages will be the same from company to company if they choose the same lettered plan.

Though the coverages are the same from company to company, premium rates vary depending on the insurance company that you choose. The discrepancy on rates is determined by the experience of each insurance company and the pool of policyholders that own the same policies with that company. Other variables between companies that reflect in the premium rates include sales commissions and expected profits from the sale of these policies. These factors can add up to a difference in premium of up to $1,000 per year or more for the exact same coverage.

Most Medicare Insurance recipients could save money by switching to the same plan with another company. However, most people covered by Medicare Insurance pay more than they should for their Medicare Supplemental Insurance Plan. The reason is that they simply don’t shop around. By shopping multiple companies, many could get the exact same coverage at a lower rate

For instance, a Medicare Insurance Recipient could have an AARP Medicare Supplemental Insurance Plan G and pay a premium for this plan. Yet if this person shopped around they might see that Mutual of Omaha could offer the same Plan G for a lower premium. Yet if they continued shopping around to companies like Aetna or Cigna Supplemental or many other top rated companies they could realize an even bigger savings- often up to $1000 per year (and sometimes even more) for the same coverage. It pays to find out how much you can save.

Not shopping around can have financial consequences as well. Many seniors and those with disabilities who are covered by Medicare Insurance earn a majority of their living from Social Security. Paying those extra Social Security earnings to an insurance company rather than saving it for themselves and their families can leave many worse off than they should be. Some even will not be able to buy food or other basic necessities because of this additional premium.

Stop throwing your hard earned Social Security earnings away. Shopping around could save you hundreds if not thousands of dollars per year.

To compare rates and plans on Medicare Supplemental Insurance in your area, simply fill out the form on the right side of this page. Or for faster service you can call and speak directly to a licensed Medicare Supplement Insurance specialist at (844) My-Gurus (694-8787.)

Medicare Insurance Benefits - What You Need To Know

Medicare Insurance is a Health Insurance Program For:

• People Age 65 or Older,
• People under age 65 with certain disabilities, and
• People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

Medicare Insurance Benefits Plan Basics:

Medicare Part A (hospital) pays for in-patient hospital services, skilled nursing facility care after a hospital stay, home health care, and hospice care. Medicare Part A also pays for all but the first three pints of blood in a calendar year.

Medicare Part B (medical) pays for medical expenses, clinical laboratory services, and outpatient hospital treatment. In most cases, Medicare Insurance pays 80 percent of the cost of covered services.

Covered medical expenses include physicians´ services and supplies. Some Medicare Part B services are paid as a fixed copayment under the outpatient prospective payment system.

Medicare Part B also pays for some preventive services. Ask your physician about screening tests, flu shots, and vaccines covered by Medicare.

Medicare prescription drug coverage (also called Medicare Part D) pays for prescription drugs, both generic and brand name. You must join a prescription drug plan to have this coverage.

Options for receiving Medicare Insurance benefits

Medicare enters into annual contracts with insurance companies and managed care plans to provide coverage through different types of health plans. The original Medicare plan is available to everyone. Original Medicare is also sometimes called Medicare fee-for-service or traditional Medicare. You can go to any doctor or hospital that accepts Medicare. Original Medicare coordinates with most group retirement plans, Medicaid, Medicare savings programs, and Medigap insurance.

You may have the option to join a Medicare Advantage plan (formerly called Medicare + Choice). Medicare Advantage plans include health maintenance organizations (HMOs), preferred provider plans (PPOs), private fee-for-service plans (PFFS), and medical special needs plans. You can only join a Medicare Advantage plan if a plan is available in your area and you have Medicare Parts A and Part B. Some plans may have additional eligibility requirements. The federal Centers for Medicare and Medicaid Services (CMS) administers Medicare Advantage plans. Plans provide their members with a handbook upon enrollment that outlines the complaints and appeals process for denial of services.

CMS publishes a handbook, called Medicare and You, that describes Medicare coverages and health plan options. The handbook is mailed to every Medicare beneficiary each year.

Services Not Covered by Medicare Insurance Benefits

• Long-term care services (generally not covered)
• • Custodial care, such as help walking, getting in and out of bed, dressing, bathing, toileting, shopping, eating, and taking medicine (these are commonly referred to as activities of daily living)
  • More than 100 days of skilled nursing facility care during a benefit period following a hospital stay (the Medicare Part A benefit period begins the first day you receive a Medicare-covered service and ends when you have been out of the hospital or a skilled nursing facility for 60 consecutive days)
  • Homemaker services
• Private-duty nursing care
• Most dental care and dentures
• Health care received while traveling outside the United States, except under limited circumstances
• Cosmetic surgery and routine foot care
• Routine eye care, eyeglasses (except after cataract surgery), and hearing aids.

What You´ll Have to Pay with Medicare

Both Medicare Part A and Part B have costs that you must pay. These include monthly premiums, deductibles, copayments, and coinsurance. You also pay the full cost of services not covered by Medicare.

Premiums are amounts you pay regularly to keep your coverage. Most people do not have to pay a Part A premium, but everyone must pay the Part B premium. The premium amounts may change each year in January. A deductible is the amount you must pay for covered medical expenses before Medicare begins to pay. A copayment is a fixed charge for a medical service. Coinsurance is the percentage of the cost of a covered service that you pay after Medicare pays its portion of the cost.

Health care providers who accept "assignment" agree to limit their fee to the Medicare-approved amount for a service or supply, although you must pay any deductibles, coinsurance, or copayments due. Providers who do not accept assignment may charge as much as 15 percent above the Medicare-approved amount when treating Medicare patients. You must pay the excess amount. The amount you owe is shown on the Medicare Summary Notice that you receive from Medicare. If you were charged more than the 15 percent and paid it, your provider must refund the excess charges to you within 30 days. If you believe a provider has overcharged you, question the bill before you pay it and contact the Medicare carrier that processed your claim.

Medicare Supplement Insurance Plans at Lower Rates

Why a Medicare Supplement Insurance Plan from Medicare Gurus?

If you are on Medicare, you are probably facing tough decisions on choosing the right Medicare Supplement Insurance Plan. If you are like most of the people we have assisted in the past 26 years, you have found that trying to make the decision on the right Medicare Supplement Insurance Plan (Medigap Plan) can be stressful to say the least.

The good news is that it doesn’t have to be.

And you can have the same peace of mind that they have by choosing a Medicare Supplement Insurance Plan from Medicare Gurus.

What’s even better is that if you choose the right Medicare Supplement Plan you will never have to pay a penny when receiving treatment in a physician’s office, hospital or specialty treatment center that accepts Medicare Insurance.

That’s right, whether your doctor or hospital bills are $5 or $5,000,000, if you choose the right Medicare Supplement Plan you will never have to pay anything for doctor or hospital bills as long as Medicare approves a penny of the charges.

There are:

• No Deductibles
• No Co-Pays
• No Referrals Necessary
• No Complicated Claims Paperwork to Fill Out
• No remaining bills to pay if you choose the right Medigap Insurance (Medicare Supplement) Plan

YOUR DOCTOR DECIDES HOW YOU SHOULD BE TREATED… not your Medigap insurance company.

You simply show your Medicare Supplement Insurance Card to the Doctor or Hospital and it will all be taken care of for you. In fact, Medicare will in most cases send your claim directly to your Medicare Supplement Insurance Company and they will process the claim without you ever having to do anything. When Medicare is unable to forward your claim, the hospital is required to file with your Medicare Supplement Plan for you. So you never have to worry about claims paperwork or hassles. You only need to Compare Medicare Supplements and find the one that is right for you and all is taken care of for you.

And again, if you choose the right Medicare Supplement Insurance Plan from Medicare Gurus, you will never have to pay a penny.

We believe that doctors are for deciding on your treatment and Medicare Supplement insurance companies are there to pay your bills if and when health problems occur… and they should stay out of your doctor’s way when he is treating you

Don’t pay high rates for a Medicare Supplement Insurance Plan?

Did you know that there are a whole lot of companies offering Medicare Supplements in the United States? Yet most people on Medicare Insurance can only name one or two of them. The reason why is that only a few spend big money on advertisements or go to the expense of sending you a pile of information about themselves in the mail. Most Medicare Supplement Insurance Companies rely on companies like Medicare Gurus to educate the public while they concentrate on providing the services of issuing policies and paying claims.

And since there are many Medicare Supplement Insurance companies offering may Medigap Plans at different rates, you can guess that by shopping around that you will find a company that is offering Medicare Supplements at lower rates than you are currently paying or considering. Most people find that, by letting us at Medicare Gurus do the shopping for them, that they can save money on what they are currently paying or considering from the company or companies that they have talked to already.

And what’s better is that since Medicare Supplement Insurance is standardized from one Medicare Supplement insurance company to the next, you can get the exact same or even better coverage for lower Medigap rates.

But who has time to shop dozens of Medigap (Medicare Supplement) insurance companies? Even more, why would you want to deal with the loads of information that they send you (that is more confusing than it is helpful) or with salespeople that want to come to your home and pressure you to buy what their Medigap insurance company is paying them to sell (not what’s necessarily best for you.)

Well the good news is that you no longer have to. With one simple phone call to Medicare Gurus you will talk to a licensed Medicare Supplement Insurance Specialist. He or she will be able to help you choose the right Medicare Supplement Plan and ensure that you are saving money and paying fair and lower Medigap Insurance rates.

When I Need Help Choosing a Medicare Supplement Insurance Plan, What Makes Medicare Gurus Different?

What makes Medicare Gurus different is that WE WORK FOR YOU, not some insurance company. We shop all the companies that offer Medicare Supplement / Medigap Insurance and find the ones that are reputable and can live up to their promises for many years to come. (Basically we weed out all the small Medigap companies and the fly by nighters.)

Then, from the companies that pass our rigorous requirements, we use state of the art technology to compare their Medicare Supplement Insurance rates and plans with you right over the phone (not in your home… we respect your privacy) and find the very best value for your particular situation.

But that’s not all. Have you ever applied for an insurance plan such as a Medigap Insurance plan or a Medicare Supplement Policy and been denied or gotten restrictions on your policy that you didn’t see coming… only after you had paid the initial premium. Remember the hassle it took to get a refund or to find other suitable coverage? Well, at Medicare Gurus, we don’t want that to happen to you ever again.

We are also Medicare Supplement Insurance “field underwriters” at Medicare Gurus. This means that we will not only find you the best rates for Medicare Supplement Insurance but we will make sure that you will qualify for the coverage before we ask you to apply. As long as you are honest with us about your health, we will be able to tell you right over the phone if you meet the underwriting standards of the Medicare Supplement or Medigap Insurance Company that is best for you.

This means that you get approved the first time and don’t have to worry about losing coverage.

Then what’s best is that we make arrangements with all of our Medigap and Medicare Supplement insurance companies to be able to enroll you in their plans right over the phone. We don’t need to come to your house and invade your privacy just to get you the covered for at lower rates.

How Does Medicare Gurus Medicare Supplement Insurance Plans Work with Pre-Existing Conditions?

The simple truth is this. If you have had another Medicare Supplement Plan for at least 6 months or if you’re new to Medicare Insurance and have been covered under a Group or Individual Major Medical Plan then all pre-existing conditions will be covered immediately by your new Medicare Gurus Medicare Supplement Insurance Plan.

If you haven’t had such Medigap or creditable coverage other than Medicare Supplement Insurance Plans for the past 6 months and you have a pre-existing condition or conditions, then the good news is that you are in exactly the right place. A simple call to one of our Licensed Medicare Supplement Insurance Specialists at Medicare Gurus and you will know your options in a matter of minutes.

In some cases we can get your pre-existing conditions covered, in others you will only have a short waiting period. One thing is for sure, you will be advised of the absolute best possible course of action to get the treatment that you need. And you will always find the Medicare Gurus recommendations and options for Medicare Supplement Insurance Plans to be the lowest in the United States. This is why we are here.

Call us today for the Medicare Supplement Quotes at the lowest Rates possible and for industry leading advice and counseling.

Eligibility for Medicare Supplement (Medigap) Insurance

Medigap Eligibility

Insurance companies must sell you a Medigap (Medicare Supplement) plan during certain periods of time — one period is called "open enrollment period." The others are called "guaranteed issue periods."

At other times, insurance companies may refuse to sell you a policy. If you have or used to have health problems, you may not be able to buy the Medigap plan of your choice. Most companies will have a few simple health questions that your Medicare Gurus Medicare Supplement Specialist can ask you to determine your eligibility.

Eligibility: Open Enrollment & Guaranteed Issue Periods

Open Enrollment

Seniors: Medigap companies must sell you a policy - even if you have health problems - if you are at least 65 and apply within six months after enrolling in Medicare Part B. These six months are called your "open enrollment" period. During open enrollment, a company must allow you to buy any of the Medigap plans it offers. You can use your open enrollment rights more than once during this six-month period. For instance, you may change your mind about a policy you bought, cancel it, and still have the right to buy any other Medigap policy, so long as the sale takes place during the six months after you enroll in Medicare Part B.

Although a company must sell you a policy during your open enrollment period, it may require a waiting period of up to six months before covering your pre-existing conditions. Pre-existing conditions are conditions for which you received treatment or medical advice from a physician within the previous six months.

Your right to open enrollment is absolute, even if you wait for several years after you become 65 to enroll in Medicare Part B because of continued employment or other reasons.

People with disabilities: People under age 65 who receive Medicare because of disabilities have a six-month open enrollment period beginning the day they enroll in Medicare Part B. This open enrollment right is only applicable to Medigap Plan A. Companies selling Medicare supplement insurance in Texas may not deny you a Plan A policy because you have pre-existing conditions. Companies are not required to offer the other plans to Texans with disabilities, but they may do so if they wish. During the first six months after you turn 65 and are enrolled in Medicare Part B, you will have a right to buy any of the 12 plans.

Guaranteed Issue

You may have the right to buy a Medigap policy outside of your open enrollment period if you lose certain types of health coverage. For people over age 65, the guaranteed issue right applies to Medigap plans A, B, C, F, K, and L. For people under age 65, this guaranteed issue right applies only to Medigap Plan A. In general, this right is for 63 days from the date coverage ends or from the date of notice that coverage will end. Companies may not place any restrictions, such as pre-existing condition waiting periods or exclusions, on these policies. This is called "guaranteed issue." You must provide proof of the loss of your health care coverage. Texans under age 65 with disabilities who enroll in Medicare Part B also have guaranteed issue rights, but they are only eligible for Medigap coverage under Plan A. This guaranteed issue right is also extended to people on Medicare who lose Medicaid because of a change in their financial situation.

Guaranteed Issue and Medicare Advantage Plan Disenrollment

What often goes unnoticed about Medicare Advantage Plans is that they reserve the right to terminate their contract with Medicare from year to year in any service area that they wish. When this happens, you will no longer be able to continue with your plan and will be placed back on Original Medicare at the beginning of the following year.

If your Medicare Advantage plan terminates its contract in your service area, you have the right to purchase any Medigap plan A, B, C, F, K, or L offered in your state without regard to your medical history or condition. If your Medicare Advantage plan ends services in your area, it must explain to you in writing your options and timeframes to buy a Medigap policy.

Medicare Supplement Insurance Consumer Rights

Your Rights as a Medicare Supplement Consumer

Open Enrollment

Medicare Recipients: Medigap companies must sell you a policy - even if you have health problems - if you are at least 65 and apply within six months after enrolling in Medicare Part B. These six months are called your "open enrollment" period. During open enrollment, a company must allow you to buy any of the Medigap plans it offers. You can use your open enrollment rights more than once during this six-month period. For instance, you may change your mind about a policy you bought, cancel it, and still have the right to buy any other Medigap policy, so long as the sale takes place during the six months after you enroll in Medicare Part B.

Although a company must sell you a policy during your open enrollment period, it may require a waiting period of up to six months before covering your pre-existing conditions. Pre-existing conditions are conditions for which you received treatment or medical advice from a physician within the previous six months.

Your right to open enrollment is absolute, even if you wait for several years after you become 65 to enroll in Medicare Part B because of continued employment or other reasons.

Texans with disabilities: In Texas, people under age 65 who receive Medicare because of disabilities have a six-month open enrollment period beginning the day they enroll in Medicare Part B. This open enrollment right is only applicable to Medigap Plan A. Companies selling Medicare supplement insurance in Texas may not deny you a Plan A policy because you have pre-existing conditions. Companies are not required to offer the other plans to Texans with disabilities, but they may do so if they wish. During the first six months after you turn 65 and are enrolled in Medicare Part B, you will have a right to buy any of the 12 plans.

Guaranteed Issue

You may have the right to buy a Medigap policy outside of your open enrollment period if you lose certain types of health coverage. For people over age 65, the guaranteed issue right applies to Medigap plans A, B, C, F, K, and L. For people under age 65, this guaranteed issue right applies only to Medigap Plan A. In general, this right is for 63 days from the date coverage ends or from the date of notice that coverage will end. Companies may not place any restrictions, such as pre-existing condition waiting periods or exclusions, on these policies. This is called "guaranteed issue." You must provide proof of the loss of your health care coverage. Texans under age 65 with disabilities who enroll in Medicare Part B also have guaranteed issue rights, but they are only eligible for Medigap coverage under Plan A. This guaranteed issue right is also extended to people on Medicare who lose Medicaid because of a change in their financial situation. For more information, read the Guide to Health Insurance for People with Medicare.

30-Day "Free Look"

You can return your Medigap policy within 30 days after receiving it and get your money back-with no questions asked. Be sure to keep a record of the date you received the policy. Read the policy as soon as you get it. If you return the policy to the company, use certified mail with a return receipt as proof that it was returned within the 30-day time limit.

Renewability

All Medigap policies are guaranteed renewable. A company cannot cancel your policy or refuse to renew it unless you made intentional material false statements on your application or failed to pay your premium. However, the amount of the premium is not guaranteed. An insurance company may raise your premium as often as once a year on a class basis. In addition, if you have an "attained-age policy," a company may raise your premium on your birthday.

Medicare Supplement Claims

Your doctor and other health care providers must submit Medicare claims to the appropriate carrier or fiscal intermediary for you. In most cases, the carrier or intermediary will send your Medigap claim directly to your insurance company.

Medigap policies won´t pay for services that Medicare does not deem medically necessary.

Therefore, if the carrier or intermediary denies your claim as medically unnecessary, your Medigap company won´t pay it. You have the right to appeal the decision to deny a claim. The appeal process and timeframes to request an appeal are described in your Medicare Summary Notice.

Texas law requires insurance companies to pay claims promptly. If your Medigap company refuses to pay a claim for a Medicare-approved charge or delays payment of your claims, you may file a complaint with TDI.

Group Medicare Supplement Insurance

Your rights with a group Medigap policy are essentially the same as with an individual policy. Because the group might make decisions that are out of your control, you have the following additional protections:

• If the group changes insurance companies, the new company must offer coverage to everyone previously covered. The new Medigap policy must cover pre-existing conditions that were covered by the old policy.
• If you leave the group, the insurance company must offer to provide unbroken Medigap coverage with an individual policy or continuation of your group insurance.
• If the group cancels its coverage, the insurance company must offer you either an individual policy continuing the benefits you had before or a different policy meeting Texas requirements.

Many Seniors Unknowingly Find Reduced Access to Healthcare Because they Enrolled in a Medicare Advantage Plan

Theres an age old saying: "If it sounds too good to be true it probably is." Millions of Seniors are now learning this the hard way due to Medicare Advantage Plans. Though these plans look good on the surface, they offer limited benefits when compared to comprehensive Medicare Supplemental Insurance Plans. Often these plans have as many or more limitations than Medicare alone without Medigap Insurance. Many plans restrict Seniors ability to choose their healthcare providers and put restrictive administrative regulations in the way of the doctor's ability to get their patient the best healthcare possible. Such a reduction in access to the best available healthcare possible can cause preventable or prolonged illness or complications of illness and even preventable death.

The Truth About Medicare Advantage Plans

A Medicare Advantage Plan is a private insurance plan that takes the place of Medicare based on an insurance company's contract with Medicare. There are two types of Medicare Advantage Plans: Managed Care Plans such as an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) and Private Fee for Service Plans. To enroll in a plan you must voluntarily drop out of Medicare and sign up with the Insurance Company offering the plan. What's more, each plan can choose not to renew their contract with Medicare each year in any service area they please and, if they do so, you will be dropped from the plan. Medicare Supplemental insurance, on the other hand, is Guaranteed Renewable for life. You cannot lose your coverage for any reason as long as you pay your premiums.

What Your Medicare Advantage Agent May Not Tell You

Once you enroll in a Medicare Advantage HMO or Fee for Service plan you no longer have health coverage through Medicare. Medicare will pay the Insurance Company a pre-negotiated monthly rate as long as you are enrolled. In most cases you will also have to pay a small premium to the insurance company as well. Medicare Advantage Plans normally market these plans to you by comparing their smaller premium to the higher premium of a Medicare Supplemental Plan F (which provides 100% coverage of all Medicare approved doctor and hospital expenses.) Yet this is not an apples to apples comparison. Though the premium is less, so is the coverage. Also, many Seniors enroll in Medicare Advantage plans in order to receive the prescription drug coverage without knowing that prescription drug coverage is available to them without restricting their access to healthcare options through Medicare Part D.

The truth is Medicare Advantage plans leave gaps in coverage even for simple doctors visits. In addition, there are often copayments for hospital visits, skilled nursing care and emergency room care where a Medicare and Medicare Supplemental plan F would cover every penny of your expenses. These gaps can wind up costing from a small amount to thousands of dollars per year based on usage.

Yet these copayments and coverage gaps are not the worst part of having a Medicare Advantage Plan. Often times people sign up for a plan because it is "Medicare Approved" without knowing they are signing up for an HMO, PPO or restrictive Fee for Service Plan. This takes away the patient's right to choose their own doctor, hospital or specialist. They are confined to the doctors and hospitals that are in the insurance company's network.

In the case of Fee for Service Plans, there is no network to choose from but many doctors will not accept the plan because of long delays in payments and complicated claims procedures. When choosing an HMO, they are often forced to first make an appointment with their "primary care physician" to get a referral before seeing a specialist. Then, as if this unnecessary step wasn't hard enough for someone with a serious medical condition, they force the patients doctor to work with complicated administrative processes just to get their patient the care that they need.

Even then the physician has limited choices. For instance, if a cancer patient wishes to go to a cancer treatment center that boasts a lot higher success rate than local hospitals, that center may not be in the insurance company's network. Therefore the patient is forced to accept treatment at a local hospital that does not specialize in such treatment and may run a lot higher risk of dying from their disease than if they had kept their Medicare coverage and were able to go to the treatment center of their choice. What's worse, the patient has now opted out of Medicare so they can't even fall back on Medicare Coverage if they wish to choose their own treatment facility.

The bottom line is that the choice of health insurance that you make determines the type of treatment you will receive when the time comes that you need treatment. Often, making the wrong choices now could mean the difference between life and death later. When you look back on all the tax dollars that you paid over your lifetime so that you would have good health insurance during your Golden Years, why would you throw your choices away just to try to save a few dollars when the odds of you needing quality healthcare are the highest they've ever been?

Recommendations

It is the opinion of Medicare Gurus that Medicare recipients should be cautious about giving up their freedom to choose quality healthcare by giving up the Medicare Coverage they have been paying for their entire life to take a restrictive Medicare Advantage Plan. We do not say this because we are in competition with them. We will even help you enroll in a Medicare Advantage Plan in the rare cases that it is the right thing for you and you know what you are getting into.

Get unbiased help from a Medicare Guru Call (844) My-Gurus (694-8787) Call Now!