Wednesday, July 28, 2021

Idaho Medicare Insurance Plan | Everything You Need To Know About Medicare Coverage

How Do You Know If Your Medicare Coverage Is Right For You?

If you're just getting started with Medicare or are in your first year, we have the information you need to help you understand your health care options and get the coverage that best fits your situation.


Medicare.gov to get answers to questions like "what are the parts of Medicare?" and "Medicare basics: What you need to know" w hen it comes to choosing between private and public plans for seniors like yourself, there are some basic differences that may not be obvious.

Here’s what you should know about both types of coverage before making an informed choice.

Idaho Medicare Insurance Basics

  • What is Medicare Advantage?

The MA program offers supplemental benefits beyond those offered by traditional fee-for-service Medicare. 

  • When can I sign up for Medicare?

You have until the end of your IEP to apply for coverage. You must be at least 65 years old on January 1st or December 31st to qualify for Medicare Part A & B benefits. However, if you are younger than age 60 as of September 30th, 2016, you will not need to wait until your IEP expires to start receiving these benefits. Instead, you'll automatically become a member of Medicare when you turn 66.


Original Medicare (Part A and Part B)

You may need supplemental insurance if you have additional expenses such as deductibles, co-insurance and/or out of pocket maximums. We recommend contacting us at any time so we can help you find the right plan.


Medicare Supplement Plans

There are many different types of plans available from private companies. These plans supplement original Medicare by covering some or all of what is missing. They also offer other advantages like lower premiums than traditional Medicare. 


New to Medicare?

You may want to start with our New Member Guide which provides basic information about what Medicare covers and does not cover. It also includes links to helpful resources such as the Centers for Disease Control and Prevention website where you can access additional information about Medicare.


The following sections describe some of the most common questions people have about Medicare. We hope this helps answer many of them!


What Is Medicare Automatic Enrollment

You can enroll automatically for Part D coverage if:

  • You have been enrolled in a qualified health plan through an employer-sponsored group insurance program;
  • The QHP has provided information about its prescription drug benefit options;
  • You meet certain income requirements; and
  • You do not qualify for Medicaid or CHIP.


In addition, you may be able to sign up for Medicare at any time during the year by calling 1-800-MEDICARE (1)


Initial Enrollment Period

If you are not eligible for Automatic Enrollment, contact the Social Security Administration at 800-772-1213 or enroll online at, or visit the nearest Social Security office to enroll in Medicare Part A and Medicare Part B. The initial enrollment period begins when you become entitled to benefits as determined by age, disability status, and other factors. The initial enrollment period ends three days after the end of the calendar year in which you became entitled to benefits. For example, if you turn 65 years old on January 1st, then the initial enrollment period would begin on January 2nd and last until February 3rd. 


General Enrollment Period

  • January 1 – March 31
  • July 1 – December 7


Special Enrollment Periods

You may be able to qualify for special enrollment periods if:

  • Your spouse or partner has died;
  • You have been diagnosed as having end stage renal disease ;
  • You were covered under an employer plan that was terminated before February 14, 2006;
  • You had a break in insurance because you moved out of state without changing providers;
  • You lost health care benefits due to bankruptcy;
  • Working Past Age 65 (Special Enrollment)
  • You can apply for special enrollment after you turn 66 years old. This allows you to remain on your EGHP until 70 years old with no premiums or deductibles. However, there are some restrictions:
  • Your EGHP cannot cover services received while employed outside the United States.
  • The maximum number of days allowed for Special Enrollment is three times the amount of time remaining on your original eligibility period. 


Medicare enrollment in Idaho

In 2019, there were approximately 1,814,000 Medicare enrollees living in Idaho, representing a little more than 20% of all Medicare recipients nationally. This number represents an increase from 2016, when there were roughly 1,633,000 Medicare enrollees in Idaho. The national average has remained relatively steady since 2012, hovering around 18 million Medicare enrollees.


Medicare spending in Idaho

The spending amounts are based on data that were standardized to eliminate regional differences in payment rates, and did not include costs for Medicare Advantage. Per-beneficiary spending for Medicare was highest in Louisiana, at $11,932 and lowest in Hawaii, at just $6,971.


It was about 10 percent below the nationwide average of $10,096 in 2018. In 2017, it was 9 percent higher than the national average of $8,744.

The top five states with the largest increases in average per-beneficiary spending between 2017 and 2018 were:

  • New York
  • California
  • Texas
  • Florida


Medicare statistics in Idaho

Idaho has an estimated population of 2,907,000 people. The median age was 37 years old. There were approximately 565,000 males and 624,000 females living in the state at this time. In 2016, there were 4,744 Medicare enrollees who lived in Idaho. In 2015, there were 3,631 Medicare enrollees who lived here.

There were 7,564 Medicare enrollees in 2014. 


Medigap in Idaho

As of 2018, there were 87,738 Idaho Medicare beneficiaries with Medigap coverage, according to an AHIP analysis. Although Medigap plans are sold by private insurers, the plans are standardized under federal rules, with ten different plan designs. Also for all Medigap plans sold since 1995, state law also prohibits insurers from using attained-age rating, which means that premiums cannot increase simply due to the enrollee's increasing age.


Idaho joined those states in 2018, with changes to Idaho insurance statute that took effect January 1, 2018 Idaho Medigap insurers are now required to offer their plans to disabled Medicare beneficiaries under age 65, with the same six-month open enrollment period that applies to people who gain eligibility for Medicare due to age.


In addition, the new rule limits the premiums for under-65 Medigap to no more than 150 percent of the premiums that apply to a person who is 65 years old. The following table shows how the average monthly premiums compare between Medigap plans in Idaho:


What Are the Most Popular Medicare Supplement Plans?

The most popular Medicare Supplement plans are Plans F, G and N. America's Health Insurance Plans. “ State of Medigap: Trends in Enrollment and Demographics.” ahip.org. Medigap policies can be confusing because they offer different benefits for different types of coverage. The following table shows which Medicare supplement plans cover what. It also lists some other important features that you should know about each type of plan.


*Note: Some states require insurers to pay 80% of all medical expenses incurred by their members who use skilled nursing facilities. This is called SNF-related benefit. 


Medicare Advantage in Idaho

Medicare beneficiaries can choose to get their healthcare coverage directly from the federal government via Original Medicare, or through private Medicare Advantage plans assuming Advantage plans are available in their area. Despite the lack of Medicare Advantage availability in some of Idaho's more rural areas, almost third of Idaho Medicare beneficiaries had Medicare Advantage plans as of 2018, which was nearly the same as the nationwide average.


Medicare Advantage plans include all of the benefits of Medicare Parts A and B, and they often provide additional benefits and programs, such as integrated Part D coverage for prescription drugs, dental and vision coverage, a 24-hour nurse hotline, gym memberships, and even assistance with things like transportation and in-home safety.


Out-of-pocket costs for Medicare Advantage are often higher than they would be if a beneficiary had Original Medicare plus a Medigap plan. There are pros and cons to either option, and the right solution is different for each person.

People who are already enrolled in Medicare Advantage also have the option to switch to a different Advantage plan or to Original Medicare during the Medicare Advantage open enrollment period, which runs from January 1 to March 31.


In 2019, about half of Idaho Medicare beneficiaries chose Medicare Advantage over Original Medicare. That number increased slightly in 2018, but it remained below 50 percent throughout 2017–2019.

The percentage of Idaho Medicare beneficiaries choosing Medicare Advantage grew significantly after 2010, when the Affordable Care Act went into effect. By 2016, Medicare Advantage accounted for roughly two thirds of total Medicare enrollment in Idaho. And while Medicare Advantage enrollment declined somewhat in 2017, it rebounded in 2018 and continued growing in 2019.


Idaho Medicare Part D

The following table shows the number of people enrolled in different types of Medicare Part D plans sold in Idaho in 2019:

Plan Type Number of Plans Percent Total Stand Alone Plan 28 11% Medicare Advantage With Prescription Drug Coverage 117 67% Other 10 5% No Supplemental Insurance 9 4% Not Stated 3 2% Totals 195 100% Source: Centers for Medicare & Medicaid Services

The following table shows the number of people enrolled in different types of Medicare Part D plans in every county across Idaho:


Medicare resources in Idaho

The following links provide more detailed information regarding Medicare coverage options available in Idaho. For additional information, please contact your local Area Agency on Aging office.

  • Medicare Resources - AARP
  • Medicare Resource Center - United States Department of Health & Human Services
  • Medicare Plan Finder - United States Department of Labor
  • Medicare Rights Center - National Senior Citizens Law Center
  • Medicare Supplement Information - Kaiser Family Foundation
  • Medicare Supplements - U.S. Government Accountability Office
  • Medicare Savings Programs


Idaho SHIBA Resources

The SHIBA website provides information and resources to help you understand how Medicare works, what it covers, where To find out more about SHIBA or if you have any questions please contact us at: 1-800-722-9072 Or visit our web site at www.shiba.idaho.gov


Idaho Medicaid Program - The Idaho Medicaid Program offers health insurance coverage to low income individuals who are not eligible for other types of medical care programs such as Medicare.


What is SHIBA?

SHIBA Is Idaho's State Health Insurance Assistance Programs (SHIP), a program that helps states enhance And support a network of local staff And volunteers to assist people with Medicare.


Learn About Medicare with SHIBA

Medicare helps cover medical care costs that may not otherwise be covered under your health plan. It pays doctors, hospitals, nursing homes, home healthcare agencies, hospices, pharmacies, durable medical equipment suppliers, dialysis centers, ambulance companies, and more. Learn More »


About Us

SHIBA provides information and resources to Idaho residents who want to learn more about Medicare and its benefits. We offer free one-to-one counseling sessions where we will answer questions and explain what Medicare covers and

 In Conclusion, Medicare can be confusing so don't hesitate to give us a call today with any of your questions. Our agents work throughout all of Idaho


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Original post here: Idaho Medicare Insurance Plan | Everything You Need To Know About Medicare Coverage

Idaho Medicare Insurance Plan | Finding The Right Coverage And Plans For Your Healthcare Needs


Watch on YouTube here: Idaho Medicare Insurance Plan | Finding The Right Coverage And Plans For Your Healthcare Needs
Originally published by Boise Health & Life Insurance Agency

Monday, July 26, 2021

Differences Between HMO And PPO Plans

Health Maintenance Organization (HMO) & Preferred Provider Organization (PPO) | Which Is Better Plan?

There are a lot of decisions and factors to consider when making a decision about choosing the right health insurance plan. The first decision to make is which plan you’re going to select and if this will blend with your needs.
As you enter the insurance market, you’ll be bombarded with plans and terms as well as the different rates and prices. Between HMO and PPO, health insurance can be challenging. If you heard of HMO and PPOs and the other health insurance plan acronyms.

We’ll help you decide on what is the right insurance for you, and more importantly, what the difference is between these two popular plans.

We compare the two plans for you to help you understand more-from the basic features to understanding the plan types up to how the policy works for or contract with the HMO


HMO (Health Maintenance Organization)

An HMO is a type of health insurance plan that lets you access certain hospitals and doctors within its network. It has a certain limit of coverage to care from the doctors and hospitals who work for or have contracted with the insurance company. Meaning, this plan will not cover out-of-network care accepts if it is an emergency. Usually, to get qualify for this plan you must be live within the service area to access the coverage. HMO often focused on integrated care, prevention, and wellness. Apart from this, HMO provides lower costs and expects to pay less out-of-pocket.


How Does HMO Work?

Members choose a single doctor or physician from the list of approved healthcare hospitals and providers. If you enroll on an HMO, the plan required you to see only a health care specialist such as an obstetrician, rheumatologist, or cardiologist under your primary care physician’s (also known as the gatekeeper ) referral or recommendation, if your PCP cannot treat you,  which is still part of the in-network specialist.


PPO (Preferred Provider Organization)

A type of insurance health plan that offers maximum benefits, if you visit an in-network provider, but lets you access coverage from out-of-network providers. PPOs are not restricted to received care in-network, this policy provides more flexibility when picking physicians or healthcare providers. PPO allows the policyholder to have multiple choices regarding their healthcare and healthcare providers.


How Does PPO Work?

With the PPO plan, members get to see physicians or specialists without a referral for their PCP. However, emergencies or routine care are exempted. In addition to that, members who choose to receive care from the healthcare provider outside the network will likely pay more for it.


There’s a lot of consideration you need to understand before making a decision on both these plans. We’ll explain the big differences in the costs, network providers, claim forms, services covered, and their exceptions. in our next article.


In conclusion, which is better, HMOs and PPOs are both types of managed care , which is a way for insurance providers to help manage medical costs. The answer will largely depend on the personal preferences of the customers. Everyone doesn’t have the same medical needs or the same medical attention.


HMO provides affordability and a PPO that offers great flexibility and freedom of choice getting the best healthcare plan will require you to choose from these plans. As far as you’re aware, at some point in your life, your health might fail you, when this day comes you make sure that you are already clear on your decision on which plan will work and best fit for you.

Thank You For Reading!



Original post here: Differences Between HMO And PPO Plans

Identifying What Is The Difference Between HMO & PPO Health Insurance Plan | How These Two Works


Watch on YouTube here: Identifying What Is The Difference Between HMO & PPO Health Insurance Plan | How These Two Works
Originally published by Boise Health & Life Insurance Agency

Wednesday, July 21, 2021

What You Need To Know About Living Benefits Of Life Insurance

Understanding About The Basics Of Living Benefits | And How Far It Differ To Whole & Term Policy

As we always say, it is important for an individual who has a family that depends on them to acquire life insurance. You may have a good understanding of the benefits of life insurance, like how it can help your loved one financially in the event of your loss. Apart from this, did you know how life insurance can protect you while you’re still living? 


Yes! Aside from givin
g financial assistance to your beneficiary if you left them behind, life insurance also provides a living benefit for the policyholder. This feature enables the policy owner to access a portion of his death benefit while the policyholder is still alive.


What is Living Benefit?

Living benefits also refer as cash benefits can be accessed by the owner after they have their premiums over a specific period or number of years. When buying life insurance, the coverage allows the holder to build cash value through its policy that accumulates over your lifetime. It is considered a living benefit because differs from a death benefit that pays out when you pass away, you use the money you can get while you’re still alive.


The living benefit you can access will depend on a policy to will buy. Whole or permanent life insurance may offer more expensive premiums than a term life which covers a specific length of time because long-term coverage accumulates cash value or tax-deferred basis, which a term policy does not.


Here’s a good look at the difference of whole between term life insurance when it comes to living benefits.


Whole Life Insurance - Living Benefit

The whole policy allows you to access funds all through your life if you needed in four important ways:


  • Cash value withdrawal. A cash value withdrawal lets you access a portion of the cash value through your permanent coverage. You won’t owe any taxes on this type of withdrawal if the amount you withdraw is not higher than your monthly payments or equal. However, taxes enter if you choose to withdraw from the interest, dividends, or capital gains. On an important note, the amount you withdraw will be subtracted from the death benefit of your policy if it’s not returned.
  • Policy loan. Of course, it’s a loan, you’ll be charged interest if you take out a loan against your coverage, but it is normally has a lower interest, unlike the other lenders.
  • Policy surrender. A policy surrender is when you decide to cancel your coverage to access the cash value portion as a one-time lump sum. Your insurance provider will give the amount, minus the outstanding loans and/or unpaid premiums.
  • Long-term care benefits. Long-term care benefit is a care you receive when you need it later in life. Adding LTC benefit to your whole life policy lets the policyholder tap into death benefit to cover long-term care expenses that normally your health insurance doesn’t cover. 


Term-Life Insurance - Living Benefit

For term coverage which covers a specific period, living benefits may a lot differ from the whole policy.


  • Accelerated death benefits. Term life living benefit allows you to access a portion of your policy if you are ever diagnosed with certain illnesses. This will help you cover medical expenses, debt, and more. Some people used the funds to trip on a dream vacation or make good memories with their loved ones. 
  • Return of premiums. A living benefit that pays and returned all the premiums you paid as long as you don’t pass away during the term. Normally, this kind of policy pays more than a traditional term policy.
  • Disability waiver of premium. While other living benefits involve cash, this benefit gives you the opportunity to skip your monthly premiums payments in the event you suffer from a long-term disability for six months or more. 


Although there are some features that make them different from each other, they also have similarities such as provide a death benefit for the people you left behind.


A licensed insurance agent or broker can help you extend and explore all your options about living benefits. They can also answer your questions about the policy you want to take. Regardless of what policy you decide to purchase make sure you are well-aware of its components. 

Thank You For Reading!



Original post here: What You Need To Know About Living Benefits Of Life Insurance

Understanding What Is Living Benefits For Life Insurance Coverage | How It Differs From Whole & Term


Watch on YouTube here: Understanding What Is Living Benefits For Life Insurance Coverage | How It Differs From Whole & Term
Originally published by Boise Health & Life Insurance Agency

Monday, July 19, 2021

Where Can You Get Health Insurance In Boise Idaho | Chris Antrim Independent Insurance Broker


Watch on YouTube here: Where Can You Get Health Insurance In Boise Idaho | Chris Antrim Independent Insurance Broker
Originally published by Boise Health & Life Insurance Agency

The Two Categories Of Health Insurance Plans

Categories Of Health Insurance Coverage |  What Are The Two Types Of Plan Available In The Market

Health insurance is everywhere. Affordable plans, reasonable rates, and combined coverage, insurance available in the market are overwhelming.


But before buying one, you need to answer the question “are you sure you’re buying the right plan?" Or "does all the medical assistance you need cover it?” . Purchasing health insurance is easy but finding the right one that covers all the medical treatment you require is tough.


All these questions will be answered once you understand the main types of health insurance and its components.

The best you need to identify about the coverage you choose is if it’s public or private, like if your coverage is a government-funded program or partially paid through your employer. In this article, you will understand how to categorize the types of health insurance .


Public Health Insurance Coverage

Public health insurance is one of the two types of health insurance, in this insurance, the health coverage is provided by a government program. Public insurance is not necessarily free, however, the cost of the monthly premiums is heavily reduced. All health insurance plans are built to help the policyholder save money on medical costs.


In Idaho, Medicare, Medicaid, or CHIP is a public health insurance program that is run and funded by the U.S. government. People with this type of coverage are still paying for their costs of care such as premiums, deductibles, and out-of-pocket expenses, but as expected the costs of these are not as high as with the other coverage.


Private Health Insurance Coverage

Private health insurance unlike public is not a government-funded program and this is the other type of health insurance. Some people get their coverage through a group plan from their employer. Employer-sponsored health insurance is considered a type of private health insurance, in which the employer pays part of the cost, giving the employee lower premiums. There’s a lot of private health insurance coverage you can choose from, but all these plans are available as well as with private insurance companies. 


If you decide to buy health insurance through private insurance or Obamacare, you may need to wait for an open enrollment period to start before you can get enrolled. There are different enrollment periods for public insurance coverage.


Regardless of what type of health insurance you’re going to buy, make sure that this plan will cover all the medical assistance you need. A plan that will provide a cover for the ten essential benefits such as preventive care and ambulatory services or medical expenses.

 

Consider having coverage?

You can check out some of our insurance services . Or need to request a quote for your plans? Give us an email. We are working with some of the top nations and insurance carriers here in Idaho, the plans and rates are guaranteed affordable and reasonable that will suit your medical needs. Just tell us what you need.

Thank You For Reading!



Original post here: The Two Categories Of Health Insurance Plans

What Are The Two Categories Of Health Insurance Coverage | Identifying What Are Their Differences


Watch on YouTube here: What Are The Two Categories Of Health Insurance Coverage | Identifying What Are Their Differences
Originally published by Boise Health & Life Insurance Agency

Thursday, July 15, 2021

What You Need To Consider When Buying Life Insurance

What Are The Things You Need To Have Before Deciding To Buy Life Insurance

Though your mind is decided to purchase life insurance from a private carrier, don’t you think that having coverage will be enough?


Not just for your but also for the one you’re leaving when anything happens to you. As you grow and understand how things work around you, buying life insurance will be the best decision you’ll make.


Not just because it will ensure the future of your loved ones when you leave them behind, it can be a useful tool that you ever expected.

Aspects To Consider When Buying Life Insurance

While your decisions are made, there are certain things you need to consider when choosing your plans and coverage. Make sure to look for an agent that will sit down on you and will help you understand all the certain options to ensure you’re getting the right coverage.


The first thing you need to know when buying life insurance is:


  1. How Long You Need Coverage.

Not all insurance is designed to cover you for a lifetime. Some insurance can last a certain period of time called term life. This type of insurance can cover you will vary on the plans you buy but in Idaho you can purchase term insurance from 1 up to 12 months depending on the carriers. Term insurance will work well for people who need coverage for a specific period of time. On the other hand, if you need life insurance for as long as you live, you can buy permanent life insurance or whole life insurance that will cover you as long as you live. Determining how long you need the coverage is the first you need to consider when you buy coverage.


    2. Determining The Amount Of Life Insurance You Need.

To calculate how much coverage you need, you must understand the word DIME in the insurance industry.

D - Debt such as a mortgage, student loan, credit card loan, and others.

I -  Income Replacement for the one you left behind, your spouse or dependents. 

M - Mortality is for burial expenses.

E-Education is when you have children who are still going to school, do you want your coverage to pay for the remaining years up to finish their school.



    3. Understanding objectives.

Some permanent life insurance can be used as savings. Permanent policies offer cash values that will increase eventually over time. It is best to ask your agent about this for more information and ideas about cash values and death benefits.


    4. Name Of Beneficiary.

It is necessary for life insurance to ask for a beneficiary. A beneficiary is the one entitles to receive the life insurance policy. It is someone close to you, maybe a friend, family, or if the policy will be for your business make sure to have a formal plan in place to ensure how the benefits will be used.


In line with these, to explore all the possible options make sure to talk with a trusted advisor, you need someone who will help and guide you throughout the process. The one who will open and will speak out for your needs. Having a trusted agent will help you in your decision-making and give you the peace of mind that whenever happens to you,  you have the right amount of coverage in your policy.

Thank You For Dropping By!



Original post here: What You Need To Consider When Buying Life Insurance

Aspects To Consider When Buying Life Insurance | Things Your Life insurance Must Have


Watch on YouTube here: Aspects To Consider When Buying Life Insurance | Things Your Life insurance Must Have
Originally published by Boise Health & Life Insurance Agency

Thursday, July 8, 2021

Identifying Which Coverage Is Right For Your Needs | Difference Between Medicaid & Long-Term Care

Which Coverage Will Suit For Your Needs & Wants? Understanding Medicaid & Long-Term Care

The most misunderstood aspects of Medicaid are it is long-term care benefits. Many enrollees are unaware of this plan, that is why they tend to choose plans without the care they want or need. Before you decid e on the plan you’re going to choose that will cover your long-term care needs, it is necessary to understand its components and how this differs from long-term care insurance.

Medicaid

We all know that Medicaid is a program designed to provide various healthcare needs and custodial services for some people who cannot afford it or have limited income and resources. Medicare long-term care is a great benefit for those who don’t have much income for their retirement or needs more care aside from what their families can provide.


However, some people decided not to buy long-term care insurance and just rely on Medicaid instead. Unfortunately, many people found out that the Medicaid they acquire does not offer what they really want and which is a little too late. The components you want such as benefits and coverage options are provided by long-term care insurance itself.


Long-Term Care Insurance

While long-term care insurance is coverage that offers all parts of nursing-home care, home healthcare, and personal or adult daycare for U.S residents aged 65 or older with a chronic condition that needs continuous care. Long-term care insurance is available at private insurance and to anyone who can afford to pay for it. This coverage offers more flexibility and options than Medicaid. The good thing about this is because you’re the one paying for this, there are no income and asset limits.


Here are the key differences between Medicaid and long-term care insurance.

As you can see there are several differences between these two. Medicaid offers limited access to your wants and needs. While the long-term care since you’re the one paying it you have all the flexibility and access to all coverage as long as you keep paying for these services. Before applying for a plan make sure you understand how it works and the components on it. It is best to ask an agent to get a full idea about this, or they even give you a better suggestion on what is right for your needs. 

Thank You For Reading!



Original post here: Identifying Which Coverage Is Right For Your Needs | Difference Between Medicaid & Long-Term Care

What Are The Difference Between Medicaid And Long-Term Care Insurance | Choosing The Right Coverage


Watch on YouTube here: What Are The Difference Between Medicaid And Long-Term Care Insurance | Choosing The Right Coverage
Originally published by Boise Health & Life Insurance Agency

Navigating Boise's Health Insurance Coverage Solutions

Health insurance coverage is an essential aspect of healthcare access, providing individuals with financial protection against the high co...