Medicare Insurance Products

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Medicare Specialist Insurance Kristin Sinclair

Kristin Sinclair: Your Medicare Insurance Professional. 

Kristin understands how important it is that Medicare Supplements once issued are guaranteed for life.  Once issued and accepted by you these supplements cannot be cancelled by the insurance company as long as you pay your premiums on time.

Kristin can help you find the Medicare Supplement product that fits your coverage needs and your budget. Over 90% of the Physicians Nationwide accept Original Medicare.  Medigap Policies are also known as Medicare Supplements work with the Original Medicare. You will be able to rely on your Medicare Supplement to help make your coverage more  complete.  Coverage that travels with you anywhere n the Good Old USA !  Enjoy the opportunities that a life of working helped make possible.

Kristin’s team has been providing clients with insurance coverage since 1987.  You can apply for Medicare Supplement coverage year round – no need to wait for an annual enrollment period.  Contact Kristin today for a Medicare Supplement that fits your needs

 

 


Index of Medicare Articles

New Medicare Cards on the Way!

New Medicare Cards are Coming!

by Kristin P. Sinclair – A Accu Tax – September 6, 2018

You might have yours already, if not they are being mailed in stages. It is expected that over the next month or so, Medicare Beneficiaries who are residents in North Carolina, South Carolina, Georgia, and Florida will be getting new cards.

So something to think about, is your address current with Social Security and with Medicare? You certainly want your important mail to get to You. And You definitely would not want someone else to get your mail.

3 things to know

Your new card will automatically come to you. You don’t need to do anything as long as your address is up to date. If you need to update your address, visit your My Social Security account. Visit your local office, or call to schedule your appointment. Find out what you need to have with you to provide proof you are you…..

Once you get your new Medicare card, destroy your old Medicare card and start using your new card right away.

Your new Medicare Number is a unique combination of numbers and letters. Your new number uses numbers 0 thru 9. And Letters.

The letters S, L, O, I, B, and Z are never used.

 

Watch out for scams

Medicare will never call you uninvited and ask you to give personal or private information to get your new Medicare Number and card.

Scam artists may try to get personal information (like your current Medicare Number) by contacting you about your new card.If someone asks you for your information, for money, or threatens to cancel your health benefits if you don’t share your personal information, hang up and call us at 1-800-MEDICARE (1-800-633-4227).

When you visit your insurance agent in October or November to review your drug plan options you will want to have your new medicare card with you if it has arrived. As well has a current PDP card as well. And a list of the medications that you are taking. Your Medicare Number is referenced on your application for your Medicare Part D plan coverage even though you have a unique ID number for your drug coverage with your insurance company.

When your new medicare card arrives, feel free to call your insurance company to inquire how they update their records when new medicare cards numbers are issued. Find out if they need you to update them, or if they are updated by Medicare. You want to be the person in the know. You want to feel confident that you are in control.

 

Guard your card and protect your personal information

To help protect your identity, Medicare is mailing new Medicare cards. Your new card will have a new Medicare Number that’s unique to you, instead of your Social Security Number.

Don’t share your Medicare Number or other personal information with anyone who contacts you by phone, email, or by approaching you in person, unless you’ve given them permission in advance.

Medicare, or someone representing Medicare, will only call and ask for personal information in these situations:

  • A Medicare health or drug plan can call you if you’re already a member of the plan. Theagent who helped you join can also call you.
  • A customer service representative from 1-800-MEDICARE can call you if you’ve calledand left a message or a representative said that someone would call you back.
  • Only give personal information like your Medicare Number to doctors, insurers acting onyour behalf, or trusted people in the community who work with Medicare like your StateHealth Insurance Assistance Program (SHIP).
  • Be familiar with how Medicare uses your personal information. If you join a Medicareplan, the plan will let you know how it will use your personal information.If someone calls you and asks for your Medicare Number or other personal information, hang up and call Medicare at 1-800-MEDICARE (1-800-633-4227).

Medicare Part B: Is it covered?

by Kristin P. Sinclair – A Accu Tax – September 1, 2018

what-is-a-fixed-annuityIs your test, item, or service covered?

Medicare coverage for many tests, items and services depends on where you live. This list only includes tests, items and services that are covered no matter where you live. If your test, item or service isn’t listed, talk to your doctor or other health care provider. They can help you understand why you need certain tests, items or services, and if Medicare will cover them.

  • Abdominal aortic aneurysm screening one time test covered by Medicare
  • Advance care planning annual opportunity to review with your Doctor Annual Wellness Visit
  • Air-fluidized beds & other support surfaces When Your Doctor orders such as medical needed
  • Alcohol misuse screening & counseling
  • Ambulance services
  • Ambulatory surgical centers
  • Anesthesia
  • Artificial eyes & limbs
  • Bariatric surgery under certain circumstances
  • Blood after the first thee pints
  • Blood processing & handling
  • Blood sugar (glucose) monitors
  • Blood sugar (glucose) test strips
  • Bone mass measurement (bone density)
  • Braces (arm, leg, back, and neck)
  • Breast prostheses
  • Canes
  • Cardiac rehabilitation programs
  • Cardiovascular disease (behavioral therapy)
  • Cardiovascular disease screenings
  • Cataract surgery
  • Cervical & vaginal cancer screenings
  • Chemotherapy
  • Chiropractic services
  • Chronic care management services
  • Clinical research studies certain studies with cost sharing
  • Colorectal cancer screenings
  • Commode chairs
  • Concierge care
  • Continuous passive motion (CPM) machine
  • Cosmetic surgery for certain situations when medically necessary
  • Crutches
  • Custodial care if it is part of the skilled care your Doctor has determined is medically necessary
  • Defibrillator (implantable automatic)
  • Dental services part of inpatient hospital care when medically necessary
  • Depression screenings
  • Diabetes screenings
  • Diabetes self-management training
  • Diabetes supplies & services
  • Diagnostic tests
  • Dialysis (children)
  • Dialysis (kidney) services & supplies
  • Doctor & other health care provider services
  • Durable medical equipment (DME) coverage
  • EKG or ECG (electrocardiogram) screening
  • Emergency department services
  • Enteral nutrition supplies & equipment (feeding pump)
  • Eye exams
  • Eyeglasses/contact lenses
  • Federally Qualified Health Center Services
  • Flu shots
  • Foot care
  • Foot exam
  • Glaucoma tests
  • Glucose control solutions Well the Medical Community can Guide You, You make the solution.
  • Health education & wellness program an example would be a Cardio Rehab program
  • Hearing & balance exams when determined to be medically necessary
  • Hepatitis B shots
  • Hepatitis C screening test
  • HIV screening
  • Home health services for skilled intermittent care
  • Hospice part of Medicare Part A
  • Hospital beds Durable Medical Equipment
  • Inpatient hospital care Medicare Part A
  • Insulin
  • Kidney disease education
  • Kidney transplants (adults) If the Adult is a Medicare beneficiary Part A and Part B are factors
  • Kidney transplants (children) If the Child is a Medicare beneficiary Part A and Part B are factors
  • Laboratory services (clinical)
  • Lancet devices & lancets
  • Lung cancer screening
  • Macular degeneration eye exam and a few other medical conditions as well, not preventative.
  • Mammograms a schedule exists review with your Health Care Provider for your benefits.
  • Manual wheelchairs & power mobility devices Durable Medical Equipment
  • Mental health care (inpatient) Medicare Part A
  • Mental health care (outpatient) Medicare Part B
  • Mental health care (partial hospitalization)
  • Nebulizers & nebulizer medications Medicare Part D
  • Nursing home care Limited period of time when parameters are met, oop cost sharing exists
  • Obesity screening & counseling
  • Osteoporosis drugs for women
  • Outpatient hospital services Medicare Part B
  • Oxygen equipment & accessories
  • Physical therapy/occupational therapy/speech-language pathology services
  • Pneumococcal shots
  • Prescription drugs (outpatient) Medicare Part D
  • Preventive visit & yearly wellness exams
  • Prostate cancer screenings
  • Prosthetic devices
  • Pulmonary rehabilitation
  • Radiation therapy
  • Second surgical opinions
  • Sexually transmitted infections (STI) screening & counseling
  • Shingles shot Medicare Part D Review with your Insurance provider
  • Shots (vaccinations) Medically necessary Review which are covered with your Medicare Part D
  • Skilled nursing facility (SNF) care Up to 100 Days when parameters are met with cost sharing
  • Sleep apnea & Continuous Positive Airway Pressure (CPAP) devices & accessories
  • Sleep study
  • Smoking & tobacco use cessation (counseling to stop smoking or using tobacco products)
  • Substance-related disorders
  • Surgery (estimating costs)
  • Surgical dressing services
  • TDaP shot (tetanus, diphtheria, & pertussis shot) Medicare Part D
  • Telehealth
  • Therapeutic shoes or inserts For Certain Medical Conditions when Medically Necessay
  • Traction equipment
  • Transitional care management services After Hospitalization under certain situations briefly
  • Urgently needed care
  • Walkers Durable Medical Equipment
  • X-rays

 

This lists shows many, but not all, of the items and services that Medicare might cover..

Medicare.gov has a search engine that you can populate the field with your item to look up and

you can see what is covered by what part of the Medicare system. A, B, D etc. And this search engine can also provide detail as to what is not covered.

 

For more information, view the official medicare.gov website https://www.medicare.gov/

 

Kristin P Sinclair

@Sinclair Financial Solutions

803-329-0615

 

August 22, 2018

Rock Hill, SC 29730

 

Take Advantage of the “Welcome to Medicare” Visit

by Kristin P. Sinclair – A Accu Tax – August 21, 2018

Screenings, shots, and referrals can be achieved. You will find you will be a very important part of your well being, be willing to talk and share information with your health care provider.

Do yourself a favor and have a written down set of notes that you can provide your health care provider about family history of health concerns. Your doctor will likely have this information added to your records. Make a copy; you will want to share this detail with your various medical care providers.

Provide your health care provider detail about your exercise patterns. And ask your provider to help when you know that you need guidance on your exercise journey.

Provide your health care provider a list of the RX medication(s) you are taking, as well as your over the counter vitamins and minerals, and herbs you are taking and what schedule to have in place to take the above.

 

Yearly Wellness Visit

Yearly, covered every 12 months. If things have changed you need to share this with your Doctor. If you are out walking more days and enjoying the trees and flowers and listening to the birds sing to you let your Doctor know that. Share with your Doctor all the things you are doing to help make you healthier. If you need advice to help you reach your goals, you need to also let your Doctor know that you feel you need help to achieve your goals. Your Doctor can advise you it you want to alter the schedule to walk after a meal.

Your annual wellness visit is a chance to share information and gain information. It is a chance to talk about what has changed.

And every day of the year you have an opportunity to make changes which can be shared as you wear out one pair of tennis shoes and replace them with new pairs. Your out of pocket costs for new tennis shoes that you use wisely, and new insoles for your shoes are a small price compared to some other choices.

Did you know that when you take a walk in a park and enjoy the trees and flowers which bring you oxygen and clean the air that you breath you can make a tremendous difference in how you feel and look at your day.

Did you know that when you take a walk you are helping your body bring precious supplies of nourishment to your brain. And you also make additional changes as well which can make your next annual wellness visit reason to celebrate. As you see others out enjoying the great opportunities each day it can make it possible to share a hello with others. Enjoy the smile you feel as you enjoy your accomplishments.

Then after your exercise, enjoy the opportunity to relax, and clear your mind. Enjoy the feeling of being awake and relaxed, and simply enjoy being in the moment for a little while before you begin the rest of your day.

Kristin Sinclair

@ Sinclair Financial Solutions

803-329-0615

 

Updated August 2018

Rock Hill SC

Medicare Part B: Let’s Review Some More Detail

by Kristin P. Sinclair – A Accu Tax – August 15, 2018

medicare

Abdominal Aortic Aneurysm Screening

This is a one-time covered test.

So if you and your Doctor Feel that you need to have this test done again sometime after the initial testing, this would be an example of you having some out of pocket costs for the testing.

There is a potential way to get several items reviewed and supply your Doctor with the results. Many of you have heard of Life Line Screening. You can have several tests done for a low fee. All in the convenient location of where the Life Line Screening is being done in your area.

 

Bone Mass Measurement (Bone Density Screening)

Medicare covers this test once every 24 months when certain criteria are met.

So sometimes you need to be proactive in taking care of yourself before an issue becomes medically necessary. Something you can do to be good to yourself. Just like you know you need to exercise your body to remain healthy, you exercise your wallet when you purchase those tennis shoes you will wear when you take your walks. You will sometimes want to exercise your wallet and get some cost efficient tests done and share the results with your Health Care Providers.

Bone Mass Measurement also called Bone Density Screening, this too is an example of one of tests you could have done at a Life Line Screening location. And supply your doctor with the results.

 

Cardiovascular Disease Screening

Medicare covers screening blood test for cholesterol, lipid, and triglyceride levels every 5 years.

I have some news for you. If you apply for a life insurance policy at certain levels of coverage the insurance company is likely going to have a paramed exam completed that will likely include a blood test. You can request a copy of those lab results and supply that information to your health care provider. And likely your Doctor will very much appreciate having this information available before a time frame of 5 years has come and gone

 

Diabetes Screening

Medicare Part B will cover these tests if your Doctor determines you are at risk.

For instance if you have hypertension, if you have high cholesterol, high triglyceride levels.

For instance if you are obese, if you have a history of high blood sugar, or high glucose levels.

If you are 65 or older and have a family history of diabetes, or are over weight, or if you had gestational diabetes during pregnancy, or gave birth to a child 9 lbs or in weight.

Your Doctor might want to run tests more often than Medicare covers those tests. Your Doctor office will let you know if additional out of pocket funds are due. You will determine what you want to pursue. One of those things to pursue will likely be those marvelous tennis shoes just waiting for you to use them more often. You are worth what you need to make yourself more healthy.

 

Flu Shot

When You have Medicare Part B, one of the annual benefits available to you is the annual Flu Shot. It might not have an out of pocket charge to you if, your provider Your Doctor or another qualified health care provider, accepts assignment. Yes, it is getting to be that time of year again.

 

Pneumococcal shots

Medicare Part B will cover this shot(s) if your provider accepts the Medicare assignment you would not have additional out of pocket (oop) costs. Did you know that there is more than one type of pneumococcal shot. One shot is covered one year the other type is covered one year later. So you will want to discuss this schedule with your doctor. A good time to (discuss) these things is during you Annual Wellness Visit. Your Doctor can provide you with a nice schedule that you will want to keep and use a guide for your future visits that you will schedule. Talk with you Doctor to find out which shot they feel you might need and when it will be time to schedule that event.

 

Updated in Rock Hill, SC

Kristin P Sinclair

@Sinclair Financial Solutions

803-329-0615

Medicare and Yes, I Have Choices

by Kristin P. Sinclair – Charlotte NC – August 15 2018

Other items to include in your decision making when it comes time think about health care.
Which Health Care practitioners(s) you wish to offer your health care during the year. Does the provider accept Medicare, if yes, then they will accept your Medicare supplement as well.

Next question, when the health care provider accepts Medicare, do they accept the Medicare Advantage plan you are considering. Well, you need to verify that before you make you plan decision. Health Care providers have the option to either accept a Medicare Advance Plan as an insurance option, or possibly they could make a choice to not accept Medicare Advantage plans. Many Advantage Plans are Network Based.  Many Advantage Plans have a geographic area that offer the particular plan design. The Providers that accept the Medicare Advance Plan will usually be geographically accessible to that specific plans area.

Original Medicare is a Federal Program, Insurance products which work with the Original Medicare follow both Federal and State Guidelines.  Original Medicare will provide coverage with in the United States. Medicare Part A offers coverage to help with the costs for a Medically necessary  in patient hospital stay(s), with applicable Deductible and Co-Insurance cost sharing. When you select  a  Medicare Supplement plan, you are selecting a plan to help fills the gaps in Original Medicare.
Medicare Part B is the out patient care portion of medicare, Medicare Part B has an annual deductible and co-insurance cost sharing as well, the Medicare Supplement plan you select will offer coverage  to help fill gaps in the Original Medicare.

Helping to fill the gaps in the Original Medicare is going to reduce your out of pocket costs associated with health care.

Medicare Advantage Plan often you must use providers who accept your plan, and the plan could have limits on where you can travel and still have access to benefits if not in an emergency situation. And If you travel away from home for a period of greater than 2 months, you might need to change your plan, because of the amount of time you have chosen to be away from home.  Medicare Advantage plans have specific geographic regions, states, or counties that they offer coverage. MA will have annual contracts with Medicare, they must be as good as Original  Medicare and they will have Out of Pocket limits annually which can change per annual period.  Often the MAPD (Medicare Advantage Prescription Drugs) will be one policy choice for Hospital, Out patient and Drug plan coverage.

Stand Alone Prescription Drug plans are approved  Federally,  Center for Medicare Services, and  are State specific.  Stand Alone Medicare Part D covers the medications which are not administered under Medicare Part A or Medicare part B, Medicare Part D medications will usually be the medications you fill at your preferred local pharmacy or the mail order service your Part D provider has in place for your benefit as a potential cost saving opportunity when you seek a 90 mail order alternative. Using your plans  Preferred Mail order provider might offer you savings through out the Annual Period. A Medicare Part D plan will help round out your coverage when you select a Medicare Supplement.

From Oct 15th though Dec 7th each annual period you have what is called the annual Enrollment period, also called the Open Enrollment period. This is a time that you will review various Medicare Part plan and various Medicare Part C plans to decide what change you will make for the coming year. If a change is indicated.

However, Medicare Supplement or MediGap plans do not have the Annual Enrollment Period.
You can keep your plan as long a you pay your premiums. You have the opportunity to change your Medicare supplement plan any time of the year. As long as you can pass any underwriting requirement which might be applicable.

If you move to another state, you have guarantee issue rights so long as you make your change within 63 days of the change of residents.  Always keep a record of which plan you have and keep your letters you receive from your plan pertaining to your rights. Medicare has protections in place for your benefit.  We live in a mobile culture. It is great that we have the protections available to us, especially after our life time of work. We certainly deserve the protections that Medicare makes available to us.

 

Kristin P. Sinclair (803)329-0615
Charlotte NC, Rock Hill SC and Charleston SC
August 15 2018

* For those under age 65 that have Medicare Coverage due to a disability, and suffer End-Stage Renal disease there may be limitations to their coverage options.

KPS: More information available at Medicare.gov

 

 

 

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What Are Medicare Supplements ?

by Kristin P. Sinclair  – A Accu Tax  – September 12, 2018

Medicare Supplements are policies sold by private insurance companies. Medicare supplements are designed to help pay many of the health care cost not covered by Original Medicare.

Medicare Supplement plans are standardized. Meaning the basic plan design with a Letter Designation such as Plan F or High Deductible Plan F, Plan G,  Plan L or Plan N, has a standard set of benefits for that particular Letter used to describe what basic standard features are in the plan. Some companies will offer Value Added Benefits above and beyond the Supplemental Benefit.

Some companies will not have a plan which has added Value Added Benefits above and beyond the Supplement Benefit. Some companies will indeed have Value Added Benefits, so as a consumer you will want to ask your agent about things which you as a consumer are interested in to determine a plan which might be suitable for you needs.

 

Updated in Charlotte NC and Charleston SC

by Kristin P. Sinclair   A Accu Tax – Rock Hill SC

(803)329-0615   September 12, 2018

KPS: More information is also available at Medicare.gov

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Part B covers 2 types of services, and it’s great to have those protections

by Kristin P. Sinclair – A Accu Tax – August 15, 2018

Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.

Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment

Part B covers things like:

  • Clinical research
  • Ambulance services
  • Durable medical equipment (DME)
  • Mental health
  • Inpatient
  • Outpatient
  • Partial hospitalization
  • Getting a second opinion before surgery
  • Limited outpatient prescription drugs

2 ways to find out if Medicare covers what you need

  1. Talk to your doctor or other health care provider about why you need certain services or supplies. Ask if Medicare will cover them. You may need something that’s usually covered but your provider thinks that Medicare won’t cover it in your situation. If so, you’ll have to read and sign a notice. The notice says that you may have to pay for the item, service, or supply.
  2. Find out if Medicare covers your item, service, or supply.

Medicare coverage is based on 3 main factors

  1. Federal and state laws.
  2. National coverage decisions made by Medicare about whether something is covered.
  3. Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

 

For more information, view the official medicare.gov website: https://www.medicare.gov/

Kristin P Sinclair

@Sinclair Financial Solutions

803-329-0615

August 15, 2018

Rock Hill, SC 29730