medicare advantage plans Archives

What Is A Medicare Medical Savings Account

Medicare Medical Savings Accounts (MSAs) are a special type of Medicare Advantage plan that combines a high-deductible health plan (HDHP) with a medical savings account. The HDHP portion is a type of health plan where you have to pay a large annual deductible before your coverage benefits kick in. Specifically, you are responsible for the full cost of any Medicare covered services until you meet your deductible. After you meet the deductible, your plan covers 100% of all covered services.

The savings account portion is a savings account set up by your insurance company. Medicare annually deposits a predetermined amount into the account. The amount varies depending on the plan you select but is always less than your HDHP’s annual deductible.

Just like other Medicare Advantage plans, MSAs are offered by private insurance companies that are approved by Medicare. These accounts are tax-free and allow for tax-free withdrawals for medical expenses. While similar, these plans differ from regular Medicare Advantage plans in several ways, which we will get into below.

How MSAs Work

You can immediately pay for medical services with your MSA. You are not required to wait until you meet your HDHP’s annual deductible to access it. In fact, money you use from the account on Medicare approved health services will actually help you meet that deductible. For instance, say you have an MSA plan with a $4,000 deductible and Medicare deposits $2,500 annually into your MSA. If you spend your $2,500 on Medicare-covered medical expenses, you’ll meet your deductible. Now suppose you spend the $2,500 in another way. Such as $1,500 on dental expenses and $1,000 on medical costs. Only the $1,000 will count towards your deductible. This means you now have to pay an additional $3,000 before your deductible is met.

However, there are some rules to the MSA account that you should keep in mind. For one you don’t deposit funds into this account, but you can withdraw them at any time. The account will accrue interest, and any money you don’t use will carry over into the next year. While funds you use for medical services are tax-free, any non-medical expenses could cost you. You may face a 50% tax penalty for non-qualifying medical expenses, and the money will be considered taxable income.

Qualifying Medical Expenses

While all qualifying medical expenses are exempt from federal income tax, not all of them count towards your deductible. Keep in mind that if you use your MSA for expenses that don’t count towards your deductible, you may have to pay more out-of-pocket before your HDHP provides coverage.

Qualifying medical expenses that count towards your deductible are generally inpatient and outpatient services that Medicare Parts A and B cover such as:

Hospital stays
Doctor visits
Durable medical equipment (DME)
Home health care
Skilled nursing care

Expenses that don’t count towards your deductible are:

Dental care
Vision care
Part D or other prescription drug coverage cost-sharing (premiums, deductibles, copayments, coinsurance)
Non-medical expenses (groceries, rent, utility bills etc.)

MSA Eligibility

To enroll in a medical savings account plan there are some eligibility requirements. First you have to enroll in Medicare Part A and Part B. This can be easy if you are receiving social security benefits because then you will automatically be enrolled in Parts A and B. Also, if you are eligible for Social Security or Railroad Retirement Board benefits (RRB) you don’t have to pay a premium for Medicare Part A. So basically, if you qualify for Medicare you can enroll in an medical savings account. You can enroll in an MSA plan unless:

You have health insurance that covers the Medicare MSA deductible. This includes benefits from an employer or union sponsored retirement plan.
If you get benefits TRICARE or the U.S Department of Veterans Affairs.
You’re a retired federal employee and participate in the Federal Employees Health Benefits Program (FEHBP).
You’re eligible for Medicaid.
You have End-Stage Renal Disease (ESRD), However you can still enroll in an MSA plan if you formally had a Medicare Advantage Plan and left Medicare and you haven’t joined another Medicare Advantage Plan yet.
You currently receive hospice care.
If you live outside of the U.S for more than 183 days a year in total, either consecutively or not.

Pros and Cons Of MSAs

Deciding whether or not to use an MSA is highly personal. You have to consider your current financial situation as well as any medical needs you need or anticipate needing in the future. Take a look below at the pros and cons list to help decide if this is the best plan for you.

Pros

If you are unable to afford the higher premiums of a traditional plan, the HGHP plans can prove to be a more cost-effective alternative. An MSA refuses total costs, creating a Medicare plan with several advantages, especially if you are in good health. You do not pay into this account so there are no additional enrollment fees. Additionally, funds roll over annually. So if you are in good health you have the opportunity to continue saving your MSA funds year after year. Thus creating a large healthcare fund for any emergencies. Finally, there is no tax penalty on funds you use for qualifying medical expenses. This allows you to spend the money on medical expenses without having to report it as income.

Cons

The most significant disadvantage of an medical savings account is the high deductible. If you don’t reach this deductible within the year you could be left with large medical bills that you have to pay out-of-pocket. Additionally, if you use the funds for non-medical expenses you face a severe tax penalty. Meaning you have limited financial flexibility in the event of a non-medical emergency.

Cost of MSAs

The premiums for these plans vary depending on your plan. Additionally you have to continue to pay your Medicare Part B premiums. Your out-of-pocket expenses will also vary based on your plan and how you use your MSA funds. Different plans have different deductibles, and Medicare deposits varying amounts of money into your account.

MSAs Vs. HSAs

In some respects, the concept of an MSA plan is similar to high-deductible health plans (HDHPs) and health savings accounts (HSAs). However HSA contributions come from your employer, you, or anyone else who wants to contribute to the account. Whereas MSA contributions come from your Medicare Advantage plan. The money comes from funds that Medicare allotts to you, meaning you cannot contribute to your own MSA.

You can then use the MSA funds to pay for medical expenses throughout the year. Your MSA withdrawals are tax-free as long as you use them for qualified medical expenses. You can also use the funds for non-medical expenses, such as groceries, rent or utility bills. However any non-medical withdrawals are considered taxable income and also have a 50% penalty.

Similar to HSAs, MSA funds that remain unused at the end of the year will roll over into the following year. If you maintain your plan then next year’s deposit will be added to the funds remaining from the previous year.

MSAs Vs. FSAs

An MSA is typically for Medicare recipients, while a flexible spending account (FSA) is typically for employees with optional coverage. Accounts for FSAs have a “use it or lose it” rule. Meaning the funds will not roll over. However, some plan administrators may provide brief grace periods at the end of a benefit year to give employees an extra chance to spend the funds. FSAs are not a great long-term savings option, even for those who can benefit from the tax savings they offer. Additionally, if you change employers, you will most likely lose your FSA. Unlike MSAs, FSAs typically do not allow you to use the funds for non-medical expenses.

When to Enroll

You can enroll in an MSA when you first become eligible for Medicare during your Initial Enrollment Period (IEP). This is the 7-month period that starts 3 months before you turn 65, including your birth month, and then comes to a close 3 months after you turn 65. If you are eligible for Medicare due to a disability, you can enroll 3 months before and after you’ve received at least 25 months of disability benefits. You can also enroll during the fall Open Enrollment Period, between October 15th and December 7th every year. If you enroll during this time, your coverage will start on January 1st.

Let EZ Help

If you’re interested in an MSA, EZ.Insure can help you compare options based on deductibles and benefits, such as vision and dental care. We will assign you with your own personal agent who can answer all of your questions and help you find the best plan while saving you money. Our help is totally free! To get your free instant quotes give one of our licensed agents a call at 877-670-3602 or simply enter your zipcode into the box below. Let us remove the hassle of shopping around and make it simple for you.

Medicare Advantage Vs. Medicare

You’re probably already familiar with Original Medicare, especially if you’re nearing the age of 65 and getting ready to enroll. You may not be aware, though, that there are some gaps in Original Medicare’s coverage, which lead many people to either add a Medicare Supplement Plan or choose a Medicare Advantage Plan. Medicare Advantage Plans, also known as Medicare Part C, are very similar to Original Medicare. However, there is a slight difference between the two, mainly that Medicare Advantage Plans offer more coverage than Original Medicare.

caucasian hand over an older caucasian hand bringing it towards blocks — *Medicare Part B covers physical therapy, doctor visits, and more.*

Original Medicare Overview

Medicare is a government health insurance program consisting of:

Part A– Hospital insurance that covers hospital stays, skilled nursing care facilities, hospice care, and limited home healthcare services.
Part B– Medical insurance that covers preventive services, doctors’ office visits, flu shots, physical therapy, durable medical equipment, diabetes screening and supplies, and mental health care.

In most cases, you will not pay a monthly premium for Medicare Part A; the Medicare taxes that you paid while you were working are what pay for Part A. However, Part A does have a deductible, coinsurance, and co-payments.

Part B, on the other hand, does have a monthly premium: the Medicare Part B premium for 2020 is $144.60, but could be higher depending on your income. Like Part A, Part B also has a deductible, coinsurance, and co-payments for most services. Medicare Part B covers 80% of your costs, meaning you will need to pay the remaining 20% of any bills.

Medicare Advantage Overview

Medicare Advantage is an “all-in-one” alternative to Original Medicare. Private insurance companies approved by Medicare can offer Medicare Advantage Plans. Unlike Original Medicare, most Medicare Advantage Plans include prescription drug coverage, and some plans offer more benefits, like routine dental or hearing care. In order to be eligible for Medicare Advantage, you have to be enrolled in Medicare Part A and Part B. You must also live in the plan’s service area, and you cannot have end-stage renal disease.Medicare Advantage Plan premiums differ from plan to plan. Many Medicare Advantage Plans have low-cost, or even $0, premiums. The average Medicare Advantage premium is only $30 a month. Remember, you will still have to pay your monthly Medicare Part B premiums in addition to any Medicare Advantage premium.

The Similarities

All Medicare Advantage Plans have to offer at least the same benefits as Medicare Parts A and B do. This means that if Original Medicare covers hospital care at a certain level, then so will a Medicare Advantage Plan.

The Differences

The benefit of Medicare Advantage Plans is that they offer more coverage than Original Medicare. The following chart breaks down the differences between the two:

Mutual of Omaha Plans To Sell Medicare Advantage Plans in 2019

In 2019, Mutual of Omaha, an Omaha-based insurer will begin selling Medicare Advantage plans with prescription drug coverage. They have partnered up with Lumeris, a St. Louis company that will handle the health provider networks, and healthcare solutions.

The Kaiser Family Foundation recorded that one in three Medicare recipients are enrolled in a Medicare Advantage plan. They project the number to rise to nearly 41 percent by the year 2027.

Omaha is introducing Medicare Advantage Plans in 2019. — *Omaha is introducing Medicare Advantage Plans in 2019 to provide options for seniors.*

The Plan

James Blackledge, the Mutual Chairman and CEO said “Our entrance into the Medicare Advantage market represents a significant step forward for Mutual of Omaha as we strive to respond to customer needs and offer a meaningful suite of senior health solutions. We’re confident that our collaboration with Lumeris will lead to better health outcomes for our Medicare Advantage customers.”

Mutual started in 1909, and has been one of the first providers of Medicare Supplement plans. But recently Medicare Supplement plan sales have been declining, while Advantage sales have increased.

Lumeris has over 10 years of experience with Medicare Advantage plans, even starting their own called Essence Healthcare, which has about 65,000 members in the St. Louis area. They have built a value-based model to provide seniors with better health for a lower cost while providing a better patient and physician experience. The company functions to help other medical providers deliver better care and financial outcomes by its value-based care model.

*The idea is to create more plans so that Medicare beneficiaries can save money, and receive better care.*

“Our new initiative with Mutual of Omaha is exciting because it enables both of our companies to build on our successes while remaining laser-focused on what matters most—delivering the highest quality care to seniors,” said Lumeris Chairman and CEO Mike Long. “This new partnership also leverages each company’s unique strengths to benefit the larger healthcare ecosystem. Together, we will make a deeper, more meaningful difference in the lives of patients and providers.”

Hopeful Future

The alliance between the companies will allow Mutual of Omaha to continue to lead in the senior health market. Mutual will provide Medicare Advantage plans, while Lumeris will evaluate markets, and establish networks.

A Mutual executive vice president, Brad Beuchler said that the plans will have narrow networks. The networks will be limited as to how many physicians, hospitals and care providers to choose from. This way there will be reduced costs while improving efficiency and medical outcomes.

The multiyear agreement is expected to be ready by Medicare open enrollment October 15, and the plans taking effect January 1, 2019. This will hopefully provide better healthcare quality with lower costs for seniors.

Medicare Advantage Plans Have A $0 Premium For Most

When it is time to consider Medicare, usually around the time you turn 65 years old, it would be wise to take a look at different Medicare Advantage plans. Medicare Advantage plans, also known as Medicare Part C, usually offer more benefits than Original Medicare for a lower cost. About one-third of Medicare beneficiaries have chosen to go with a Medicare Advantage plan, and it is projected to be almost 34% more in the upcoming years. The reason for this estimated rise and popularity is due to how many benefits you get at such a low cost, in fact, many plans have a $0 premium.

prescription drug bottles — *Medicare Advantage Plans will cover things that Original Medicare does not, such as prescription drug coverage.*

How Medicare Advantage Works

Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. MA plans include both Medicare Part A and Part B. When you enroll, you continue to pay your Part B premiums, and you have a separate monthly premium for having the Medicare Advantage plan (Part C plan). The Part C plan offers the same benefits offered by Original Medicare along with medically necessary procedures, prescription drug coverage and other benefits like vision and dental.

You must have Medicare Parts A and B to join an MA plan. You must also live in the plan’s service area, and you must not have End-Stage Renal Disease (ESRD).

Different Medicare Advantage plans:

Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Private Fee-for-Service (PFFS)
Special Needs Plans (SNPs)
HMO Point-Of-Service (HMOPOS)
Medical Savings Account (MSA)

How Cheap Medicare Advantage Costs

hundred dollar bills inside a glass jar. — *Medicare Advantage Plans will help you save money, especially since most plans have a $0 premium.*

If you worked for at least 10 years and paid Medicare taxes, then your Part A premiums are free, if not you will pay a monthly premium. The standard Part B monthly premiums for 2018 is $134, but may be higher depending on your income. For a Medicare Advantage plan (Part C), you pay very little. Around 81% of Medicare enrollees have the option of a $0 premium plan. If you do end up paying $0, you may be responsible for paying higher cost sharing such as copays, coinsurance, or deductibles (which is determinant on the plan you choose).

The average Medicare Advantage plan premium in 2018 will be around $30, and can range anywhere from $0 to $200 a month. An example of how affordable these plans are, are the estimated monthly premiums of different Advantage plans in 2017. HMO monthly rate was around $28, the Regional PPO plan was $41, and the Local PPO was around $55.

All Medicare Advantage plans include a yearly Maximum Out-of-Pocket amount. This amount is the maximum you will pay out of pocket for covered services within a year. When this limit is met, your plan will cover 100% of the costs for the rest of the year.

Need Help?

Medicare’s Open Enrollment is October 15-December 7 every year, which is when you can enroll into a Medicare Advantage plan. EZ.Insure will answer any questions you might have regarding the different plans, and guide you through the process. Start saving on Medicare costs with a low costing, or $0 premium Medicare Advantage plan! Our agents are trained and knowledgeable on the plans in your area. To start saving, contact an agent by entering your zip code in the bar above, email replies@ez.insure, and call 855-220-1144. What’s even better, is you get all this help from our agents free of charge. Our goal is to help you save and provide you with the best customer service possible.

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