Arizona Local Medicare Broker

Ralph Bredahl - Independent AZ Licensed Medicare Broker Agent, since 2007
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Surge in Medicare Advantage Sign-Ups

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Medicare Advantage Signups 

medicare advantage signups    WASHINGTON — Five years into Medicare spending cuts that were supposed to devastate private Medicare options for older Americans, Medicare Advantage signups in private insurance plans through Medicare has shot up by more than 50 percent, confounding experts and partisans alike and providing possible lessons for the Affordable Care Act’s insurance exchanges.

When Congress passed President Obama’s signature health law nearly six years ago, it helped offset the cost by cutting payments to Medicare Advantage plans, offered by private insurers operating under contract with the government. Insurers and Republicans said the cuts — about $150 billion over 10 years — would “gut” the program, a major theme in the 2010 and 2012 elections. The Congressional Budget Office predicted that enrollment would fall about 30 percent. [Read more…]

Arizona Medicare Advantage-Nutshell

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Arizona offers many choices for Medicare Advantage plans. HMO, PPO, PFFS, POS and SNP

Ralph Bredahl is an Independent Medicare Broker in Arizona and is licensed in the state of Arizona. Medicare beneficiaries in Arizona have many choices when deciding on a Medicare Advantage plan and it can be a confusing choice. To enroll in an Arizona Medicare HMO, you must have Medicare Part A and Medicare Part B, pay your Medicare Part B premium and live in the plans area

“As an Independent Medicare Broker in Arizona I have clients telling me that the task of choosing a plan for their needs is daunting” explained Ralph an independent broker with Arizona Medicare Advisors.  (Health Maintenance Organization), PPO (Preferred Provider Organizations), PFFS (Private Fee-for-Service). POS (Point of Service) and SNP (Special Needs Plans) are all Medicare Advantage options available to Medicare Beneficiaries in Arizona. There is no best plan or best type of plan since everyone has different needs. An overview of Medicare Advantage plans available in Arizona follows: Arizona Medicare Brokers

Arizona Medicare Advantage Plans
HMO (Health Maintenance Organization) An HMO is a Medicare Advantage plan where, other than emergency, your health care is managed by a primary care physician. The primary care physician refers its patients to the appropriate specialist. All specialists referred to must be in the plans network. You are not required to go to a network provider in the event of an emergency. Arizona Medicare Advantage plans are generally available by county and some companies even go by zip codes.

PPO (Preferred Provider Organizations) An Arizona Medicare Advantage PPO differs from an HMO in a couple of important ways. You are not required to go to your primary Physician to have a referral to see a specialist. Also, you can see a provider that isn’t in the network, but you would have to pay higher copays. Once again Arizona PPO plans have a network and are available by county or sometimes cities.

PFFS (Private fee For Service) Medicare beneficiaries in Arizona can opt for a Medicare Advantage PFFS plan. An individual enrolled in a PFFS can go to any Medicare-approved doctor or hospital that accepts the plan’s payment terms and agrees to treat you. However, not all health care providers will. In some PFFS that have a network, an individual may be able to go out-of-network for certain services usually, for a higher cost. Arizona plans are generally available by county of residence.

POS (Point of Service) Like an HMO, an Arizona Medicare Advantage POS plan requires that you have or select a primary care physician from within the plan network. And like a PPO plan, you have the option of using out-of-network physicians. The difference is that an out of network provider must first be approved by the plan. Unapproved out-of-network care will not be covered by the plan or by Medicare. In addition, you usually pay more for an approved out-of-network service than for the same service in-network.

SNP (Special Needs Plans) Special Needs Plans (SNPs), a form of Medicare Advantage plan, were authorized in 2003 to provide a managed care option for three groups of beneficiaries with significant or relatively specialized care needs

1. Medicare beneficiaries who are dually eligible for Medicare and Medicaid (In Arizona AHCCCS)

2. Beneficiaries living in nursing homes or other institutions.

3. Beneficiaries with severe chronic or disabling conditions. Several companies in Arizona offer SNP plans

To learn about Medicare Supplements and Medicare Part D Plans go to

Contact an Arizona Independent Medicare Broker

If you are confused about the Arizona Medicare plan options that you have or just would like to review your current plan, call me at 602-390-8573.

 

Senior Health Common Facts

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What are some common facts about health in seniors?

  • As people get older, physiological changes occur in their body as a natural part of aging.
  • Physical changes due to aging can occur in almost every organ and can affect seniors’ health and lifestyle.
  • Some diseases and conditions become more prominent in the elderly.
  • Psychosocial issues can also play a role in physical and mental health of older adults.
  • A balanced diet and regular exercise are strongly linked to better health outcomes in seniors.
  • A series of routine screening tests and preventive measures are recommended for the elderly.
  • Important preventive measures at home can improve the safety and health of seniors.
  • Geriatrics is a medical subspecialty dedicated to the care of the elderly. Physicians who have specialized training in this field are known as geriatricians.

[Read more…]

Senior Sleep Disorders How Much sleep is needed

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  • By Diana Rodriguez | Medically reviewed by Pat F. Bass III, MD, MPH

Getting enough sleep is important for everyone, but it’s especially vital for seniors. Follow these steps to a better night’s rest.

Many seniors deal with a number of health problems related to aging — one in particular is sleep disorders or not getting enough healthy sleep. It’s not the advancing of age per se that keeps seniors from a good night’s rest, but various sleep disorders or sleep disturbances that often come with age. [Read more…]

Healthy Aging -7 Steps

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Great ideas to help Aging

Getting older involves change, both negative and positive, but you can enjoy aging if you understand what’s going on with your body and take steps to maintain your health.

Many different things happen to your body as you age. Your skin, bones, and even brain may start to behave differently. Don’t let the changes that come with old age catch you by surprise.

Here are some of the common ones: [Read more…]

Sitting harmful to health

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Senior Health Alert

Researchers are finding that a sedentary lifestyle is harmful to your health, and over time, sitting on your backside can literally kill you. Thanks to the electronic age, people worldwide are spending less time in physically active jobs and hobbies and more time sitting at computer screens and texting via smartphones. At home, couch potatoes watch TV, pay bills online and catch up with friends via Facebook and FaceTime – all without standing up and moving around. As people of all ages sit for longer periods of time, their metabolism slows, circulation decreases and muscles become weak and stiff.   [Read more…]

Slow Cognative Loss as you Age

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Activities that slow cognitive loss

By Grace Burke

Mental Activity

  • • According to the senior care directory, keeping the brain active seems to increase its vitality and may build its reserves of brain cells and connections and may actually generate new brain cells
    • Higher levels of education appear to play a role in protecting against dementia, possibly because brain cells and their connections are stronger, symptoms may still appear but later in a person’s life

[Read more…]

More Senior Citizens are working

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12 Jobs for Senior Citizens

Retirement is changing. People are working past 65 and many seniors are staying in or returning to the workforce, either full time, part time or as consultants or independent contractors.

According to a study from the Families and Work Institute, this change is largely because people want to earn more money to retire more comfortably or because they believe they would be bored by not working. [Read more…]

Seniors move to Protect Medicare Plans

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 Growing Movement to protect Medicare Plans

Washington, D.C. –The Coalition for Medicare Choices (CMC) -a national grassroots organization of more than 1.6 million individuals who receive their health care coverage through a Medicare Advantage health plan – today announced the launch of a new website as part of a growing effort to promote the value of Medicare Advantage and protect the benefits it provides to millions of American seniors. The new site includes enhanced tools to allow seniors in Medicare Advantage to engage with their members of Congress, take action to protect their health care benefits, and tell their personal Medicare Advantage stories. [Read more…]

Medicare Screening

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Medicare Screening for Prostate Cancer

Men with Medicare.

Are you the type of guy who puts off doing a task and later wishes he’d just done it? If you’re a man with Medicare, now’s the time to talk with your doctor about whether you should get screened for prostate, for colorectal cancer, or for both. Even if you’re feeling fine, Medicare approved screening tests can find cancer early, when treatment works best. [Read more…]

Medicare Advantage Enrollments increase

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 Medicare Advantage growing among seniors

January 06, 2014 08:00 AM Eastern Standard Time

KENNEBUNK, Maine–(BUSINESS WIRE)–Aggregated enrollment in Medicare Advantage (MA) plans was 15.1 million as of December 2013, up nearly 1.3 million members since December 2012. Membership surpassed 15 million members in October, according to a new report by Mark Farrah Associates (MFA). [Read more…]

Medicare an overview

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Medicare Overview

Medicare is a federal health insurance program that provides hospitalization, medical, and prescription drug insurance for the elderly and individuals with disability. It was created by Congress in 1965. The basic idea is for the Government to provide health insurance as part of Social Security.

As insurance, it is not government assistance, unlike Medicaid or AHCCCS and other plans which are assistance programs for people of limited income. [Read more…]

Medicare Annual Open Enrollment

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Medicare Annual Open Enrollment

With so much fuss and frustration over the open enrollment for the health-care marketplaces, some people might be missing important information about another open-enrollment season.

Open enrollment for the exchanges is overlapping and overshadowing the importance of the Medicare open-enrollment period, which started Oct. 15 and ends Dec. 7. It is during this period that those covered by Medicare can change their health plan and prescription drug coverage  [Read more…]

Medicare Beneficiaries have plan options

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options for Medicare in arizonaMedicare Part A provides coverage for inpatient care and Part B for outpatient services.

There are options available to help with the costs not covered

Options available to Medicare Beneficiaries besides Original Medicare Medicare Part A which covers inpatient treatment for Medicare Beneficiaries and Medicare Part B which provides for outpatient services are both available to seniors and some people on disability under age 65 and is referred to as original Medicare. However, original Medicare by itself can leave the senior with significant out of pocket expense. “As an Independent Insurance Broker in Arizona” states Ralph Bredahl with Arizona Medicare Advisors, “I find a lot of confusion among seniors on what is available to them to help with medical costs. I trust this list will help to answer some of the questions that I hear”

Medicare Supplement also called a Medigap plan; a supplement pays for many of the costs that are not covered by Medicare. It is a separate plan and the company providing the coverage may ask health questions. There are certain times and situations where a beneficiary is guaranteed issue. Also, there are several Medicare supplements plans available. Plan A, B, C, F, G, K, L, M and N. Not all companies carry all plans. I won’t go into the differences here but it is important to point out that all plan types are the same with every company. In other words Plan F with company A will be the same basic coverage as Plan F with company B. Arizona Medicare Advisors can answer your questions on plans in Arizona but consult a broker licensed in your state for particulars.

Part D Prescription Drug Plan provides coverage for prescription drugs and has copays for various tiers of drugs. In addition, it has a premium that is paid by the beneficiary. Low income seniors can apply for assistance with the premiums and copays through social security. There is an open enrollment and special enrollment periods. If a senior declines to enroll when eligible they will have a penalty if enrolled later. As with Medigap Arizona Medicare Advisors can answer your questions on plans in Arizona but consult a broker licensed in your state for particulars

Medicare Advantage is also known as part C. These plans are available in Arizona and in many other areas as well. Once again, check with your local broker. With a Medicare Advantage plan the beneficiaries opts to receive their medical coverage from a private company. The company must provide coverage as good as or better than original Medicare. The plans provide coverage for Part A and for Part B and often incorporate Part D into the plan. Like the Part D plans, Medicare Advantage plans are guaranteed issue and have open enrollment. There is also a disenrollment period if the senior wants to return to original Medicare.

Ralph Bredahl

Local Independent Medicare Broker

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