​As I mentioned before - I am not a Social Security expert.  But, I work closely with several Social Security experts and would highly recommend that you attend an educational workshop to ensure you understand ways to maximize your Social Security Benefits.

There are two workshops coming up in Red Bank, NJ on November 5 Workshop  and November 10 Workshop .  The AFEA presenter, Greg Dillon is a colleague of mine and an excellent Social Security resource.  I highly recommend you attend if you have any questions about Social Security benefits.

There is an important provision with Medicare Part A Benefits that is creating unexpected bills for some Medicare Beneficiaries.  Most people understand that Medicare Part A covers Hospital expenses… but Part A also covers Short-Term Skilled Facility Care, up to 100 days (20 days full covered by Part A, Days 21-100 have a copay, which most Medigap Plans pay.)

There is a nuance to qualify for the Short-Term Skilled Facility Care benefit.  In order to qualify for this benefit, you must have been “Admitted” to the hospital for at least 3 days, and enter the Medicare-approved Skilled Nursing Facility within 30 days after leaving the hospital.

For most people that get hospitalized for three days and need Short-Term Skilled Care, this is not a problem since they have been “Admitted” to the hospital.   The people that are impacted are those that were never “Admitted” and kept in an “Observation” status, and then transferred to a Skilled Nursing Facility.  These people are given a notice explaining that they will be responsible for the bills at the Skilled Nursing care, but most people are in too much pain/stress to really understand this information at the time.  These people end up getting bills for thousands and thousands of dollars that are not covered by Medicare (or Medigap).
 
 
Why did CMS Create this Rule?
There is a great article in philly.com this week, which highlighted some key data points and history related to this rule:

“The three-midnight policy was created in 1965 to limit post-hospital care. In 1988, Congress waived the requirement, and Medicare expenditures on skilled nursing home care jumped 243 percent. The requirement was back in place a year later.” 

So it doesn’t sound like the rule will be changing any time soon.

 
What can you do about this?
First, it’s important to at least be aware of this rule.  If you (or a loved one) does get hospitalized and then transferred to Skilled Nursing, you should be aware of whether the patient was “Admitted” with a 3-night stay before the transfer.  If not, the patient will be responsible for all the bills at the Short Term Nursing Facility.

If you want additional coverage for Short-Term Skilled Nursing Care to address these “Observation” situations, give us a call and we can let you know what’s available in your area.

Are you aware that the Medicare Annual Enrollment Period started on Saturday, Oct 15?  

 
What does this mean for you?  
If you have a Part D Prescription Plan, this is your one opportunity to review your RX coverage for 2017 and make sure you select the right Part D Plan.   We are offering a Free RX analysis if you would like us to review your Part D coverage for 2017.  

We use a tool on the Medicare.gov website which analyzes all the available Part D plans in your area (~25 per state) and let you know which is the best Part D Plan for you.  If you would prefer to do this analysis on your own, you can watch our short video here, which walks you through how to use the tool on Medicare.gov for Part D analysis.

If you have a Medicare Advantage Plan, this is also your opportunity to review your coverage and determine if you want to keep your plan (if it's available in 2017), move to another Medicare Advantage Plan, or go back on Original Medicare with a Medigap + Part D Plan.

If you have an AmeriHealth Medicare Advantage Plan in 2016, you should have received a cancellation notice from AmeriHealth.  You have the right to choose another Medicare Advantage Plan in 2017 from one of the carriers in your Service Area, which could include UnitedHealthcare/AARP, Aetna, Clover, and others.   If you prefer to switch to Original Medicare with a Medigap plan, you have a Guaranteed Issue right to get into a Medigap Plan in 2017, with no medical questions.  Call us today to find out more.​

Call now 
(1-908-272-1970)   Cranford Office

or 

(1-856-866-8900)   Moorestown Office
​

Call now 
(1-908-272-1970)   Cranford Office

or 

(1-856-866-8900)   Moorestown Office
​

The Medicare.gov Part D Prescription Analysis tool has now been updated with the 2017 Part D plans.​

Even though you can't actually make a change to the Part D coverage until October 15, you can start to review the best Part D Prescription coverage for you in 2017.

If you already filled out our form for a Free RX analysis, you should be hearing from us in the next 1-2 weeks with our recommendation for your 2017 Part D plan.  

​We will accept new RX forms up until November 15 for the December 7 enrollment deadline.