Posts Tagged ‘medicare part b’

Choosing A Medicare Advantage Plan

Monday, November 10th, 2014

Medicare beneficiaries have a choice in health plans. They may choose Medicare Part A (hospital insurance) and Part B (physician and outpatient coverage), which together are also known as traditional or original Medicare, or they may choose Part C, a Medicare Advantage plan, which replaces Parts A and B. Medicare Advantage plans also usually come with their own prescription drug plan, thereby replacing Medicare Part D as well.

Medicare Advantage plans are offered by private health insurance companies that contract with the government to provide Medicare benefits. Most of them are managed care plans similar to preferred provider organizations (PPOs) or health maintenance organizations (HMOs). Medicare Advantage plans may cost more than traditional Medicare, but they may also offer additional benefits. It is important for beneficiaries to understand the options in order to make the best choice for their circumstances. For many, traditional Medicare is the default choice, but there are reasons why beneficiaries may prefer Medicare Advantage.

Some people may prefer the way Medicare Advantage plans handle prescription drug coverage. Most of them include prescription drug coverage in the cost of the plan, so the extra cost of Medicare Part D can be avoided. However, the total that beneficiaries pay depends on what prescriptions they have. The Medicare Plan Finder at can help individuals determine how much they would pay for prescription drugs under various plans.

Another reason people choose Medicare Advantage plans is the limits on out-of-pocket spending. Under traditional Medicare, there is no out-of-pocket maximum, but Medicare Advantage plans are restricted to a cap for out-of-pocket expenditures. Whether a beneficiary would meet that cap depends on individual circumstances. In addition to the cap, Medicare Advantage coinsurance payments may be structured in a more beneficial way.

Beneficiaries may also choose Medicare Advantage because they want vision or dental plans included, or they want an alternative to purchasing “Medigap” coverage to pay for costs that traditional Medicare does not cover. Individuals should examine the costs and benefits of plans carefully to determine the right choice for them.


Learn more about our services by visiting

Was this article of interest to you? If so, please LIKE our Facebook Page by clicking here.

Seniors Should Be Aware of Benefits Available to Them

Thursday, July 26th, 2012

As people approach their golden years, they should be aware of public benefits that can improve their quality of life.  The Brookdale Center for Healthy Aging and Longevity has produced a helpful Benefits Checklist for Older Adults.  The Center is associated with Hunter College, of the City University of New York.

The first item on the list is Medicare, which guarantees access to medical insurance for Americans over the age of 65.  Medicare Part A covers hospital care and provides limited coverage for hospice and in-home care.  Part B provides limited coverage for outpatient services, physicians and durable medical equipment, while Part D covers prescription drugs.

Another important benefit is Supplemental Security Income (SSI), which provides monthly cash benefits to individuals age 65 or older, and to persons who are blind or disabled.  To receive the benefits, individuals must meet certain income and resource limits, and must submit an application.

There are also benefits that apply specifically to older New Yorkers, such as the New York State School Tax Relief Program (STAR).  New York state residents who meet certain income limits can receive a reduction in school property taxes.  A real property tax credit and the Senior Citizens Homeowners Exemption (SCHE) are also available to those who qualify.

There are many public benefits that can provide assistance to seniors, and it is important to be aware of the help that is available.

The checklist is available here:

To learn more about our estate planning services, visit

Free Wellness Services and Discounts Available to New Yorkers on Medicare

Wednesday, November 16th, 2011

More than 1.3 million New York state individuals have received free preventive services through Original Medicare this year so far. But only a little more than 113,000 people have taken advantage of its free annual wellness exam. With more than 1.77 million New Yorkers enrolled in Medicare Part B, these recipients should use these free services to better their health and longevity.

Along with these benefits through Medicare Part B, the average prescription drug premiums are not expected to rise in 2012. The U.S. Department of Health and Human Services reported that 900,000 Medicare recipients who are in the prescription drug donut hole had 50 percent discounts on their prescription drugs this year.

The Centers for Medicare & Medicaid Services notes that generic prescription coverage will not increase for those in the donut hole in 2012. Out-of-pocket costs will also be lower due to discounts on brand name prescription drugs. Individuals should still carefully review their Medicare plan elections for 2012 to see that their pharmacies, prescriptions, and preferred doctors are still available at reasonable prices as plans can fluctuate annually.

For those on Medicaid in New York, the program made a change earlier in the fall. Medicaid’s pharmacy benefit and the Family Health Plus pharmacy benefit is now part of the managed care benefit package. Each health plan has its own category of medicines, including prescription drugs, some over-the-counter drugs and medical supplies. It is important to make sure the plan has the medicines each individual needs. The New York health plans do allow a one-time only fill of a drug in the event that individuals cannot reach their doctor to get guidance to switch to a plan that does cover what they need.

Littman Krooks LLP counsels seniors and families to access government benefits as well as plan for health care needs and personal decisions. Our New York City, White Plains and Fishkill elder law attorneys and estate planning attorneys are accomplished in comprehensive planning for a senior’s golden years. To learn more about New York elder law, visit or