Planning a Healthcare Budget

At The Arthritis & Infusion Center, we are all too aware of the struggles many people have in paying their medical bills. And, with the most recent changes in medical reimbursements due to government regulations, it is even more important to plan ahead. But, the most significant question is: How does someone prepare for an illness, or health issues, that come as a complete surprise?

      When you are trying to budget, communicate with your  insurance agent, as well as all the physicians/clinics who service your family’s medical needs. Ask, point blank, if their rates will be increasing in the near future. You have every right to ask this critical question.  Therefore, the areas you need to include in your healthcare budget include, but are not limited to:

• Insurance premium costs: Insurance coverage can be negotiable depending on your lifestyle (i.e., non-smoker, active lifestyle, etc.) 
•  When you know what your insurance covers, but more importantly, what it doesn’t cover, make a conscientious attempt at estimating out-of-pocket costs.
•  Once you’ve come to the two estimates (above), factor into the equation your medications, visits to the dentist, and eye appointments. (Remember, your health insurance policy will outline what dental services, if any, are covered.) 
•  If you take vitamins, belong to a gym, or take advantage of specialized services like therapeutic massage, these costs need to be estimated and included in your budget as well.

“Many of our patients struggle paying their bills, and many pharmaceutical companies have programs in place to help the truly disadvantaged,” said Dr. Hulon Crayton, owner of The Arthritis & Infusion Center. “In addition, there may be other government programs that may be able to be accessed.”

People on Medicare must also understand that healthcare services, at some point, may become rationed. Their healthcare budget must allow for them, as senior citizens, to pay – out of pocket – if they want to ensure that some yearly tests (mammograms, pap smears, etc.) are covered. Otherwise, these tests will only be done every other year.

At The Arthritis & Infusion Center, we encourage our patients to ask us how to most effectively manage their healthcare, and we can certainly assist with the necessary data patients need in order to compile a comprehensive healthcare budget. Don’t wait another day to get started to take control of your healthcare finances.

Medicare Card Fraud: Protect your Identity!

There are so many stories about identity theft in the news lately.  Join Dr. Hulon Crayton, as he shares with you a quick and simple step to protect your identity.

Pictured below is a Medicare card card and a social security card.  We all know that protecting our social security numbers is important.  However, your Medicare card typically has your social security number on it.  In the unfortunate event that your wallet or purse is stolen, the thief not only has your money but now has your personal information that can lead to financial disaster.  An identify thief can take your driver’s license and social security number off your Medicare card and have all the information they need to assume your identity and open lines of credit in your name.

A simple solution to carrying your original Medicare card with your social security number is this.  Make a copy of your Medicare card.  With a black marker, mark through the first 5 numbers leaving only the last 4 numbers visible.  Carry the altered version of your Medicare card with you and place your original Medicare card in a secure location such as a safety deposit box or safe.  When you are required to present your Medicare card to physician’s offices or pharmacies, simply fill in your full Medicare card on the required paperwork. 

This is a quick and simple action for you to take to help protect your identity. 

For more information from Dr. Hulon Crayton with The Arthritis & Infusion Center on arthritis, helpful tips, or on my practice, follow me on Twitter, Facebook or visit my website.

Medicare Advantage Plans: What You Need To Know

Medicare Advantage plans are very popular and are a wonderful way to combine three traditional Medicare policies and even add an extra coverage without purchasing a separate policy.  However, be extremely careful when choosing this type of policy.   As with any insurance plan, there are advantages and disadvantages to these particular combined plans.

By definition, Medicare Advantage Plans are a combined Medicare policy that will take the place of traditional Medicare Part A and B and often Medicare Part D.  These plans are offered by a private insurance company that is approved by Medicare, and have a set monthly premium.  Medicare Advantage plans are not supplemental coverage to traditional Medicare.

Medicare Advantage Plans would cover the traditional healthcare cost that are usually covered by traditional Medicare to your doctors, hospitals, and pharmacy.  In many cases you may also purchase additional coverage to include vision, dental, and hearing.  However, keep in mind that additional coverage equals additional premiums. 

There are a few disadvantages to this type of plan.  Here are a few questions you should consider before choosing a policy: 

·    Are you required to choose a physician that accepts, and participates, in Medicare Advantage Plans?

·    Are you required to have referrals to specialists, outpatient or radiology services?

·    Does the policy have a flat copay for physician services, or is there a deductible and coinsurance?
·    What does the prescription policy cover?  Is there a mail-order supply company offered?

·    Am I locked into the policy for a specific amount of time before I can change back to traditional Medicare or switch to a different policy?

·    Am I purchasing this policy from a reputable company with actual patient reviews of their product?

·    Is there a limit on how much this policy will pay out in one year?

There are many more questions that need to be considered before you make such an important decision for your healthcare needs.  The point of this blog is to get you thinking about your current healthcare situation, policy, as well as your future needs.  Take time, ask questions, and get multiple quotes for coverage. 

DEDUCTIBLES: What to Expect January 1st

There are many concerns regarding the cost of healthcare these days. Now it is more important than ever to know the details of your policy and formulate a budget for your healthcare needs. The Arthritis and Infusion Center understands that healthcare language can often be confusing. We have compiled a few of the most commonly used terms that refer to healthcare insurance policies.

Healthcare definitions according to the Medicare website: 

• Assignment - An agreement by your doctor, other health care provider, or supplier to be paid directly by Medicare, to accept the payment amount Medicare approves for the service, and not to bill you for any more than the Medicare deductible and coinsurance.
•  Coinsurance - An amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance is usually a percentage (for example, 20%).
• Deductible - The amount you must pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay.
• Medically Necessary - Services or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice.
• Medicare Approved Amount - In Original Medicare, this is the amount a doctor or supplier that accepts assignment can be paid. It may be less than the actual amount a doctor or supplier charges. Medicare pays part of this amount and you’re responsible for the difference. 

Typically deductibles renew on January 1st each year. In other words, the slate is wiped clean from the previous year and you are required to pay your annual deductible again. Keep in mind, when making your healthcare budget, often deductibles and coinsurance will be collected at the same time from your provider until the annual deductible is satisfied. Be prepared, before your office visit, with the necessary monetary means to satisfy your obligations at the time of the service.

The Arthritis and Infusion Center is ready to help. If you are unsure of your policy’s deductibles or coinsurance, give us a call and we will be more than happy to help you determine this information. An informed patient is a happy patient.