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The Pain of Prior Authorization

While insurers and providers fundamentally disagree on the usefulness of prior authorization policy, consumers continue to experience delays in treatment. According to an April 2022 report, the US Department of Health and Human Services’ inspector general found 13% of prior authorization denials by Medicare Advantage plans were for Medicare approved services. The rise in authorization denials is being addressed by state lawmakers, health providers and...

Medicare expertise for Financial Planners

A retiree’s financial plan without Medicare considerations may leave clients with unplanned health care expenses that deplete savings negatively affecting their financial wellness and planned standard of living.  Financial Planners should read the Financial Planner PDF...click the link. Financial_Planner_One_Sheet  ...

Know Your Medicare Advantage Plan’s Authorization Policy

Know Your Medicare Advantage Plan’s Authorization Policy

Avoid the Hassle.   Clients often choose a MAPD PPO plan because they believe such a plan has no "Hassle Factor". They are often mistaken. The following "Hassle Factors" examples are taken from one health plan's Evidence of Coverage (EOC). Some In-Network services do require prior authorization from the plan in order to be covered. Obtaining prior authorization is the responsibility of the Primary Care Physician...

How to Apply For Your Medicare Card

How to Apply For Your Medicare Card

There are several ways to apply for your Medicare card: In Person - Contact your local Social Security Office By Phone - Call Social Security at 1-800-772-1213 to make a telephone appointment for an interview to begin benefits. Social Security will call you at the appointed time. Tell the representative that you wish to apply for Medicare Parts A&B only, unless you are desirous of other services,...

Independent Broker or Captive Agent?

Independent Broker or Captive Agent?

What is the Difference? Adults entering Medicare will be amazed by the volume of direct mail email and cold calls that they will begin receiving months before their 65th birthday. This enormous pile of material does more to confuse than to provide any clarity. Navigating the Medicare system, and the many different Medicare Supplement Insurance Plans, Medicare Advantage Plans, and Prescription Drug Plans can become...