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Health Insurance For Babies Only

If you are preparing to be a proud parent soon then I am sure the life style change parenthood brings along? You might be having health insurance for yourself and spouse and now searching for health insurance for babies. Maternity insurance, generally doesn’t rollover to include health insurance for babies only. Before we discuss health insurance for babies and the cost associated with it, you might also be interested in finding

affordable maternity health insurance coverage

. Now if you already have a health insurance policy for yourself you can add your baby on to it. If not, you have three options to purchase health insurance for your new infant in the form of a private, federal or through state health insurance provider. Health insurance plan for babies, cover all necessary well-baby check ups.


Health Insurance Options For New Born

Medline Plus | insurekidsnow

Options To Get Health Insurance For Babies

  • Adding Your New Born To Your Current Health Plan:First up, obtain a social security number (SSN) for your new born. Once, you have it, you can add your infant to your existing health insurance policy. To get SSN for your baby you can call on 1-800-772-1213 speak to a social security administrative for application.It can take up to 6 weeks for the SSN to be issued and and you have 30 day window to add your new born to your health insurance plan.Also, it has been noticed that almost all health insurance companies will cover your baby for the first 30 to 60 days from the time he/she was born. The trick is to wait until almost 30 days are over and get this benefit availed. If you enrol your baby right at the start you premium will increase. Just have all the information handy like the SSN and the birth certificate.If your are a working professional and have health insurance through your employer then just contact your HR department and they will do the needful by contact their health insurance provider. Now according to American Academy Of Pediatrics, a total of 9 visits are required for your baby for the first 3 years under well baby care. So you can understand the importance the health insurance for babies and plans which will cover the same.



      • How To Obtain Your Baby’s Birth CertificateYou will have to contact your county’s registrar to obtain your baby’s birth certificate. As mentioned above the turn around time for the birth certificate to be made and added to your state’s records is approximately six weeks. Please note, that if you order the same online then the birth certificate will be more costly. Around $20 or so in total including handling charges.
      • Applying For Health Insurance For Babies Only If You Do Not Have Health Insurance Through Your Employer And Also Not Through Medicaid:In such scenarios, the best option to consider is enrolling your new born in your state sponsored
        Children Health Insurance Program

        (CHIP). This article will cover all the details of getting health insurance for babies through CHIP.

      • Low Income Group (Medicaid Qualification):

If you belong to the low income group, contact your county’s department of social service’s office to find out if you qualify for Medicaid. Medicaid is a government sponsored health insurance plans for low income family’s. Cost may me none to minimum. For more information on Medicaid you may check this article about

Medicaid Advantage Plans and Enrolment in 2013
    • and
types of health insurance plans
    • .
  • Emergency Medical Treatment And Active Labor Act(EMTALA)Don’t need to go into the technicalities here. This act was passed in 1986 by the U.S. Congress and under this law, hospitals are required to give medical treatment for woman in labor.
  • State Specific Health Insurance Plan For Babies:Almost all states have their own state specific health insurance plans for children and infants. I will not be covering these in future for sure however just to give you an example of one such health insurance program for the state of New York is “Child Health Plus”. You can check for your state at the county’s registrar office or contact any social and health community network.


NICU (Neo Natal Care Is Very Important Part Of Infant Health Insurance….

Tips On Health Insurance For Babies

  1. Under the Newborn and Mothers Health Protection Act of 1996, hospital stay for 48 hours (normal delivery) and 96 hours (caesarean) cannot be denied immediately after child birth. However, the onus is on you to inform your health insurance company well in advance about your pregnancy and delivery due date so that all the formalities are in place well in advance.
  2. Always check with your health insurance company if your baby will be added to your current health insurance plan or you have to switch to a family plan to get him/her added.
  3. Always check, what coverage is being provided to your baby under your health insurance. As per law, all basic coverage is guaranteed however special situations like post delivery neo-natal care might be an exception. It is always good to be prepared.

Some questions which you need to be clear off are:

Is pre-certification mandatory before you get hospitalized? If yes, then take of it or you might face issues while filing a claim.
How long your hospital stay will be covered?
Does your health insurance policy have provisions to cover any complications arising from any premature delivery?
Does your health plan provides well bay care services before you leave the hospital like doctor exams, normal tests, nursery services etc.?

  1. Remember, you have 30 days to cover your baby in your health insurance plan from the time of birth. After your child’s birth, irrespective of the day you inform your health insurer
    within 30 days, the coverage will start the day your baby was born.
  2. If you somehow miss the enrollment window to cover your baby, you can purchase a temporary health insurance plan in the meantime. Keep in mind that buying a temporary insurance plan have it’s limitations as it would not provide preventive care and and regular doctor visits and check ups.

Cost Of Health Insurance For Babies

Now no one can give you a ball park figure regarding the cost of health insurance for infants. There are a lot of factors which are considered in deciding the cost.

The cost of health care is rising at a rate of 7% to 8% on an annual basis. In 2002, for a family of four, the annual health insurance expenses were around $9,235 and in the year 2012 it is somewhere around $20,000.

  • If you are getting your baby covered through your employer sponsored health plan then you will be offered a special rate which largely depends on two factors viz:Your employer’s health plans features which will differ between two companies, and
    It would also depend on “Group Risk Factors”. (Average age of the employees, how much they earn etc.). The cost would be somewhere around $200 – $300 at an average.
  • If the baby, god forbid, is born with complications or if you have a premature delivery then your insurers will increase the cost of health coverage for infants.

Medicare Part F Plan And Coverage

Generally, Medicare part F plans can be considered as a rider hence are optional. They are more like bridging the gap of extra expense which you have to pay out of your own pocket. A doctor’s fee at times can be more than the actual amount you receive through Medicare which is a federal government program. This extra amount is supplemented through Medicare part F plans. Medicare part F is also used as a supplement coverage plan (also known as defined benefit insurance) for Medicare part A and B. Medicare due to it’s vast scope of providing health and medical coverage is also one of the most comprehensive supplemental health insurance option. These health supplemental plans are available in all states except Minnesota, Wisconsin and Massachusetts.


Medicare Supplement Part F – Most Comprehensive Among All Ten Medicare Plans


Medicare part F provides health cover for the following:

  • Co-Insurance coverage expenses offered for Medicare part A for additional 365 days after your standard Medicare policy limits are exhausted.
  • Additional supplemental coverage provided for Medicare part B in co-insurance and co-payments or 20% of your out patient bills.
  • Co-Insurance payment for skilled nursing facility (SNF)
  • Coverage offered for foreign travel emergency. (Limit Of $50,000)
    Certain amount of deductibles and extra medical service payments need to be born by you.
  • Co-Insurance and Co-Payment for hospice care.
  • Deductible for Medicare part A and part B
  • Blood deductible coverage in an approved medical procedure
  • This plan also has a high deductible Medicare Plan F option if you wish to opt for. If you do, you need to pay around $2,070 (amount in 2012) before your plan

Basically, Medicare part F health plan would pay for any additional charges over and above what Medicare part A and B have already taken care off. It is a good add on to your standard Medicare policy.


What Does Medicare Part F Plan Does Not Cover?

In one sentence, Medicare part F plan does not cover anything which Medicare itself doesn’t cover, but just to specify:

  1. It does not pay for any expenses incurred while you are recovering at home.
  2. Does not cover preventive health services.

What Are The Requirements To Buy Medicare Part F Plan

  • First things first, it is but obvious, to buy Medicare part F plan you need to have Medicare part A and Part B.
  • You keep paying premium for your standard Medicare Part B policy and additional premium to the insurance company providing you Medicare plan F.
  • NOTE: – If you ever decide to switch over from a Medicare to
    Medicare Advantage Plan

    then you don’t need a Medicare part F plan. you can drop the coverage.

How Much Does Medicare Part F Supplemental Insurance Cost?

  • The cost of Medicare Supplemental Insurance includes expenses for out of pocket expenditure, any deductible you choose and monthly premiums. It also includes cost of co-payments and co-insurance.
  • Additional cost of stay at hospital beyond 356 days when your medicare limits are used up.
  • If you have availed the services beyond 101 days in skilled nursing facility then you pay.

Long Term Care Insurance Cost

Check the map below. In recent times, there has been a lot of buzz and debate over the rising cost of long term care insurance plans. What is “Long Term Care Insurance?”. (LTC or LTCI are the abbreviations used). Insurance is an individual need hence it is very important to assess your needs before your decide on a long term care insurance plan rather than going ahead with something, other people suggest you. It is very important that you are clear in your mind about your long term health care requirements and buy a plan accordingly. Most common questions we come across are, is long term care insurance worth the price? or should we purchase long term care insurance? Thinking about long term medical care is something which we always avoid in the current world because either we are too busy or we don’t understand the importance of it in the future. Mentioned below are some of the best options to get long term car insurance plan. Long term car insurance majorly helps in covering expenses for assisted living facilities. A recent research conducted by “Fidelity Investments” showed that married couple retiring in 2012 will shell out approx. $240,000 towards health care cost after retirement. This is a rise of 6% over the amount in 2011.


Long Term Care Insurance Cost

Long Term Care Insurance Cost would mainly depend on your age and marital status. The cost for long term health care will vary between states and we need to understand different terms before we actually get into the cost structure for long term care. Some of the terms associated with long term care insurance are explained below and on the map just click on your home state and check for the approx. cost in 2012. The cost is shown keeping annual expenditure. Also, currently enrollment is going on for Medicare Plans in 2013. You can get more information in this article

Medicare Plans And Enrollment 2013


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Cost Shown In The Map Is Annual Estimate

Source: Genworth 2012 Long Term Care Insurance Cost Survey


  • Home Health Aides: This for elderly individuals who are extremely ill and need special medical attention which might not be feasible at home or residential care facilities.
  • Home Maker Services: This service helps senior citizens to live lead a normal daily life and help these individuals to do their daily chores in the comfort of their home. Individuals helping you out through home maker services can complete a variety of daily activities like cleaning the house, cooking food and other daily activities.
  • Adult Daily Health Care: The fundamental functionality of this type of health care for seniors can be compared to kindergarten for children. It’s a special type of service for those who only need care during the day and do not require help at night. This type of service is more inclined towards keeping elders busy and engaging through social and therapeutic services.
  • Residential Care Facilities (More Commonly Known As Assisted Living Facilities): First and foremost, assisted living is not an alternative or compromise on nursing home care. They are not similar. Choosing between the two largely depends on what level of health care facilities and medical attention you require in your daily life. Normally you would find people having any kind of disability opting for assisted living centers. You want to live independently however due to your old age and disability you need supervision and assistance in your day to day activities, then Assisted Living Centers are apt for you.
  • Nursing Home: People who need individual medical attention 24 hours a day as their condition might not be suitable for living in assisted living facilities, would choose nursing home facilities.




Also, when you are purchasing long term care insurance please ensure that you discuss the following terms with the insurance specialist or whomever is giving you the long term care policy (Insurer). I will not be covering each term in detail as that would be a little out of scope of this article but would list down the terms below. I will surely try to cover these in the near future.

  • Daily Benefit Amount
  • Type Of Plan (Group Vs Renewable Plan)
  • Are you getting a standard LTCI product or a LTCI product linked with annuity or life insurance.
  • Inflation Option
  • Benefit Period
  • Alternative plan for health care
  • Gatekeepers, Qualifiers and triggering events
  • Premium Rate Stability (Very Important as this would decide for future increase in premium rates)
  • No forfeiture Benefits

Long Term Care Financing Session In Progress….


Where To Get Long Term Care Insurance

Mentioned below are some of the best and reliable options to buy long term care insurance plans. Please note, these are not affiliate links and in any way I am NOT associated with these offers. My main aim through through my blog is to provide valuable information related to all insurance products so that you are a well informed consumer before you consult am insurance specialist. Each and every article is an endeavour towards proving you the latest and reliable information to make your buying job easier.

JohnHancockltc | Federal Long Term Care Insurance Program | Genworth | LifeSecure | Massachusetts Mutual | Mutual Of Omaha | MedAmerica |Prudential Long Term Care Insurance| TransAmerciaLTC

It is important to note that neither Medicaid nor Medicare will provide cover for long term care insurance. Long term care is provided through federal medicare programs. Mostly all long term care insurance policies have certain limits and exclusion list to keep your premium affordable.

Affordable Maternity Health Insurance Coverage

In US, the fact is that “mother’s to be” are either under insured or they don’t have maternity health insurance coverage. Not having maternity insurance is a result of either being careless or under the impression that your individual health insurance policy includes maternity health coverage. Most likely, your health insurance policy will not include maternity care insurance. Each year in US, their are about 6 million pregnancies and among those only 13% women are covered for maternity. To start off right away, go Here. Medicaid is also a good option for pregnant women. For pregnant women, Medicaid offers special treatment if you have low family income. Although, eligibility for Medicaid under maternity insurance varies by state, by law all states must cover expecting mothers with an annual income of $20,000 as an individual. A lot of states also cover pregnant women under Children’s Health Insurance Program (CHIP). If you need more information on CHIP, you can read the article on affordable health insurance for children only. If you are a working women, then you should be having maternity coverage under your group health insurance plan. If not, then please be informed that under the federal law HIPAA (Health Insurance Portability and Accountability Act) group health plans cannot consider pregnancy as pre-existing condition and cannot deny you coverage for prenatal procedures or any other reason related to pre-condition health history. HIPAA, is only applicable to group health insurance option. The difficulty arises, when you are seeking maternity coverage in the open market through a health insurance provider.

States Where Maternity Insurance Is A Mandate To Be A Part Of Health Insurance Coverage.

As of now states where maternity coverage is a mandate for individual and family health coverage are:

Washington | New York | Vermont | Colorado | New Jersey | Montana | Massachusetts

If you reside in California, there is good news for you. Effective July 1st 2012, it is mandatory for health insurance plans to provide inbuilt maternity coverage in the state of California. Also, if you live in CA, you can also check another good program called Access For Infants and Mothers (AIM). This program is specially for uninsured women who are pregnant. One condition is, you should be within 28 or 30 months of your pregnancy for approval. This program covers everything.

Although The Affordable Care Act (Obamacare) has made purchasing health insurance much more simpler however we may not see any significant change until 2014 when the law actually comes in effect. Post 2014, maternity coverage and new born care and treatment will become a part of essential health benefits and hence will be offered by individual health plan providers and also by the health insurance exchanges which will be functional by then. Large group health insurance plans are for now excluded from this mandate.



Maternity Insurance Coverage Options Right Now

Individual Health Insurance Plan With Maternity Coverage

  • First and foremost, if you are already pregnant, then you will not be able to purchase individual health insurance plan with maternity coverage. One exception to this is, if you qualify for the guaranteed issue HIPAA sanctioned health insurance plan. Guaranteed Issue policies can only be bought if you have group coverage for 18 months at a stretch.
    As per the recent study which was conducted by National Women’s Law Center Washington D.C. on around 3,300 individual health insurance policies the results were quite shocking. Only 12% of those had maternity coverage.
  • Everything boils down to planning. If you already have an individual health insurance plan then you can add maternity insurance as a supplemental coverage. Commonly known as a rider. However, their is a waiting period attached to it. You might have to wait for 6 to 12 months before you get full maternity insurance benefits.
  • Mostly all health insurance companies offer maternity coverage on their health insurance plans as an extra add on. Before buying, compare plans through at least 3 insurance companies.
  • Just to guide you in the right direction, always purchase your health plan with maternity coverage much before planning your baby. There have been instances wherein expecting mothers have been denied coverage from their current health insurance providers for the reason which goes like this,” We cannot cover you because, you took out the policy before conceiving your baby” I know this atrocious and absolutely absurd but this practical example is mentioned so that you are well prepared in advance.


  • Even when you are covered for maternity insurance through your employer’s group plan, the stage of your pregnancy and the waiting period of your maternity coverage plays a major role. What if you are in the 8th or 9th month of your pregnancy and there is a waiting period of at least 2 months before your cover kicks in?
  • COBRA plan (specific to your state) can be used to cover this drawback of waiting period. You can enroll yourself in your former employees COBRA plan in the meantime and avail maternity insurance. As states have adapted their own COBRA laws, at times they are also referred as “Mini COBRA Laws”. Keep in mind that this can be an expensive alternative in terms of premium and deductible amount and opt for it only when it is necessary.

Planning Is The Key…. Plan Your Baby and Your Maternity To Avoid Any Waiting Period Hassle…


Pre-Existing Condition Insurance Plan (PCIP) Alternative:

  • This can be a good option for maternity insurance if you qualify for it. You need to be a US citizen and should be without any insurance coverage for at least 6 months.

Medicaid and Special Supplemental Nutrition Program for Women Infants & Children (WIC)

  • Medicaid: Medicaid is a good alternative for you if you are a low income individual for maternity insurance. If you are already enrolled into Medicaid then there is no need of filing a separate application for the new born. He or She is automatically eligible for Medicaid until the first birthday.
  • Supplemental Nutrition Program for Women Infants & Children (WIC): WIC targets low income families who are need of prenatal and post natal care. Further information on WIC can be obtained

Maternity Insurance Coverage Options If You are Already Pregnant

Maternity Card:

All health insurance plans which offer maternity insurance have a waiting period ranging from 1 months up to 2 years. This is where “Maternity Cards” come into picture. Before we discuss this option, let me tell you that it is NOT a maternity insurance coverage but an alternative if you can’t find maternity coverage. It is a mean to reduce your cost of maternity treatment pre and post delivery. Also, if you already have Medicaid then you will not qualify for a maternity card.

Maternity Card Covers the Following:

  1. It will provide cover for doctor visits.
  2. Sonograms
  3. 24/7 counseling
  4. Check Up For The New Born
  5. Hospital Stay Expenses
  6. Prenatal Treatment
  7. Fertility and Sterilization Therapy etc.

Individual Health Insurance Plans And Obamacare

A little more than 50% of the population in the US have health insurance through their employers. About 15 million people buy their own insurance. Buying your own health insurance can be a very daunting task. You should know which option will work best in your favor and it should be affordable as well. Individual health insurance plans in a nutshell are health insurance plans which you purchase on your own rather than being offered by a employer. The best way to search for such a health plan is to go to a insurance company’s website and look for their online tools to compare the plans and their related costs. The best way to keep the costs affordable and meet your coverage requirements is to follow some basic guidelines as we discuss below:

[dropshadowbox align=”center” effect=”lifted-both” width=”400px” height=”” background_color=”#ffffff” border_width=”1″ border_color=”#dddddd” ]TIP: Effective 2014, individual health insurance plans cannot deny or charge you higher premium if you have a pre-existing health condition. As of now, insurance companies can charge you a higher premium if you wish to purchase an individual health insurance plan for yourself or your child with a pre-existing condition.[/dropshadowbox]

Affordability Checklist For Individual Health Insurance Plan

Identify What Is Relevant To You: Nobody can predict, what will happen the very next moment when it comes to illness and injuries. However, there are certain medical treatments which we know will require attention in the near future like the on going preventive care, any specific health problem which you might have, like heart disease and also maternity coverage. Not all individual health insurance plans offer maternity coverage.

Don’t Get To Tempted To Buy: When it comes to our own self and family’s health insurance needs, we are driven by emotion and as a result instead of applying our mind and some logic we think through our heart. Honestly, even i did initially. This results in paying exorbitant amount for health plans. Analyse your financial budget and cross check your affordability before deciding on one particular health insurance option. One’s age plays a major role when it comes to reducing cost. Someone who is young and healthy, would choose an individual health insurance plan with a

higher deductible amount

 (Out Of Pocket expense which you need to pay before the insurance company coverage kicks in). As a young person, paying high deductible amount can reduce your monthly premiums considerably and save you a lot of money in the long run.



Check The Health Care Provider: Not all are comfortable in going to a new doctor as per the health insurance policy bought. Check with your long term serving family doctor if he is a part of the network which you have chosen through your individual health insurance plan.

Hoe Much Will You Be Paying: Always get a clarity on the amount which you will have to pay as a premium each month. There are a lot of hidden costs like coinsurance and co-payment which can add up to your expense every time you go for medical treatment. Knowing your expenses is vital here.

Patient Protection and Affordable Care Act (PPACA): This one is not so helpful right now but will affect individual health insurance plans costs drastically in 2014 and beyond. If your family income is less than 400% of the federal poverty line then you would be eligible for premium subsidies on individual health insurance plans. Premium subsidies are provided under PPCA for individuals purchasing individual health plans through health insurance exchanges. Please note, if you have a health plan through your employer then you are not eligible for these subsidies. For further details, you can refer this article: Individual Health Insurance Premium Subsidies In Exchanges.

2014…. Change Is Coming……..


The Affordable Care Act Perspective For Individuals

  • According to the health care law, if you have a pre-existing condition and hence have not been able to obtain health insurance on your own or rejected by private insurance companies, you can get individual health insurance through Pre Existing Condition Health Insurance Plan.
  • I am sure you or someone in your knowledge has faced the dilemma of mis-selling and got deprived of health insurance benefits. If you feel that you were promised coverage for something which is denied by your insurance company then you have the right to appeal. More information can be accessed
  • Effective 2014, if your family income is less than or equal to $88,000 for a four member family and your job does not provide you affordable health coverage then you can may be eligible for tax credits which will eventually help you to pay for individual health insurance plans.

How Does An Individual Health Insurance Plan Compare Against Group Plans

It is important to understand the differences between individual and group health plans as both have their own merits and disadvantages. Choose which suits you the best:

Individual Health Insurance Plans & Pre Existing Conditions
In most states, you can be turned down for individual health insurance if your pre-existing medical condition is of serious nature (eg: HIV or Cancer). Having said that, you do have health insurance options like PPACA (Patient Protection and Affordable Care Act) provides a pre-existing condition health insurance plan for states which do not have their own health programs.

Medicare Advantage Plans and Enrollment – 2018

What Is a Medicare Advantage Plan? In this article we will cover Medicare Advantage Plans only. If you wish to seek more information on different types of health insurance plans, you can check this article on our site Types Of Health Insurance. Medicare advantage plans, are a collaboration between Medicare and a private health insurance company to give you combined benefits of Part A (Hospital Insurance) and Part B (Medical Or Doctor Insurance). Medicare Advantage plans includes HMO’s PPO’s and Fee For Service plans. All Medicare advantage plans provide you with prescription drug coverage. Some of the top companies providing Medicare Advantage Plans are United Health, Blue Cross and Humana. Medicare advantage plans are like all inclusive deals. They are often referred as Medicare Part C (Medicare plus Choice). If you are eligible for original Medicare Coverage then you are also eligible for Medicare Advantage Plans however it is important to consider the fact that as these plans are on offer through private insurance companies there might be some additional eligibility criteria. Always read the offer document carefully. Initially you have to enroll first into Medicare Part A and Medicare Part B before you can sign up for Medicare Advantage. Enrollment for these plans vary throughout the year. The only coverage which might not be covered in Medicare Advantage is the hospice care ( End of Life Care provided by health professionals and volunteers).


What Are The Different Types Of Medicare Advantage Plans Available Today

The types of Medicare Advantage plans are listed below:

  1. HMO Plans
  2. PPO Plans
  3. Fee For Service Plans
  4. Special Needs Plan (SNP’s)
  5. HMOPOS Plans (HMO – Point Of Service Plans), and
  6. MSA Plans (Medical Savings Account)


Eligibility Criteria For Medicaid Advantage

  • To be eligible for medicare advantage you have to be enrolled in Medicare part A and B.
  • You should be residing in an area where the plan is offered, and
  • You should not be having an end stage renal disease at the time of enrollment.

Medicare Advantage Plans Coverage

A Medicare Advantage plan shouldn’t be confused with the original Medicare coverage. It is a kind of alternative (second option) when compared to original Medicare. Coverage provided by these plans are mentioned below:

  • These plans cover all hospital and medical related services included in Part A and Part B.
  • You cannot be denied enrollment in Medicare advantage plan if you have any per-existing condition unless it is ESRD (End Stage Renal Disease). If ESRD comes to picture after you have opted for Medicare Advantage then you cannot be dropped from the coverage.
  • These plans also cover urgent and emergency care.
  • A lot of Medicare advantage plans also offer coverage for vision care, health and wellness programs and dental care coverage.
  • Some of these plans are called as Medicare Advantage Prescription Drug (MAPD) which also provide coverage for prescription drugs. (Medicare Part D)
  • Most of these plans are managed care plans. Meaning either they are HMO’s (Health Maintenance Organization) or PPO’s (Preferred Provider Organization). Due to this nature you might have to first opt for a PCP( Primary Care Physician) who will then refer you to one of the network’s hospital’s or medical centers.

EnrollmeFor Medicare Advantage 2013 Has Begun. Oct 15th 2012 To December 7th 2012


Cost Of Medicare Advantage Plans

The cost associated with medicare advantage depends on a lot of questions which might be in anyone’s mind among us:

  • Do you have to pay extra premium for medicare advantage plan over and above your medicare part A and B?
  • Are you allowed to use out of network medical providers?
  • Do you have to pay any deductible amount?
  • Are you entitled to any additional benefits and what is the cost?

Medicare contributes a fixed amount to your advantage plan each month. Your provider is responsible for paying the expenses for health and medical care. Cost will vary from one provider to another. As these plans are offered by private health insurance companies you might have to pay certain additional premiums and out of pocket expenses. Now as per the latest news from the CMS( Center for Medicaid and Medicare Services) the average cost of monthly premium in case of medicare advantage plans will be around $32 approx. in 2013. This number will surely vary on case to case basis and it’s mention here should only be considered for reference purposes.

Where To Enroll For A Medicare Advantage Plan

You can check this website for further details: – Medicare Plan Finder

or, you can also call on: – 1-800-MEDICARE (1-800-633-4227) for further information.

Your enrollment to Medicare starts 3 months before you turn 65 and ends 3 months after you turn 65. So, if you turn 65 today 30th October 2012 then you have the range between 30th July 2012 up to 30th January 2013 to get yourself enrolled.

Need To Know Facts About Medicare Advantage Plans

Some additional information which might be useful to you:

  • If you choose an HMO plan, you have to opt for a PCP (Primary Care Physician) and you cannot go out of network for treatment.
  • If in case your existing medicare plan provider opts out of the network you have the option of joining another advantage plan or continue with original medicare plan.
  • Medicare Advantage and Medigap (Medicare Supplemental Insurance) don’t go hand in hand. Meaning, till the time you are enrolled in an advantage plan you don’t require Medigap. Your Advantage plan covers everything offered in Medigap (Part D) through Medicare Advantage Prescription Drug (MAPD).


n New Mexico, the Open Enrollment deadline has not been extended. However, customers who were unable to successfully enroll in a plan by March 31 may still qualify to sign up on a case-by-case basis. Call 1-855-99-NMHIX to add your name or find out if you’re still eligible.