Paid Advertisement Ask the Medical Specialist by: Aaron Zolbrod QUESTION: Question from John: As a retired teacher, I'm on the HOP Medical plan. However, I see in your columns all of these different letter Supplements and have no idea which of these is most comparable to HOP. A) Is HOP different, or is it just one of the lettered plans without using the letter? I'm 71 and healthy and my wife is 68. She just had major cancer surgery and will start treatments next month. My thoughts on a Supplement are I want it to pay for most of our treatments and do not mind paying a bit more monthly for a plan to ensure that is the case. B) Is there a plan other than HOPI should consider? My wife starts chemo this week in Pittsburgh and we've have had lots of doctor meetings. Last week I got a call or from the hospital billing department about visits to oncologists and surgeons at the hospital. The representative said to check with my insurance as they bill chemo as a hospital visit and many insurance companies do not pay what the hospital demands. C) Has this been a problem for many in the past for those who have Medicare and HOP? D) Will HOP pay this or amI stuck paying their extra charge in a bospital setting for a regular visit to see them? ANSWER: This is another great question. Please keep them coming as they're so important, not only for Assignment without paying any can use any doctor or hospital in C)Ihave no idea why a the country that accepts Medicare representative would have mentioned this unless he those asking the question, but the additional costs, not the case with or she thought you had an Advantage Plan HMO or PPO. entire senior community This one HMO's and PPO's. I'm honestly in particular has implications for not sure why HOP even offers both those on HOP as well as all Medicare beneficiaries. I'm also wondering if there was Advantage Plans to public school a communication breakdown of retirees. some kind. Medicare is primary for those on the HOP Medical Plan A) The HOP Medical plan is a Supplement as it's secondary to Medicare and designed to pay almost all of what Medicare B) Anyone eligible for HOP who gets the $100 premium assistance, as well as all other Supplements. That means any provider who which most teachers do, should absolutely never consider any plan accepts Medicare Assignment, doesn't: the $1,484 Part A hospital other than HOP Medical, The price which all full-service hospitals do including UPMC, is legally deductible, days 21-100 in a Skilled is fantastic and rarely increases like Supplements such as G, E or bound to accept what Medicare N. The coverage is excellent, with and the Supplement reimburse as payment in full. It would be illegal for a Medicare provider to bill any additional charges. I've never heard of this happening as a standard practice although that doesn't mean there may not be a billing error from time to time. Nursing Facility, and the 20% for outpatient services (Part B). However, it's not one that is regulated the same as Medigap all Medicare approved services paid at 100% other than the small policies A through Nand why it's co-pays I listed. It provides access not only to Pittsburgh's best health care systems, but other world class hospitals such as the Mayo Clinic, Cleveland Clinic, Johns Hopkins, MD Anderson not labeled with any letter. That being said, it most resembles plan N, my favorite and the one I rcommend to approximately 95% of clients who choose to go the Supplement route. Both N and HOP have minimal co-pays, although unlike N, the HOP Medical plan does not have a Part B deductible. N has a $20 co pay D) You don't have to worry about Cancer Center, ete. HOP not paying for any Medicare covered service, which any related to Cancer will be with the exception of oral chemotherapy It simply can't happen to those with on the HOP Medical plan in addition to Medicare. In fact, What we do often recommend is for the spouse of a HOP recipient to buy a Federally regulated Supplement because it's about for a PCP or Specialist visit and a half the price of HOP Medical $50 co pay at the Emergency Room. for those who don't get the $100 discount. We also recommend both HOP actually pays in place of for an Emergency Room visit. 825 the HOP recipient and spouse buy Medicare in the rare occasion HOP Medical has co-pays of $10 at a PCP, $20 for a specialist, $40 when certain Medicare covered services are exhausted such as physical therapy or days 101 or more in a Skilled Nursing Facility They provide $1.000,000 in lifetime benefit, which would be virtually a Medicare Part D prescription for an MRI or a CT scan, and 10% plan outside of HOP. As good of a value as HOP Medical is, the HOP prescription options are Medicare covered service is paid bad. The Basic plan is $88/month for at 100%. This ensures that your compared to the $15 median (up to $100 per item) for durable medical equipment. That's it. And just like Plan N, every other impossible to reach. premium our clients pay. Co pays wife will get no bills for chemo treatments. for both generics and brand name Please call one of our office locations or email me personally if you have questions regarding this or any other Medicare health insurance related topic or to request an appointment for a no cost consultation. I'd like to remind everyone that I do a live call-in talk show called Medicare to enroll in a one. That's because our annual recommendation letter A to Zevery Ist and 3rd Monday of the month on WMBS Uniontown, 590AM and 101.1FM. from 1 to 3 PM. You can listen in on their website, wmbs90.com. drugs are significantly higher Please be advised that not all HOP on HOP plans as well. Any HOP recipient who would like us to offer Advantage Plan HMO's and analyze their Part D plan and make a recommendation this clients who aren't eiigible for HOP coming AEP can call or email enroll in Advantage Plans, we have me and request to be put in our database. They will then receive plans are Supplements. They do PPO's. Although we often help never advised a HOP reciplent in September like all our other HOP Medical plan while limiting Supplement clients. We provide this service at no charge. they're more expensive than the one's access to doctors and hospitals. Those on HOP Medical 724-603-3403 The Health Insurance Store. Email your question to: aaron@getyourbestplan.com Connellsville 412-349-8818 www.getyourbestplan.com Forest Hills No-cost, unbiased Medicare plan review and consultation with local, licensed agents Paid Advertisement Ask the Medical Specialist by: Aaron Zolbrod QUESTION: Question from John: As a retired teacher, I'm on the HOP Medical plan. However, I see in your columns all of these different letter Supplements and have no idea which of these is most comparable to HOP. A) Is HOP different, or is it just one of the lettered plans without using the letter? I'm 71 and healthy and my wife is 68. She just had major cancer surgery and will start treatments next month. My thoughts on a Supplement are I want it to pay for most of our treatments and do not mind paying a bit more monthly for a plan to ensure that is the case. B) Is there a plan other than HOPI should consider? My wife starts chemo this week in Pittsburgh and we've have had lots of doctor meetings. Last week I got a call or from the hospital billing department about visits to oncologists and surgeons at the hospital. The representative said to check with my insurance as they bill chemo as a hospital visit and many insurance companies do not pay what the hospital demands. C) Has this been a problem for many in the past for those who have Medicare and HOP? D) Will HOP pay this or amI stuck paying their extra charge in a bospital setting for a regular visit to see them? ANSWER: This is another great question. Please keep them coming as they're so important, not only for Assignment without paying any can use any doctor or hospital in C)Ihave no idea why a the country that accepts Medicare representative would have mentioned this unless he those asking the question, but the additional costs, not the case with or she thought you had an Advantage Plan HMO or PPO. entire senior community This one HMO's and PPO's. I'm honestly in particular has implications for not sure why HOP even offers both those on HOP as well as all Medicare beneficiaries. I'm also wondering if there was Advantage Plans to public school a communication breakdown of retirees. some kind. Medicare is primary for those on the HOP Medical Plan A) The HOP Medical plan is a Supplement as it's secondary to Medicare and designed to pay almost all of what Medicare B) Anyone eligible for HOP who gets the $100 premium assistance, as well as all other Supplements. That means any provider who which most teachers do, should absolutely never consider any plan accepts Medicare Assignment, doesn't: the $1,484 Part A hospital other than HOP Medical, The price which all full-service hospitals do including UPMC, is legally deductible, days 21-100 in a Skilled is fantastic and rarely increases like Supplements such as G, E or bound to accept what Medicare N. The coverage is excellent, with and the Supplement reimburse as payment in full. It would be illegal for a Medicare provider to bill any additional charges. I've never heard of this happening as a standard practice although that doesn't mean there may not be a billing error from time to time. Nursing Facility, and the 20% for outpatient services (Part B). However, it's not one that is regulated the same as Medigap all Medicare approved services paid at 100% other than the small policies A through Nand why it's co-pays I listed. It provides access not only to Pittsburgh's best health care systems, but other world class hospitals such as the Mayo Clinic, Cleveland Clinic, Johns Hopkins, MD Anderson not labeled with any letter. That being said, it most resembles plan N, my favorite and the one I rcommend to approximately 95% of clients who choose to go the Supplement route. Both N and HOP have minimal co-pays, although unlike N, the HOP Medical plan does not have a Part B deductible. N has a $20 co pay D) You don't have to worry about Cancer Center, ete. HOP not paying for any Medicare covered service, which any related to Cancer will be with the exception of oral chemotherapy It simply can't happen to those with on the HOP Medical plan in addition to Medicare. In fact, What we do often recommend is for the spouse of a HOP recipient to buy a Federally regulated Supplement because it's about for a PCP or Specialist visit and a half the price of HOP Medical $50 co pay at the Emergency Room. for those who don't get the $100 discount. We also recommend both HOP actually pays in place of for an Emergency Room visit. 825 the HOP recipient and spouse buy Medicare in the rare occasion HOP Medical has co-pays of $10 at a PCP, $20 for a specialist, $40 when certain Medicare covered services are exhausted such as physical therapy or days 101 or more in a Skilled Nursing Facility They provide $1.000,000 in lifetime benefit, which would be virtually a Medicare Part D prescription for an MRI or a CT scan, and 10% plan outside of HOP. As good of a value as HOP Medical is, the HOP prescription options are Medicare covered service is paid bad. The Basic plan is $88/month for at 100%. This ensures that your compared to the $15 median (up to $100 per item) for durable medical equipment. That's it. And just like Plan N, every other impossible to reach. premium our clients pay. Co pays wife will get no bills for chemo treatments. for both generics and brand name Please call one of our office locations or email me personally if you have questions regarding this or any other Medicare health insurance related topic or to request an appointment for a no cost consultation. I'd like to remind everyone that I do a live call-in talk show called Medicare to enroll in a one. That's because our annual recommendation letter A to Zevery Ist and 3rd Monday of the month on WMBS Uniontown, 590AM and 101.1FM. from 1 to 3 PM. You can listen in on their website, wmbs90.com. drugs are significantly higher Please be advised that not all HOP on HOP plans as well. Any HOP recipient who would like us to offer Advantage Plan HMO's and analyze their Part D plan and make a recommendation this clients who aren't eiigible for HOP coming AEP can call or email enroll in Advantage Plans, we have me and request to be put in our database. They will then receive plans are Supplements. They do PPO's. Although we often help never advised a HOP reciplent in September like all our other HOP Medical plan while limiting Supplement clients. We provide this service at no charge. they're more expensive than the one's access to doctors and hospitals. Those on HOP Medical 724-603-3403 The Health Insurance Store. Email your question to: aaron@getyourbestplan.com Connellsville 412-349-8818 www.getyourbestplan.com Forest Hills No-cost, unbiased Medicare plan review and consultation with local, licensed agents