Proposals For Reforming Medicare
As legislators continue to seek new ways to control the cost of Medicare, a number of new proposals to reform Medicare have been introduced in recent years.
Since the mid-1990s, there have been a number of proposals to change Medicare from a publicly run social insurance program with a defined benefit, for which there is no limit to the government’s expenses, into a publicly run health plan program that offers “premium support” for enrollees. The basic concept behind the proposals is that the government would make a defined contribution, that is a premium support, to the health plan of a Medicare enrollee’s choice. Sponsors would compete to provide Medicare benefits and this competition would set the level of fixed contribution. Additionally, enrollees would be able to purchase greater coverage by paying more in addition to the fixed government contribution. Conversely, enrollees could choose lower cost coverage and keep the difference between their coverage costs and the fixed government contribution. The goal of premium Medicare plans is for greater cost-effectiveness if such a proposal worked as planned, the financial incentive would be greatest for Medicare plans that offer the best care at the lowest cost.
Currently, public Part C Medicare health plans avoid this issue with an indexed risk formula that provides lower per capita payments to sponsors for relatively healthy plan members and higher per capita payments for less healthy members.
How To Apply For Medicaid In Alabama
Learning how to apply for Medicaid in Alabama is the next step after an applicant determines whether or not he or she qualifies for medical assistance. It is important for applicants to understand where to apply for Medicaid and how to fill out an application in order for them to maximize their chances of being accepted into the program. Additionally, beyond the AL Medicaid application, petitioners must learn about the supporting documents they may be asked to submit in order to receive approval. If you are wondering, Where do you sign up for Medicaid? or want to find out more information about the details that need to be provided on a Medicaid application form in Alabama, continue to the sections below for everything you need to know about how to apply for the program.
Where do you sign up for Medicaid in Alabama?
If applying for Medicaid online is not their preferred option, interested applicants can obtain a physical Alabama Medicaid form by printing it online or visiting a local office. After completing this Medicaid application form by hand and providing a signature, petitioners can mail the document to the All Kids Program. Additionally, if the applicant chooses to not apply for Medicaid by mail, he or she may submit the paper application form via fax.
Information Required on the Medicaid Application Form in Alabama
- Social Security Numbers
The Top 10 Medicare Advantage Plans In Alabama
Seniors and disabled persons in Alabama potentially have access to several types of Medicare Advantage plans, with numerous insurance providers serving multiple areas of the state. The table below compares the top 10 most popular Medicare Advantage providers statewide based on their total MA plan enrollment. Because each provider typically has multiple plans available, the table calculated their total enrollment by combining the enrollment numbers of all the plans each provider offered.
The table also provides a range of costs for the plans included in the enrollment totals to allow for cost comparisons. It includes the providers Medicare star rating to show how they ranked based on plan performance and feedback from member satisfaction surveys. The information used for this table is current as of April 2022. Medicare recipients can also visit Medicare.gov to get up-to-date information on the plans available in their area.
Whos Eligible For Medicaid For The Aged Blind And Disabled In Alabama
Medicare covers many services including hospitalization, physician services, and prescription drugs but coverage varies between Original Medicare and Medicare Advantage. Medicare can also have significant premiums and cost sharing obligations .
In Alabama, Medicare enrollees whose incomes make them eligible for Medicaid ABD can receive coverage for Medicare cost sharing. But Alabama Medicaid does not cover any dental care for adults.
Medicaid ABD does offer limited vision benefits in Alabama. Adults are covered for a full eye exam and one pair of eyeglasses every three years.
Medicaid ABD is called SSI-Related Medicaid in Alabama.
Asset limits: The asset limit is $2,000 if single and $3,000 if married.
Assistance with prescription drug costs in Alabama
Effects Of The Patient Protection And Affordable Care Act
The Patient Protection and Affordable Care Act of 2010 made a number of changes to the Medicare program. Several provisions of the law were designed to reduce the cost of Medicare. The most substantial provisions slowed the growth rate of payments to hospitals and skilled nursing facilities under Parts A of Medicare, through a variety of methods .
PPACA also slightly reduced annual increases in payments to physicians and to hospitals that serve a disproportionate share of low-income patients. Along with other minor adjustments, these changes reduced Medicare’s projected cost over the next decade by $455 billion.
Additionally, the PPACA created the Independent Payment Advisory Board , which was empowered to submit legislative proposals to reduce the cost of Medicare if the program’s per-capita spending grows faster than per-capita GDP plus one percent. The IPAB was never formed and was formally repealed by the Balanced Budget Act of 2018.
Meanwhile, Medicare Part B and D premiums were restructured in ways that reduced costs for most people while raising contributions from the wealthiest people with Medicare. The law also expanded coverage of or eliminated co-pays for some preventive services.
Also Check: Does Medicare Cover Motorcycle Accidents
How Old Do You Have To Be To Get Medicare In Alabama
Alabama residents qualify for Medicare when they reach age 65. Only under specific circumstances can you qualify for Medicare before 65: if you have end-stage renal disease or Lou Gehrig’s disease, or if you are permanently disabled for other reasons. If you have questions about Medicare eligibility, you can always ask a benefits advisor, who can give you more information about whether you might qualify.
Cost Of Medicare Supplement Plans In Alabama
How much Medicare Supplement plans in Alabama cost varies depending on several factors. Commonly, your monthly premium is based on your location, age, gender, and tobacco-use status. While there may be other factors depending on the carrier, these are the most common across all policies and Medigap insurance companies.
Typically, men will pay more for coverage than women, and plans with higher benefit levels will cost more than plans with lesser benefits.
The charts below depicts the monthly premium costs between a 65-year old male and female compared to a 75-year-old male and female in the same Alabama zip code.
|Female, No Tobacco, Alabama ZIP Code 35242|
* If on Medicare before 1/1/20
Additionally, as you can see in the table above, it is beneficial to sign up for a Medicare Supplement plan as soon as you are eligible. If you enroll at 75, you will likely pay more each month than if you utilized your Medigap Open Enrollment Period.
In addition to premiums, you must account for any out-of-pocket costs your Medicare Supplement plan requires.
Read Also: What Does Medicare Part B Include
Medicare Advantage Plans In Alabama
Medicare Advantage provides a cost-effective way for seniors aged 65 or older and younger individuals with qualifying disabilities to get the health care coverage they need. Medicare Advantage plans, often referred to as MA plans or Medicare Part C, take the place of Original Medicare. These plans must provide the same coverage as traditional Medicare plans, but they often offer more perks than Original Medicare. The federal government offers Original Medicare to qualifying recipients, but Medicare-approved private insurance companies offer Medicare Advantage plans. Because MA plans bundle several types of health care coverage together, recipients often have lower out-of-pocket costs than they would with Original Medicare.
Alabamas Medicare Advantage recipients have steadily grown, as they have nationwide. In 2020, the state had more than a million Medicare beneficiaries, and nearly 45% of them chose Medicare Advantage over Original Medicare. This percentage was significantly higher than the national average, which was 38% that year. In 2021, the rate of Medicare Advantage recipients had grown to nearly 50%. The percentage rose again to just over 54% of the 1,065,866 Medicare recipients recorded in Alabama during the 2022 plan year. The average monthly Medicare Advantage premium remained relatively unchanged, rising from $11.19 in 2021 to $11.21 in 2022, but the number of available plans increased from 82 to 91.
Medicare Part D In Alabama
Original Medicare does not cover outpatient prescription drugs. But Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan , or a stand-alone Medicare Part D plan.
As of May 2022, there were more than 821,000 Medicare beneficiaries in Alabama who were enrolled in Medicare Part D coverage. The majority, about 555,000, had coverage under a Medicare Advantage plan with integrated Part D coverage. Another 267,000 had stand-alone Part D plans.
For 2022 coverage, there are 26 stand-alone Part D plans available in Alabama, with premiums ranging from about $7 to $144 per month.
Medicare Part D enrollment is available when a beneficiary is first eligible for Medicare, and also during the annual open enrollment period in the fall . This window is an opportunity for Medicare beneficiaries to change their Part D coverage, with any plan changes taking effect January 1 of the coming year.
Also Check: How Can I Pay My Medicare Bill Online
How Medicare Advantage Plans Work In Alabama
Depending on the insurance provider and the beneficiarys geographic location in Alabama, they could have several MA plan options or just a handful. Since private insurers offer Medicare Advantage plans, their plans may be unique to the areas they serve or the intended recipients. There are four primary types of plans available in Alabamas Medicare Advantage program. Health Maintenance Organizations are typically the most common, followed by Preferred Provider Organizations . Private Fee-for-Service plans and Special Needs Plans may have limited availability statewide.
If You Already Receive Benefits From Social Security:
If you already get benefits from Social Security or the Railroad Retirement Board, you are automatically entitled to Medicare Part A and Part B starting the first day of the month you turn age 65. You will not need to do anything to enroll. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If your 65th birthday is February 20, 2010, your Medicare effective date would be February 1, 2010.
Also Check: What Does Aarp Medicare Supplement Cost
Third Party Website Disclaimer
You are about to leave Blue Cross and Blue Shield of Alabama’s website and enter a website operated by Prime Therapeutics, LLC. Prime is our business associate and is an independent company that provides pharmacy benefit management services to Blue Cross health plans. Prime has agreed to follow Blue Cross’ privacy and security policies regarding the confidentiality and protection of your personal health information.
To continue to the Prime website, click “Accept.” If you want to stay on the Blue Cross website, click “Cancel.”
What Medicare Advantage Plans Cover In Alabama
Medicare Advantage takes the place of Original Medicare, so MA plans must provide the same Medicare Part A and Part B coverage. Part A covers inpatient/hospital coverage, and Part B covers outpatient/doctor services. Most MA plans also cover Part D prescription drug coverage, which Original Medicare recipients must purchase separately. Even better, MA plans usually provide coverage for various additional perks such as vision care, wellness programs, hearing aids, telehealth and dental care. More than 90% of nationwide MA plans offered these and other health-related benefits in 2022.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
*Select plans offer this coverage
** Most plans offer this coverage
Also Check: How Old Before Eligible For Medicare
Medicare Resources In Alabama
Learning about your Medicare options is important. Seniors and their caregivers have a number of Alabama organizations that they can turn to if they need guidance including the states Area Agencies on Aging , local public health agencies, and nonprofit groups. These organizations also offer a variety of services and programs aimed at promoting a high quality of life for aging residents.
How Does Alabama Regulate Long
Medicare beneficiaries increasingly rely on long-term services and supports or long-term care which for the most part is not covered by Medicare. In 2015, 20 percent of Medicare beneficiaries who were living at home received some assistance with LTSS and even more seniors will need those services as the population ages.
Recommended Reading: Can A Doctor Refuse A Medicare Supplement
You Automatically Get Medicare When You Turn 65
- Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.
Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months of turning 65, you might have to wait to sign up and pay a monthly late enrollment penalty.
Where Can Medicare Beneficiaries Get Help In Alabama
State Health Insurance Assistance Program
Free volunteer Medicare counseling is available through Alabamas State Health Insurance Assistance Program at 800-AGELINE . The SHIP is part of the Alabama Department of Senior Services and sponsored by the federal government.
SHIPs can help beneficiaries enroll in Medicare, compare and change Medicare Advantage and Part D plans, and answer questions about state Medigap protections. They may also be able to offer referrals to local agencies for services like home care and long-term care. This website has more information about the SHIP in Alabama.
Elder Law Attorneys
Elder law attorneys can help individuals plan for Medicaid long-term care benefits. Use this search feature from the National Academy of Elder Law Attorneys to find local legal help.
If you are low-income, you may qualify to receive legal help with Medicaid issues from Legal Services Alabama.
Area Agencies on Aging
Area Agencies on Aging can provide information about benefits and services available to older adults and people with disabilities. This website lists AAAs in each region in Alabama.
Where can I apply for Medicaid in Alabama?
The Alabama Medicaid program is administered by the Alabama Department of Public Health. You can find more information about applying for Medicaid or an MSP in Alabama by visiting this website or calling 800-362-1504.
You May Like: What Is Deductible On Medicare
When Youre Ready Contact Social Security To Sign Up:
- Apply online This is the easiest and fastest way to sign up and get any financial help you may need. Youll need to create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online.
- Contact your local Social Security office.
- If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
Contact Social Security To Sign Up For Medicare
You can either:
Know when to sign up for Part BYou can only sign up for Part B at certain times. If you dont sign up for Part B when you turn 65, you might have to wait to sign up and pay a monthly late enrollment penalty. Find out when you can sign up. How much is the Part B late enrollment penalty?
You May Like: How To Get Medicare Part C
Alabama Medicare Supplement Plan Faqs
- Was this article helpful ?
Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.
Stacy Crayder is the corporate trainer and licensed Medicare agent at MedicareFAQ. As an educator, Stacy is dedicated to teaching new Medicare agents all the necessary information regarding Original Medicare, Medicare Advantage, and Medicare Supplement plans. In her Medicare101 training classes, Stacy provides an intensive education on all things Medicare. Additionally, as a Medicare Expert, Stacy provides high-quality Medicare information to beneficiaries eager to learn more about their healthcare coverage.
Medicare Plans In Alabama
Original Medicare is your federal option, and its available to anyone who is eligible for Medicare. Original Medicare includes Parts A and B, which cover both inpatient and outpatient care.
Part A is typically premium-free if you have worked, but you will have to pay a monthly premium for Part B. That premium can increase depending on if you make a high income. You also may opt to buy Medigap to pair with Original Medicare. Medigap can help handle some of Medicares costs like copayments and deductibles.
If youre looking for some perks or more coverage, then you might want to consider a Medicare Advantage plan. These plans are purchased through private insurers and your options vary based on where in Alabama you live.
Medicare Advantage plans often include expanded benefits and coverage, and always include at bare minimum everything that is covered in Original Medicare. According to the U.S. Centers for Medicare and Medicaid Services, the average monthly premium in Alabama for a Medicare Advantage plan in 2021 is $11.06.
Alabamians may also want to take advantage of the Part D prescription drug plans that are available. Prescription drug coverage is often included as part of a Medicare Advantage plan but there are also 32 stand-alone plans in Alabama.
Need FREE Medicare Help?
Recommended Reading: How Much Medicare Pays For Home Health Care