Category: Medicare

Why You Can Try a Medicare Advantage Plan at No Risk

Why You Can Try a Medicare Advantage Plan at No Risk

 

Infomercials have done it for years.  When people feel uneasy about trying a new product, they offer a free trial or a money back guarantee.  It provides security for the buyer to know that even if the supposed benefits of a product were oversold or blown out of proportion, he can still send it back.  There’s no risk.

 

Well, Medicare offers something very similar.  It’s called the “Medicare Advantage Trial Right”.

 

A lot of people are uncomfortable with trying Medicare Advantage because they don’t want to feel trapped in a plan they hate until the next Annual Enrollment Period.  The trial period takes this risk away.  As long as it will be your first time enrolling in a Medicare Advantage Plan, you qualify for Medicare Trial Right!  This means that—no matter what time of year it is—you can drop your Medicare Advantage plan with no penalty and enroll in a Medicare Supplement Plan.  This “free trial” period lasts 12 months from the date the Advantage Plan coverage goes into effect.

 

But as the infomercial cliché puts so obnoxiously…

 

 WAIT…There’s More!

 

Some people believe that if they have pre-existing conditions and get on an Advantage Plan, they will be denied switching back to a Medicare Supplement Policy based on their health.  In other words, they think that if they give up their Supplement for an Advantage Plan, they will never get it back.  But that’s where the “money back guarantee” part of the deal comes in.  Regardless of health, the Medicare Trial Right guarantees that you will be able to get back on a Supplement, no medical underwriting involved.

 

It’s true that Medicare Advantage plans are alluring with their sometimes shockingly low premiums.  But they aren’t always the right (see here for related article) fit for retirees.  They change unpredictably and can be quite a hassle.  This is why the Trial Right is so beneficial.  It allows you to try a plan on for size, and then toss it back on the rack.  To test drive it around the block, and then park it in the lot if it doesn’t meet your standards.  And all the while, it guarantees that your old, trusty Medicare Supplement will be there.

 

Want to look into switching to a Medicare Advantage Plan?  Call Seniormark at 937-492-8800 for a free consultation.

Don’t “Set It and Forget It” This Annual Enrollment Season!

Don’t “Set It and Forget It” This Annual Enrollment Season!

Does anyone remember Ron Popeil?  If you don’t, allow me to rephrase the question.  Does anyone remember the “set it and forget it” infomercial king?

 

I bet it’s ringing a bell now.

 

I, for one, can still see him in his green apron, armed with nothing but some well-seasoned meats and a fancy rotisserie cooker, taking the cheesy and overly scripted infomercial world by storm: “All you have to do is…”  The unrealistically enthused audience chants, “SET IT AND FORGET IT!”

 

He was like the Billy Mays of the 70s, but with food instead of cleaning products.

 

But I digress…back to the topic at hand.  The reason I retrieved this slogan from memory lane is to make a point: Many people have the “set it and forget it” mindset with their Medicare Health Insurance Plans.  They think that once they undergo the process of enrolling in Medicare, enrolling in supplemental coverage or an Advantage plan, and signing up for a drug plan that they never have to change anything again.  Happily ever after.

 

But this just isn’t true.  Yes, most of the work is done.  And you’ve definitely done the minimum to get by.  But there’s a good chance your situation will change over time.  And, even if your situation doesn’t change, there is a very good chance your health care plans will, oftentimes drastically.  This leaves you in an ill-fitting plan that doesn’t meet your needs or your budget.  You may need to switch!

 

When it comes to Medicare Annual Enrollment, there is a reason for the season.  From October 15—December 7, you have the opportunity to make strategic changes to your health care plans.

 

Here are 3 reasons you might need to make changes this year!

 

The Medicare Supplement Creep

Medicare Supplements are typically consistent from year to year.  The benefits are guaranteed to stay the same, and the premiums rarely increase drastically.  But the premium cost almost always creeps up, dollar by dollar, slowly but surely.

 

If you stay on that ride for too long, you could end up paying $100+ more a month than you should.  In fact, if you have been in the same Medicare Supplement Plan for 4-5 years, there’s a good chance you’re paying too much for it.  Shopping around for a better deal this year could save you hundreds…and all without reducing your coverage.

 

REMINDER:  You can change your Medicare Supplement any time of year (click here for related info), not just annual enrollment.

 

The Advantage Plan Leap

There are so many aspects of an Advantage Plan that can frog around over time.  The deductible may go up.  The premium may go down.  You might have higher copays.  Your coinsurance might drop.  And beyond benefits and price, doctors and hospitals may go in and out of your plan’s network.  A doctor available to you this year, may not be available the next.

 

This is why it is important to review your plan.  Is your family doctor still within the plan’s network?  Is it still the best value for you?  If you simply set it, forget it and let it skate by another year, you’ll never know.

 

The Drug Plan Drop

A drug plan may vary in cost from year to year, but what you really need to check is the list of medications the policy covers, also known as the formulary.

 

Over the years, a drug plan may discontinue or reduce coverage on certain medications.  Imagine if the drug it discontinued was your most expensive one, and you didn’t realize it.  Yeah…it could be a financial disaster.

 

Review Your Plan This Year!

So make sure to take control of your health insurance options.  Review your plans, and take careful note of all the changes.  The “set it and forget it” philosophy might work well for cooking chickens, but it doesn’t work for this.

 

For your health insurance, I offer another slogan:  If you set it and forget it, you might regret it.

 

Maybe that will catch on…

 

Yeah…probably not.

 

Looking to review your plans with a Certified Senior Advisor? Call Seniormark at 937-492-8800 for a free consultation.

A Little Known Reason Why Medicare Will Deny Coverage For Your Nursing Home Stay

A Little Known Reason Why Medicare Will Deny Coverage For Your Nursing Home Stay

There are few things more wrinkle-inducing than the stress of any unexpected bill, let alone a $6000-8000 nursing home expense left uninsured by Medicare.

 

But it happens everyday. If you receive only custodial care at the nursing home, Medicare will not cover you.  (Read this blog for a few answers.)   And even if you are receiving skilled nursing care, there is still a chance you won’t be insured.

 

Here’s the reason: Many people don’t receive 3 days of inpatient care before moving onto the nursing home. This is a requirement for coverage!

 

Check Your Status!

What really throws people for a loop is that not all hospital stays qualify as the required inpatient care. So even if you stay a week in the hospital’s luxurious half-room with a moaning mystery patient on the other side of the curtain, that doesn’t mean you satisfied the requirement (even though you definitely earned it, in my opinion).

 

Why, you ask?

 

It has to do with your official status. Some people are formally checked-in, but others are filed under “observation status”. In other words, they are not receiving any specific treatment but are rather checked in for the purpose of evaluation, testing, and monitoring. In almost all respects, they receive similar care to those who are formally checked in, but these patients are billed and covered like they are receiving outpatient services. They don’t fulfill the 3-day inpatient requirement and—when they move on to a skilled nursing facility like a nursing home—they are denied coverage when they need it most.

 

Sounds a bit unfair, right? I agree wholeheartedly. Luckily, the government is aware of the issue and is taking steps to resolve it.

 

Baby Steps

One of these small steps occurred in August of 2015 when Obama signed the Notice of Observation Treatment and Implication for Care Eligibility Act. I know—legislators have a knack for snappy titles. But in all seriousness: What the article lacks in creativity, it makes up for in functionality. This Act requires hospitals to alert you of your observation status and how it will affect your Medicare coverage in both writing and in person.

 

Potential Strides

The Notice Act doesn’t solve the whole issue, of course. It would be better to just allow all hospital stays to count toward the 3-day inpatient requirement. The good news is—yet again—politicians are working toward this.

 

But until then, be aware and ask about your status.  It pays to be educated. And it can save you an arm and a leg to know what others don’t and what hospitals neglect to tell you.

 

Turning 65 soon and confused about Medicare?  Call Seniormark at 937-492-8800 or click here to sign up for a free consultation!

Think Poor Health Will Stop You From Getting Medicare Supplement Insurance? Think Again.

Think Poor Health Will Stop You From Getting Medicare Supplement Insurance? Think Again.

Insurance companies can’t refuse you coverage for having cancer or being on an expensive chemo-treatment. They can’t deny you a policy for having diabetes or (Burger King-induced) sky-scraping cholesterol or any other pre-existing condition for that matter. These companies are federally mandated to grant you coverage as long as you enroll within the Medicare Supplement Open Enrollment Period. This is good news for you!

 

The Open Enrollment Period

The Medicare Supplement Open Enrollment Period is a 6-month window beginning the day you both turn 65 and are enrolled in Part B of Medicare. During this time frame, you have all the privileges of someone who doesn’t have poor health, including:

  • Access to all 11 Supplement plans (A, B, C, D, F, HDF, G, K, L, M, and N)
  • No premium hikes due to health conditions
  • No medical underwriting

 

You’ve Got Another Shot.

And then there’s guaranteed issue. Although this is based on very specific circumstances (such as coming off of employer insurance or your current plan discontinuing service), it still offers many people with pre-existing conditions another shot at getting on a plan. It is important to note, though, that some plans may not be available under guaranteed issue. It isn’t an all-access pass like the Open Enrollment Period, but it does give you the assurance to know you will not be denied.

 

 

It’s Not the End of the World!

But don’t sweat if you are no longer within the Open Enrollment Period. This definitely does not mean you won’t be able to get Medicare Supplement Insurance. It just means you will have to answer questions about your health, where they might look at your whopper addiction with a more critical eye.  You may have to pay more, but (depending on your specific conditions) they won’t automatically deny you coverage.

 

Of course, this doesn’t mean that there aren’t still circumstances where you will be unable to receive coverage. But—because of open enrollment and guaranteed issue—this doesn’t happen nearly as much. The government is making strides to ensure that health coverage is available to those who need it most: those who are unhealthy.

 

Need help picking out one of the 11 Medicare Supplement Plans? Want somewhere to start? Call Seniormark at 937-492-8800 or click here to set up a free consultation.

Why Dental Plans Aren’t Worth Their Weight in Premium For Retirees

Why Dental Plans Aren’t Worth Their Weight in Premium For Retirees

If you’re coming off your employer plan and onto Medicare, you might have been surprised to find out that neither Medicare nor Medicare Supplements cover most routine dental services. So I understand why you might find it quite attractive to get on a dental plan in addition to Medicare.   After all, who else will insure your million-dollar smile?

 

But allow me to reason with you. Because I believe that—in most cases—a dental plan just isn’t worth it.  Don’t believe me?  Using the pictured plan as an example, give me a few minutes to explain.

 

Scaling Benefits, Depleting Value

Way back when, Dental Plans had much better benefits. Their maximum benefits started on day one and continued until you dropped the plan.  But people abused it.  They got on a plan when they found out they needed a major surgery, let the insurance company foot the bill, and then cancelled the plan, getting away with no more than $30-40 in out-of-pocket costs.

 

The insurance companies needed to get smart if they were going to make any money.  So what did they do?  They fought fire with fire, and introduced scaling benefits.  Now most plans do not grant you full benefits until much later, after you paid your dues in premiums.  In the example below, the full benefits aren’t granted until 2 years.  In other words, not until you spend $800 in premiums!  The only thing the plan pays in full on day one is preventative services such as cleanings and exams.

 

Maximum Benefits

Here’s where a dental plan can really get you: the maximum benefits per calendar year is $1000.  This means you will never squeeze anymore than one grand out of them per year, no matter how long you’ve paid into the plan.

 

So what do you pay in premiums per year for this plan?  Let’s crunch the numbers.  $33.71/ month X 12 months per year = $404.52.  So, for all intents and purposes,  you pay about $400.  Consider this:  if you put the money you would’ve paid in premiums into a savings account, you would cover the maximum benefits in 2.5 years.  So—as long as you don’t expect to spend well over $1000 in 2.5 years—why would you bother with a dental plan?  For most people, it is just not reasonable.

 

You might’ve notice that you can upgrade your maximum benefits to $2000 dollars for an extra $7.61 in monthly premium.  But did you notice the fine print?  Without squinting, you probably didn’t.  So let me help you out with the gist: despite the upgrade, major services will still not exceed $1000.  In other words, for the services that actually have a chance of exceeding $1000 like dentures and oral surgery, the benefit limit is the same.

 

What to Do Instead

If you are still concerned about paying for routine checks, I would recommend telling the dentist you don’t have insurance and asking about “network pricing.”  A lot of times they are willing to cut the price (as much as 50% for exams and cleanings).

 

And if you are still concerned about major services that are going to cost up to $1000 or more, I recommend saving up what you would’ve paid in premium to put into a savings account.  In 2.5 years, you will have a thousand dollars of self-insurance for that million- dollar smile.

 

Need help with your retirement transition? Seniormark is here to help! Call us at 937-492-8800 for a free consultation.

Q&A: What You Need to Know about the New Medicare Cards and Numbers

Q&A: What You Need to Know about the New Medicare Cards and Numbers

I’m sure you’ve heard about it on the news or from a friend. If you haven’t, I would like to inform you now: As a part of the Social Security Number Removal Initiative, the Centers for Medicare and Medicaid Services (CMS) will be issuing new Medicare cards with a new number gracing the front. Unlike the old HICN number that is on all the old cards, this new number is not based on your Social Security number. Rather, it is a randomly generated 11-character identifier.

 

I anticipated a little bit of  “buzz” surrounding this topic, so I thought I would provide quick, simple answers to some of the questions you might be asking out of curiosity or general concern. Let’s get started.

 

How Much Will It Cost?

It won’t cost you anything. However, the government has set aside $320 million over five years to fund the initiative. It’s amazing how something as simple as changing numbers and letters on a card can end up costing so much!

 

Why Are They Doing It?

Think $320 million is a lot of money? How about $60 billion? As it turns out, that is one estimate of the amount of money Medicare loses every year due to fraud, according to AARP. The government hopes taking everyone’s Social Security numbers off the cards will help prevent identity theft and put a dent in that multi-billion dollar problem.

 

How Is My Medicare Beneficiary Identifier (MBI) Generated?

Unlike the old Health Insurance Claim Number (the number on your current card), which is based on your Social Security Number, your new Medicare number (the MBI) is a completely randomly generated 11-character identifier. It does not have any special meaning whatsoever.

 

For more information on the MBI, how it will look on the card, and each of the characters, see this helpful explanation.

 

When Will I Receive Mine?

They began the transition in April of 2018. Their goal is to have a new Medicare card in the hands of every active Medicare beneficiary by April of 2019.  You can also sign up at medicare.gov to receive an email when your state mails their new cards.

 

What Does This Mean for My Healthcare Provider?

Your doctors and care facilities will likely need to update their software and information systems to recognize the new number. Issues and challenges may arise as the transition takes place, but all the kinks should be worked out before you get your new card in the mail.

 

Do I Need to Do Anything?

Be sure to destroy your old card (it has your social security number on it), start using your new card as soon as you get it, keep the new number safe, and also check out our blog post about potential scams that may arise throughout this transition.

 

Do You Have Other Medicare Questions?

At Seniormark, we’re always here to help. If you have any questions about when and how to sign up for supplements, Medicare Advantage or drug plans, give us a call at 937-492-8800 or click here to sign up for a free consultation!

Watch Out for Medicare Scammers as New Medicare Cards are Issued

Watch Out for Medicare Scammers as New Medicare Cards are Issued

If you have read any of my other blog posts detailing the evils of Medicare fraud, then you know what a pervasive and serious problem it is. Not only does it cost Medicare recipients and taxpayers such as yourself millions in false claims, it can also cost lives in some rare cases due to malpractice and misdiagnosis.

 

This is why the Center for Medicare and Medicaid Services (CMS) launched an initiative to help tackle this complex problem. It is called the Social Security Number Removal Initiative (SSNRI), which accomplishes almost exactly what it sounds like it does. The measure ensures that Medicare will issue new Medicare cards to over 57 million enrollees with (you guessed it) the Social Security numbers removed. Instead the card will proudly display a new identification number called the Member Beneficiary Identifier (MBI). Medicare hopes that, with such an important number replaced on the card, it will make it more difficult for the bad guys to steal your precious identity.

 

However, the reason why I am alerting you of such a change is because the Better Business Bureau predicts that, scammers will prey on the uncertainty of this transition in the form of phone scams, and I do not want you to be a victim. Over the period of April 1, 2018 to December 31, 2019, be on special guard against these kinds of attacks. Knowing how this initiative will take place will help keep you safe. Therefore, keep the following things in mind about the SSNRI:

  1. You will not need to pay for your new card. If someone claims you have to, it’s a scam.
  2. You will not need to share your Social Security Number over the phone either. Reminder: Medicare will not call you or ask for personal information over the phone.
  3. You will not lose your Medicare Coverage in this transition. If anyone threatens this if you do not give them your information, it is a scam as well.
  4. This process is entirely automatic! Your new card will just show up in the mail sometime between April 1, 2018 and December 31, 2019.

 

It’s certainly frustrating that scammers can take an initiative designed to stop them and use the process as an opportunity to trick even more people. However, once you have your new Medicare card in hand, it will make it even more difficult on them. And, as long as you remember those four points, you will keep yourself safe in the transition as well.

 

Did you know that if you have been in the same Medicare Supplement for 4-5 years, you are likely overpaying for your coverage?  Click here to find out how much you could be paying:  http://seniormark.com/resources/#medicare-rate.

 

Want more information?  Contact our office at 937-492-8800 or via e-mail at admin@seniormark.com.  We are here to help!

New Medicare Cards Come with New Scams

New Medicare Cards Come with New Scams

 

There is great news for Medicare beneficiaries, and a bit of caution regarding scammers.  The good news is that Medicare will be sending out new Medicare cards to each recipient.  Mailing of the new cards will begin April 1st of this year and will be completed by April 1st of next year.

 

The new cards will not have the enrollee’s Social Security number on them, as they do now.  This is a major accomplishment for Medicare and is being done to help put a stop to identity theft via Social Security identification numbers.  This problem has been rampant nationally and is very serious business for Medicare enrollees who have had their cards compromised by internet bandits.

 

The new cards will have a randomly generated 11 digit number that even the holder will not be able to decipher.  So that is good news.  For the State of Ohio, delivery of new cards is scheduled to begin after June 1st.

 

But, along with the good news, bad news sometimes seems to follow.  The bad news is that Medicare scammers have already jumped into the game.  There is more than one technique involved, but these are the two most used.

 

First, scammers are calling Medicare recipients, sometimes identifying themselves as Medicare or “government” officials, and telling them that the new cards are coming out, but that they will have to send $30-50 to get the new cards.  This is bogus—there is no charge for the new cards—and CMS/Medicare does not call people—it only uses the US Postal Service to communicate.

 

The second technique is for the scammer to say that they have a Medicare Advantage Prescription Drug Plan available, but then request personal Medicare information so that the new plan can be utilized.  This is also bogus.  Whatever you do, do not fall for this.  Medicare information is personal, and the scammers simply use it for illegal activities.

 

So, we don’t know when or how the scammers will spring into operation in Ohio, or the Miami Valley region, but if you receive one of these calls, just hang up, and report the activity with a call to 1-800-Medicare.  And…above all, do not feel pressured to respond to any of these calls—the scammers are well-trained in intimidation and persistency.  Don’t fall for it.

Warning: New Medicare Scams Coming!

A New Wave of Medicare Scammers

 

Yet another wave of Medicare scammers is on the rise.  As new Medicare cards will be mailed out, seniors are finding themselves susceptible to phone scammers who are calling and identifying themselves as representatives from Medicare.

 

Callers are requesting payment for the new Medicare cards that are absolutely FREE.  Please be wary of such scams and not to give out private information about yourself.  Medicare will correspond only via mail.

 

To report a scam, please use the Better Business Scam Tracker or contact Medicare.gov directly at 1-800-MEDICARE.

 

In this latest attempt at medical identity theft, a caller posing as a Medicare representative will ask for payment in exchange for the new ID.  (The cards, which will be automatically sent sometime between April 2018 and April 2019, are free and require no extra steps.)

 

The same goes for someone asking if you want to purchase Medicare’s prescription drug coverage, known as Part D.  In this case a scammer may try to persuade you to buy Part D or lose your Medicare coverage.  (Part D is voluntary and has no impact on your health plan.)

Another common ruse is that you’re owed a refund from your insurance company and the caller needs your bank account number and Social Security number to deposit it.  A similar fraud also involves a caller claiming to be with Medicare requesting to update or confirm your information.  In each of these attempts at medical identity theft, scammers can then use your insurance to see a doctor, obtain prescriptions, buy medical equipment or even file a false claim.”

Scammers are taking advantage of the new security measures by targeting Medicare recipients before the changes roll out.  North Carolina Department of Insurance Commissioner Mike Causey says fraudsters are calling recipients, asking for personal information before the new cards come in.  He says they’ll ask you to verify your information, pay a fee or offer to track down your new card by using your old card information.”

If you have questions or concerns about the new Medicare cards, please contact our office for assistance:  937-492-8800.

2018 Medicare Parts A & B Premiums and Deductibles Announced

2018 Medicare Parts A & B Premiums and Deductibles Announced

 

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released the 2018 premiums for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs.

For 2018, the Part B premium will be $134 for those new to Medicare.  For those already on Medicare, their premium will be between $108-$134, depending on the amount of their social security cost of living increase.  The Part B deductible will remain the same ($183). There are some changes to the numbers which are listed below, but if you have a Medicare supplement policy, it will take care of some, if not all, of these expenses.
2017                     2018
Part B Premium                                              $109.00                $134.00
Part B Deductible                                           $183                     $183
Part A Hospital Deductible                             $1316                   $1340
Part A Hospital Coinsurance Days 61-90        $329/day          $335/day
Part A Hospital Coinsurance Lifetime Reserve Days
$658/day          $670/day
Skilled Nursing Coinsurance Days 21-100
$164.50/day      $167.50/day

For more information on the 2018 Medicare Parts A and B premiums and deductibles, please contact our office at 937-492-8800.