Author: Dan Hoelscher

Dan Hoelscher founded Seniormark in 2007 in an effort to help individuals make a successful transition into retirement. Dan is a Certified Financial Planner™ Practitioner and holds Certified Senior Advisor (CSA)© and Certified Kingdom Advisor™ certifications. Since founding Seniormark, Dan has helped thousands of retirees throughout Ohio.

Medicare Supplement Insurance: Are You Insurable?

Medicare Supplement Insurance: Are You Insurable?

If you are in your Medicare Supplement Open Enrollment Period, you are 100% insurable, no questions asked. If you are in a guaranteed issue period, some plans may not be available to you but—again—you are 100% insurable. Still no questions asked.

 

But even if you are not in one of these two groups, it is likely that you will be able to get on a plan anyhow. You will have to undergo some health evaluation questioning, but that doesn’t mean your less than perfect health will prevent you from getting the coverage you need.

 

Lower Your Expectations

You’re 65 or older. Insurance companies don’t expect you to be able to land a round off back hand spring or have an empty medicine cabinet or even have decent cholesterol. In fact, I am looking at the most recent application for AARP Medicare Supplement Insurance, and they do not ask anything about blood tests or weight or most resolved issues. This is typical across most applications.

 

The only thing they look for is that you don’t have any “big-ticket” pre-existing conditions or alarming circumstances on your health resume: cancer, upcoming surgery, Alzheimer’s disease, etc. In short, they are looking to answer this question: is your health stable? They are not concerned with whether your health is particularly impressive.

 

Two Examples of Supposed “Uninsurables”

This week a client of ours called in who thought she was uninsurable because she had cancer 4 years ago. But this just wasn’t true. In fact, most insurance companies will offer you coverage if you have been cancer free without treatments for two years. After we assured her of the good news, she was promptly put on a great plan for her needs.

 

We also had another case of a man who just had a stent put in 1 year ago. Although he thought this would make it difficult to find a provider, this wasn’t the case either. We shopped some Supplement plans for him and found him a plan that still insured people with stents as long as it wasn’t put in within a year.

 

Concluding Thoughts

The goal of this post is not to deceive you into thinking that no one is uninsurable, but I do want to give those people with imperfect health some hope. Even pre-existing conditions as bad as diabetes can be insured. There are a lot of insurance companies out there, so shop around. Chances are one of them will take a chance on you!

 

Limited Time Offer

In fact, right now we have a company offering their Medicare Supplement policies with no medical underwriting!  That means even if you are affected by some of the above, they will not look at your health history before insuring you.  This is a limited time offer, so you may want to call our office for details if you are interested.  An additional bonus of this plan is that it offers the Silver Sneakers benefit!

 

Need help finding a Medicare Supplement for your unique situation? Looking for a licensed expert with a passion for assisting retirees? Contact Seniormark at 937-492-8800 for a free consultation.

Medicare Supplement Insurance: Are You Insurable?

Medicare Supplement Insurance: Are You Insurable?

If you are in your Medicare Supplement Open Enrollment Period, you are 100% insurable, no questions asked. If you are in a guaranteed issue period, some plans may not be available to you but—again—you are 100% insurable. Still no questions asked.

 

But even if you are not in one of these two groups, it is likely that you will be able to get on a plan anyhow. You will have to undergo some health evaluation questioning, but that doesn’t mean your less than perfect health will prevent you from getting the coverage you need.

 

Lower Your Expectations

You’re 65 or older. Insurance companies don’t expect you to be able to land a round off back hand spring or have an empty medicine cabinet or even have decent cholesterol. In fact, I am looking at the most recent application for AARP Medicare Supplement Insurance, and they do not ask anything about blood tests or weight or most resolved issues. This is typical across most applications.

 

The only thing they look for is that you don’t have any “big-ticket” pre-existing conditions or alarming circumstances on your health resume: cancer, upcoming surgery, Alzheimer’s disease, etc. In short, they are looking to answer this question: is your health stable? They are not concerned with whether your health is particularly impressive.

 

Two Examples of Supposed “Uninsurables”

This week a client of ours called in who thought she was uninsurable because she had cancer 4 years ago. But this just wasn’t true. In fact, most insurance companies will offer you coverage if you have been cancer free without treatments for two years. After we assured her of the good news, she was promptly put on a great plan for her needs.

 

We also had another case of a man who just had a stent put in 1 year ago. Although he thought this would make it difficult to find a provider, this wasn’t the case either. We shopped some supplement plans for him and found him a plan that still insured people with stents as long as it wasn’t put in within a year.

 

Concluding Thoughts

The goal of this post is not to deceive you into thinking that no one is uninsurable, but I do want to give those people with imperfect health some hope. Even pre-existing conditions as bad as diabetes can be insured. There are a lot of insurance companies out there, so shop around. Chances are one of them will take a chance on you!

 

Great news!

Right now, we have a company who is accepting anyone without answering ANY health questions!  They are only doing this until June, so if you are interested, give us a call.  BONUS:  They offer a gym membership along with their supplement!

 

Need help finding a Medicare Supplement for your unique situation? Looking for a licensed expert with a passion for assisting retirees? Contact Seniormark at 937-492-8800 for a free consultation.

 

Take It Personally: Why Rampant Medicare Fraud Affects You and Your Family

Take It Personally: Why Rampant Medicare Fraud Affects You and Your Family

In 2012, the FBI boasted the arrest of 107 individuals for 452 million dollars in false billing. In 2015, The United States Department of Justice reported a fraud takedown of 243 individuals for 712 million dollars.

 

And if you look at the June 2016 edition of the AARP Bulletin, you will see the somber mug shot of physician Jacques Roy, facing life in prison for leading a fraud scheme of 375 million in phony charges—the single most expensive home health care fraud in the history of Medicare and Medicaid!

 

Sweet Victory?

Those sound like some huge numbers, right? So big it seems like the entire Medicare Fraud Strike Force could just sunbathe in the warmth of their victories. We’ve won, after all…

 

Well…not so much. How about these numbers? 60 billion. 90 billion. 30% of Medicare’s annual spending (180 billion).

 

These are the numbers that ABC News, the National Center for Policy Analysis, and AARP (respectively) estimated as the yearly dollar amount lost due to Medicare fraud.

 

The Scope of the Issue

But the hard truth about the scope of Medicare Fraud is this: no one knows. Everyone accepts that it is a staggering amount, but it is hard to pinpoint, mostly because it goes undetected so often. In fact, even Malcolm Sparrow, Harvard professor and health care fraud expert feels uncomfortable putting an exact number on it: “the point is, we don’t know, and we shouldn’t have to guess,” he says in AARP’s Bulletin.

 

So maybe the strike force should put away the sunscreen and beach towels. They’ve got some work to do.

 

Why It Matters to You

The sheer, unpunished treachery of this madness is enough to make anyone frustrated, for sure. But beyond the foundational longing for justice that lies within us all, let’s get practical. And—more than that—let’s get personal. Medicare fraud costs you and your family money. If you pay taxes, you are paying for it. If your children pay taxes, they are paying for it as well. Medicare premiums go up? This is part of the reason.

 

The One Thing You Have in Common With a Fraudster

Now I want to cycle back to Dr. Jacques Roy.  According to AARP, when the authorities searched his lakefront house in the Dallas suburbs, they found deposit slips to a bank in the Cayman Islands and a guide to registering yachts there.

 

Go figure. You do have something in common with a hardened criminal. All those years of saving, planning, and roosting on your nest egg prove it: you both want to retire well.

 

Some people are just willing to steal from you to do it.

 

Want to know how you can recognize Medicare Fraud and make up to $1000 doing it? Click here to find out.

 

Have more questions about Medicare?  Call our office at 937-492-8800 and we will help you out!

 

10 Terms to Beef Up Your Medicare Literacy

10 Terms to Beef Up Your Medicare Literacy

In this day and age, you have a vast pool of knowledge available to you. But none of that matters if you can’t understand any of it. If you’ve done any researching on the Internet about Medicare, you know what I mean. To help you out, I compiled a list of important terms that often catch retirees unaware.

 

  1. Annual Enrollment Period (AEP)

The AEP is the busy time of year for Insurance companies such as ours. You can think of it as the black Friday of Medicare. It is the time of year (October 15—December 7) when Medicare beneficiaries can switch plans, drop plans, and join new ones. It is an open market, a bustling time for anyone involved with the Medicare industry.

 

  1. Open Enrollment Period

The day you turn 65 and are signed up for Medicare Part B is the first day of your open enrollment. This 6-month long time frame is the window in which you can get on ANY Medicare Supplement plan, regardless of health! You will want to take advantage of this…your options narrow significantly outside of open enrollment.

 

  1. Deductible

A deductible is the money you have to pay upfront before the benefits of a plan begin. For example, Part A of Medicare has a $1340 deductible. They will not cover anything until you reach it.

 

  1. Copayments

Copays are a set dollar amount you pay in addition to the payment made by the insurer (whether it be Medicare or a private insurance company). Think of the $10-50 fees when you visit the doctor’s office or buy a certain prescription drug.

 

  1. Coinsurance

This is very similar to copayments, but it is a set percentage instead of a dollar amount. For example, the Medicare Part B coinsurance is 20%. This means you pay 20% of the total bill, not a set dollar amount.

 

  1. Out-of-pocket Costs

All three of the previous terms (deductibles, copays, and coinsurance) are all a part of a much larger concept of out-of-pocket costs. In other words, your out-of-pocket costs are everything you pay for your healthcare beyond your premium. One warning you will receive a lot is this: With only traditional Medicare (parts A and B), there is no limit to your out-of-pocket spending. Yes, I am low-key warning you again, but hopefully you fully understand it now.

 

  1. Donut Hole

Speaking of out-of-pocket costs, for a Part D drug plan, they are highest in the donut hole, a gap in prescription drug coverage. You enter the donut hole when you reach $3750 in total costs and exit it once you reach $5000 in out-of-pocket costs.

 

  1. Drug Tiers

Drug plan companies often organize the medications they cover into levels. They call these levels—you guessed it—tiers. Drugs on a lower tier (often generic brands) have lower copays and coinsurance. Drug on a higher tier (such as brand name or specialty drugs) often have higher associated costs.

 

  1. PPO

PPO stands for Preferred Provider Organization. So a PPO is a health plan that has a network of “preferred” doctors and hospitals. If you use those doctors and hospitals, they reward you will lower out-of-pocket costs.

 

  1. HMO

HMOs (Health Maintenance Plans) are a little bit more intense than PPOs. It is the same idea, but HMO plans won’t cover you at all if you don’t use their network of hospitals and doctors.

 

That brings this list to close. If you are still confused about a term on this list, ask us for help in the comments section. Have you come across another difficult word on your Medicare planning journey that you think we should add? Let us know. We want to hear from you!

 

Annual Enrollment is the only time of year you can switch your Medicare Advantage Plan or Part D Drug Plan! Looking to review your plans with a Certified Senior Advisor this open enrollment season? Call Seniormark at 937-492-8800 or click here to set up a free consultation.

Can I Really Get a Medicare Advantage Plan For Free?

Can I Really Get a Medicare Advantage Plan For Free?

Yes, for quite a few Medicare Advantage plans, you will not have to pay a dime in premiums. And to sweeten the deal, you can even get extra benefits like gym memberships or a built in drug coverage with some plans. But I’m very stingy with my use of the word “free.”

 

From my experience, an Advantage Plan is free in the same way the newborn puppies of your best friend’s dog are “free.” You may not have to pay for the puppy, but how many know having man’s best friend around the house isn’t exactly a recipe for super savings (especially if you’ve got furniture and footwear that look especially appetizing in black and white)?

 

You see, a Medicare Advantage Plan might not cost anything in premiums, but it may eat up your money in the end. I’m not saying they aren’t right for some people, in fact; I’ve placed people in $0 Advantage Plans to their long-term satisfaction. For the cost-conscious retiree who is romping into retirement, healthy as a horse, it may be the best option. But before you purchase one, make sure you understand the hassles and extra costs that come along with the decision. I’ve outlined a few of the most important ones:

 

Networks

Advantage Plans have networks of health care providers that they have contracted with, usually within a fairly tight geographic area. If you do not receive care at one of their pre-picked providers, it can mean much higher co pays and coinsurance amounts. If you are in an HMO plan, they may not even cover you at all while receiving care out of network. This can work just fine for a person who stays local most of the year, but it does put the burden on you to ensure that your health care provider is in-network. Making mistakes could cost you heavily.

 

Inconsistency

With a Medicare Supplement, the benefits are stable, but with an Advantage Plan, this is hardly ever the case.

 

Since the private insurance companies that offer Advantage Plans re-file their contract with Medicare every year, the benefits always change—sometimes dramatically. One of your preferred doctors could go out of network. Co payments, coinsurance, and deductibles can all shoot up. This is why you must review your plan every year so you won’t be caught unaware. If you set your plan to the side and forget about it for even one year, it can be quite upsetting financially.

 

Potentially High Out-of-pocket Costs

I always like to remind people that Advantage Plans have more of a “pay as you go” approach. You pay less in premiums, yes.  But you may make up for it in deductibles, co payments, and coinsurance. For example, almost all Advantage Plans still keep you on the hook for the 20% coinsurance on Part B. That’s fine for an x-ray, but not as much for an outpatient surgery that may be $20,000 or more.

So be aware, Advantage plans do limit your annual out-of-pocket spending, but these caps are generally pretty high. If you have a period of extended illness, you could spend anywhere from $3500-6000 per year or more!

 

That doesn’t sound like free to me.

 

That is why you need to be wary of salespeople who may just be trying to convince you to switch to a Medicare Advantage Plan this Annual Enrollment Season. It may be right for you, but—then again—it may cost you a lot more in the long run.

 

Looking to review your plans with a Certified Senior Advisor this Annual enrollment season? Call Seniormark at 937-492-8800 or click here to set up a free consultation.

 

Don’t Make One of These Common Medicare Mistakes!

Don’t Make One of These Common Medicare Mistakes!

The whole process of switching from your employer plan or private insurance to Medicare is fraught with potential costly mistakes. Misconceptions can leave you without much needed insurance. Failure to take the essential steps on time can leave you in the jaws of lifelong penalties.

 

After working in the Medicare industry for over 20 years, I see the same common goofs over and over, ones that cost people an arm and a leg. That is why I feel it is necessary to address them. Hopefully, this post will keep you on the straight and narrow, avoiding the misconceptions and missteps so many fall prey to.

 

Without further ado, let’s dive right in!

  1. Not Signing Up For Medicare When You Turn 65

“I’ll take care of that Medicare enrollment stuff later.”

Don’t procrastinate when it comes to Medicare planning. A couple weeks can easily turn into a couple months and then, next thing you know, it is a year or more later and you’ve missed the Initial Enrollment Period (the 7-month period surrounding your 65th birthday month).

 

It doesn’t seem like a big deal until you look at the penalties. Let’s just take a look at the Part B penalty alone, which is a 10% premium increase for every year you could’ve had Part B but didn’t sign up. This doesn’t sound like a lot, but if you are one year late and live another 20 years (a rough life expectancy estimate), you can easily pay over $3,000 in penalties. This is definitely a mistake you want to avoid!

 

  1. Not Signing Up For Part B Because of Retiree Insurance or COBRA

Why would I want to pay for Part B if my retiree insurance provides my coverage?”

While it is true that you can delay Part B if you have coverage through active employment, retiree insurance and COBRA don’t count. If you aren’t continuing to work past 65, you can’t delay Part B. Period.

 

If you do choose to delay, check the Part B penalties in the above section. They will apply to you, and they aren’t good!

 

  1. Getting on the Same Drug Plan as Your Husband or Wife

“We’ve got matching tattoos, matching drug plans, and a joint Facebook account.”

You can get matching tattoos, and although I question the joint Facebook account, I can let that slide too. But you absolutely can’t get matching drug plans, even if your husband or wife’s plan is low premium.

 

Why?

 

Because every drug plan is different. They each have different preferred pharmacies, different copays, and—this is the important one—they cover different drugs at varying rates. So, even though it might seem convenient to get on the same plan, your drugs may not be covered by his or her plan. This may not be a big deal for a simple blood pressure medication, but prescription drugs are often expensive. Leave the wrong drug uncovered, and it could break the bank and shrink the nest egg.

 

  1. Not Getting on a Part D Drug Plan at All

I’m not on any expensive medications right now, why do I need one?”

The key words in that quote are “right” and “now.” You may be able to get your prescriptions for a small copay now, but—as I said before—what are you going to do if a drug costs $400 or much more a month? If you wait, you will still be able to get on a plan outside of your Initial Enrollment Period (IEP), but not without a Medicare Part D late enrollment penalty. And, since you can only make changes to your Medicare health insurance plans during the Annual Enrollment Period (October 15- December 7), you will have to pay for your expensive drugs out-of-pocket until that time.

 

  1. Thinking Original Medicare Alone (Parts A and B) Will Cover All Your Health Insurance Needs

“Medicare is all inclusive, right?”

Medicare provides good coverage, but it doesn’t cover everything. Extended hospital stays, some skilled nursing care, 20% coinsurance on all outpatient services are just a few of the bigger expenses that will be left up to you. Other smaller ones include vision, dental, or hearing aids. Although I wouldn’t worry about those last three small ones, the bigger ones can be potentially disastrous. Why? Because there is no out-of-pocket maximum in Medicare. No matter how high the out-of-pocket expenses get, you are still on the hook.

 

That is why you need to get something to supplement Medicare alone. You don’t need to pay out the nose to get the most comprehensive coverage, but you can’t leave yourself vulnerable. You have lots of options from plans that cover almost everything to $0 per month Advantage plans that—although are often a hassle—do cap out your out-of-pocket spending at $4-6,000 per year.

 

  1. Accidentally Missing the Medicare Supplement Open Enrollment Period or Your Initial Enrollment Period for Advantage Plans

Oops…”

The time to buy a Medicare Supplement is during your open enrollment period, a 6-month period that starts when you turn 65 and enroll in Medicare Part B.

 

The time to buy an Advantage Plan is during your Initial Enrollment Period, a 7-month period that begins 3-months before your 65th birthday month.

 

You can get on an Advantage Plan during the Annual Enrollment Period (October 15- December 7) if you miss the deadlines, but that can be problem if you need the insurance right away. What if you’ve got some big- ticket medical expenses before the end of the year?

 

And, with Medicare Supplements, although you can try to get on one anytime of year, there is no guarantee you can get one at all. You will have to undergo medical underwriting, and—if you don’t meet their requirements—they will deny you coverage. Now, you don’t have to be in perfect health to meet these requirements, but for some the underwriting can be a real problem.

 

  1. Trying to Do It All Alone

“This can’t be too hard, can it?”

Let’s face it: Medicare is complicated. It is a convoluted government program serving over 50 billion beneficiaries. There are lots of deadlines and rules—as you can see—many opportunities for blunders. At Seniormark, we’ve seen people baffled by Medicare again and again, even people who’ve spent their entire lives in the health care industry! You should definitely educate yourself so you understand your options and don’t get taken advantage of, but at the end of the day, don’t do it all by yourself!  Sit down with a professional who will help ensure you aren’t making any mistakes!

 

Don’t do it alone this Annual Enrollment Season!

We can sit down with you and guide you through the whole process. Call Seniormark at 937-492-8800 or click here for a free consultation!

 

 

 

Is There an Advantage to Medicare Advantage?

Is There an Advantage to Medicare Advantage?

According to Reader’s Digest, 1 in 4 retirees receive their health insurance coverage from a Medicare Advantage Plan. And I can certainly understand the attraction. Premiums as low as $0 a month. Prescription drug plans often included. What’s not to like?

 

But—as it goes for most purchases—you get what you pay for. And when it comes to Medicare Advantage Plans, they definitely have a dark side. Allow me to shed some light on the subject.

 

The Medicare (Dis)Advantage Plan

Networks

Medicare Advantage Plans contract with specific hospitals and doctors, usually within a relatively tight-knit geographic area. If you don’t receive care from the ones with whom they’ve “networked”, you may be subject to higher co pays or coinsurance at each visit.  Depending on the plan, they may not even cover your expenses at all.

 

This can be a problem for anyone, but especially for those who travel frequently. So for you snowbirds out there who fly south for the winter and leave us all to freeze, this serves you right (forgive my jealous outburst). You may find yourself with less (or even no) coverage at your vacation home. Although they will still cover you in emergencies, that doesn’t mean it won’t be an expensive hassle.

 

Inconsistency

Because Medicare Advantage Plans are funded by government subsidy, the cost and benefits can change drastically from year to year. If the government decides to spend your tax dollars elsewhere, your plan may let prices creep (or even leap) up, while benefits wane. This all depends on politics, which—as you already know—is rarely consistent.

 

Potentially High Out-of-Pocket Costs

Medicare Advantage Plans have more of a pay-as-you-go approach. Although the premium is low, deductibles, coinsurance and co pays are often much higher. This is not a problem if you are healthy, but if you are struck with sudden illness, you might be stuck with astronomically high out-of-pockets: $3,500 to $6000 a year or more! And if the diagnosis is bad enough, you may not qualify to switch to a Supplement plan.

 

Let’s take a real life example.

A client of ours came in with an Advantage Plan. He was diagnosed with cancer in fall of 2012 and started chemotherapy immediately. Since he was in charge of 20% of the costs due to his plan, he very speedily met his $7,500 annual out-of-pocket limit. Then it was the New Year, and his out-of-pocket limit reset. He continued chemo-treatments, which lead to another $7,500 expense. That is $15,000 of spending in less than 6 months!

 

And since a cancer diagnosis prevented him from switching to a Supplement, he had to stay with his Advantage Plan. He was stuck, and—needless to say—very unhappy about it.

 

So Here’s the Bottom Line…

Is there an advantage to a Medicare Advantage Plan?

If your doctors are in your plan’s network, you stay on top of changes, and—here’s a big one—you don’t get horribly ill (leading to high out-of-pocket costs), then yes! The Medicare Advantage dark side has vanished. The force is with you, and you’ve saved hundreds or even thousands in premium costs.

 

But you need to assess your situation. You need to take the risk into consideration. 1 in 4 people might be on a Medicare Advantage Plan, but that doesn’t mean it is right for you!

 

Looking to switch to or purchase a Medicare supplement? Call Seniormark at 937-492-8800 for a free consultation. We are here to help.

The Truth About Your Barber’s Medicare Drug Plan (And Why It Shouldn’t Be Yours)

The Truth About Your Barber’s Medicare Drug Plan

(And Why It Shouldn’t Be Yours)

We hear it all the time from our clients. Their brother, mother, cousin, co-worker, pen pal, or barber is on a certain 18 dollar a month drug plan, and now they want on. They are really excited about it. It’s a deal, after all!

 

But this is actually the last thing they should do.

 

Why? Because drug plans aren’t one size fits all. What worked for their barber won’t necessarily work for them. And it probably won’t work for you either. With this in mind, I challenge you to push your friends, family, and acquaintances lovingly aside and consider these 3 things when shopping for a drug plan.

 

Medications

Drug plans only cover certain medications. And if your medications aren’t on their list, there’s a good chance it won’t be the best plan for you. There are exceptions, of course, but considering your medications is the first step in shopping a drug plan.

 

So raid your medicine cabinet. Which drugs are you on? What’s your dosage? Are they generic or brand name? If you answer these questions, you will have come a long way.

 

Pharmacy

There’s such a thing in the world of drug plans called preferred and non-preferred pharmacies. Certain plans favor (prefer) specific pharmacies by granting you better co pays for getting your medications there. You want to save money on co pays and be able to shop at the most convenient pharmacy. So, it is your best bet to get on a drug plan that prefers the pharmacy across the street rather than across the city through rush hour traffic.

 

The Total Cost

The total cost includes the plan’s

  • Deductible
  • Premium
  • Out-of-pocket drug costs

Notice how it isn’t just the premium. It includes the premium, of course. But just because the premium is the lowest doesn’t mean the plan is the best value. In fact, considering any one of these numbers to the exclusion of the others is dangerous.

 

The premium may be low, but if it takes you forever to meet the deductible, it might not be the cheapest. Yes, the deductible may be tiny, but if the premium is outrageous, what’s the point? The deductible and premium may even be phenomenal, but if you are on a $250 medication that isn’t covered by the plan…well…it’s still junk.

 

The point is you have to do some math on your unique situation to figure out which plan is the best value.

 

This drug plan comparison tool on Medicare.gov does the number crunching for you. Just plug in your information and it will rank all of the 26 drug plans specific to you and based on total cost! Use the general search to avoid putting in personal information.

 

So What’s The Truth About Your Barber’s Drug Plan?

It is specific to him! And why shouldn’t it be yours?  Because yours should be tailored specifically to you! Shopping for a drug plan this way isn’t as easy. And it certainly takes more time. But it’s worth it. It will save you many headaches, long drives, and—wait for it—cold, hard cash…cash that you can use to spoil your grandkids, travel the world, and make the most of your hard-earned retirement life.

 

Looking to get started researching various drug plans? You may need to know a few terms. Click here to read our post “Know the Drug Plan Lingo! 5 Terms to Get You Started”.

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  (LINK TO IS THERE AN ADVANTAGE TO MEDICARE ADVANTAGE) 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.

Hate Your Medicare Insurance Plan? Here’s a Quick and Easy Guide to Switching!

Hate Your Medicare Insurance Plan? Here’s a Quick and Easy Guide to Switching!

You thought the Medicare mess was all tidied up when you first enrolled and purchased proper Medicare insurance (whether it be Medicare Advantage or Medigap), but then you discover a sad fact of life: Costs change. Benefits change. Your needs change. Or, perhaps you’ve quickly come to realize that a plan you thought was all sunshine, rainbows, and good value is a terrible fit for you. Regardless of the reason, it’s time to switch to an option that is more suited to you needs.

 

That is why I want to offer you a simple guide, answering some questions you may have about switching. Is it possible for you to switch? If so, when? And how should you go about it? I will also cover some of my best tips all of us at Seniormark have learned after helping thousands of retirees through this process—tips to save you time and needless hassle.

 

This post is organized into section based on the type of switch you are planning to make:

  1. From a Medicare Supplement to another Medicare Supplement
  2. From a Medicare Supplement to a Medicare Advantage Plan
  3. From a Medicare Advantage Plan to a Medicare Supplement
  4. From a Medicare Advantage Plan to another Medicare Advantage Plan
  5. From a Part D Drug Plan to another Part D Drug Plan

 

Feel free to skip to the section that is most pertinent to you, and don’t forget to call us at 937-492-8800 if you have any additional questions!

From Medicare Supplement to another Medicare Supplement

Can I Switch?

Most people can, except people with very serious, chronic health conditions. You will have to undergo medical questioning and get approved, but don’t lose hope too fast: in many cases, even those with poor health can find a company who will accept them (click here for an blog to answer some questions about this)!

 

When Can I Switch?

Anytime of year. However, I recommend avoiding switching during the Annual Enrollment Period (October 15- December 7). That is a really busy time of year for insurance agencies, so the process might not be as smooth.

 

How Do I Switch?

 (1) Find the best plan for you by doing private research or shopping with an independent insurance agency like Seniormark. (2) Call the company and follow their application process. (3) If you are approved, cancel your previous supplement.

 

Best Tip

This type of switch is not just for those who hate their plans, but is also for those who like to save money (which I assume includes most of us). If you have been in the same Medicare Supplement for 3-5 years, you could save hundreds a year or more by switching without changing your benefits (click here for some help on shopping around).

 

From a Medicare Supplement to a Medicare Advantage Plan

Can I Switch?

Yes, in the vast majority of cases. As long as you don’t have End Stage Renal Disease (kidney failure), you can switch!

 

When Can I Switch?

You can switch during the Annual Enrollment Period (October 15- December 7).

 

How Can I Switch?

(1) Find the best plan for you by doing private research or by shopping with an independent agency like Seniormark. (2) Call the company and follow their application process. (3) Cancel your previous coverage effective January 1st and wait for your new coverage to go into effect for the New Year.

 

Best Tip

Before switching to an Advantage Plan, realize that you are giving up benefits for the lower premium. Advantage Plans are more cost effective when it comes to premium, but even the ones that cost $0 aren’t really free (click here for our blog on “free” Advantage plans), so make sure you understand what you are getting into.

 

And as you are shopping plans, remember to consider more than just the premium. For instance, are your doctors in the plan’s network? If your plan has a built-in drug plan, does it cover your medications? We’ve had unfortunate retirees call in for help after they found out they couldn’t see their own doctor without losing all coverage. And the worst part? They were locked into their plan for the whole year! Advantage Plans can be an excellent fit, but only if you find the right one for you.

 

From a Medicare Advantage Plan to a Medicare Supplement

Can I Switch?

Most people can, except people with very serious, chronic health conditions. Anytime you switch to a Medicare Supplement, this will be the case: You will have to undergo medical questioning and get approved. But don’t lose hope too fast: in many cases, even those with poor health can find a company who will accept them (see link above)!

 

When Can I Switch?

You can only switch during the Annual Enrollment Period (October 15-December 7).

 

How Can I Switch?

(1) Find a plan that’s right for you by doing private research or by shopping it with an independent, local insurance agency like Seniormark. (2) Call the company and follow their application process. (3) If approved, ensure that your policy gets cancelled effective January 1st and then simply wait for your coverage to go into effect in the New Year.

 

Best Tip

Don’t wait until the last minute to switch. Since Annual Enrollment is such a busy time of year for Insurance companies, it may take 3-4 weeks for your application to get processed. So, put your application in early (in October or early November); you don’t want to be stuck in an Advantage Plan you hate for another whole year!

 

From a Medicare Advantage Plan to Another Medicare Advantage Plan

Can I Switch?

Yes, in the vast majority of cases. As long as you don’t have End Stage Renal Disease (kidney failure), you can switch!

When Can I Switch?

You can only switch during the Annual Enrollment Period (October 15-December 7).

 

How Can I Switch?

(1) Find a plan that’s right for you by doing private research or by shopping it with an independent, local insurance agency like Seniormark. (2) Call the company and follow their application process. (3) Wait for your previous plan to cancel by itself and wait for your new coverage to go into effect on January 1st.

 

Best Tip

As I’ve previously noted, make sure your new Advantage Plan has your doctor in its network, and—if your new plan has a built-in drug plan—that your medications are covered. It’s a real pain to kick off New Year off with an ill-fitting insurance plan!

 

From a Part D Drug Plan to Another Part D Drug Plan

Can I Switch?

Yes, there are no restrictions to changing coverage!

 

When Can I Switch?

You can only switch during the Annual Enrollment Period (October 15-December 7).

 

How Can I Switch?

(1) Find a plan that’s right for you by shopping it yourself on Medicare Plan Finder or call OSHIIP (Ohio Senior Health Insurance Information Program) at 1-800-686-1578 and they can help you re-shop your plan. (2) Enroll online at www.medicare.gov for a new plan. (3) Your new coverage will go into effect on January 1st and your old coverage will automatically end when you sign up for a new part D plan.

 

Best Tip

Do not make drug plan decisions with a tunnel vision focus on premiums. Make sure you find a plan that covers all of your medications and, if possible, has your desired pharmacy as one of its preferred pharmacies.

 

The Ultimate Best Tip: Get Expert Guidance When Making Your Switch This Annual Enrollment Season!

Annual Enrollment is the only time of year you can switch your Medicare Advantage and Prescription Drug plan.  Looking to review your plans with a Certified Senior Advisor this Annual enrollment season? Call Seniormark at 937-492-8800 or click here to set up a free consultation.