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.

Saying Goodbye to Supplement Plans F and C

Posted on January 11, 2017 by - Medicare, Medicare Supplement, News

Saying Goodbye to Supplement Plans F and C

(Why It’s Happening and Why It Matters To You)

You can pocket your tear-soaked hanky now. You don’t have to worry! If you are currently on plan C or F and have come to know and love it, the government will not force you to give it up. But for those of you yet to meet Medicare Supplement’s most comprehensive and popular plan (F) and his trusty companion (C), you may never get the chance. In 2020, the government will discontinue them both.

This begs the question: if the plans are so popular, then…

 

Why Are They Being Discontinued?

It’s a long story, but I’ll keep it brief. It all began with the “doc fix” bill, which President Obama signed into law back in 2015. The purpose of this legislation is to increase Medicare payments to doctors, so they continue to accept Medicare beneficiaries at their practices. Sounds like a good deal, right?

But by signing this bill, Medicare agreed to a hefty associated price tag of 200 billion dollars (according to The Hill). The money has to come from somewhere, so the federal government went to work on reforming Medicare in order to foot the bill for the bill (the bill’s bill, if you will). Phasing out plans C and F just happened to be the product of their brainstorm.

Here’s how they expect it will save Medicare money: Since plans C and F are the only ones that offer Part B deductible coverage ($166 in 2016), getting rid of both makes all Medicare beneficiaries responsible for their Part B deductible. Their hopes are that this will cause retirees to question their need to go to the doctor. The rationale is “if Medicare beneficiaries have a little more skin in the game (having to pay the deductible), maybe they won’t go to the doctor for every cough, ache, pain, or sniffle”. This—they believe—will save Medicare some cold, hard cash!

But this leads us to yet another “why” question…

 

Why Does It Matter to Me?

If you plan to enroll in Medicare after 2020, it’s quite obvious: plans C and F won’t be available to you. However, even if you are currently on plan C or F, saying goodbye to either one of these plans could have a costly effect on your monthly premium.

When a plan discontinues, it stops younger and healthier people from getting on the plan. This leaves an aging pool of beneficiaries, who (at least statistically speaking) have more health problems and file more costly claims. In order for the insurance provider to survive, they will likely counteract this loss with premium hikes.

Of course, this still leaves a lot of the 200 billion still unfunded, which—according to Forbes and Money Magazine—will likely come at high cost to Medicare beneficiaries.

To read more about how the “doc fix” bill could affect you, click the following link:

Proposed Medicare ‘Doc Fix’ Comes at a Cost to Seniors

 

Approaching 65 and not sure what to do? Click here to download our free E-book to get you started.  As always, you can call our office at 937-492-8800 with any questions.

 

The Little Known Shortcut Out of an Advantage Plan You Hate

Posted on January 2, 2017 by - Medicare, Medicare Advantage, Social Security, Uncategorized

The Little Known Shortcut Out of an Advantage Plan You Hate

Buyer’s remorse. Everyone has been there. You might feel like you were misled, misinformed, or like you just plain missed it. But—regardless—it doesn’t feel good. And when you believe you’ve been locked into your purchase for a whole year—like people so often think after switching to an Advantage Plan—the regretful, trapped feeling only grows in intensity.

 

So you can imagine the relief when I tell my clients that there may still be a way out—a little known shortcut out of a seemingly costly dead end. This is exactly what I am telling you today.

 

It’s Called the Medicare Disenrollment Period

Extending from January 1st to February 14th every year, the Medicare Disenrollment Period offers you an outlet to drop the Advantage Plan you hate. All you have to do is call or write your Advantage Plan provider and notify them. From the time you drop your plan, the changes go into effect the 1st of the following month. No questions asked. You are then automatically signed up for traditional Medicare (Parts A and B).

 

Warning: Time Crunch Ahead

The vast majority of people will want to get on a Medicare Supplement before they dis-enroll from Medicare Advantage. If this is you, you want to plan ahead to ensure you have time to get it all done.

 

Although some people will have what is known as a “Guaranteed Issue Right” or a “trial right,” and therefore, won’t have to take the extra steps of getting approved, many people will not. In fact, most have a fairly cramped checklist to complete before February 14th arrives. They will have to

  1. Shop for a Medicare Supplement
  2. Apply for a plan (and undergo medical questioning)
  3. Receive letter of approval from the plan.
  4. Dis-enroll from their advantage plan.

All within the short 45-day disenrollment period! This is an especially difficult feat if the Medicare Supplement Company is running slow and the “receive letter of approval” portion of the to-do list takes 2 weeks or more.

 

So start early and finish the course way before Valentine’s Day. Because—although it may not say I love you—nothing kills romance like being stuck on a shoddy Advantage plan.

 

Any issues or concerns with your Advantage Plan? Contact Seniormark at 937-492-8800 for a free consultation.

 

Image:  http://fastest-jobs-search.com/2009/10/step-8-shortcut-to-follow-up-emails-letters/maze-2/

How to Detect Medicare Fraud and Make Up to $1000 Doing It—The 4 Easiest Ways

Posted on December 22, 2016 by - Uncategorized

How to Detect Medicare Fraud and

Make Up to $1000 Doing It—The 4 Easiest Ways

Medicare fraud is out of control. Experts estimate that anywhere from $50 billion to $180 billion is lost due to Medicare fraud. I’m talking every year! This is astounding. If the experts reporting $180 billion are right, this would account for 30% of Medicare’s total yearly expenses. Imagine what that loss has done to your tax rates!

 

Given the sheer magnitude of this issue, the government is at a loss for how to handle it. That is why they are looking to you for help. In fact, they are willing to pay you for it…up to $1000 or 10% of the payments recovered (whatever is lower). You qualify for this reward as long as:

  • You report it with a specific accusation
  • Your claim is approved as potential fraud by Medicare
  • The organization or person you are reporting isn’t already under investigation
  • Your report leads to at least a $100 recovery of Medicare funds

 

But before you can call 1-800-MEDICARE or go online to report fraud, you first have to know how to recognize it. So—to help you out—I compiled a list of the easiest ways to beef up your sleuthing skills and detect Medicare fraud.

1.  Look Over Your Billing Statements

Fraudsters thrive on inattention. They expect that you won’t check you Medicare Summary Notice or your Explanation of Benefits, and they get away with millions because of it. So scour these documents for inaccuracies. Check for care or medical supplies you didn’t receive or things that were billed twice. You’ll have them shaking in their boots.

2.  Ask Questions

It’s been drilled into your head since you were young. If you don’t understand something, just ask! The same goes for Medicare fraud. If you notice something on your bill that you didn’t receive, if you feel as if you received care that wasn’t necessary, or you are just confused, ask your doctor or provider. You don’t want to falsely report your family doctor for fraud, but you also don’t want to let him get away with it if he is guilty. So just ask. If he is innocent, he will provide a clear explanation. If not, maybe you should report him.

3.  Be Suspicious of Door-to-door and Over-the-phone Scams

If someone shows up on your doorstep and claims to a representative of Medicare, just slam the door. If you pick up the phone and someone asks for your Medicare number as a part of a “health survey,” hang up. It’s a scam. And these are only two of many! There is a reason why these people are called con artists. They get creative when it comes to fraud. So, as a rule of thumb, if they ask for personal information, it’s probably fraud. And if they claim to be a Medicare representative and ask for your Medicare number, it definitely is. Medicare already has your number; they are the ones that gave it to you!

4.  Educate Yourself

This is another principle you’ve been taught since you were young: Knowledge is power. Educating yourself about Medicare fraud (and about Medicare in general) is the single best way to detect Medicare fraud. When you know your enemy, you know the way they operate. You know their common ploys. When you know how Medicare works, you can better recognize when people are exploiting it.

 

And when you can recognize when people are exploiting it, you are one step closer to being $1000 richer.

 

Paying too much for your Medicare Supplement Insurance? Call Seniormark at 937-492-8800 to find out how you can save money without reducing your coverage!

Photo source:  WRCBtv

 

When Can I Switch My Medicare Supplement?

Posted on December 16, 2016 by - Uncategorized

When Can I Switch My Medicare Supplement?

Anytime.

There’s your answer. If your Medicare Supplement is giving you a hard time, if it’s holding you back with its sky-high premiums, then get a new one.

 

But before exiting this window, I need you to consider this one fact.

 

The Switch Will Not Be a Free-for-all.

In other words, there’s no guarantee you will be able to get into another plan. The first time you enrolled in a Medicare Supplement was different. You were in your Open Enrollment Period, so insurance companies were obligated to give you insurance. Now? Not so much.

 

Now you will have to prove your insurability through medical questioning. They aren’t looking for perfect health, of course, and they won’t care if you’re on a few blood pressure or cholesterol pills. But this is something to consider…especially if you have a chronic condition. Ask yourself this question: What are the chances that you will be able to get on a plan that is better than your current one based on your health?

 

Definitely try. This is for sure. You don’t even need to wait until the Annual Enrollment Period (October 15- December 7). You can do it now. There are a lot of companies out there with great rates. It can only help you to shop around.

 

But heed our warning. Do not discontinue the plan you are on until you get accepted by another plan. We don’t want you to get stuck uninsured or on a plan that doesn’t meet your needs. We know you don’t either.

 

Looking to switch your Medicare Supplement? Need expert guidance to choose the right plan? Then call Seniormark at 937-492-8800 for a free consultation.

10 Christmas Toys Many Boomers Bought For Their Kids

Posted on December 8, 2016 by - Uncategorized

10 Christmas Toys Many Boomers Bought For Their Kids

 

Black Friday and Cyber Monday have passed, which means that the Christmas season is in full swing. It means that the Hallmark channel will deck their airtime with cheesy but (let’s be honest) heartwarming Christmas movies. It means Nativity reenactments at church. It means the Charlie Brown Christmas special on ABC (Woo!). And in the sugarplum-infested minds of millions of children, it means toys.

 

So, to stir your Christmas spirit, I want you to think back to the toys your now grown-up kids asked for when they were little tikes. Did you wait in line for hours to purchase these special toys? Did you spread Holiday cheer with a few punches? Or were you one of the more cautious ones who picked up what was left in the aftermath? Whatever your shopping style, you will enjoy this list of nostalgic toys from when your kids were still writing letters to the jolly fellow up north.

 

  1. Etch-a-Sketch

It was about 3 ‘o clock in the afternoon, and your still pajama-ed son turned the dials to draw a masterpiece. If his little sister didn’t come around and shake erase his work, it would’ve been world-class art like some Etch-a-Sketch prodigies created. One of the holidays most wanted toys in the 1960s, this toy had longevity, its popularity spanning several decades.

 

  1. Cabbage Patch Kids

If you want to talk about toy fads, you cannot leave Cabbage Patch Kids out of the conversation. These chubby, dimpled dolls were all the rage 1983 and 1984. According to NBC News, desperate parent pursuits led to fist fights in ‘83. NBC also claims that demand was so high that they were selling on the black market—for 10 times the retail price! There’s nothing shadier than meeting a trench-coated man in a dark alley to buy a Cabbage Patch doll.

 

  1. G.I. Joe

“It’s not a doll. I’ll only say this one more time, Mom: it is an action figure.” Your son didn’t want a stupid Ken doll; it was all about the macho, kick-butt warrior named G.I Joe. According to History.com, it was released in the 1960s, fell in and out of style for a decade, but made a resurgence in the 1980s as Star Wars figurines gained popularity. To this day, he still soldiers on—in toy stores, on screens (2009’s G.I. Joe: Rise of The Cobra), and in comic books.

 

  1. Easy-Bake Oven

Every little girl wanted to cook just like Mom. Every Mom wanted to protect her house from toddler-incited combustion. The compromise? It’s called the Easy-Bake Oven, a tiny baker’s dream toy of confectionery delight. Cooking with only the energy of a light bulb, the results were…well…not quite like what Mother makes. Oh well! You still have to admire the culinary enthusiasm of an 8-year old. In Time’s List of the 100 Greatest Toys, Townsend writes, “23 million Easy-Bake Ovens have been sold and more than 140 treats have been (at least somewhat) baked.” Yum. Flavorless, sugar goop on Christmas morn.

 

  1. Barrel of Monkeys

It is (completely un-sarcastically) more fun than a literal barrel of monkeys. This very simple game of “string the plastic primates together by their arms” was popular in the 1960s, and I—as a 19 year-old—have played with them. It’s such a classic that I’m sure your kids received it at one point or another.

 

  1. Lite Brite

You’ve got Easy-Bake Oven for the future chef. You’ve got Lite Brite for the best future artist (and worst future speller). It’s just a couple hundred colored pegs and a plastic pegboard with a light behind it. I’ll let you—or your kids—put that together.

 

  1. Stretch Armstrong

Popular in the 70s, Stretch Armstrong didn’t just work on his biceps. As a well-rounded athlete, he also worked on his flexibility. And, boy, did he get results. Children could taffy pull him to 4 times his length according to Time. And if he is anything like the stretchable Mr. Fantastic toy I had, he is full of cornstarch that hardens over time. I had to bathe my action figure in hot water to keep him loose!

 

  1. Play-Doh

They rolled it out with a little plastic rolling pin. They pressed it through various shape-shifting contraptions to make colored noodles of every shape and size—whether angel hair or linguini. But, through all the madness, 2 things were sure: the distinct scent of Play-Doh and a rainbow of gunk under your son or daughter’s fingernails. According to Mental Floss, 2 billion cans have been sold, equivalent to the weight of 2,000 statues of liberty!

 

  1. Silly Putty

Stretch it. Bounce it. Or, if Mental Floss is correct, take it on Apollo 8 in 1968 to secure tools in zero gravity! And these are only a few of the many novel uses of Silly Putty. Did any of your kids ever smash it on a Newspaper to lift off the inked words? I know I did when I was little!

 

  1. Star Wars Action Figures

I was reluctant to put this one on the list because I knew I would feel obligated to make a serious confession: I haven’t watched all of the Star War’s movies. But before any Star Wars fanatics banish me to the dark side, I would like to say that…well…yeah…I don’t have a good excuse. Sorry y’all! If it is any consolation, I did include the miniature figurines of Luke Skywalker, Princess Leia, and the whole crew in this list. It had to beat out some very fierce competition from Mr. Potato Head, Mrs. Beasley, and Barbie, so be gracious!

 

And if you are feeling extra gracious (you should be; it’s Christmas time, after all) share this with you kids. Or—if you are the “kid”—share it with your parents. A beautiful time of closeness flurries when memories are shared, and when Christmases past connect with Christmases present.

 

A warm Merry Christmas from all of us at Seniormark! May God bless you this special season and beyond.

 

Turning 65 and not sure what to do next? Need Medicare questions answered? Call Seniormark at 937-492-8800 or sign up online for a free consultation.

(Photo:  https://www.pinterest.com/lalovesjesus/artwork-done-on-a-etch-a-sketch/)

Should I Sign Up For a Drug Plan? (Even if I’m Not on Medications)

Posted on November 21, 2016 by - Uncategorized

Should I Sign Up For a Drug Plan? (Even if I’m Not on Expensive Medications)

I don’t know? Should you sign up for home insurance even if your house isn’t on fire?

Of course, this question is absurd. I mean, when was the last time you saw your soot-covered neighbor pant past you, saying, “We left the oven on! I need to go purchase home insurance! And fast!”

 

But the sad truth is that retirees often do this very thing with their prescription drug coverage. They refuse a drug plan to avoid the premium and then come into our office a month or year later in hopes of getting coverage. Unfortunately, we have to tell them, insurance just doesn’t work like that. Sure, they will be able to get on a Part D drug plan eventually, but it will cost them both in penalties and out-of-pocket expenses.

 

For the “If” in Life

The point is, like the MetLife commercials put so brilliantly: insurance is for the if in life. What if I get in a fender bender? What if my son needs braces? What if I leave the oven on and the house burns down? You get the idea. For prescription drug coverage, it is the same thing:

  • What if I receive an unexpected diagnosis?
  • What if I get in an accident?
  • What if a sudden illness strikes?

You don’t expect these things to happen, of course, but that doesn’t mean they aren’t possible and shouldn’t be planned for. In fact, a Fidelity study shows how often retirees underestimate their medical expenses. The study discovered that a couple retiring now should expect to pay $245,000 in out-of-pocket expenses even though 48% of retirees in the study estimated they would only spend $50,000. You see, insuring your uncertain future is just an unpleasant but real part of life. It is also why getting on a dug plan is so vital.

 

Allow me to provide you with a real life example.

 

“I’d Like to Get on a Drug Plan Now”

In 2012, we had a client come in who refused a drug plan the year previously. Her husband painfully announced that they had some bad news: she had breast cancer. And not only that, her doctor prescribed her Femara, a pill that (in 2012) cost $500 a month. They needed a drug plan! And fast!

 

But—like I said before—it isn’t that easy. Not only did she incur an irritating premium increase for late enrollment, she had to wait until the Annual Enrollment Period (October 15- December 7) to sign up. And even then, the coverage wasn’t effective until the following year, January 1st. During this wait time, she racked up over $5500 in drug expenses. You can imagine the shock, the discomfort, and the regret the couple felt when we told them the bitter truth.

 

We Want You to Be Secure!

The goal of this post is not to make you a nervous wreck about your future health. This is about security. It is about educating you about risk, so you can make an informed decision about your coverage needs. Ultimately, it is about making sure you are taken care of when you need it most and expect it least.

 

In other words, for the “if” in life.

 

If you are questioning your need for a Part D prescription drug plan, we can help! Just call Seniormark at 937-492-8800, and we will be more than happy to assist you.

 

We are also offering “Solving the Medicare Puzzle” workshops in December for those who want to learn more about Medicare.  Sign up for the date and location you choose here:  Seniormark workshops.  Hope to see you there!

 

 

Why You Can Try a Medicare Advantage Plan at No Risk

Posted on November 1, 2016 by - Medicare, Medicare Advantage, Medicare Supplement

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 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.

 

Other questions about what to do during Medicare Annual Enrollment?  Download our Annual Enrollment Checklist and you can relax when it is complete!

 

 

Here’s a Reliable Online Tool to Help You Choose a Part D Drug Plan!

Posted on October 26, 2016 by - Uncategorized

Here’s a Reliable Online Tool to Help You Choose a Part D Drug Plan!

It’s annual enrollment season again (October 15—December 7), the time of year when you can finally drop that drug plan you hate and shop a new one. The entirety of the drug plan market is available to you, and that’s exciting (well…as exciting as it gets with prescription drugs).

 

But it’s also overwhelming. I want to make sure you know that a drug plan is unique to you. It is based on your situation, your preferred pharmacy, your location, and—most importantly—your list of medications. It is a challenge to consider everything, especially if you don’t have the right tools.

 

This is why, on Medicare.gov, they have a shopping tool for drug plans. You put in all your information, and the system ranks all of the available drug plans based on total cost.

 

Total Cost is the Boss!

Total cost is not just the premium. It includes the premium, of course. But it takes into account all that you pay in an entire year in a given plan. This includes copays, coinsurance, deductibles and all the unexpected costs a plan may hide under the cloak of a low premium.

 

A plan may be $18.40 a month, but if it doesn’t cover one of your prescriptions or has excessive copays, it may not be the best-valued plan for you. This is why total cost should dictate your choices, not the premium.

 

Using the Medicare.gov drug plan shopping tool takes this into account, and it’s actually easy to use. Just follow these simple steps, and let it do the number crunching for you:

  1. Go to https://www.medicare.gov.
  2. Click on “Find health and drug plans”.
  3. Enter your zip code into the general search bar.
  4. When a pop-up window appears, choose your county.
  5. Enter your basic information.
  6. Enter your medications and dosage.
  7. Click “My Drug List is Complete”.
  8. Add your pharmacy.
  9. Select “Prescription Drug Plans (with Original Medicare)” and click “Continue to Plan Results”.
  10. Shop the available plans!

(Any questions or concerns? Just leave it in the comments. We love to hear from you!)

 

Good luck and happy Annual Enrollment Period! I recommend taking care of all the changes to your health care plans now, so that when the holidays roll around, (they’ll be here faster than you think; they always are!) you don’t have to deal with it!

In other words, focus on what needs to be done now, so you can focus on what really matters later.

 

Think you’re spending too much on Medicare Supplement Insurance? Call Seniormark at 937-492-8800 for a free consultation!

 

Be sure that you have covered all of your bases by downloading our handy “Annual Enrollment Checklist”!

 

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

Posted on October 18, 2016 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement

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!

 

1.  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, not just annual enrollment.

 

2.  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.

 

3.  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.

 

If you haven’t already downloaded our Annual Enrollment Checklist, there is no time like the present!  Make sure you have completed it — and then you can forget it — until next year this time!  Download it here:  https://seniormark.com/annual-enrollment-period-checklist/.

 

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

 

6 Things Everyone Needs to Know About Their 2 Medicare Choices

Posted on September 27, 2016 by - Medicare, Medicare Advantage, Medicare Supplement

6 Things Everyone Needs to Know About Their 2 Medicare Choices

Medicare Advantage and Medicare Supplements. Two feasible choices. Two Medicare buzzwords. One startling misconception. And here it is: Medicare Advantage plans and Medicare Supplements are the same.

 

But this is just not true…not even a little. In fact, Medicare Advantage plans and Medicare Supplements are fundamentally different. So different that not knowing these differences could cost you…in convenience, in security, and in dollar signs.

 

So…without further ado…these are the 6 things you need to know about the 2 Medicare choices:

 

  1. Medicare Supplements pay secondary. Medicare Advantage Pays Instead.

The “street name” for a Medicare supplement is a “Medigap” plan, and it is a nickname rightfully earned. Medigap plans are called as such because they “fill in the gaps” of what traditional Medicare (Parts A and B) doesn’t cover. Therefore, you will have little to no out-of-pocket expenses. A Medicare Advantage plan doesn’t do this. It functions as an alternative for traditional Medicare. This means that—if the Advantage plan doesn’t cover it—you can be stuck with some pesky deductibles, copays and coinsurance.

 

  1. Medicare Advantage Plans have Networks. Medicare Supplements Don’t.

Medicare Advantage plans contract with specific hospitals and health care providers. And if you don’t go to their pre-picked “network” of providers, your share of the costs may rise. In some cases (especially out of state), the plan may not cover you if you receive care at a hospital outside of their network (except in the case of emergency)! Medicare Supplements allow you to go to any doctor or hospital you want as long as they accept Medicare.

 

  1. Medicare Supplements Don’t Change. Advantage Plans Do.

Since Advantage Plans are funded by government subsidies, their benefits are greatly affected by politics. The more money they can get from the government, the better their benefits and premiums can be. This means that plans will likely change from year to year and you may have to reevaluate, re-shop, and re-enroll in a different plan. Medicare Supplement plans are the opposite. Since the policyholder funds them, the plans are usually consistent from year to year.

 

  1. You Can Always Change to an Advantage Plan. You Can’t Always Change to a Medicare Supplement.

If you are in a Medicare Supplement plan, you can switch to an Advantage plan without any medical health questioning as long as it is during the annual enrollment period. It doesn’t matter if you have pre-existing conditions (with the exception of kidney failure); you will still be able to obtain coverage.

 

However, if you want to switch from an Advantage plan to a Medicare Supplement, it is not as simple. Although you can still enroll during annual enrollment, you will have to qualify based on your health. This can be a problem for those with pre-existing conditions. For instance, let’s say the government curbs their funding for your Advantage Plan. This raises the premium and lessens the benefits significantly. You have cancer. You can’t change to a Medicare Supplement because you couldn’t qualify based on health. What do you do? More than likely, you will have to stay with your unwanted Advantage plan!

 

  1. Medicare Supplement Have Premiums. Advantage Plans Have Low Or No Premiums.

While the average Medicare Supplement premium is up around $100-120 a month for a 65 year-old, the average Advantage plan premium is about 50-60. And (aside from your Part B premium) they may be completely free!

 

  1. Two Choices Can Quickly Become Two Hundred.

You only have two options in the beginning, but once you choose a route—whether Medicare Advantage or Medicare Supplement—it will likely multiply into many more choices. There are 11 supplements, 24 drug plans, and dozens of Advantage plans. Not to mention the other decisions you have to make regarding when and how to go about signing up for Medicare to avoid penalties. Like I always tell my clients, Medicare is a big animal. I always recommend consulting with a retirement advisor for help.

 

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