Author: Pam Kaiser

Pam is the voice of assurance you’ll likely hear from your first call to the day you can hold your insurance card in hand. She oversees the entire application process from start to finish. In addition, holding life and health licenses, she writes both the term and whole life policies for the agency. Pam wuz also the spelling bee champion in the 6th, 7th, AND 8th grade. The runner-up was the same every year (too bad so sad, Fran)!

What Does a Medicare Supplement Really Cover?

What Does a Medicare Supplement Really Cover?

Everyone will say, “It fills in the Medicare coverage gaps” or “it covers what Medicare doesn’t” In fact, I’ve said those mantras to my clients many times. But when you’re looking at paying $80-150 in premiums per month for one of Medicare’s more popular and comprehensive plans, that’s not enough of an explanation.


Retirees like you have a lot of things pulling for your cash. And when you’re living post full-time employment, money can be tight. It can even leave you wondering if a Medicare Supplement is really worth it. For that reason, I think it’s time to take a closer look and see what that monthly premium is really paying for.


I have addressed Medicare’s most costly coverage gaps below. Do the most popular Medicare Supplements (F, C, G, D, and N) pay for them?


20% Coinsurance on Part B

For outpatient coverage like lab tests, doctor visits, and surgeries (any care received while not admitted to a hospital), Medicare covers 80% of the costs. A Medicare Supplement picks up where Medicare leaves off, taking care of the other 20%. The only popular plan that doesn’t cover the 20% in full is Plan N, but Plan N only leaves a couple small copays of $20 for office visits and $50 for trips to the emergency room.


If you are thinking of a $100 x-ray, the 20% isn’t a big deal. But what about a $20,000 outpatient surgery? What about $150,000-200,000 on chemo-treatments, like my father-in-law experienced? Then you start to understand why this is such an important benefit.


$1340 Part A Deductible

Before Medicare pays anything on inpatient care, you have to meet a $1340 deductible, sometimes more than once per year. All of the popular Medicare Supplement policies cover the Part A deductible in full.


Hospital Coinsurance

Medicare pays for the first 60-days of your hospital stay (after the $1340 deductible, of course). However, you will have to pay $335 per day for days 61-90 and $670 per day for days 91 and beyond (these days do not necessarily need to be consecutive.) Again, all of the popular Medicare Supplements cover this in full.


Without a Medicare Supplement, a 120-day hospital stay would cost you over $30,000 in out-of-pocket costs!


Skilled Nursing Coinsurance

Medicare pays for the first 20 days. For days 21-100, you pay $167.50, and for 101 and beyond, you pay all the costs. Yet again, all of the popular plans cover every dime of this coinsurance amount for days 21-100.


And all of these benefits are just the foundation of what makes a Medicare Supplement such an attractive option for retirees. Many plans cover a lot more than what I’ve addressed here. For instance, a Plan F (Medicare’s most comprehensive and popular supplement plan) covers, well, almost everything. Assuming a procedure is Medicare approved, you will have no out-of-pocket expenses with a Plan F.


That is why, although they are not right for everyone, I often recommend them to my clients. They really do “cover what Medicare doesn’t” and “fill in the Medicare coverage gaps,” as it has been said so many times. Of course, no one wants to pay the monthly premium, but in the end, you get what you pay for. For most retirees, the peace of mind to know that they will never get stuck in one of those huge Medicare coverage gaps is worth it.


Have more questions?  Sign up for our next workshop at or call Seniormark at 937-492-8800.  We offer the answers to these questions and many more!

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.

A Major Announcement from Premier Health Plans!

Major Announcement from Premier Health Plans!


Premier Health Insuring Corporation, which does business under the name Premier Health Plan (“Premier Health Plan”), and the Centers for Medicare & Medicaid Services (“CMS”) recently mutually agreed to terminate their Medicare Advantage plan contract, effective April 1, 2018.


Each beneficiary enrolled in Premier Health Plan’s Medicare Advantage plans (Premier Health Advantage (HMO), Premier Health Advantage Choice™ (HMO-POS), and Premier Health Advantage VIP (HMO SNP) will receive a letter within the next few days that will outline important details about this transition. Click on the appropriate plan description below to view a copy of the notice letter. The letters will begin mailing on March 2 and should arrive in as early as March 5.


CMS has granted each impacted beneficiary a Special Enrollment Period (“SEP”) through May 31, 2018. If a beneficiary does not take action by April 1, 2018, they will be automatically enrolled in Original Medicare and Silverscript, a Part D plan for prescription drug coverage.


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.

7 Hits From 1970: Did You “Groove” to Any of These Songs Your Graduation Year?

7 Hits From 1970: Did You “Groove” to Any of These Songs Your Graduation Year?

Music has often defined a generation, and—let me tell you—you baby boomers had it all. The most iconic music festival of all time (need I actually say it?). Heart felt country. Psychedelic rock.  Folk rock. Soul. You guys even had the Beatles and the Jackson 5 for crying out loud! It’s just not fair (really…we’ll trade you Taylor Swift and then we can call it even)! The 60s and 70s were no-doubt the complete package.


So—as a testament to your senior year of high school—here are 7 songs you used to groove to in 1970. Click the links; hear the tunes.

  1. Coal Miner’s Daughter by Loretta Lynn

The twang of steel guitars interpolated between the twang of Loretta’s sweet voice is still ringing in my ears. And the genuine, tear-jerking lyrics are a refreshing change from the worn out phrases that so often adorn the overly produced country music of modern times. Loretta Lynn had it right. Being country has little to do with alcohol or trucks or “painted on blue jeans;” instead, it has everything to do with humble roots, a good work ethic, and priceless love in the midst of financial hardship.


Memorable Lyric: “Well, I was borned a coal miner’s daughter in a cabin, on a hill in Butcher Holler. We were poor, but we had love. That’s the one thing that daddy made sure of. He shoveled coal to make a poor man’s dollar.”

2. Ain’t No Mountain High Enough by Diana Ross

This song was originally released by Marvin Gaye and Tammi Terrel in 1967, but Diana Ross’s version resurfaced the classic song in 1970. Ross puts some new twists on the song including several dramatic spoken sections, but the gospel vibes and the soulful, dynamic power that inspires audiences to overcome any difficulty still remain from the original release all the way to now. Thank you, Diana Ross. Your soaring vocals are greatly appreciated.


Fun Fact: According to, Hillary Clinton used this song extensively in her 2016 campaign for the presidency.

3. Bridge Over Troubled Water by Simon and Garfunkel

With a gentle piano accompaniment and Garfunkel’s flowing tenor vocal, this song stills the troubled mind. A simple but profound piece about sacrificial love, “Bridge Over Troubled Water” is a ballad not too soon forgotten. According to The Rolling Stone, it reached the number one spot in spring of 1970 and didn’t sink from the charts for over a year, remaining at the top for 10 weeks and selling 13 million copies!


Memorable Lyric: “I’m on your side, oh, when times get rough and friends just can’t be found. Like a bridge over troubled water, I will lay me down.”

4. American Woman by The Guess Who

I felt like we’ve been a little soft so far down this list, so I’m going to drop in a hard rock song for good measure. “American Woman”, with its aggressive, no-nonsense lyrics and its growling, “stick-it-to-you” vocal does just the trick.  But be careful. It may induce head banging.


Memorable Lyric: “American woman, stay away from me-he. American woman, mama let me be-he. Don’t come hanging around my door. I don’t wanna see your face no more…”

5. Layla by Derek and the Dominos

Instant ear gratification. The iconic fire of Eric Clapton’s opening guitar riff is almost mesmerizing. While “American Woman” is more about getting rid of a woman, “Layla” is all about going mad, pining for her affections. “Let’s make the best of the situation before I finally go insane. Please don’t say we’ll never find a way, and tell me all my love’s in vain,” Clapton writes. This anthem of unrequited love made the Rolling Stone’s List of “The 500 Greatest Songs of All Time.” Number 27…check it out.


Fun Fact: Did you know that Eric Clapton penned this classic about Pattie Boyd, the same woman who inspired the Beatle’s George Harrison to write “Something”? Dang, this girl must’ve been the cat’s meow! The whole story of this love triangle is quite unbelievable.

6. Let It Be by the Beatles

No 1970s playlist would be complete without a Beatle’s song, so I dug this one out of the archives. This simple song with its message of comfort and peace was written during one of the more turbulent times of Paul McCartney’s life. He said that his Mother (named Mary, of course) appeared to him a dream, whispering this profound and reassuring word of wisdom: “Let it be.”


Memorable Lyric: “When I find myself in times of trouble, Mother Mary comes to me,
speaking words of wisdom, let it be.”

7. ABC by The Jackson 5

To go out with a bang of boyish exuberance, I would like to reintroduce you to Jackie, Tito, Jermaine, Marlon, and (of course) little Michael himself. Taking on the concept of love, these 5 Jacksons sold it every performance—with color, soul, and some killer synchronized dance moves.


Memorable Lyric: “Sit yourself down, take a seat. All you gotta do is repeat after me…”


Well, that’s a wrap! I could write a witty conclusion to this post, but I think I’ll just let it be (did you see what I did there?).


Also, remember to talk to us! What’s your favorite song on this list? Can you think of another nostalgic song from the year 1970? If so, leave us a comment! We love to hear from you.


Turning 65 soon and not sure what to do? Click here to sign up for our free Medicare workshop. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!



List ideas Courtesy of Seek Publishing, Inc – Birmingham AL

New Workshops Announcement

We are expanding our workshop offerings! Beginning in August, we will still be offering our Welcome to Medicare workshop, but we are adding in a Social Security Planning workshop, along with a 401(k) planning workshop. Our new series is titled “Life After Work” and will help people ages 62 and up start planning for retirement, as well as introduce them to the world of Medicare.

Visit our workshops page at to sign up for one or all of our workshops!

We look forward to seeing you there!