Category: Medicare Annual Enrollment

Take Advantage of What Medicare Covers in FULL

Take Advantage of What Medicare Covers in FULL

Medicare alone doesn’t cover very much in full. There’s almost always some sort of coinsurance or copayment or other out-of-pocket cost.  This is why many people purchase Medicare Supplement Insurance to fill in the gaps (I recommend that you do so as well).


But there is something that Medicare fully covers—and that is preventive services. This includes lab tests, screenings, vaccinations, virtually any service performed to ensure that health problems are caught early—before they become…well…even bigger and more threatening problems.


This means that—as long as you meet basic eligibility requirements—you won’t pay a dime for most preventive services. The only ones I found that required any out-of-pocket costs were glaucoma screenings, diabetes self-management training, digital rectal exams (to detect prostate cancer), and barium enema (to detect colon cancer).


To give you an idea of the scope of preventive services that Medicare offers, here is a quick list:

  • Colonoscopies
  • Mammograms
  • Annual Wellness Visits
  • Diabetes Screenings
  • Vaccinations
  • Blood Tests
  • Depression Screenings

And this is just scratching the surface.

For a more comprehensive list with all the details, click here to access the Medicare preventive services guide.


Keep Track of Preventive Services on!

Some of these services are offered every year, some every other year, and some less or more often. Your risk level for certain diseases (based on age, gender, or family history) can also play a factor in how often you are eligible for services. Needless to say, it can be a lot to manage, which is why I recommend using This free online account (among other things) allows you to see which preventive services you are eligible for and when.  Sign up here:  MyMedicare.  You can also print off a personalized report to bring to your doctor. This will help the both of you plan out when and if you should receive the various services.


I hope you consider taking advantage of what Medicare has made available. The reason they made it free is because they know how important it is for retirees to take care of themselves in a proactive way. It is good for them, and it is good for you—money wise and otherwise.  No one likes to spend time at a cold doctor’s office, especially when getting a colonoscopy (geesh). But staying on top of your health now, can save you having to deal with major health issues later. It can keep you on the go and healthy during retirement, an era of life that I believe should be as (if not more) fulfilling and exciting as all the rest.


Have any questions or concerns about Medicare? Call Seniormark at 937-492-8800 for a free consultation.

Turning 65 and not sure what to do?  Consider signing up for one of our FREE workshops in Sidney or Vandalia, Ohio!  Sign up here:  Seniormark workshops.

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 to 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:



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 copays 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.



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. Copayments, 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 (see “Don’t Set it and Forget 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, copayments, 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.


Need Expert Help Navigating Medicare? Confused About Your Options?

Click here to sign up for our free Medicare workshop or call our office at 937-492-8800 and get the guidance you need! No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

6 Annual Enrollment Dates You (Quite Literally) Can’t Afford to Forget

6 Annual Enrollment Dates You (Quite Literally) Can’t Afford to Forget

I know you’ve got a lot of dates to juggle: birthdays, anniversaries, holiday get togethers, or departure dates for long awaited travel plans. But you have to leave some empty space—in your memory and on your calendar—to add these 6 dates.




Because the Medicare Annual Enrollment Period is upon us, a time when the Medicare marketplace is bustling with transactions. Beneficiaries such as yourself are switching Drug Plans, Advantage Plans, or transitioning from an Advantage Plan to a Medicare Supplement or vice versa. These are strategic moves you can only make during Annual Enrollment!


Now, if you are thinking, “I’m perfectly fine with my health insurance. I’ll just let it go this year,” I’d like to offer a word of warning: Not reviewing your Medicare health insurance plans this Annual Enrollment Period could cost you thousands. You see, Benefits and premiums change from year to year, so you have to review your plans with a professional to ensure you are still in the best-valued plan for your needs.


It doesn’t seem like letting it slide just one year could end up being so costly, but I’ve seen it happen again and again. In fact, I recently had a man come into my office in January, confused about why his approximately $190 per month prescription wasn’t covered anymore. As it turns out, he missed Annual Enrollment. The insurance company dropped his prescription from their formulary (list of covered drugs) for the new year. Unfortunately, I had to tell him, he was stuck in the ill-fitting Drug Plan for the whole year, the consequences of a mistake that would (by the end of the year) cost him $2,280. Ouch.


So, if you are a current Medicare beneficiary, get your pen ready and calendar ready. Annual Enrollment (October 15—December 7) is chock full of clear-cut deadlines. Don’t find yourself locked into a financially draining health insurance plan! You (quite literally) can’t afford to miss these 6 dates:

1. October 1st

This is the day we, as an insurance agency, receive all of the new information regarding plan changes.

  • Did your Drug Plan drop your most expensive prescription from its formulary?
  • Was there a premium hike?
  • If you have an Advantage Plan, is your doctor still considered “in-network?”

October 1st is the day we have all these answers and can speak to you about the possibility of switching to save you money and hassle.


Note: You can call about your options anytime during Annual Enrollment, but the earlier is truly the better. This time of year is quite busy!

2.October 15

The marketplace is open!  Annual enrollment has officially begun, and you can now enroll in a new plan.

3.December 7

I hope you have made all the necessary changes, because—at this date—you are locked into your plans for another year. Annual enrollment is closed.

4.January 1

It’s a new year, a new resolution, and—quite possibly—new insurance. This is the date any changes you made during the open enrollment period go into effect.

5.January 1

Nope, you didn’t just read the same line twice, and you are not seeing double! I know this is a repeat, but I want to clarify why this date is worth the extra mention: It is also the first day of the Advantage Plan disenrollment period. Just in case you’re second-guessing your decision, Medicare set up a disenrollment period where you can get out of your Advantage Plan with no penalties.

6.February 14

Finally, this is the last day of Medicare’s disenrollment period. If you are in an Advantage Plan and don’t like it, this is your last chance to drop it!

BONUS: February 14th is also Valentine’s Day. You’re welcome.


Looking to Review Your Plans With a Medicare Expert?

Even if you are not yet sure if you want to switch, I recommend giving Seniormark a call at 937-492-8800! Our friendly and caring staff is more than willing to be a resource during this bustling Annual Enrollment season. We will help ensure you meet all the deadlines and end up in a great plan for your needs and pocketbook as the New Year rolls around.