Category: Medicare Annual Enrollment

“Broadway Joe” Namath Isn’t Giving You the Whole Story

“Broadway Joe” Namath Isn’t Giving You the Whole Story

By:  Dan Hoelscher, President & Founder, Seniormark, LLC

 

If you haven’t already had enough of the Celebrity-Sponsored Medicare Commercials, then buckle up!  With the Medicare Annual Enrollment (AEP) season quickly approaching, you are soon to be inundated with them.  They will feature celebrities such as NFL great Joe Namath, Good Times Jimmy Walker and Ernie Hudson of Ghostbusters fame.  They are obviously effective!   Since Joe Namath became the spokesman for the Medicare Coverage Hotline. we have had more calls regarding Medicare Advantage plans than ever before.  Joe encourages you to not miss out on “New Medicare Benefits” and to make sure you get the “Medicare Benefits You Deserve.”

Benefits such as:

  • Rides to Medicare Appointments
  • Private Home Aides
  • Doctor’s and Nurse’s visits by telephone
  • Home delivered meals
  • Dental, Vision, Hearing and Prescription Drug Coverage

 

Some even offer a premium credit to your social security check for your Part B Medicare premium.  I spent some time recently watching numerous such commercials.  And what the commercials said was true, to the extent that it was said.  However, what is left unsaid is what is most crucial for you to make a wise decision.

 

There are a couple of things you need to consider before you race to your phone to “Call Now.” First, Joe Namath, while he may be a perfectly upstanding gentleman, is no Medicare expert.  He is a paid endorser.  In fact, I doubt he even understands what a Medicare Advantage plan is.  Even if he is on a Medicare Advantage plan, I doubt he is concerned with the potential out of pocket costs involved.  I believe his $25 million net worth may place him a little out of touch with the average American budget. Second, be aware that he is speaking on behalf of the Medicare Coverage Hotline, not Medicare.  And if you were to pause the commercial on the last slide, you would see that The Medicare Coverage Hotline is a for-profit lead generation campaign.  This means that they are simply trying to get you to call their 800 number so they can sell you as a lead to an insurance agent.

 

At Seniormark, we can help you with both Medicare Supplement and Medicare Advantage plans.  And we want you to choose your coverage based on the plan you believe it right for you, based on all the information, not just the information a salesperson wants you to hear.  You deserve a fair comparison!

 

Call our office at 937-492-8800 to see what plans might work best for you!

Annual Enrollment Period (AEP) To-Do List

  1. Write the important Annual Enrollment dates to remember on your Calendar, and clip your calendar on your fridge.
  2. Don’t eat that midnight snack until you’ve read the dates at least once.
    1. October 1st— we can talk about your options!
    2. October 15th— The AEP games begins.
    3. December 7th—AEP comes to exhausting close.
    4. January 1st— Plan changes go into effect.
  3. Compare your medications to the formulary (drug list) mailed to you by your drug plan company.
  4. Consider changing your drug plan if some of your medications are no longer covered or if the premium is too high (call OSHIIP at 800-686-1578 to reshop your plan).
  5. Call us and set up an appointment to have a good chat about your Advantage plan.
    • Consider switching Advantage Plans if:
    • Your hospital or doctor went out-of-network
    • Plan changes for the following year result in jaw-dropping out-of-pocket spending or a high premium.
    • Your medications are no longer covered or are costing a lot.
    • Your Advantage plan is (all around) a bit of a drag.

6.  Remember — you can change your Medicare Supplement any day of the year.  If you currently have a supplement, you are not bound by AEP in order to switch companies.  However, if you want to switch from a Medicare Supplement to a Medicare Advantage plan or if you want to switch from a Medicare Advantage plan to a Medicare Supplement, you must do that during this time.

7.  As a golden rule, your ultimate to-do list item is …plan ahead!

Still confused about what to do?  Give our office a call at 937-492-8800, find us on Facebook at www.facebook.com/seniormark or fill out the contact page and we will be in touch:  https://seniormark.com/contact/ We are here to help!

“Broadway Joe” Namath Isn’t Giving You the Whole Story

“Broadway Joe” Namath Isn’t Giving You the Whole Story

By:  Dan Hoelscher, President & Founder, Seniormark, LLC

 

If you haven’t already had enough of the Celebrity-Sponsored Medicare Commercials, then buckle up!  With the Medicare Annual Enrollment (AEP) season quickly approaching, you are soon to be inundated with them.  They will feature celebrities such as NFL great Joe Namath, Good Times Jimmy Walker and Ernie Hudson of Ghostbusters fame.  They are obviously effective!   Since Joe Namath became the spokesman for the Medicare Coverage Hotline. we have had more calls regarding Medicare Advantage plans than ever before.  Joe encourages you to not miss out on “New Medicare Benefits” and to make sure you get the “Medicare Benefits You Deserve.”

Benefits such as:

  • Rides to Medicare Appointments
  • Private Home Aides
  • Doctor’s and Nurse’s visits by telephone
  • Home delivered meals
  • Dental, Vision, Hearing and Prescription Drug Coverage

 

Some even offer a premium credit to your social security check for your Part B Medicare premium.  I spent some time recently watching numerous such commercials.  And what the commercials said was true, to the extent that it was said.  However, what is left unsaid is what is most crucial for you to make a wise decision.

 

There are a couple of things you need to consider before you race to your phone to “Call Now.” First, Joe Namath, while he may be a perfectly upstanding gentleman, is no Medicare expert.  He is a paid endorser.  In fact, I doubt he even understands what a Medicare Advantage plan is.  Even if he is on a Medicare Advantage plan, I doubt he is concerned with the potential out of pocket costs involved.  I believe his $25 million net worth may place him a little out of touch with the average American budget. Second, be aware that he is speaking on behalf of the Medicare Coverage Hotline, not Medicare.  And if you were to pause the commercial on the last slide, you would see that The Medicare Coverage Hotline is a for-profit lead generation campaign.  This means that they are simply trying to get you to call their 800 number so they can sell you as a lead to an insurance agent.

 

At Seniormark, we can help you with both Medicare Supplement and Medicare Advantage plans.  And we want you to choose your coverage based on the plan you believe it right for you, based on all the information, not just the information a salesperson wants you to hear.  You deserve a fair comparison!

 

Please join us for our next workshop on October 6th at 10:00 a.m. at our Sidney office (2551 Michigan Street, Sidney, OH) where we will disclose the details that have been left out of the Joe Namath commercial.  Call our office at 937-492-8800 to save your seat, or you may RSVP online at https://seniormark.com/workshops/.

2020 AEP Checklist

Annual Enrollment Period (AEP) To-Do List

  1. Write the important Annual Enrollment dates to remember on your Calendar, and clip your calendar on your fridge.
  2. Don’t eat that midnight snack until you’ve read the dates at least once.
    1. October 1st— we can talk about your options!
    2. October 15th— The AEP games begins.
    3. December 7th—AEP comes to exhausting close.
    4. January 1st— Plan changes go into effect.
  3. Compare your medications to the formulary (drug list) mailed to you by your drug plan company.
  4. Consider changing your drug plan if some of your medications are no longer covered or if the premium is too high (call OSHIIP at 800-686-1578 to reshop your plan).
  5. Call us and set up an appointment to have a good chat about your Advantage plan.
    • Consider switching Advantage Plans if:
    • Your hospital or doctor went out-of-network
    • Plan changes for the following year result in jaw-dropping out-of-pocket spending or a high premium.
    • Your medications are no longer covered or are costing a lot.
    • Your Advantage plan is (all around) a bit of a drag.

6.  Remember — you can change your Medicare Supplement any day of the year.  If you currently have a supplement, you are not bound by AEP in order to switch companies.  However, if you want to switch from a Medicare Supplement to a Medicare Advantage plan or if you want to switch from a Medicare Advantage plan to a Medicare Supplement, you must do that during this time.

7.  As a golden rule, your ultimate to-do list item is …plan ahead!

Still confused about what to do?  Give our office a call at 937-492-8800.  We are here to help!

 

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.

 

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.

Why You Can Try a Medicare Advantage Plan at No Risk

Why You Can Try a Medicare Advantage Plan at No Risk

 

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

 

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

 

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

 

But as the infomercial cliché puts so obnoxiously…

 

 WAIT…There’s More!

 

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

 

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

 

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

Drug Plan Check Up: Is your Drug Plan Still the Best Plan for You?

It’s annual enrollment…is your Part D drug plan still the best plan for you?

As most of us remember, there are some VERY important dates associated with Annual Enrollment.  As we discussed earlier in “Don’t set it and forget it” we don’t want to miss these dates.  There are several things that need to be done during annual enrollment but for now let’s focus on the Part D drug plan.  DON’T ASSUME THAT SINCE YOUR PLAN COVERED YOUR MEDICATIONS LAST YEAR THAT YOUR MEDICATIONS WILL BE COVERED THIS YEAR.  Yes, I know, it isn’t convenient that things change, but they do.  So please make sure you review your part D plan this annual enrollment.

For 2019 there will be more than 20 drug plans available in Ohio.  How in the world do you know which is best for you?  Well, there are several things to consider.  Your medications.  The plan’s formulary.  Your preferred pharmacy.  The plan’s preferred pharmacy.  The premium cost.  And so on…  You should have received the Annual Notice of Change for your current plan in late September so make sure you review it!   How do you know if your current plan is still the best plan for you in 2019?  Let’s face it, even if you try and do your homework this stuff is confusing!  As much as we would love to help everyone review their prescription drug plan for 2019, annual enrollment is just too busy for us.  We unfortunately can’t help with the Part D comparisons BUT there are people that can!    If you are still confused and unsure if you’re in the right plan for 2019, please call OSHIIP (Ohio Senior Health Insurance Information Program) at 1-800-686-1578.  OSHIIP trained volunteers are happy to help.  Make sure you have your Medicare card and list of prescription drugs handy.  If you don’t want to make a phone call, check with your pharmacy and see if they will help you re-shop your plan.  Some pharmacies will assist with this process.  And of course, if you are internet savvy and comfortable doing the comparisons on your own, visit www.medicare.gov and shop it yourself.  Please click here for more information on comparing your plan online.   No matter which way you choose – please make sure you review your Part D drug plan this annual enrollment period starting October 15th through December 7th!

And, as always, if you still have questions, do not hesitate to give our office a call at 937-492-8800.

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

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

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

 

I bet it’s ringing a bell now.

 

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

 

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

 

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

 

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

 

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

 

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

 

The Medicare Supplement Creep

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

 

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

 

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

 

The Advantage Plan Leap

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

 

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

 

The Drug Plan Drop

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

 

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

 

Review Your Plan This Year!

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

 

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

 

Maybe that will catch on…

 

Yeah…probably not.

 

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