Category: Medicare Drug Plan

Warning Retirees: 5 (or 6) Annual Enrollment Dates You Don’t Want to Miss

Warning Retirees: 5 (or 6) Annual Enrollment Dates You Don’t Want to Miss

Clip these dates up on your fridge. Write them on your calendar. Sticky note them to your bathroom mirror or your spouse’s forehead (or maybe not). Annual enrollment is approaching!

 

But before we get into the dates, you’ll first want to know…

 

What Is Annual Enrollment?

Annual enrollment is the busy time of the year for Insurance agencies such as ours. Department stores have their black Friday. Local ice cream shops have their last day of school. And Insurance companies have the Annual Enrollment Period. During this roughly 3-month time frame (October 15- December 7), all Medicare beneficiaries are free to change their plans. They can switch from:

  • An Advantage Plan to a Medicare Supplement
  • A Medicare Supplement to an Advantage Plan
  • One Advantage Plan to another
  • One Part D Drug Plan to another
  • One Medicare Supplement to another (Although you can do this at any point during the year)

The Annual Enrollment Period is for any existing Medicare beneficiary. For those just turning 65 and joining Medicare, you have a different enrollment period called the Initial Enrollment Period, which is the 7-month time frame that surrounds your 65th birthday month. But for those of you who have already enrolled for the 1st time, this is for you!

 

There are 6 very important dates for you to remember.

  1. October 1

This is the day we get all the plan changes, details, benefits, and prices for the following year. It is also when we can start talking to you about which ones will best fit your needs.

  1. October 15

Let the games begin! Annual enrollment is officially started. You can now enroll in a new plan.

  1. December 7

I hope you like the choices you’ve made because, at this date, you are locked into your plans for another year. Annual enrollment is closed.

  1. 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.

  1. January 1

I apologize for the unsettling déjà vu. I know this is a repeat, but I want to emphasize why this date is doubly important: It is also the first day of the Advantage Plan disenrollment period. Just in case you’ve got some buyer’s remorse, Medicare set up a disenrollment period where you can get out of your Advantage Plan.

  1. February 14

All good things must come to an end. 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.

 

And that’s it! I hope you commit these dates to memory or you write them down somewhere. If you forget it, you might regret it!

 

To be sure you have covered ALL of your bases, be sure to download our AEP Checklist by clicking here.

 

Look to switch plans during open enrollment?  Call Seniormark at 937-492-8800 for a free consultation.

Do you “wonder” who is turning 65? Read below to find out!

Lynda-Carter

July 12—Cheryl Ladd

Cheryl_Ladd The actress, singer and author is best known for her role as Kris Munroe in the ABC television series Charlie’s Angels, replacing Farrah-Fawcett Majors. The popular 1976 to 1981 series followed the adventures of three women working in a private detective agency in Los Angeles. Born in South Dakota, Ladd initially came to Hollywood in 1970 to begin a career in music as a singing voice on Hanna-Barbera’s Josie and the Pussycats animated series. She soon began to land non-singing roles in commercials and episodic television, including guest appearances on shows such as The Rookies, The Partridge Family and Happy Days. The Charlie’s Angels series made her an overnight star, and Ladd guest-starred in musical-comedy variety series and specials, plus she released three albums, including a Top 40 Billboard Hot 100 single and a Gold record. In 2000, Ladd starred on Broadway in a revival of Irving Berlin’s Annie Get Your Gun.

Following Charlie’s Angels, Ladd starred in more than 30 made-for-television films, including as Grace Kelly and in Purple Hearts, Millennium and Poison Ivy. Ladd had the lead role in the television series One West Waikiki (1994–96), and made guest appearances in other TV shows. She’s published two books: the children’s book The Adventures of Little Nettie Windship (1996) and Token Chick: A Woman’s Guide to Golfing With the Boys (2005).

July 24—Lynda Carter

Lynda-CarterThe actress, singer, songwriter and beauty pageant titleholder starred in the TV series Wonder Woman from 1975 to 1979. In 1978, Carter was voted “The Most Beautiful Woman in the World” by the International Academy of Beauty and the British Press Organization. Carter started out by winning a local Arizona beauty contest and gained national attention in the United States by winning Miss World USA, representing Arizona. After taking acting classes at several New York acting schools, she made her first acting appearance on the 1974 police drama Nakia. She then began making appearances on such TV shows as Starsky and Hutch and Cos, and in several “B” movies.

Carter’s acting career took off when she landed the starring role on Wonder Woman as the title character and her secret identity, Diana Prince. Carter’s earnest performance endeared her to fans and critics, such that Carter continues to be closely identified with Wonder Woman. Credits since then include the title role in Rita Hayworth: The Love Goddess (1983) and a variety of her own musical TV specials, including Lynda Carter’s Special (1980) and Body and Soul (1984). Throughout the 1990s, Carter appeared in a string of television movies. In 2001, she was cast in the independent comedy feature Super Troopers as Vermont Governor Jessma, and played a washed-up, former beauty queen in The Creature of the Sunny Side Up Trailer Park (2004). Carter made her first appearance in a major feature film in numerous years in the big-screen remake of The Dukes of Hazzard (2005).

In 2005, Carter played “Mama Morton” in the West End London production of Chicago. In 2007, Carter toured the U.S. with her one-woman musical cabaret show, An Evening with Lynda Carter. In June 2009, her second album, At Last, was released and reached No. 10 on Billboard’s Jazz Albums Chart. In June 2011, she released her third album, Crazy Little Things, Carter is married to Washington, D.C, attorney Robert A. Altman, and they have two children. They live in Potomac, Md.

Source: Wikipedia

Next “Solving the Medicare Puzzle Workshop” date set!

workshop solving the medicare puzzle

Announcing our next Solving the Medicare Puzzle Workshop, Tuesday, March 15, at 5:30 pm at our Troy office. Please call our office at 937-492-8800 to reserve one or more seats for yourself or a friend!

Prescription Drug Assistance: Where to Get Help

Here is a Helpful article that was recently in the Dayton Daily News.

By Marci Vandersluis

Contributing Writer

I recently visited with a couple that shared that they were having difficulty paying for some of their prescription medications. One spouse stated that some of their medications had very high out of pocket costs. These co-pays were affecting their ability to pay for some needed home repairs along with food purchases. While this article has no magic solutions on how to eliminate prescription drug costs, it should be of some relief to know that with a little perseverance, along with some web “surfing”, there are programs and services available directed towards providing prescription assistance to lower income older adults.

Since 2006, those eligible for Medicare have been encouraged to enroll in a Medicare Part D plan, which provides prescription drug coverage. The two ways to get coverage are either through adding drug coverage to original Medicare, or to enroll in a Medicare advantage plan that offers Medicare prescription drug coverage. Beneficiaries must first have Medicare A and/or B to enroll in a drug plan and must have Medicare A and B to qualify for enrollment in a Medicare Advantage Prescription Drug plan. It is important to note that while enrolling in a Medicare D plan, is voluntary, not signing soon after eligible or when other medical coverage (such as an employer sponsored plan) ceaseD-resized-600s will result in a monthly financial penalty that will continue through the duration of coverage.

Most have found that while the implementation Part “D” has provided significant cost saving, it continues to present some challenges for beneficiaries. One such frustration is the feared coverage gap or “doughnut hole.” In 2015, once the beneficiary and drug plan have spent $2960, the person is responsible for much higher of pocket costs for prescriptions. Once these costs reach $4,700 the beneficiary is only responsible for 5 percemt of prescription costs, for the remainder of the year. While Medicare is working on more discounts for those in the coverage gap with the ultimate goal of closing the gap in 2020, there are still significant costs while in the “ doughnut hole.” Monthly statements from your drug plan will outline explanation how much has been spent on medication and if you have reached the coverage gap.

Co-pays for some medications can be very expensive even when not in the coverage gap. Fortunately, for those who meet certain financial guidelines there are some programs to help with prescription drug costs. One such program is the Chubby Checker, Patty Duke, endorsed Medicare Extra-Help program. Individuals with income of approximately $17,655 yearly income ($23,895 for married couples), with resources of approximately $13,640 ($27,250 for married couples) should consider applying for this program as it can offer considerable savings. See below for the link to apply online. If there are additional circumstances, if only marginally above these guidelines, or even if in doubt regarding eligibility, it is encouraged to apply. The Medicare website also advises contacting and your specific drug plan to see if eligible for any type of extra help.


Resources

Ohio Benefit Bank-Consumer Hotline: 800-648-1176 or www.ohiobenefits.org

United Health Solutions: 937 220-6600 or www.uhs-dayton.org

Partnership for Prescription Assistance: 888-477-2669 or https://www.pparx.org

Needymeds: Helpline 800-503-6897 or http://www.needymeds.org/newuser

Ohio’s Best Rx: 866-923-7879 or http://www.ohiobestrx.org/en/index.aspx

Good RX-drug discount card: 888-799-2553 or https://www.goodrx.com

Drug companies that offer assistance:http://www.needhelppayingbills.com/html/get_free_prescription_drugs.html

Medicare information on lowering drug costs: 800-633-4227 or https://www.medicare.gov/part-d/costs/coverage-gap/ways-to-lower-drug-costs.html

Ohio Senior Health Insurance Information Program (OSHIIP): 800-686-1578 orhttp://www.insurance.ohio.gov/Consumer/OSHIIP/Documents/whatisoshiip.pdf

Medicare Extra Help: 800-772-1213 or www.socialsecurity.gov/extrahelp (Online application)

Next “Solving the Medicare Puzzle” Workshop

Announcing our next “Solving the Medicare Puzzle” Workshop!  Monday, March 16 at 5:30 pm in our Troy office at 1385 Stonycreek Road in Troy.

Are you, or someone you know, feeling overwhelmed about signing up for a Medicare Supplement? Is your mailbox overflowing with flyers and invitations? Are you more confused now than you were a couple of months ago? What do all of the letters of the alphabet have to do with healthcare? Well, look no further. Sign up today so you can be in the know!

Call our office at 937-492-8800 to reserve a seat (or two!), or simply complete the form below:

[contact-form][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’I would love to come! There will be a total of __ people in our group:’ type=’radio’ options=’1,2,3,4’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Website’ type=’url’/][contact-field label=’Comment’ type=’textarea’ required=’1’/][/contact-form]

Oooh La La! Look who is turning 65 in January! Happy birthday!


Victoria Principal
January 3- Victoria Principal is best known for her role as Pamela Barnes Ewing on the CBS nighttime soap opera Dallas (1978–1987), which centered on a wealthy and feuding Texan family. She began her career in TV commercials at age five. In 1972, Principal won her first film role in Paul Newman’s The Life and Times of Judge Roy Bean, after which she appeared in The Naked Ape (1973) and posed in the nude in Playboy magazine to promote the film. In 1974, she was cast in the disaster film Earthquake. After she left Dallas in 1987, Principal starred in various made-for-television movies such as Mistress, Blind Witness, Naked Lie, Sparks: The Price of Passion, and Don’t Touch My Daughter, a few of which she co-produced. In 1987, she began her own production company, Victoria Principal Productions, producing mostly movies for television. In 1989 she created a self-named line of skin-care products, Principal Secret. In 1995, she was named “Entertainment Business Woman of the Year” by the National Association of Women Business Owners. In January 2011, Principal launched a line of jewelry called Keys & Hearts. She became a best-selling author, writing three books about beauty, skin care and health.

Debbie AllenJanuary 16- Debbie Allen is perhaps best known for her character on the 1982–1987 musical-drama television series Fame, where she portrayed dance teacher Lydia Grant and served as the series’ principal choreographer. For her role, Allen was nominated for the Emmy Award for Best Actress four times during the show’s run. She first began receiving critical attention in 1980 for her role of Anita in the Broadway revival of West Side Story which earned her a Tony Award nomination and a Drama Desk Award, and in the title role of Bob Fosse’s Sweet Charity, for which she received a second Tony Award nomination in 1986. In 2008 Allen directed the all-African-American Broadway production of Tennessee Williams’ Pulitzer Prize-winning drama Cat on a Hot Tin Roof. She currently teaches young dancers and taught choreography to former Los Angeles Lakers cheerleader-turned-choreographer-and-singer, Paula Abdul. Allen has released two solo albums, 1986’s Sweet Charity and 1989’s Special Look. The younger sister of actress/director/singer Phylicia Rashad, Allen is a member of the President’s Committee on the Arts and Humanities.

Richard Dean AndersonJanuary 23 – Richard Dean Anderson rose to prominence as the lead actor in the television series MacGyver (1985–1992). Angus MacGyver was an action hero who was notable for using a Swiss Army knife instead of a firearm as his weapon and tool of choice. Anderson later produced two follow-up movies to MacGyver, in 1994. After the cancellation of the TV version of MacGyver, he complained that “MacGyver was seven years of being in virtually every frame that was shot and having absolutely no life at all.” Anderson later appeared in films, including Through the Eyes of a Killer (1992), Pandora’s Clock (1996) and Firehouse (1997). In 1997, he returned to television as the lead actor of the series Stargate SG-1, a spin-off of the 1994 film Stargate. Since 1997, the only film Anderson has starred in is Stargate: Continuum (2008).He has supported Waterkeeper Alliance, an organization trying to stop water pollution and is on the Board of Trustees for Challengers Boys and Girls Club, a youth organization. He also supports various Sclerosis Society nonprofit organizations and the Special Olympics. In recent years, he has helped several environmental organizations around the world.

Ann JillianJanuary 29 – Ann Jillian is known for her role as Cassie Cranston on the 1980s sitcom It’s a Living, which elevated Jillian to sex symbol status. After being canceled, the show become a surprise success in syndication. When Jillian was 35, she made headlines when she was diagnosed with breast cancer, after which she became a vocal advocate for cancer research and prevention. Her treatment, including a double mastectomy, was chronicled in the top-rated 1988 made-for-TV film, The Ann Jillian Story, in which Jillian portrayed herself. She started acting in 1960 in the Disney film Babes in Toyland, and in 1962, in the movie version of Gypsy. TV appearances in the 1960s and 1970s included a regular role on the 1960s sitcom Hazel (1965–66 season). In 1983, Jillian was recognized for her achievements within the entertainment industry as a child actress. In the late 1970s she toured in musical comedies including Sugar Babies on Broadway with Mickey Rooney. TV appearances include portraying Mae West in a 1982 made-for-TV film. She appeared in six of Bob Hope’s TV specials, including entertaining U.S. troops stationed in Beirut (1984) and Saudi Arabia (1991). She displayed her athletic abilities on three Battle of the Network Stars specials and a Circus of the Stars special and appeared in the charity extravaganza Night of 100 Stars. In 1985 the producers of It’s a Living made the relatively unheard-of decision to resume production of the series, by then a couple years off the air, for the USA cable network, and Jillian was contractually obligated to return to the series. Today, she mostly works as a motivational speaker and also performs as a singer in corporate and symphony “pops” circles.

Our Latest Celebrities Turning 65…….

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Lindsey BuckinghamOctober 3- Lindsey Buckingham, is best known as guitarist and male vocalist of the musical group Fleetwood Mac, a British-American rock band formed in 1967 in London. Lindsey was a member of Fleetwood Mac from 1975 to 1987 when the pop-oriented act also featured Christine McVie and Stevie Nicks, his sometimes girlfriend. The band’s second album with Buckingham and Nicks, 1977’s Rumours, produced four U.S. Top 10 singles (including Nicks’ song “Dreams”) and is the fourth-highest-selling album of all time. In Fleetwood Mac’s heyday, Buckingham was known for his finger-picking guitar style and wide vocal range As a member of Fleetwood Mac, he was inducted into the Rock and Roll Hall of Fame in 1998. In 2011, Buckingham was ranked 100th in Rolling Stone magazine’s 2011 list of “The 100 Greatest Guitarists of All Time.” Buckingham has also released six solo albums and three live albums. In May 2012, Buckingham began a solo tour of the United States and in November 2012 released a completely solo live album One Man Show via download at iTunes that was recorded from a single night in Des Moines, Iowa.

Sigourney WeaverOctober 8-Sigourney Weaver, first received attention for the lead role in the four Alien films: (Alien, Aliens, Alien 3 and Alien Resurrection) and later for her roles in Ghostbusters and Ghostbusters II, Gorillas in the Mist, Working Girl and Avatar. Her 1986 Academy Award nomination for Aliens is considered a landmark in the recognition of science fiction, action and horror genres, as well as a major step in challenging traditional gender roles in cinema. Weaver progressively received fame for her numerous contributions to the science fiction film history (including minor roles in Futurrama, WALL-E, Paul and The Cabin in the Woods), earning the nickname of “The Sci-Fi Queen.” She also played the lead role as Secretary of State Elaine Barrish on USA Network’s Political Animals miniseries.Weaver has been nominated for three Academy Awards: Best Actress for Aliens and Gorillas in the Mist: The Story of Dian Fossey, and Best Supporting Actress for Working Girl. She also won a BAFTA Award for Best Actress in a Supporting Role for The Ice Storm. Weaver earned nominations for an Emmy Award, Drama Desk Award and Tony Award. She has been nominated for seven Golden Globe Awards and won both Best Actress in Drama and Best Supporting Actress in 1988 for Gorillas in the Mist and Working Girl, becoming the first person ever to have won two acting Golden Globe Awards in the same year. After making Gorillas in the Mist, she became a supporter of The Dian Fossey Gorilla Fund and is now its honorary chairwoman. In October 2006, she drew international attention at a United Nations General Assembly policy deliberation when she outlined the widespread threat to ocean habitats posed by deep-sea trawling, an industrial method for harvesting fish.

Benjamin October 21 – Benjamin “Bibi” Netanyahu, is the prime minister of Israel and chairman of the Likud party. Born in Tel Aviv, Netanyahu is the first Israeli prime minister born in Israel after the state’s establishment. In 2012, he was listed 23rd on the Forbes magazine’s list of “The World’s Most Powerful People.” In 2010 and 2012, he was ranked first on the list the “Most Influential Jews in the World” by The Jerusalem Post. After joining the Israel Defense Forces during the Six-Day War in 1967, he took part in many missions and achieved the rank of captain. After he was discharged, Netanyahu served as the Israeli ambassador to the United Nations from 1984 to 1988 and became prime minister in June 1996, serving until to July 1999. After he was defeated by Ehud Barak, he joined the private sector.In 2002 Netanyahu returned to politics as foreign affairs minister (2002–2003) and finance minister (2003–2005) in Ariel Sharon’s governments but departed over disagreements regarding the Gaza disengagement plan. He retook the Likud leadership in December 2005, after Sharon left to form a new party. Following the 2009 parliamentary election, in which Likud placed second and right-wing parties won a majority, Netanyahu formed a coalition government. After his victory in the 2013 elections, he became the second person to be elected to the position of prime minister for a third term, after Israel’s founder David Ben-Gurion.

Bruce JennerOctober 28 – Bruce Jenner, a track and field athlete, won the gold medal in the Decathlon at the 1976 Summer Olympics held in Montreal. As a result of his win, Jenner became a national hero, named the top amateur athlete in the United States and the Associated Press Male Athlete of the Year in 1976. He was inducted into the Olympic Hall of Fame in 1986 and the United States National Track and Field Hall of Fame in 1980. Following his Olympic victory and the related recognition, Jenner appeared on the front of Wheaties brand breakfast cereal as a “Wheaties champion.” Of several hundred athletes who have been so featured, Jenner is one of seven Wheaties spokesmen. His professional career also led to success in television. By 1981, he had starred in several made-for-TV movies and was Erik Estrada’s replacement briefly on the top-rated TV series CHiPs. In 1991, he married Kris Kardashian and can be seen as the stepfather of the Kardashian siblings on the cable television reality series, Keeping Up with the Kardashians since 2007. He has also been a businessman. His company, Bruce Jenner Aviation, sells aircraft supplies to executives and corporations.

Medicare Solicitation

knockingIt has been brought to our attention (thanks to our clients) that several medicare supplement/medicare advantage agents in the area have been going door to door soliciting new business.

If you don’t know, it is illegal for an agent to stop at your door, or call you on the phone, without an existing business relationship.

If this happens to you, please do us and yourself a favor and let them know they are not allowed to solicit door to door. If they don’t agree, direct them to Ohio Administrative Code 3901-8-09, Section (D)(2)(a).

At Seniormark, we work diligently to follow the rules put before us.  If you are considering making any changes to your existing plans, give us a call before you do — we are happy to help!!!  (937) 492-8800.

 

 

Athletes, Political Commentators, Models and Musicians — who turned 65 in September?

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Joe TheismannSeptember 9- Joe Theismann, a former quarterback in the National Football League (NFL) and Canadian Football League (CFL), achieved his most enduring fame in his 12 seasons playing for the Washington Redskins, where he was a two-time Pro Bowler and quarterback of the winning team in Super Bowl XVII. In 2003, he was inducted into the College Football Hall of Fame. Following his retirement from football, Theismann began a career as a sportscaster. He worked as an analyst with ESPN, primarily with Mike Patrick, for the network’s Sunday Night Football package and for one season of Monday Night Football with Mike Tirico and Tony Kornheiser. Theismann also worked as a color analyst on NFL Network’s Thursday Night Football package with Bob Papa and Matt Millen. Theismann also co-hosts the network’s weekly show Playbook.

Bill O'Reilly, Jr.September 10-Bill O’Reilly, Jr., the television host, author, syndicated columnist and political commentator, is currently best known as host of the political commentary program The O’Reilly Factor on the Fox News Channel. The program is routinely the highest-rated show of the three major U.S. 24-hour cable news television channels and began the trend toward more opinion-oriented prime-time cable news programming. During the late 1970s and 1980s, O’Reilly worked as a news reporter for various local television stations in the United States and eventually for CBS News and ABC News. From 1989 to 1995, he was anchor of the entertainment news program Inside Edition.O’Reilly is widely considered a conservative commentator, though some of his positions diverge from conservative orthodoxy and he characterizes himself as a “traditionalist.” Until early 2009, O’Reilly hosted The Radio Factor. He is the author of ten books, most recently The Last Days of Jesus: His Life and Times and Killing Patton: The Strange Death of World War II’s Most Audacious General.

Twiggy (Lesley Lawson)September 19 – Twiggy (Lesley Lawson), is an English model, actress and singer who achieved prominence in the mid-1960s as a British teenage model of swinging sixties London. Known for her thin build (thus her nickname) and her androgynous look consisting of large eyes, long eyelashes and short hair, she was named “The Face of 1966” by the Daily Express and voted British Woman of the Year. By 1967, Twiggy had modeled in France, Japan and the U.S., and had landed on the covers of Vogue and The Tatler. After modeling, Twiggy enjoyed a successful career as a screen, stage and television actress. She hosted her own series, Twiggy’s People, in which she interviewed celebrities, and also appeared as a judge on the reality show America’s Next Top Model. Her 1998 autobiography, Twiggy in Black and White, entered the bestseller lists. Since 2005, she has modeled for British department store Marks & Spencer. In 2012, she worked alongside Marks & Spencer’s designers to launch an exclusive clothing collection.

Bruce SpringsteenSeptember 23 – Bruce Springsteen, nicknamed “The Boss,” is widely known for his poetic lyrics, focus on the Americana working class, sometimes political sentiments centered on his native New Jersey and lengthy and energetic stage performances. He and his “house” band, E Street Band, have performed together since the 1970s, with concerts that run over three hours in length.Springsteen’s recordings have included both commercially accessible rock albums and more somber folk-oriented works. His most successful studio albums, Born in the U.S.A. and Born to Run, showcase his talent for finding grandeur in the struggles of daily American life. He has sold more than 64 million albums in the United States (making him the 15th highest-selling artist of all time) and more than 120 million records worldwide, making him one of the world’s best-selling artists of all time. Springsteen has earned numerous awards for his work, including 20 Grammy Awards, two Golden Globes and an Academy Award. In 1999 he was inducted into both the Songwriters Hall of Fame and the Rock and Roll Hall of Fame. Springsteen’s 17th studio album, Wrecking Ball, released in 2012, became his 10th No. 1 album in the United States, tying him with Elvis Presley for third most No. 1 albums of all-time. In January 2014, he released High Hopes, his first CD in which all songs are either cover songs, newly recorded outtakes from previous records or newly recorded versions of songs previously released.

Seniors need to “Be Prepared”!

Be Prepared for Medicare AEP

 

The Boy Scouts motto is dead on: “Be Prepared!” However, for many of us, procrastination is much easier because it takes less time (in fact, it takes no time). With the Medicare Annual Enrollment Period (AEP) rapidly approaching (Oct 15 – Dec 7) it is going to be vitally important for you to be prepared. And since procrastinating is the path of least resistance, I am going to make this easy on you by giving you a single step that will go a long way in helping you be prepared for the upcoming AEP. I know that insurance is at the top of everyone’s “Most Interesting Topics” list, so do your best to stick with me.

The first step is Know What You Have. If you don’t know what type of Medicare Health Plan you have, you are an easy target for being taken advantage of. There are 2 major types of Medicare Health Plans:

  1. Medicare Supplement plans
  2. Medicare Advantage plans

These 2 types of plans are very different when it comes to how they work and the benefits they provide, but they are extremely misunderstood by policyholders. I often hear from policyholders, “I have a Medicare Supplement,” when in fact they have a Medicare Advantage plan. So what is the big difference between these plans?

 

Medicare Supplement Plans:

  1. Work in unison with Traditional Medicare Parts A & B: A supplement policy will pay most, if not all, of what Medicare does not pay. It acts as a secondary insurance.
  2. Do not have networks: They are not HMO or PPO plans so you are free to use any doctor or hospital that you want as long as they accept Medicare.
  3. Are funded entirely by policyholder premiums: This is important as it allows companies to keep benefits the same from year to year.
  4. Travel with you in all 50 states: Your plan works the same out of state as it does in your home state.

 

Medicare Advantage Plans:

  1. Work in replacement of Traditional Medicare Parts A & B: An advantage plan works in place of Medicare as your primary insurance and you do not have a secondary insurance. You are responsible for all deductibles, copays and coinsurance. And you don’t get out of paying your Medicare Part B premium.
  2. Are network plans: They are HMO and PPO plans so you may be restricted in the doctors and hospitals you are allowed to use.
  3. Are funded by Government subsidies and policyholder premiums: This is critical because as government subsidies are reduced, plan premiums will go up and benefits will go down, as has been the case for the past 7 years and I expect to be the case in the years ahead.
  4. May not cover you in other states (except in emergency cases): Many advantage plans only cover you in the case of an emergency if you are outside of your home state.

The biggest advantage in advantage plans has been the lower premiums. But as government subsidies have been reduced in years past, this benefit has been greatly diminished. For example, in 2007 you could get a Medicare Advantage PPO plan for a $0/month premium and your maximum annual out of pocket expense was $2,000. For 2014 that same plan has a $50/month premium and maximum annual out of pocket of $5,100 (for Shelby county plans).

As you can see, there is a big difference between these two types of plans. Know What You Have…because you may not be able to get your old plan back.

Seniormark will be sponsoring a workshop on September 11 at 5:30 pm at their office in Troy. “Solving the Medicare Puzzle” lays out the different parts of Medicare, and then will show you how the pieces fit together. This event is only for educational purposes and no plan-specific benefits or details will be shared.

DanDan Hoelscher is the founder of Seniormark, LLC, a company that has specialized in helping retirees make a successful transition from the workplace into retirement for the past 18 years.  Seniormark has offices in Sidney and Troy.  You can reach Dan by email at dan@seniormark.com or you can visit their website at www.seniormark.com.  Seniormark, LLC has no connection or affiliation with, and is not in any way sponsored by, the federal or state government, the social security administration, the centers for Medicare and Medicaid services or the department of health and human services.