Category: Medicare Supplement

Why You Should Consider Working In Retirement

Why You Should Consider Working In Retirement

(Even If You Don’t Need the Money)

Work? Retirement? The two words don’t even sound like they belong in the same sentence. After all, retirement is for relaxation. Retirement is for grandkids. Retirement is for vacations and bucketlisting.

 

But wait just a minute.

 

Although all of those things are true, studies show that regular work is also on the agenda, nestled in-between the couch sitting as well as babysitting. According to a Merill Lynch Retirement Study, 72% of pre-retirees age 50 and up will work in some capacity during their retirement.

 

This raises the question: Why are so many soon-to-be retirees planning to spend time working, the same thing they’ve likely been doing for the last 40 years?

 

It’s Not All About the Dollar Signs

As it turns out, there are a lot of reasons, and not all of them are financially related. Participants of the Merrill Lynch Study reported working in order to

  • Stay mentally active
  • Stay socially connected
  • Maintain a sense of identity and self worth

…as well as many other valid reasons. Surprisingly, staying mentally active was the number one cited reason. Money was still a consideration, especially considering that many retirees have not saved enough for a 20-year-or-more retirement, but those other motives definitely pulled their weight in the statistics.

 

And, fortunately, these desires were not left unfulfilled. The study also indicated that retirees who are working in retirement get out what they put in. As it turns out, working retirees reported feeling 10% prouder, 17% more connected to others, and 17% more stimulated than their non-working counterparts! It seems the sense of accomplishment, social interactions, and work environment provided a sense of overall well-being.

 

The Bottom Line

The point is today’s retirees and pre-retirees refuse to see retirement as the end. They are, instead, viewing it as a new horizon, a new beginning, a springboard instead of a landing pad. According to the study, many do take a 2.5 year break from work after retiring, but they are using that rest to recharge rather than wind down.

 

From working with my clients, I’ve heard some of their ideas for work. One client of mine does woodworking projects for people. Others give private music lessons. I even know a couple that travels down the east coast, selling kettle corn at local festivals during the summer. I remember them telling me all about the fun of traveling from year to year and the relationships they’ve built with some of the locals. Doesn’t that sound like fun?

 

You see, work and retirement only sound like they don’t belong in the same sentence if you consider work to be stressful or boring. However, if you can make money doing what you like, working will turn into a passion rather than a drag. In fact, you just might find that work and retirement is a match made in heaven.

 

Do You Have Retirement Questions?

Deciding whether or not to work is just one of many decisions you will have to make as you transition to retirement. Luckily, our Life After Work series of workshops seeks to cover the three critical areas of a successful retirement transition: Medicare, Social Security, and 401(k) planning. You can sign up for just one or all three. No high-pressure sales pitches here, just in-depth discussion about what you need to know as you approach retirement.   Our Welcome to Medicare workshop is Thursday, June 25, beginning at 5:30 on Zoom.  Call our office at 937-492-8800 or head on over to our web page and sign up for a free workshop today!

Will I Be Able to Afford Medicare?

Will I Be Able to Afford Medicare?

The shortest and most honest answer is “I don’t know”. But I know this doesn’t help you answer the most pressing questions weighing on your mind as you approach retirement age. Am I ready? Or Should I delay my retirement? And most of all—how am I going to afford health care without my employer insurance?

 

So here’s what I am going to do. Using my 20+ years of experience working with retirees, I am going to lay out a framework for what to expect when it comes to Medicare expenses. These will just be “in-the-ballpark” figures, but I believe they will help you come to a decision. You just might find that Medicare falls squarely into your budget.

 

So let’s get started with some good news.

 

Medicare Part A (Inpatient Care) Is Free

As long as you’ve paid into Social Security for at least 10 years, social security will return the favor with no associated Part A premium.

 

The Associated Part B (Outpatient Care) Monthly Premium is $134.00

This figure is adjusted for high income, but most people don’t fall into the high-income category. $144.60 will be your monthly premium unless you make $87,000 per year or more as an individual or $174,000 filing jointly.

 

From this point, the cost of Medicare is heavily affected by which path you take. You can boil down all the madness into two basic choices: Medicare Advantage or Original (traditional) Medicare.

 

The Traditional Medicare Route

If you choose the Traditional Medicare route, you will want Medicare Supplement Insurance to fill in the gaps of what Medicare doesn’t cover. Otherwise, there will be no limit to your out-of-pocket spending. The premiums for a Medicare Supplement range from $45-146 per month. However, we often recommend a plan G, which typically costs $110 per month. This is a fairly standard premium. It puts into perspective what you can expect a Medicare Supplement Plan to cost.

 

To cover your medications, you will also need a Part D prescription drug plan, which will cost in additional premium anywhere between $14 to $128 monthly. The average cost for a drug plan is $42 in 2020. The out-of-pocket costs associated with Part D vary greatly depending on your medications. It is impossible to estimate without knowing your specific situation.

 

The Medicare Advantage Route

Offered as an alternative to Traditional Medicare, Medicare Advantage is often the cheaper option when it comes to premiums. They are offered for prices within the range of $0-163 monthly with the average premium being approximately $23 per month. The Part D prescription drug plan is almost always rolled into the plan.

 

Caution: Check For Possible Out-of-pocket Costs

At first glance, it looks like the Medicare Advantage route is the obvious choice. But this fails to take into account the risk of out-of-pocket costs. With a Medicare Supplement (only available with Original Medicare), the maximum out-of-pocket (for Medicare approved expenses) is only $198 annually for Plan G. However, in an advantage plan, it is more of a pay-as-you-go approach. There are less monthly premiums; but copays, coinsurance, and deductibles are much higher. The potential out-of-pocket for an advantage plan can be as a high as $3500-6000 per year or more!

 

The Costs At a Glance


So there you have it! This should give you a good idea of what Medicare costs for the average 65-year old. But—as I said before—the cost of Medicare is different for every person. If you are still concerned about being able to afford Medicare, contact us for a free consultation. We will assess your financial and health situation to find an overall plan that meets your needs, concerns, and pocketbook. Ensuring you a successful and secure transition into retirement is our number one priority.

 

There are a lot circumstances that may prevent you from retiring. But I believe that the affordability of health insurance shouldn’t be one.

 

Disclaimer: Numbers are based on Ohio 45365.

 

Turning 65 soon and not sure what to do?  Our next workshop is quickly approaching on June 25.  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!

Top 5 Retirement Myths You Probably Believe

Top 5 Retirement Myths You Probably Believe

We only use ten percent of our brains. Napoleon was short. It takes seven years to digest a piece of gum.

 

Myths like these are pervasive and stubborn. Perhaps you are just now realizing the above statements are even myths at all! Regardless, whether you first heard them on an evening sitcom, around the dinner table, or as a warning before your mom gave you a stick of juicy fruit when you were a kid, they were easy to pick up and difficult to get rid of.

 

But unlike these common household myths, which are basically harmless, widely held false beliefs about retirement can lead to unexpected bills, sore disappointments, or missed opportunities.

 

That is why I’ve compiled some of the more common and destructive retirement myths, so you can let them go and grab ahold of a better, more secure retirement.

 

  1. “Health Insurance in Retirement? Won’t Medicare Take Care of All That?”

This is a big one. Many people think that, just because the government provides Medicare for those 65 and over, the program is designed to meet all of their healthcare needs. This is, unfortunately, not the case. In truth, it’s not even close.

 

You see, Medicare has very costly gaps, ranging from small, pesky copays to potentially devastating out-of-pocket spending. Firstly, Medicare simply doesn’t cover vision, hearing, dental, or long-term care. And then—in other areas such as skilled nursing, hospital stays, medications, and much more—the coverage is limited. These gaps will not always be overly expensive, but—since there is no out-of-pocket spending limit with Medicare—one major health crisis can quickly turn into a financial crisis as well.

 

That is why we recommend talking to an advisor about getting a Medicare Supplement Plan to fill in those gaps or, if that is too expensive, a Medicare Advantage Plan that will put a cap on your potential out-of-pocket spending.

 

  1. “Social Security Will Take Care of Most of My Income, Right?”

Although Social Security isn’t going broke and skipping out on promised benefits like some believe, the program is not (and was never) designed to provide anyone’s full retirement income.

 

In fact, according to Social Security’s website, the government program is only designed to replace about 40% of a person’s pre-retirement income. As a general rule of thumb, many financial advisors predict that retirees will need 70-80% of their pre-retirement income to live comfortably That leaves 30-40% up to your nest egg. Can your nest egg handle it? 

 

 

  1. “Work? Retirement? Those Two Words Don’t Belong in the Same Sentence.”

People are living longer, and living longer means having more time on your hands. When people only lived ten or so years after age 65, it made sense to think of retirement as a time to wind down and call it quits. But now that the average life expectancy is approximately 85 years, continuing to work (at least part time) makes a lot of sense.

 

According to a Merrill Lynch Retirement Study, 72% of pre-retirees 50 and older say that they plan to work at some point in their retirement. Additionally, the same study showed that 47% of current retirees have worked or plan to work sometime in retirement.

 

  1. “Starting a New Career is For Young People, Not Retirees.”

But perhaps you don’t want to go back to the stress of your former career. Or maybe you the whole reason you retired is because you weren’t physically capable of performing the backbreaking labor.

 

Well, in that case, why not bust another myth and start afresh? Why not take a hobby or a lifelong aspiration and make a new career out of it?

 

I think Christian writer and thinker, C.S. Lewis, said it best: “You’re never too old to set a new goal or dream a new dream.”

 

And, according the aforementioned Merrill Lynch Retirement Study, many agree. In fact, nearly three-fifths (58%) of working retirees believe retirement is a good time to switch careers. So dream big. There’s more room to take career risks when you have a nest egg to lean on.

 

Maybe you can even start your own business. Did you know that retirees are three times more likely to be business owners or self-employed than pre-retirees?

 

  1. “Retirement Consists of Two Steps: Clock Out and Walk Out.”

Unfortunately, that’s just how you quit working. It’s not how you truly retire. Retirement involves careful planning and a long list of to-dos. This list must include signing up for Medicare, purchasing supplemental coverage, deciding when and how to take Social Security, considering rolling over your 401(k), as well as other non-financial items such as travel plans or simply deciding how you are going to use your extra 40 plus hours a week.

 

Do You Need Some Expert Guidance Concerning Your Retirement Transition?

In that case, you are in the right place. In our Life After Work workshops, we discuss retirement transition.  Sign up today for our free workshop.

 

Our Workshop Promise To You

  1. There will be no high-pressure sales and no obligations, just insight about your retirement transition.
  2. You will feel less overwhelmed and anxious about your decisions and options.

 

Some may not think we will live up to our promises, but that is just another common retirement myth! Our next workshop will be held virtually on Zoom on June 25 at 5:30 pm.  We hope you will come to learn more.  The workshop is free!  Sign up today at https://seniormark.com/workshops/!

 

How to Lower Health Care Costs in Retirement—The 4 Best Ways

How to Lower Health Care Costs in Retirement—The 4 Best Ways

Did you know that a recent Fidelity study shows that the average couple can expect to spend $260,000 on health care expenses in retirement? Well, unfortunately, that is the current figure circling around the retirement blogosphere. And that isn’t even taking into account the possibility of long term care such as an extended nursing home stay, a consideration which escalates the estimation well into the three hundred thousands.

 

It can’t be true, can it?

 

I know, when I saw that figure in print for the first time, I was surprised as well. But as I begin adding up all of the possible costs—really crunching the numbers—I found out it was a lot more probable than I originally thought.

 

So what are you to do? If you are still working, the answer is common sense: save more to cover the costs. But if you are beginning the retirement transition right now, it’s too late for that strategy. You need something to lessen the burden—and fast!

 

Although these four ways won’t slash that number in half by any means, they can certainly help keep your health care costs in check:

 

1.  Sign Up For Medicare On Time To Avoid Penalties

You must sign up during the six-month period surrounding your 65th birthday or else pay hefty penalties that continue for your entire life! Unless you have a qualifying reason, everyone should sign up for Medicare parts A and B. And unless you are on an Advantage plan with a drug plan rolled into the deal, you should sign up for Part D. Because, if you miss it by just one year, you will accrue $4,248 worth of penalties over your lifetime, assuming you live 20 years after 65.

 

2.  Take Advantage of the Preventive Services Provided by Medicare

Like the old saying goes, an ounce of prevention is worth a pound of cure, and Medicare agrees. While Medicare covers very few things in full, the program covers every penny of many preventive services including (but not limited to) the following:

  • Flu Shots
  • Various cancer screenings
  • Obesity screenings and counseling
  • Annual “wellness” visits
  • Tobacco use cessation counseling

Now I am not saying you should spend all of your golden years sitting in cold waiting rooms. Rather, the core of this advice is simple: take care of yourself. Take the tiny steps now, so you can avoid the big health issues later. Catch the problems in their inception, so what could have been a free office visit and quick fix doesn’t end up costing you an arm and a leg in hospital bills.

 

According to a study conducted by Age Wave, pre-retirees and retirees say the two most important ingredients to a happy retirement are health (81% of respondents) and financial security (58% of respondents). The funny thing is that taking preventive measures often helps both.

 

3.  Cut Prescription Drug Costs

It is not difficult to see that the cost of drugs, especially for those with chronic illness, contributes its fair share to that $260,000 figure in health care expenses. Sure, you have a Part D Drug Plan, but there are still expensive coverage gaps.

 

But the good news is there are a few things you can do to lessen the burden. You can switch to generics. You can try mail order. Some people are even splitting pills to split the bill with certain medications.

 

For more specific details to help you cut drug costs, read this:  “How to afford meds in the donut hole”.

 

4.  Beat the Medicare Supplement Creep by Shopping Around!

If you don’t have a Medicare Supplement, I would strongly recommend getting one. And if you do and you’ve been in the same one for 3-5 years, I strongly recommend that you shop around.

 

Why?

 

Because Medicare Supplement premiums naturally creep up year-by-year, and they rarely come back down. The best news is you don’t even have to change coverage when you switch. Because of standardization, any and all of Medicare’s 11 lettered plans (A-N) offer the same exact benefits no matter which company you purchase it from. It is not uncommon for people to save $40-50 per month by switching. I’ve even seen savings as high as $100 per month or more.

 

The point is it pays to bargain shop! And it will pay to put some or all of these health care cost cutting ideas to the test.

 

Want to check and see what you could save by switching? Use our free Medicare Supplement quoting tool.   No contact information required.   Or call our office and we can give you a free quote over the phone!  937-492-8800

Do I Need To Do Anything To Enroll in Medicare?

Do I Need To Do Anything To Enroll in Medicare?

This is a question I get quite frequently at my offices in Sidney and Vandalia, Ohio. When it comes to Medicare, soon-to-be retirees know that they’ve been paying for it since they started working through Social Security. However, they often don’t know how they collect the benefit they’ve worked so hard to earn.

 

Does it just happen automatically? Or do soon-to-be retirees like you need to do something?

 

Well, that depends on one thing…

 

Are You Already Receiving Your Social Security Benefit?

If you decided to claim your Social Security benefit before 65, then you don’t have to sign up. Your Medicare card will arrive in the mail around your 65th birthday and you will be automatically signed up for Medicare Parts A and B.

 

If Not, Make Sure You Sign Up!

But if you are not receiving your Social Security benefit, you need to sign up during your open enrollment period, the seven-month period surrounding your 65th birthday. You will be doing yourself a big favor by signing up on time because there are many late enrollment fees. For example, the Part B penalty is 10% for every year you are late. Unfortunately, this penalty will continue for the rest of your life.

 

So take the time amidst retirement planning and birthday celebrations to sign up. You can sign up online at ssa.gov or you can call or stop by your local Social Security office. If you live near Sidney, that office is in Piqua, 227 Looney Rd.  If you live somewhere else in Ohio, find your closest location here:  Ohio Social Security office locations.

 

Everyone’s Got a Lot More to Consider!

But whether or not you have to sign up for Medicare, you are far from done. It is a big misconception (see our blog on this here) to think that original Medicare alone is enough to cover all your health care expenses. There are two things you should do. Firstly, it is almost always a good idea to pick up a stand-alone prescription drug plan through Part D of Medicare. Otherwise, you will have no coverage for your medications. In addition, I also recommend finding some way to supplement Medicare with additional insurance. You can get a Medicare Supplement plan, or—for those who are more cost-conscious—a low to no cost Advantage plan.

 

As you can see, even though you may not have to do anything to sign up for Medicare, signing up is just the first step before you have your health insurance in order. I recommend seeing an advisor to help guide you through this complex process.

 

Need help navigating Medicare? Want personal help to find a plan that is right for your needs and pocketbook? Call Seniormark at 937-492-8800 for a free consultation!

 

You Can Save Hundreds on Your Supplement Without Changing Your Benefits!

You Can Save Hundreds on Your Supplement Without Changing Your Benefits!

And when I say, “without changing your benefit,” I really mean it. This isn’t about covering decreased benefits or numerous hassles under a cloak of a lower premium. You can get on an identical plan to the one you have now and still save hundreds.

 

How is this possible? Allow me to explain.

 

Standardization: Easier Comparison = Easier Savings

Before standardization, shopping Medicare Supplements was a lot more difficult. It was hard to see which one of any two plans was the better value because insurance companies provided diverse benefits at diverse premiums.

 

Then, in 1992, Medicare standardized 11 lettered plans (A-N). Now, although there are diverse benefits from plan to plan (each lettered plan is unique), the plans remain the same from company to company. In other words, a Plan F is a Plan F no matter who you shop with, no matter which company you purchase from. Similar to the apples and oranges saying, you are comparing all the fruits to their respective fruits.

 

But here’s where you can save money: even though the plans are standardized from company to company, the premiums are not. A Plan F at one company, although identical in coverage, can be over a hundred dollars more at another. To demonstrate this, I compared all the available plans for each of the three most popular Medicare Supplement plans at our agency. The difference between the most expensive company plan and the least expensive is

  • $196.43 for a Plan F
  • $212.71 for a Plan G
  • $141.65 for a Plan N

Note: These numbers are based off a woman living in Sidney, OH who does not use tobacco.

 

Imagine if you could shop like this for other items. It would be like walking onto a car dealership’s lot and, instead of being confronted with an onslaught of varying features; you just had a line up of identical cars, some of them thousands more than others. No discrepancies in gas mileage. No debating the value of seat warmers versus a little extra trunk space. Just easy comparison, making it easy to get the best deal.

 

What If I’ve Never Heard of Them? What About the Company Ratings?

This is a common fear when it comes to shopping Medicare Supplements. The Plan may be the same, but the company is different. How do you know when the company you plan to work with is qualified, trustworthy, and stable?

 

Firstly, I would say not to let the fact that you don’t recognize a company deter you. There are many qualified, trustworthy, and stable companies that are not as well known. It’s good to ask a professional or do a little research yourself, but this should not be a reason to write a company off. In our practice, we screen the companies we represent before we recommend their plans to our clients. This way we know for certain all of our clients will have a good experience in claims processing and general customer service.

 

On the other hand, when it comes to the company ratings, you should pay a little more attention. This evaluation is based on the company’s financial stability, so it is easy to see the importance. You want your insurance company to have the money to pay your claims when they are needed. However, I wouldn’t let this carry too much weight. Obviously going with a D or F rated company isn’t a good idea, but I’ve found that you can count on any company above a B+ rating. They are well established enough to deliver the promised benefits.

 

I thought I could only change during Annual Enrollment?

While this is a very common misconception, it is not true.  You can change your supplement any day of the year!  (The only items that can only be changed during Annual Enrollment are Prescription Drug Plans and Medicare Advantage plans.)  And, as an added bonus, any deductible you have already paid in a calendar year, travels with you to the next supplement if you switch.  It’s the gift that keeps on giving!

 

Concluding Thoughts

Overall, I’ve found that switching plans about every 4-5 years is beneficial. On a regular basis at Seniormark, we see people save $30-50 per month just by switching.  If you take the few minutes it takes to compare Supplement rates, you may be surprise by how much you can save!

 

Interested in Finding Out How Much You Can Save?

Use our Quoting Tool to compare Medicare Supplement rates in your area. It’s absolutely free, and we don’t ask for any personal information, so you can be sure you won’t get any annoying junk emails.   If you find a price you like, or would like us to run more quotes for you, give us a call at 937-492-8800. We would love to save you money!

Half-Truths And Medicare Advantage Commercials

Half-Truths And Medicare Advantage Commercials

Weekly, we receive phone calls from people asking about something they saw on their tv and wondering if their insurance covers whatever they are seeing advertised.  This is more prevalant in the fall of each year, when Medicare Advantage companies ramp up their advertising during annual enrollment.  As an office, we offer both Medicare Supplements and Medicare Advantage plans to our clients.  We try to help people figure out what is best for their situation, budget, and lifestyle.  Our end goal is to help people avoid costly Medicare mistakes.  Sometimes, what is portrayed on tv is only half of the story, as you will see below.  This is an article recently published online at Forbes magazine, but echoes our thoughts so we wanted to share.  Source:  https://www.forbes.com/sites/dianeomdahl/2020/02/11/half-truths-and-medicare-advantage-commercials/#3d223f8c42ff

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If you watched any television in the last several months, you probably saw a slew of commercials for Medicare Advantage plans. One that pops up frequently features a former professional football player who once did a commercial wearing pantyhose. His commercials must be working so well that another former NFL star has also started promoting Advantage plans.

All the commercials, no matter the narrator, talk about the Medicare benefits you deserve, that you should be getting. They list those benefits in a very big and bold font, and encourage you to call the free number and sign up today.

According to Federal law, whatever we see or hear in an advertisement must be truthful and not misleading. I spent some time the last few days closely watching several different commercials. Everything that was said about the cost and benefits was true, to the extent that it was said. But there was much left unsaid and that’s the important information you need to make a smart decision.

First, the benefits

Get the benefits you deserve, including rides to medical appointments, private home aides, nurse and doctor visits by telephone.

Medicare describes these as benefits for daily maintenance and doesn’t cover them. However, because of policy changes, Medicare Advantage plans can now provide them. The plan, not Medicare, must cover the costs. This is a new program and not that many plans offer these benefits.

Based on my preliminary plan research, here are some important points not mentioned in the commercials:

  • These benefits appear to be more common in health maintenance organization (HMO) plans. Except for an emergency, the benefits are only available through a network of selected providers, which can limit the individual’s choice.
  • The plan likely will require prior approval or authorization. Before receiving care, the plan must review and approve the physician’s order.
  • There are limits on these benefits. For example, two meals a day for five days after hospitalization with a limit of four hospitalizations, and a private home aide four hours a day for no more than 31 days in a year.
  • And, most important, the plans we researched require members to select only one benefit per calendar year.

In some of the commercials, there were two more benefits that require clarification.

Free preventive screenings

Medicare covers a long list of preventive and screening services. You don’t need to enroll in one of these plans to get preventive services.

A 75% discount on prescription medications in the Coverage Gap

You see this and think, “Wow! A big discount on drugs! Where do I sign?” However, as with preventive services, this benefit is not unique to Medicare Advantage plans.

The Coverage Gap is more commonly known as the donut hole. In 2020, the donut hole closed. Beneficiaries are responsible for 25% of the cost of medications in this payment stage. Or, in other words, they get a 75% discount. Anyone with Part D prescription drug coverage will qualify automatically for this discount when their total drug costs hit $4,080. This benefit comes with the plans in the commercials, some other Advantage plan with drug coverage, or a stand-alone Part D drug plan.

Second, the costs

All these benefits may be available at no additional cost to you.

The commercials focus on zero-premium plans and benefits available for no added cost. However, at the moment the narrator says this, a line of small type appears on the bottom of the screen. It’s there for only four seconds, while the list of benefits continues. The small type reads, “Plan premiums, copayments, and coinsurance can apply.”

Not all Medicare Advantage plans are zero-premium. And for those that are, it’s important to know that zero-premium does not mean zero costs. There are out-of-pocket costs for most services. Plan members will pay their share of costs until they reach the plan’s out-of-pocket maximum limit. That’s how much a person could write in checks when something happens, like a cancer diagnosis or a major car crash. In 2019, the average limit was $5,059.

Third, the call

The narrators talk about the help you will get when you call the toll-free number. But, once again, the small print is revealing.

Dial the number and you’ll be transferred to a licensed insurance agent. One commercial noted that the agent may or may not offer Medicare Advantage plans. Another said the person you talk with may not offer plans in your area.

A question

The facts, as presented, are true but then the question becomes, “Are these commercials misleading?” According to the Macmillan dictionary, misleading means something that is intended or likely to make someone believe something that is incorrect or not true.

In fall 2019, the American Medical Association (AMA) passed a resolution.

“Whereas, Medicare Advantage plans are heavily marketed to seniors by insurance companies, with less than ideal transparency in advertising; … and

“Whereas, Presentations by insurance company officials to seniors can overemphasize the value of different options and can create confusion; therefore be it

“RESOLVED, That our American Medical Association encourage AARP, insurance companies and other vested parties to develop simplified tools and guidelines for comparing and contrasting Medicare Advantage plans.”

The AMA identified the need for tools to help individuals go beyond the TV commercials and get the information they need to make a smart decision.

The Centers for Medicare and Medicaid Services redid its tool for comparing plans. The Medicare Plan Finder shows the premium in a large font. Then, you can check out the plan’s out-of-pocket costs for medical benefits on the details page. Beyond that, as pointed out in a past post, most of the essential information has disappeared. The Plan Finder no longer has links to networks, a list of preferred pharmacies, and most important, complete information about coverage rules like prior authorization.

The best way to get all the facts is to check the plan’s Evidence of Coverage. This document describes in detail the plan’s benefits, how much you will pay, and how the plan works, including authorization rules, limits, networks, and more. To find it, go to the plan’s website, look for the Evidence of Coverage link. This may take some searching but you’ll get the information you need on available benefits, limits, approval, and more.

Keep in mind that these Medicare Advantage plans are offered by for-profit entities, corporations not unlike your cable provider, department store, or neighborhood used car lot. The purpose of the TV commercials is to get you to act, to call the number on your screen, to make a purchase. First, do your research. Be an informed shopper. Go beyond the commercials to the whole truth. Your Medicare coverage is too important.

If you would like help muddling through all of this confusing information, please give our office a call.  We are happy to help you sort through the complicated Medicare alphabet and choices!  Call our office at 937-492-8800 and schedule a free, no obligation consultation.

Source:  Diane Omdahl for Forbes Magazine

Know Your Rights! (Your Medicare Supplement Guaranteed Issue Rights)

Know Your Rights! (Your Medicare Supplement Guaranteed Issue Rights)

Everyone knows that they have the right to remain silent and the right to an attorney, but few retirees know their rights to a Medicare Supplement policy. For this reason, many people believe that if they missed their Open Enrollment Period and have health problems, they will be unable to get insurance.

 

This is not so. Thanks to guarantee issue periods, retirees like you have rights. During guaranteed issue periods, insurance companies are obligated to offer you a policy at the normal rate and cover your pre-existing conditions. All of this with no pesky medical questioning whatsoever!

 

The following circumstances spur a guaranteed issue period. In other words, you have the right to a Medicare Supplement policy if:

  • Your Medicare Advantage Plan is going out of service or you are moving out of the service area.
  • Your employer health insurance is ending.
  • You’ve been enrolled in an Advantage Plan for less than one year and want to switch back to a Medicare Supplement plan.
  • You lose your coverage without fault (i.e. your insurance company goes bankrupt).
  • Your insurance company misled you or doesn’t follow the rules.

(For a more comprehensive chart of potential situations, click here to visit Medicare.gov).

 

From the day any one of these events happen to you, you have 63 days of guaranteed issue to get into a new Medicare Supplement Plan.

 

Do not take this newfound information lightly, and keep any proofs of the previously mentioned events at your disposal such as:

  • Claim denials
  • Letters from employers
  • Official notifications

 

Insurance companies will ask for these items to prove your right to a policy. Then they will have no choice but to insure you. This is why it is so important to educate yourself on your rights. It allows you to take advantage of what has been made available to you.

 

If you want to find out more about guaranteed issue rights or need help shopping a Medicare Supplement Plan for your needs, Call Seniormark at 937-492-8800 for a free consultation from licensed experts.

You Can Save Hundreds on Your Supplement Without Changing Your Benefits!

You Can Save Hundreds on Your Supplement Without Changing Your Benefits!

And when I say, “without changing your benefit,” I really mean it. This isn’t about covering decreased benefits or numerous hassles under a cloak of a lower premium. You can get on an identical plan to the one you have now and still save hundreds.

 

How is this possible? Allow me to explain.

 

Standardization: Easier Comparison= Easier Savings

Before standardization, shopping Medicare Supplements was a lot more difficult. It was hard to see which one of any two plans was the better value because insurance companies provided diverse benefits at diverse premiums.

 

Then, in 1992, Medicare standardized 11 lettered plans (A-N). Now, although there are diverse benefits from plan to plan (each lettered plan is unique), the plans remain the same from company to company. In other words, a Plan F is a Plan F no matter who you shop with, no matter which company you purchase from. Similar to the apples and oranges saying, you are comparing all the fruits to their respective fruits.

 

But here’s where you can save money: even though the plans are standardized from company to company, the premiums are not. A Plan F at one company, although identical in coverage, can be over a hundred dollars more at another. To demonstrate this, I compared all the available plans for each of the three most popular Medicare Supplement plans at our agency. The monthly difference between the most expensive company plan and the least expensive is

  • $196.43 for a Plan F
  • $212.71 for a Plan G
  • $141.65 for a Plan N

Note: These numbers are based off a woman living in Sidney, OH who does not use tobacco.

 

Imagine if you could shop like this for other items. It would be like walking onto a car dealership’s lot and, instead of being confronted with an onslaught of varying features; you just had a line up of identical cars, some of them thousands more than others. No discrepancies in gas mileage. No debating the value of seat warmers versus a little extra trunk space. Just easy comparison, making it easy to get the best deal.

 

What If I’ve Never Heard of Them? What About the Company Ratings?

This is a common fear when it comes to shopping Medicare Supplements. The Plan may be the same, but the company is different. How do you know when the company you plan to work with is qualified, trustworthy, and stable?

 

Firstly, I would say not to let the fact that you don’t recognize a company deter you. There are many qualified, trustworthy, and stable companies that are not as well known. It’s good to ask a professional or do a little research yourself, but this should not be a reason to write a company off. In our practice, we screen the companies we represent before we recommend their plans to our clients. This way we know for certain all of our clients will have a good experience in claims processing and general customer service.

 

On the other hand, when it comes to the company ratings, you should pay a little more attention. This evaluation is based on the company’s financial stability, so it is easy to see the importance. You want your insurance company to have the money to pay your claims when they are needed. However, I wouldn’t let this carry too much weight. Obviously going with a D or F rated company isn’t a good idea, but I’ve found that you can count on any company above a B+ rating. They are well established enough to deliver the promised benefits.

 

Concluding Thoughts

Overall, I’ve found that switching plans about every 4-5 years is beneficial. On a regular basis at Seniormark, we see people save $30-50 per month just by switching.  If you take the few minutes it takes to compare Supplement rates, you may be surprise by how much you can save!

 

Interested in Finding Out How Much You Can Save?

Use our Quoting Tool to compare Medicare Supplement rates in your area. It’s absolutely free, and we don’t ask for any personal information, so you can be sure you won’t get any annoying junk emails. If you have any questions, give us a call at 937-492-8800. We love to hear from you!

 

Will Poor Health Prevent Me From Switching to a New Medicare Supplement?

Will Poor Health Prevent Me From Switching to a New Medicare Supplement?

There are lots of reasons you might be dissatisfied with your current health insurance plan. Perhaps you’ve had a Medicare Supplement for a few years and the premiums have been creeping up into the stratosphere. Or—if you are in an Advantage Plan—maybe you are sick and tired of an ever-changing benefits package or pesky out-of-pocket expenses like copays or coinsurance.

 

Regardless of the reason, you realize it’s time to switch.

 

If you’re in good health, it’s simple. You make like a Nike commercial and just do it.

 

But what if you battle blood pressure or cholesterol? What if you have diabetes? What if you have a personal history of cancer or heart trouble on your records? Or even an open heart surgery?

 

Well, in this case, I’d like to be the bearer of good news. It may not be as easy for you, but there’s still a really good chance you can switch.

 

As a quick side note, if you are in a Medicare Supplement Open Enrollment Period or a Guaranteed Issue Period, you are completely in the clear. No insurance company can deny you coverage.

 

But if you aren’t in one of those periods and you just want a better premium or benefits package, you can also switch.

 

Why? You’ll be happy to know…

 

Medicare Supplement Underwriting is Not as Selective as You Might Think.

Prior to Obamacare, health insurance for people under the age of 65 was much stricter. People with more serious health issues were often immediately turned away. The approach to questioning might be something like this:

  • Have you had cancer in the last 10 years?
  • Do you have a history of heart problems?
  • Do you have diabetes and take insulin?

 

But the Medicare Supplement underwriting process is significantly less harsh. Since Medicare is footing part of the bill for them, they aren’t taking on near as much risk. And because they aren’t taking on as much risk, they can be a bit more lax. A Supplement company’s approach to those same questions might look something like this:

  • Have you had cancer in the last 10 years? Well, as long as it’s not in the past two, we can make this work.
  • Do you have a history of heart problems? Well, have you been stable over the past two years?
  • Do you have diabetes and take insulin? Let’s take a closer look.

 

I’m not saying there aren’t some companies who will still deny you.  You’re always going to have that. But I would like to widen your perspective a little bit. Just because Anthem denies you coverage doesn’t mean another one will.

 

There Are Many, Many Medicare Supplement Companies Out There!

In fact, according to page 27 of the Ohio Department of Insurance’s Medicare Supplement guide, there are 43+ Medicare Supplement companies just in Ohio. You have to think, these companies have diverse ways of evaluating the health of their potential policyholders. Chances are you will find one that will take a chance on you!

 

At our practices in Sidney and Vandalia, Ohio, we’ve had a lot of luck with the smaller companies who are trying to be more competitive. They are often more likely to take a look at your individual situation and seek clarification rather than put your application through the shredder at the first mention of a chronic disease. Then, after a close analysis of your situation, they make their final decision.

 

So don’t stay in a plan you hate.

So if you premium is too high, if the copays are frustrating, or if you just plain don’t like it, shop around! Just don’t cancel your current policy until you have another one in place.

 

If you want to shop supplement rates in your area without inputting any personal information, you can compare Medicare Supplement rates here.

 

Do You Want A Licensed Medicare Expert to Help You Shop A Supplement?

Seniormark is always here to help. We represent dozens of diverse, competitive companies in the area. Call us at 937-492-8800 and we will help you shop a plan for your unique needs and budget!